Good morning. I have 5 kitties, 4 of them rescue cats. My oldest kitty, Mollie, who is 13, has been peeing just outside the litter box for the last couple of months. She has been to the vet for ultraounds of her bladder, urine culture, basic blood work and everything came up with cystitis and some arthritis. The vet tried her on apresoline, which I stopped as she was so doped up it was awful and she was very very irritable. We have tried buprenex for 4 days now and her mood has improved tremendously but she is still peeing outside the litter box. I don't want to keep her on buprenex and was wondering if anyone else had any ideas. I was wondering about maybe her anal gland should be checked. I am running out of ideas. She doesn't like my other cats but has never had problems with them before.
If she's testing positive for cystitis (inflamed bladder), it makes sense that she's peeing outside the litterbox. She's obviously not having a walk in the park as this can be quite uncomfortable and painful for her. She's likely trying to alleviate the discomfort by peeing frequently too.
After the medication kicks in and she feels better she should return to her proper litterbox routine. Cats are notorious for hiding their pain and discomfort so although you think she's ok, she might still be in pain.
It also depends on the cause of her cystitis. Is it a bacterial infection or crystals. If it's crystals,does she have struvite or calcium oxylate?
Regardless of the cause, it would be a good idea to change her diet to a raw or wet one in order to increase water intake. You might also want to invest in a cat fountain as well if you don't have one already. Avoid any fish in the cat food as it wil aggravate her condition. Once your cat develops cystitis, reoccurences are common and so it's pertinent to take measures for the future.
The other major factor is reducing stress. Has anything changed for her such as moving house, moving furniture or litterbox location, new ppl/other animals in the house etc. Buprenex will reduce her pain which will at least reduce her stress if it's coming from pain. Also strive to keep her box spotless, increase the number of boxes to be 1 more than the number of cats in the house. So if you have 5 cats, then 6 boxes.
This is a complicated problem that requires long term treatment and monitoring. Do some research on Feline cystitis to understand more about it.