It sounds to me like Oscar may have a urinary tract infection and/or urinary crystals. Urinating outside of the litterbox is a very common symptom of both, and the fact that he is making such a point of SHOWING you this behavior indicates that he is trying to tell you that something is wrong with him. It may be a manifestation of his kidney problem, but I'm leaning toward UTI.

Low grade urinary infections aren't always identified in urine tests, so I suggest you ask your vet to prescribe a round of antibiotics for Oscar even if no infection can be verified through testing. My old CRF cat once stopped using the litterbox, and I KNEW she had a UTI. Her urine test came back clean, but I insisted that the vet give me antibiotics for her, anyway. Within a week after starting the antibiotics, she was back to using her litterbox.

About cleaning the carpet - Regular cleaning solutions won't remove urine odor to a cat's nose, so Oscar will continue to want to overmark his scent. You should clean the soiled spots with an enzymatic cleaner specifically formulated to remove pet urine stains and odor. I've gotten good results with Simple Solution. You need to follow label directions exactly, though, and really saturate the spots so that the enzymes reach down through the carpet, mat, and into the subfloor. You can also use a blacklight to locate the soiled spots that you may otherwise miss. Urine illuminates under blacklight in a darkened room.

Please give Oscar a hug from me. Several of my cats have experienced renal failure, so I know how difficult it can be for both them and us.

Take care,

Laurie

A comment about his food. Many cats will not eat the canned K/D kidney function food. However, most cats will eat the dry version of K/D, so you might try that if you haven't already.

As for the rest, laurief gives good advice, as usual.

Thanks to you both for the responses. I too was thinking of a possible UTI but I thought that the urine tests would have shown that. On Sunday morning, Oscar just finished two weeks of antibiotics for gingavitis. So I wonder if that would have taken care of any UTI. My vet is out of the office today so I will ask her about this tomorrow.

About the carpet cleaning, I used the Bissell formula for pet soiled carpets but I will pick up some Simple Solution and give that a try too.

As for the food, we've tried both the canned and the dry varieties of several different brands of kindey function foods. Oscar just won't go for them.

Thanks again.

I don't know which antibiotic Oscar was on for his gums, but the antibiotic most commonly prescribed for UTI is Clavamox, or sometimes Amoxicillin.

The most important thing you can do for Oscar's kidneys is to increase his water intake any way you can. Water will keep the toxins flushed out of his system that may otherwise accummulate due to decreased kidney function.

Place water dishes all around your house and keep the water in them very fresh. Some cats drink more generously from one of those pet water fountains or from a dripping faucet.

Canned food is advisable for a renal patient because it has a much higher water content than dry kibble. Mixing the canned food into a gruel with warm water is even better.

Food should be offered in small quantities several times a day, rather than in one or two large meals. Compromised kidneys handle smaller meals more easily.

Laurie

P.S. Simple Solution has a formula for use in a carpet cleaner, I believe, but the only formula I've used is the concentrate used for spot cleaning.

I keep reading more and more about people with CRF cats that do not feed them protein restricted diets - and don't believe it is good for a cats health to have them. I do not have a CRF cat myself, so am only going by things I have read.

If you are willing, you may want to purchase Dr Elizabeth Hodgkins book (just released). They sell it on Amazon. She has an 18 page chapter dedicated to CRF (CRD) where she explains what I have read from others actual acounts. (Headings in the chapter include - What's Wrong with a Protein-Restricted Diet for Cats, What Nutrient Restrictions are Indicated). Phosphate binders can be used to remove dietary phosphorous from foods. The book would be at least a good read to challenge the normal vet recommendations.

Whether you switch to low protein or not, I would stay with wet food. They need all the moisture they need.

For some odd reason, Wellness is one food I read about when I hear personal accounts from people with CRF. I have seen a couple of them on the yahoo IBD forum today as well as on the petfoodlist forums.

Hopefully your kitty just has a bladder infection that can be treated with the antibiotics!

I just stumbled on one of those links now....
http://thepetfoodlist.com/forums/index.php?topic=484.msg3640#new

Thanks again everyone. It's nice to have people trying to help us out.

Oscar was on Clavamox for two weeks for the gingavitis.

Oscar drinks lots of water. I refill the bowl twice a day. I used to set out extra bowls of water but they would go untouched. He seems to be a cat who is very set in his ways.

I will check out that book...thanks!

I've called/e-mailed some companies over the last few months to try to find foods that are low in phosphorous that Oscar will eat. He will have nothing to do with any of them. I've tried both Wellness and Merricks as well as a couple of others. I keep buying Merricks because my other cat loves it and I'm hoping that Oscar will eventually gravitate toward it. He's eaten it a few times but usually ends up covering the plate up with his placemat.

Also, I spread out Oscar's food to 4 - 6 small meals per day because if I don't then he throws it all up.

Thanks again everyone. This is just so discouraging because we lost a cat last summer after spending thousands trying to find out what was wrong with him and when we found out what it was, there was no treatment.

We adopted Oscar to be a friend to our girl kitty and he turned out to be a perfect match (after about a month). They get along so well and I'm so worried that our little girl is going to lose another friend and of course my husband and I will be devestated to lose another one so soon.

In case you haven't read through these sites, they'll answer just about every question you may have about feline remal problems and their management. These first two pages offer general information about dietary management:

http://www.felinecrf.org/nutritional_requirements.htm
http://www.felinecrf.com/managd.htm

These two pages offer nutritional stats of most of the popular prescription and non-prescription foods (both canned and dry) so that you can make direct comparisons of phosphorous content in each variety:

http://webpages.charter.net/katkarma/canned.htm
http://www.geocities.com/jmpeerson/canfood.html

My cat is 15 and has been diagnosed with declining kidney function. Fortunately, her appetite is good. She eats Fancy Feast Beef with Gravy and Turkey with Gravy flavors. Beef and turkey are lowest in phosphorous of FF offerings.

My CRF kitties eat IVD Select Care Modified. Dry. They really like it!! Knock on Wood!!! I know how hard it is to have a CRF cat, I have 2. Is Oscar on fluids, or vitamins, or anything else?? Do you by chance know his blood work numbers?? Hang in there!!
Rita

FWIW, with one of my cats I noticed the behavior associated with UTIs a week before tests were definitive - this happened a few times over the later years (19-23).

Re diet: it's so frustrating trying to offer cats a good diet during medical challenges. I'm particularly concerned about protein needs and the poor quality of protein in prescription foods. Good to see others are questioning this as well. When a cat (esp an older cat) loses weight, muscle loss is a big concern.

Sorry to hear about Oscar's difficulties, hope things are improving.

Greetings from another Oscar mommy - my Oscar is 17 with CRF + heart disease. He is also a horrendously picky eater - refuses k/d food and any pate style food - he only tolerates Friskies pouched food these days (chicken and salmon) and Wellness Indoor kibble - he's still mourning the loss of his Science Diet Savoury Cuts (recall casualty). And he drinks lots, I know he's unwell when the volume of urine in the litter boxes goes down. Definitely get your Oscar checked for an infection. My Oscar is prone to them due to a kidney stone in his shrunken kidney - he couldn't tolerate Clavamox for his last infection (last summer) and ended up on a very strong antiobiotic which helped. Low grade infections really do a number on their kidneys and that your Oscar is peeing outside the box certainly indicates he's unhappy about something. I'd definitely get another urinalysis done and get them to culture it to see what grows, if anything, and check for crystals.

General consenus with CRF cats is just feed them what they'll eat. Use phosphorous binders to to keep the phos. in check (I'm supposed to be using one with my Oscar but he doesn't like it). My Oscar is on no kidney meds except for a liquid B vitimin supplement and he's on meds for his heart disease (a diuretic due to fluid build-up in his chest - probably the worst kind of drug for a CRF cat!).

You should join us over at the Yahoo groups: Caring-for-CRF-Felines and FelineCRF. You'll find tons of support and tons of info on CRF.

tess

Here is a link that might be useful:

Rufus didn't like the prescription food either so I mix it thoroughly with a small amount of fancy feast. Cats get their liquids from the food they eat. Their tongues aren't made for taking up water like a dog's. Rufus gets an IV subcutaneously each day which keeps him well hydrated. But he does urinate more frequently then before. We haven't had any problems with him peeing out of the box. However, every once in a while he seems to have problems jumping onto the bed or climbing into the litter box, so we've made steps everywhere.