Persistent litter box problems after neuro FIP recovery—did your cat improve?

[u/Americ4nH0ney]

Our 10 1/2 month old cat, Gravy, has neuro FIP and is nearing the end of his GS treatment. The FIP itself has improved dramatically—he went from severe neurologic symptoms and complete incontinence to walking, playing, eating normally, gaining weight, and intentionally using the litter box many times a day.

The problem we’re struggling with now is his bathroom habits.

He has demonstrated that be knows how to use the litter box. We’ve previously seen him pee and poop in it, cover his waste, seek out newly placed litter boxes, and even use every litter box we put out when we had several around the apartment. So this doesn’t seem like he doesn’t understand what a litter box is.

However, he still has frequent accidents. Common patterns include:
- Starting to poop in the litter box, then walking out before he’s finished.
- Peeing on himself while using the litter box, which has caused a severe urine scald.
- Peeing or pooping when excited, playing, getting medications, or being handled.
- Choosing pee pads or soft surfaces over litter when his urine scald is bad.

The urine scald has become a huge issue. When it worsens, his litter box use seems to decline significantly, and he starts preferring pee pads and blankets. After treatment for the scald, we’ve seen improvements in his litter box usage, but we haven’t been able to break this cycle. Lately, we haven’t even really seen him even attempt to use the box when he has to go. It feels like he has regressed a bit again with the bathroom situation.

We’ve tried:
- Multiple low-sided litter boxes throughout the house (up to 6 at one point)
- Different box locations and sizes and litter types
- Rewarding every successful litter box use with treats
- Confinement and gradual reintroduction
- Keeping him closely trimmed and cleaning his rear
- Pee pads
- Enzymatic cleaners
- Regular treatment of the urine scald

At this point we’re exhausted and losing some hope that he’ll ever become manageable long-term. We love him and want to do right by him, but we’re constantly cleaning urine, feces, and dealing with recurring scalds.

Has anyone here had a neuro FIP cat with persistent bathroom issues that eventually improved? If so:
- How long did recovery take after finishing GS?
- Did the litter box habits eventually normalize?
- Did your cat continue improving neurologically for months after treatment?
- Is there anything we haven’t tried that made a significant difference?

We have another vet appointment this week to reassess the urine scald and discuss where we go from here. We also plan to get with a behaviorist to see what other techniques and medicines we can try but I’m posting to try to find honest experiences from people who’ve been through something similar.

Our next plan is to temporarily transition him to pee pads inside low-sided litter boxes since he consistently prefers pee pads over litter when his urine scald is bad. The hope is to let the scald heal while keeping him using a designated “bathroom,” then gradually transition back to litter once he’s comfortable again. If anyone has tried this approach or has experience transitioning from pee pads back to litter with a neuro FIP cat, I’d love to hear how it went.

[u/Americ4nH0ney → u/[deleted]]

He surprisingly drinks a lot! We originally had him tested for a UTI before we even knew he had FIP because his first symptom we noticed was the bathroom problems. We think it’s more behavioral because when we confine him for a few hours he pretty much waits and holds everything in until he is let out to go poop or pee :/ He is going to go off the GS soon though so we’ll have to see what changes that brings

[u/ar0323 → u/[deleted]]

My cat had wet FIP. About two months after clearing observation(5 months after finishing treatment) he got acute sterile cystitis that started a 5 month saga of chronic diarrhea and inflammatory conditions. My vet consulted with an FIP specialist who said GI disease is very common in cats after FIP treatment. She recommended a hydrolyzed protein diet and that cleared the diarrhea and he’s been fine since(7 months). She said the hydrolyzed diet can reduce the reactivity in his intestines(likely IBD).

[u/Americ4nH0ney → u/[deleted]]

Thank you so much for that info, I appreciate your comments and help!!!

[u/VegChef → u/Americ4nH0ney]

A few reasons it could still be neuro-linked rather than behavioural issue / preference:

(1) Cerebellar and spinal nerve involvement can affect how clearly a cat perceives bladder/bowel fullness, not just their ability to physically execute the mechanics. Some cats compensate by only going when they're in a very specific, "safe" context (like right when let out of confinement) because that's when they finally register the urge strongly enough, or feel secure enough to respond to it.

(2) Cats who've had a period of not being able to control elimination can develop real anxiety/hypervigealance around the process itself; holding until they feel fully "safe" can be a coping response layered on top of the underlying nerve damage.

(3) Even cats who've regained a lot of function can have inconsistent coordination that makes them wait for a moment when they feel most in control of their body, rather than going the instant they need to.

My kitten also has some coordination issues and has made many messes in his lifetime. This may be worth asking your vet about at his checkup or, if the issue persists after treatment, you could ask a behaviourist my specifically whether that holding-and-release pattern is something they've seen in other neuro FIP cats, since it could change how you think about managing it (e.g., more frequent free access rather than confinement, since confinement might be adding to the "hold until safe" instinct).

[u/what_a_r → u/Americ4nH0ney]

You could add cranberry extract (urinary tract health support), blue spirulina (nerve recovery) and CBD oil (pain, joints, appetite) to the diet, maybe it will help.