Why does my older cat urinate out of the box?

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This was once of today’s questions from Jill in Hollywood.  Jill’s cat is 18 years old, so my biggest concern is kidney failure (seems to be the number 1 reason very old cats deteriorate).  These cats tend to drink more, and consequently urinate more.  Other possibilities could be a bladder infection, diabetes mellitus, or a behavioral problem.  I suggested she have her cat checked out to first rule out the medical problems (kidney disease, urinary tract infection, or diabetes) before dealing with potential behavior issues.