The No. 1 behavior problem reported to veterinarians when it comes to cats? Missing the litter box.

But don't blame the cat.

If your cat is hit or miss where the litter box is concerned, chances are, the choices you've made factor into the problem. After all, your cat really isn't asking for anything more than you would when it comes to a bathroom. All that's required for most cats is that the bathroom be clean, quiet and offer no surprises.

That sounds simple, but the failure to use a litter box sends countless cats outside or to shelters every year. Before you consider such a drastic step, you need to try to work things out with your cat if you have a litter box problem.

The first step in solving such a problem is to make sure it's not a medical condition – and that means a trip to your veterinarian for a complete workup. Urinary tract infections and diseases such as diabetes make consistent litter box use impossible for even the most well-intentioned cat. You cannot hope to get your cat using the box again until any health issues have been resolved.

If your cat checks out fine, you need to start working to make sure that everything about the box is to your cat's liking. The second rule of solving a litter box problem: If the cat isn't happy, no one will be happy. Here's what to look for.

• Cleanliness: Cats are fastidious animals, and if the litter box is dirty, they'll look elsewhere for a place to go. Clean the box frequently – twice a day at least – and make sure it's completely scrubbed clean and aired out on a weekly basis. Having an additional litter box may help, too. (Multiple litter boxes are recommended for multicat households, since many cats simply will not share.)

• Box type and filler: Many choices people make to suit their own tastes conflict with the cat's sense of what's agreeable. A covered box may seem more pleasing to you, but your cat may think it's pretty rank inside or scary. Likewise, scented litter may make you think the box smells fine, but your cat may disagree – not only is the box dirty, he reasons, but it also has this extra "clean" odor he can't abide. Start with the basics: a large box with unscented, clumping-style litter.

• Location: Your cat's box should be away from his food and water in a place he can get to easily and feel safe in. Consider a location from a cat's point of view: Choose a quiet spot where he can see what's coming at him. A cat doesn't want any surprises while he's in the box.

Make the area where your cat has had mistakes less attractive by cleaning it thoroughly with a pet-odor neutralizer (available from pet-supply retailers). Discourage reuse by covering the area with foil, plastic sheeting or plastic carpet runners with the points up.

If changing things around doesn't clear up the problem in a healthy cat, you may need to retrain him by keeping your pet in a small area such as a guest bathroom for a couple of weeks. Make sure the area you choose has no good options besides the litter box – no carpet, no pile of dirty laundry. Block off the bathtub or keep an inch of water in it to discourage its use as a place to go. After your cat is reliably using the litter box, let him slowly expand his territory. As long as you keep up your end of the bargain and keep the litter box clean and safe, you have a good chance the good behavior will become permanent.

If you just can't seem to get the problem resolved, ask your veterinarian for a referral to a veterinary behaviorist. These veterinarians are skilled in behavioral problem-solving and are able to prescribe medications that may make the difference during the retraining period.

Pet Connection is produced by a team of pet-care experts headed by veterinarian Dr. Marty Becker and journalist Gina Spadafori. The two are also the authors of several best-selling pet-care books. E-mail them at petconnection@gmail.com or visit www.petconnection.com. Back columns: www.sacbee.com/spadafori.