Oh my goodness Mary, you two have been through so much! It seems that her inappropriate urinating is getting more and more excessive. It might be that she is dealing with a UTI and she may be associating an uncomfortableness that she might be feeling is connected with the use of the actual litter box. I found this quote on the net tonight:
"Inappropriate urination can be as a result of a urinary tract infection (UTI) or constipation, whereby the cat associates the litter box with the pain of the UTI or constipation, so starts urinating and/or defecating elsewhere."
It would be great if you could get a urine sample and bring it in to the vet. Those little pellets that are like litter but allow you to collect a urine sample are called No-Sorb.
Or you could put the plug in your drain in the sink and then check it every now and then and if she uses it, you could use a syringe to draw up a sample. I know it wouldn't be entirely sterile but it might be worth a try.
"UTIs and kidney infections may also damage your cat's kidneys further, so if your cat urinates or defecates in the wrong place more than once, you should go to the vet as soon as possible in order to have tests done and treatment begun if necessary."
I've read that you can't determine if a cat has a kidney infection through collecting a sample using NoSorb though and that a urinalysis and/or blood work is what is needed to show if a cat has a kidney infection or not.
I found the following quote on a site about kidney infections:
"In older cats, if you notice anything different about their behavior, like not using their litterbox, or blood in their urine, it is in your aging cat's best interests to get him/her to a vet as soon as possible. Older cats are more susceptible to kidney infections and disease than younger cats."
But I seem to remember that Puddy has been on or is on meds for a UTI or something similar. I will have to go look through some of your older threads.
I have one other idea about her excessive and inappropriate urination.
It is kind of a weird thought but after I read this quote:
"In animals, erythropoietin has one major use: the treatment of anemia due to chronic renal disease. Since most erythropoietin is produced by the kidney it should make sense that a damaged kidney cannot produce normal amounts of erythropoietin and anemia results."
I started thinking, what if her kidneys have been helped by the Epogen to the point that the sub-q fluids are not as necessary as they once were and now Puddy's body has too much fluid on board?
I started thinking about that the more I read about Erythropoietin and how it is a synthetic form of the naturally occurring hormone normally produced in the kidneys. If a cat has suffered a reduction in this hormone for a length of time and then becomes dependent on sub-q fluids to help the kidneys along, it seems like it could make sense that the kidneys might not need both fluids and the hormone at the same time because maybe it's too much help. I don't know if there is a direct connection between the hormone and urinating but the kidneys themselves are related to urinating so if changes are happening within the kidneys with the addition of meds, it seems possible that the act of urinating might be effected as it is the 'end' result of what is happening in the kidneys.
I don't know how often you are giving sub-q's at this point but you might want to try backing off on it (if your vet okay's it) and see if the inappropriate peeing decreases.
Does that make sense?I might be grasping at straws here but I want to help you so much to find some answers. I know this has been so hard on you and it would be for any of us if it was happening to one of our pets.
In the meantime, since the runner in the hall seems to be her fav spot for peeing out of the box, could you put a tarp down, folded in the shape of the runner (to fool her of course!) and then put some towels on top or an old blanket that you could toss in the wash each day until this thing is figured out? I can only imagine how frustrating this is becoming for you and something has got to give and soon. I'm praying for resolution and that you and Puddy will both find healing ASAP! Whatever you decide, Puddy has an awesome mom and she surely knows how much you love her.

p.s. I'm sure you've come across this site in your searches of CRF over the years but just in case I'll include it here because it seems to have a ton of info on it, including a bunch about Anemia and Epogen. Here is the
link.
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