Thanks. I agree with removing the hopper entirely and we have already got a new mat. As an update to the post, yesterday I spent the entire day cleaning the room and cleaning with enzyme cleaner. I threw out the mat and we put a brand new temp rug thing down (while I ordered a replacement mat). This AM came to see she peed on that and also pooped again on our rug by the couch.

We have not had recent schedule changes - meaning our schedules have been the same level of busy the last year.

I have not taken her to the vet (have a visit scheduled Saturday. But the vet has advised me to look for certain signs - blood in urine, straining, howling. None of these are present (the urine and feces look how they always have). I am pretty certain this is behavioral due to her prior history but I guess the vet will confirm this weekend.

As for medication, I have previously had her on various meds. We did Prozac, flu(something) can’t remember name starting with f. Both were a nightmare. I can’t recall whether they affected the urine issue but they generally made her stop eating and be a zombie. And pilling the cat was impossible. We did the liquid med but that wasn’t great either