If a cat gets a UTI (which is common in female cats), they associate painful urination with their litter box. They'll start going to the bathroom in unusual places (which can be a bear to clean).
Signs of a uterine infection or pyrometra in cats can vary. With open pyrometra, there's a discharge of pus and blood from the vagina. A closed pyrometra has no discharge, but the cat will be very sick.
Signs can include the cat having trouble urinating, red-tinted urine, loss of appetite, trouble defecating, hair loss, constant grooming of the genital area, and weight-loss. If a cat is showing any of these signs it should be taken to the veterinarian as soon as possible. Uterine infections can be cleared up easily if treated early.
A uterine infection may produce symptoms such as pus or blood from the vaginal area, fever, lethargy, unwillingness to eat or drink, the cat may also appear to be in pain (because she is). She should be taken to a veterinarian for treatment immediately as this can be life threatening.
Symptoms of uterine infection in your cat may include: reddish/yellow pus, bad smell,lower energy, loss of appetite, a fever,not wanting to be petted, or being thirsty.
The symptoms may be seen on their own or together and are sticky reddish or yellow pus,unusual smell,low energy,poor appetite,fever,distended abdomen,increased thirst and increased urination.A veterinary appointment is a must.
I would say when a cat starts to urinate outside of the cat litter. Also, when the smell of the urine is extremely overpowering and when the cat is constantly licking the genitals.