Feline lower urinary tract disease is predominantly stress-related in young cats, making environmental management as important as veterinary treatment.
Feline idiopathic cystitis illustrates the profound link between psychological stress and physical disease in cats. The bladder in stress-affected cats undergoes inflammatory changes mediated by neurogenic mechanisms — essentially, psychological stress creates physical bladder inflammation that causes painful urination, haematuria, and in male cats, urethral obstruction. The welfare chain runs from stressful living conditions (inadequate resources, inter-cat conflict, environmental poverty) through psychological stress, through physiological bladder disease, to welfare-relevant pain and potentially fatal obstruction. Environmental management — adequate litter trays, feeding stations, hiding places, and inter-cat resource competition reduction — is not merely complementary to veterinary treatment but is the primary prevention strategy. A cat treated medically but returned to a stressful environment will likely relapse.