Feline Cystitis Can Be Prevented and Treated Holistically

Simba’s Urinary  Problems

In June 2001 Simba was atypically licking his rear end and was visiting the litter box frequently. He ran urgently to the box every few minutes for an hour in the middle of the night. He’d try to urinate but only a few drops would pass. Sometimes nothing at all. He’d even occasionally yowl as if he was in pain while he was trying to urinate.

Certified vet homeopath Dr. Jeff Feinman's Brighthaven patient Johnnie.

“I’m not Simba, but I’m also orange and have urinary problems!”

That night his guardian found drops of urine on the floor near the box. Some of these were pink and seemed to contain blood. Simba seemed fine otherwise and ate a good breakfast the next morning. Nevertheless,  he was stuffed in a little cat carrier and whisked away to his regular vet later that day.

Simba’s exam was normal and the vet advised a urinalysis to check for a urinary problem. A few drops of pink cloudy urine were on the stainless steel exam table. The small sample was thick and showed microscopic crystals and blood.

No urine culture was done and no bacteria were seen but the vet diagnosed a bladder “infection” and dispensed antibiotics. These were given and the urinary problem quickly resolved. Simba seemed fine for awhile. A few months later the same problem returned.

Recurrence Is Common

This is an all too common scenario. Urinary problems in cats are a huge clinical and household management problem. For unknown (conventionally-speaking) reasons, there is a marked rise  in feline urinary problems in the Fall.

Simba continued to have similar recurrent urinary symptoms. In the fall of the following year he became unable to urinate. He would cry and strain unproductively in the box. His guardian thought he might be constipated but wisely went right to her vet.

Simba was unable to urinate. His urinary obstruction had caused toxins to back up in is blood. Fortunately a urinary catheter immediately enabled him to urinate and intravenous fluids flushed his blood clean of uremic (from the kidney) poisons.

Simba went home and was doing great. Then one day just a few months later he started straining again. Another emergency vet visit revealed another blockage. This time though it was difficult to pass a urinary catheter. His urethra (which allows urine to pass out of the bladder). The local vet advised surgery so referred him to a surgical specialist for a perineal urethrostomy (removal of the narrowest part of the urethra by amputating the penis).

His mom wanted to avoid surgery if at all possible. Homeopathic and holistic care helped meet this goal.

Enter Pandora

The scene was sunny Boca Raton Florida last September. During one of his lectures, an eminent vet urologist introduced me to Pandora Syndrome (PS). He had helped coin this term that included all of Oreo’s symptoms that were previously classified as Feline Urinary Syndrome (FUS), Feline Lower Urinary Tract Disease (FLUTD), Feline Idiopathic Cystitis (FIC) etc.

Diagnosis, pathogenesis and the physiologic changes seen in PS were discussed. Many of the earlier theories about cause were mentioned but discarded. Dietary ash, fish, magnesium, etc. were likely not important triggers. Wonderfully, this purely conventional veterinary scientist spent the majority of his allotted time making holistic lifestyle recommendations. Simple modifications such as enriching the environment were found to be the most helpful when managing PS.

Risk Factors for Pandora Syndrome

Simba’s urinary symptoms began in the summer, but fall and the onset of cooler weather is associated with increased cases. Indoor and overweight cats are at a higher risk for PS. So are those in multiple cat households.

Simba had many of the typical PS signs. He was also big boy. Some might say “big boned” even. It’s standard vet practice to initially prescribe antibiotics when these symptoms are seen. Unlike dogs however, bacterial infections are rarely implicated in feline UTIs.

Dr. Jeff Feinman is a certified vet homeopath who can help treat and prevent urinary problems of both dogs and cats.

“I’m not sure that I like being named after a syndrome!”


Anti-biotics Are (But Should Not Be) the First Treatment for Feline Urinary Problems

In many cats, PS symptoms resolve but then return. Sometimes they never fully resolve. In these cases, most vets will then prescribe a special diet and additional drug therapy. Anti-biotics, anti-inflammatories, muscle relaxants, urethral dilators, and anti-anxiety medications are commonly used.

Some “regulars” (vets not trained in homeopathy or holistic care) may even recommend lifestyle changes.

This is a great conventional vet article summary by one of those that coined the name PS.

Holistic and Homeopathic Help To Close Pandora’s Box

Many cat’s with urinary symptoms and diagnoses of FUS, FLUTD, FIC, PS, etc. can be helped by homeopathic and holistic treatment. Preventing urinary problems before they start is the most effective way to address all of these.

If problems arise however, immediately have your cat lose any extra weight theta s/he might have. In addition, make sure that all of their food has the same water % as a mouse (or bunny, bird, etc.). Even better is to incorporate a fresh food and meat-based diet.

Weight loss and changing to a wet and fresh food diet will help most cats with urinary symptoms.

Another extremely important factor to address is your kitty’s mental and emotional life. Is your cat happy? Unhappy cats often express their displeasure with urinary symptoms. Urinating outside the box and spraying are among the most common complaints that bring clients to the vet.

It’s A Cat’s Life?

Your cat’s life might seem perfect to you, but unhappiness might be causing him to develop urinary symptoms. In my experience, the three most common causes for kitty urinary symptoms from unhappiness are:

1-Litter box problems

2-Overpopulation (usually too many cats in a small house)


Like their namesake, Pandora kitties can be overly emotional. Addressing all of these potential problems is critical when holistically treating PS.

Resolving Litter Box Problems

Do everything possible to promote trips to the litter.Some cats develop urinary symptoms and PS strictly because they are “stressed” about some aspect of using the litter box. Do your best to maintain an immaculate litter box. Ideally scoop the box after every use. Empty and wash the box and refill it with brand new litter every week or two.

Help create a harmonious holistic home for your pets with certified vet homeopath Dr. Jeff Feinman.

Cats that love each other have far fewer problems with environmental stress.

You may also need to try different litter types (clay vs. sand etc.) in addition to maintaining good litter cleanliness. Use an unscented litter as what smells pleasant to us is often aversive to your cat. There’s a good study that shows spraying Zero Odor in the box after cleaning increases litter box use.

Vet behaviorists that commonly treat PS cats have a rule of thumb. The rule is to always have one litter box more than the number of cats in your household.  2 cats=3 boxes. If you live in a small space, it can be difficult to have multiple cats. Especially if one has urinary symptoms and needs an extra litter box but you have no place to put it. In this case it’s very possible that your cat’s urinary symptoms are (at least partially) due to feline overcrowding.

Litter boxes should be in quiet spots in  your house with easy access by your cat. It’s no surprise if your cat pees on the carpet because the door to the basement was closed. Areas where there could be loud and sudden noises can also be a problem. Move your boxes away from the washer dryer, furnace, actively used toilets, etc.

Some multi-cat households contain bully cats.These can often be seen preventing litter box access of other cats. Be on the lookout and gently intervene if you see this.

“It Burns, It Burns…”

Cats are dessert dwellers and evolved to be able to conserve fluids. One of their adaptations includes the ability to concentrate urine by allowing maximal water reabsorption of urine. Cat urine can therefore get very concentrated and irritating to the bladder wall.

The longer urine accumulates in the bladder, the greater the chance for urinary symptoms classified as cystitis.

Helping your cat maintain a dilute urine can be critical when trying to prevent bladder irritations. Not feeding dry food is the most important thing that you can do. Evolutionarily many cats are not wired to have much urge to drink. Just changing from a primarily dry to a wet-based diet is essential. Some like Oreo even allow extra liquids mixed in with the food or syringed in the mouth.

Is Boredom Causing Your Cat’s Urinary Symptoms?

You might already be doing everything I mentioned but your kitty is still sick. Time to look even more closely at the household environment.

Many cats are smart. Really smart. Sometimes stubbornness masks their intelligence. Unlike most dogs, cats are not good listeners. Our cat Chi is commonly asked 20x to “get off” a counter or table but will only do so when he is ready. Or he gets off

Dr. Jeff Feinman is a certified vet homeopath in Weston CT who will help your pets attain optimal health.

Chi can sleep in any box!

but then gets right back on. It’s not that he doesn’t understand what we  are saying. He just would rather not listen.

Chi’s playing a game commonly seen in smart kitties. It’s hard sometimes, but it is best not to reprimand your cat (too often). Especially when it comes to inappropriate urination. Promote the positive and ignore the negative. Any interact-ion with your cat is a good interaction.

Some years ago the vet urinary researchers at OSU observed an association between environmental factors and urinary symptoms. In addition to litter box and inter-cat problems, they found that some smart cats were having recurrent urinary signs because of boredom.

The indoor pet initiative is here to help suggest ways to improve your cat’s environment. Be sure to work both his brain and body to help prevent pet problems associated with lifestyle issues like PS.

What About Simba?

Simba was already on a great varied Bravo! raw diet. However his urine was still concentrated. There were no other problematic environmental factors. Simba would not eat his food when extra water or chicken broth were added.  Fortunately he would accept extra fluids given by syringe. These

kept his urine optimally diluted.

Internal medicinal homeopathic treatment was initiated. Dosing was done in liquid when needed. Simba’s urinary symptoms resolved and eventually transient mild skin symptoms developed. At the same time his energy, mood, and overall vitality improved. He never had another urinary blockage or surgery.

I’d love to hear if your kitty has any manifestations of Pandora Syndrome. We can discuss it below or only web site’s forum.

Be well.

Dr. Jeff

  1. 4:30am: I’m awake because my 6 year old female cat began exhibiting these same symptoms 3 days ago. We took her to her doctor immediately. We take her and her brother to a vet that specializes in cats only. She was given an antibiotic shot but I don’t see any improvement. She is still straining to urinate and still has blood in her urine. Her appetite is good and both cats are fed Newmann’s own organic grain free wet food. During the day when we are at work, we have been seperating her from her brother by keeping him in a bedroom. He will sometimes pick on her although they are the same size. I feel that we should have the vet rule out any serious physical problems first and I don’t know why a urinalisys was not done right away.Lack of sleep and emotional exhaustion is clouding my thought process. Advice on treating this condition in a two cat household?

  2. Thanks for asking Donna.

    Exactly what symptoms was she exhibiting?

    Has she had Pandora Syndrome/UTI symptoms before?

    Has anything recently changed in the environment, e.g. a new cat litter, carpet, painting, workers, etc.?

    Dr. Jeff

    • Thanks for your response. Absolutely nothing changed in her environment. We have since changed vets as the original vet insisted this was a stress related issue. It was NOT. I took her to another vet that pointed out that Isabella has a recessed vulva due probably due to being spayed too young. The antibiotics that we insisted she be given when we originally took her to the first vet did work after several days. We are continuing to monitor her, having her lose a pound and I periodically clean her using fragrance free feline wipes. Sometimes antibiotics are necessary. I know my cats better than anyone and I am not very happy with the first vet who insisted that there HAD to be something stressing her out. I was the one stressed out because I the professional I entrusted my cats’ care to did not take her illness seriously.

      • It still could be stress. Cats are smart and need attention and stimuli just like children and adults. It would not hurt to get an extra litter box and a climbing tree and some new toys and actually play with the cats every day.

  3. My kitty serge was diagnosed with cystitis about 6 months ago. He was going to his litter box every other minute without going. The vet gave him antibiotics and an anti-inflammatory, and his symptoms quickly resolved. A couple months later and I woke up to him not greeting me as usual, he was in his box wide eyed in pain and wouldn’t leave. I rushed him to the vet and same thing, antibiotics. And then a prescribed diet that had tryptophan and other stuff for kitty pee issues. He seemed all good until yesterday he’s been hitting up his box frequently. I’m not sure how to help him! Should I take him off his prescription foods and just have him on wet foods? Or make him food? I play with him a lot and even take him on walks wit a harness, but it’s summer here in the desert and it’s about 115 outside even in the night so I haven’t been taki ng him out on his walks. Could that be contributing? What homeopathic medicine could I give to help?

  4. My two year old male was diagnosed with FIC, looking for homeopathic medicine to help. He is not a big wet food eater and wont take tuna water, broth. Trying everything to help as this is the second episode he has had in 7 months. No change in environment and otherwise happy, has two sister he like to pounce on and sleeps with us, etc.

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