Vicky Simon BVetMed VetMFHom MRCVS

Recent restrictions and enforced home occupation over the last year may have caused stress for us all including our cats who can suffer the consequences of disruption to their regular routine. Unlike dogs, cats don’t often show their stress about new or different situations in obvious ways. Their mood may change, but they can also suffer from certain conditions linked to stress, most commonly cystitis or diarrhoea. Holistic Vet, Vicky Simon explains about cystitis which seems to have troubled the UK cat population, more than usual, during ‘lockdown’.

What is cystitis?

Cystitis is an inflammation of the bladder, causing frequent, difficult and/or painful urination. In cats it most often presents as frequent visits to the litter tray or outside, with only a little urine produced each time. Cats usually wee 2-4 times daily, so 6-8 or more times is unusual. They can also strain to urinate, lick around the urinary opening, and even urinate in unusual places, such as the bath or a bed. Yowling or meowing when urinating can occur, as can blood in the urine.

Cystitis is most commonly caused by stress in cats because stress hormones in this species can wear down the fragile lining of the bladder wall, leading to inflammation. If there has been any change in your cats’ lives around when the problem appears, then stress is the most likely cause. These changes could be anything from a change in routine, a new cat in the household or neighbourhood, pain, building work going on in the house or garden, amongst other things. It all depends on the sort of character your cat is as to what causes them stress.
Other causes of cystitis include urinary tract infections, urinary stones, and a condition known as Feline Idiopathic Cystitis (FIC).

Male cat dangers

Cystitis can happen in both male and female cats, but male cats have an added complication. The urethra is the tube that carries urine out of the body from the bladder. In females it is short and wide, whereas in males it is long and narrow, making it more prone to blockage. This blockage could occur due to inflammation, a mucous plug, or a urinary stone. Whatever the cause, this is a life-threatening condition, and so an emergency. If your male cat is showing signs of straining to urinate, or persistently licking his penis/perineum then he should be seen by a vet as soon as possible.

How can we manage cystitis?

Reduce stress

This seems like an easy and obvious one but it can be difficult to achieve. If your cat is prone to cystitis then try to make sure you keep their routine as similar as possible to normal. Make sure they have time and space to get plenty of rest, without being disturbed. If they are used to visiting a cattery, but hate building work then maybe a week at the cattery would be less stressful than being at home whilst the work is done. If you are planning on getting a new cat, then introduce them slowly, and make sure you give your cat a calming supplement or some herbs for at least 2 weeks before the new cat arrives.

Tabby cat drinking from tap

Increase fluid intake

In cats this is sometimes easier said than done. Cutting down dry food and feeding just wet food, or at least much more wet food is a great start. Making sure fresh water is put down every day, and in multiple places all over the house is another easy way. Ideally it should be in a shallow dish with no rim, and kept topped up at all times. Some cats love to drink from a water glass or a running/dripping tap. There are also cat water fountains available if your cat loves running water & is prone to cystitis. You can add water to dry food, but some cats won’t eat soggy biscuits!
Bone broth is another great way, as it is both liquid and deliciously meaty. Alternatively you could try adding a tiny bit of milk or a little cranberry juice to a bowl of water if your cat likes this, although a lot of either is not good for cats.

Put out plenty of litter trays

If you have a multi-cat household and use litter trays then you should always make sure that you have at least one for every cat you have, plus ideally one spare. Cats in multi-cat households more commonly suffer from stress and so from cystitis. Not enough litter trays exacerbates the problem.

Calming supplements

I find the best ones in cats contain L-tryptophan, the precursor for Serotonin, the body’s happy hormone. Some cats respond well to pheromone or herbal sprays or diffusers too. Remember to be very careful if using essential oils in cats as they are very sensitive to these. (Look for other articles on Zoopharmacognosy for information on this.)

Bladder supplements

The bladder lining is made up of Glycosaminoglycans (GAGs) so supplements containing N-acetyl D-glucosamine, one of the building blocks of GAG, or Hyaluronic acid, one of the main components of the GAG layer, are brilliant.

Most vets will sell Cystophan by Protexin. This contains L-trpytophan, N-acetyl D-glucosamine and Hyularonic acid and has always helped in my experience.

Herbal Medicine

There are lots of ways herbs can help in cystitis. Most usefully are those that calm, and improve or repair the bladder lining. Calming herbs are readily available in different supplements, such as skullcap, valerian, or passionflower. Herbs to help with the bladder lining less so, but these include corn silk and couch grass. If you speak to a veterinary herbalist about your cat they will be able to make you up a bespoke mixture containing both calming and bladder herbs, as well as anything else your cat might need.


Cystitis can respond really well to homeopathy, with the choice of remedy depending on your individual cat. The most common cystitis remedy is probably Cantharis, which has a picture of frequent straining to urinate, with urine coming in drops or dribbles. Your cat might find urinating uncomfortable and lick around their genitals a lot as the urine tends to burn. If this doesn’t work or the problem is chronic then it is worth seeing a homeopathic vet.

If your cat is suffering from cystitis and there is no improvement with the above management options, if the condition seems to be getting worse, your cat goes off their food or seems very unwell, then please go to your local vet as soon as possible. If your cat is not urinating at all then you should see a vet immediately.

If you do visit the vet, taking a urine sample can be very useful. In cats these can be collected either using a clean empty litter tray, or using plastic cat litter beads (available at your vets or some pet stores). Urine can then be transferred into a sterilised jar, or a urine sample pot.

Useful links

How to find a holistic vet is highlighted here

Blogs about herbal medicine

Blogs about homeopathy

Vicky Simon BVetMed VetMFHom MRCVS

Vicky is a veterinary surgeon practising integrated veterinary medicine by combining her knowledge of conventional medicine, with that of various complementary approaches. These include herbal medicine, homeopathy, acupuncture and species-appropriate feeding.

Vicky spent her first 7 years in two small animal integrated veterinary practices, where conventional medicine, surgery and diagnostics were used alongside herbal medicine, homeopathy, natural feeding and acupuncture. Holistic medical approaches have always appealed to her, so she was lucky to be able to pursue these immediately.

Having qualified as a veterinary surgeon in 2012, Vicky established ‘Holistic Vet Vicky’ in 2020 in Wiveliscombe, near Taunton, Devon. She takes referrals for holistic veterinary medicine, and offers general holistic health advice. Vicky always aims to work closely with referring veterinary practices to optimise the health and well-being of her patients. She mostly treat dogs and cats, but also sees horses, rabbits and guinea pigs and other small furries, as well as the occasional chicken.

Visit Vicky’s website here and follow her on Facebook here

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The veterinary Surgeon’s Act 1966 restricts the treatment of animals (usually other than your own*) by anyone other than a qualified vet. Always consult a veterinary surgeon if you are concerned about your animal’s health. *For full details visit the RCVS website