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This creates a vicious cycle for the patient. A fearful cat develops cystitis from stress. The cystitis causes pain while urinating. The cat associates the litter box with pain and avoids it. The owner punishes the cat for avoiding the box, increasing the cat's stress, which worsens the cystitis. The veterinarian cannot break this cycle by simply treating the bladder with antibiotics (which may not even be indicated). The veterinarian must also treat the environment and the fear .

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: Implementing environmental enrichment strategies helps prevent the development of pathological behaviors in both home and shelter settings. Emerging Trends for 2026 This creates a vicious cycle for the patient

Veterinary professionals have specific ethical and, in many regions, legal mandates to report suspected animal maltreatment. The cat associates the litter box with pain and avoids it