Anxiety and Urinary Issues! Desperate for Help!!

[Shelbyt33]

Hello, I am having trouble with my cat Loki and I am looking for some advice. His anxiety and urinary issues only continue to get worse no matter what I do and I feel like I'm running out of ways to help him. I have consulted a vet multiple times and am just looking for some guidance as I am very worried and upset and not sure what other options I have. Below I have listed any relevant information I could think of.
Thank you for reading, I’m looking forwards to your answers.
Issues:
Aggression

• Always bite-y, harder than love bite but rarely draws blood

• Aggressive mildly towards everyone

• Biting and scratching mostly, hissing started recently (post last flare up of urinary issues – 3 months ago)

• Skittish and most social interactions normally including hard “love” biting person

Idiopathic cystitis

• Frequent UTI symptoms but no stones, crystals, or bacterial infections (determine by licensed vet)

• Has been treated multiple times with antibiotics, pain relief, and anti-spasm medications

• Has been cleared as not having UTI from vet multiple times

• 3 major flare ups in last 5 months

• Vet suggested cause was anxiety

• Urinating outside litter box

• • Started with peeing in bathtub at young age
  • Progressed to peeing in and around water bowl in last 4-6 months
  • Last couple months peeing on floor outside litterbox as well as in/near food and water bowl
  • Still uses litter box regularly as well

• On medicated wet food for urinary health (42 grams) as well as regular dry food for general health(50 grams)

Anxiety

• On anxiety medication (fluoxetine)

• Began with no major environmental changes

• Added another cat to the household about 2 months ago in hopes it would help, has only made things worse

• • Shared litter box and water bowl (other cat refuses to use different box or bowl)

Depression

• No interest in playing or attention

• Sleeps all day and night

• Only interest is in food

Other notes

• Always very lazy

• Did not previously have issues with any type of animal, now seems irritated around most/all

• Very intelligent

• Occasionally is very loving for short periods of time, as of late this has seemed to stop

• Has been on diet for around a year (largest weight at 17 pounds)

• I've been his only owner

Traits
Male

• 7 years old

• 14-ish pounds

• Fixed

• Declawed on front paws (not my choice)

Environment

• 650-ish sqrft apartment

• Multiple cat “houses” as well as toys and comfort items

• Daily play

• Outside time on enclosed patio

• • Always been an indoor kitty

• Regularly cleaned litter box

• Regular feeding schedule

Help Efforts

• Isolated in bathroom with food, water, litter box, and comfort items

• All shots up to date with regular wellness visits to vet

• Tried “NaturVet Hemp Quite Moments” cbd and melatonin infused treats as well as pheromone sprays with no change in behavior

[Mollycat]

Reading your detailed list I have to be honest the first thing that jumps to my mind is how he feels about all these vet visits and medications and your anxiety that are all meant to help him. Cats pick up our emotions like little sponges, most people don't realise it as the common knowledge is how dogs respond to owners' emotions, but cats pick them up just the same they just don't usually show it.

How old is Loki? You've had him from a kitten, when did this all start? You say there was no environmental change but what was going on in your own life that might have shifted your emotional state? Not looking for blame, trying to help find reasons and from there, solutions. The fact that introducing a new cat has made things worse definitely points to a similar stress just more of it.

What I'm thinking is, something relatively small happened, he responded with a stress UTI, made you worry, and a downward spiral started from there? The more vet visits the more stress and so it goes on. Did Loki have a full blood screen, looking for mineral deficiencies as well as diseases? Magnesium deficiency is linked to FLUTD as well. Does he drink a lot? Cats' urine is quite acidic and needs to be to kill bacteria, too much fluids can dilute it too much and leave them vulnerable to bacterial infection. I would reduce the dry food, although vets often claim this is good for their teeth there is very little evidence supporting this claim but plenty linking dry food to urinary issues, especially in males. Has his urine pH been checked? It should be around 6.3 and diet adjustments can correct this if it's wildly out. Dry food is typically more alkaline due to the higher carb/lower protein ratio. Does Loki get any fresh meat in his diet, raw or cooked? Adding some high quality protein could be helpful. If he is always wanting food and is overweight, this can be due to a craving for a specific nutrient he is short of. (My girl was hyperthyroid and overweight and her thyroid tumour was making her crave iodine, her appetite and weight normalised after treatment)

All that said, it's very likely the declawing is the root cause of his issues, especially peeing in inappropriate places and near water which might be more soothing. A soft litter like paper-based will be gentler on his sore paws and might help him feel more comfortable in the tray, it sounds like he wants to go there but the pain on his paws might put him off. And of course a new cat will likely make him feel vulnerable without his defences. There's nothing you can do about his declawing of course and as you say it's not your choice, here in the UK we don't even think of it as it's been illegal for so long, but hopefully by destressing his environment as much as possible it might at least help him.

[Sandra b]

Hi there...sounds like you have a major problem with your cat, sorry it’s so bad. My cat Murphy who is 17 now has stress issues but not to this extent. He pulls his fur out and has recently had changes in his urine and vet has put that down to stress as well. I take it you’re not in the UK as your cat is declawed so I’m not sure if you can get some of the products I will mention. I use feliway diffusers in the house and have recently started on Valerian compound, can’t comment on it yet as only started. I also use Worlds best cat litter which is amazing, very fine and so easy to clean. It is more expensive but worth every penny as my boy loves it! I think I would also look at the medication he’s on as that could be making him disinterested and sleepy. Not sure what else to suggest but I really hope things improve.

[Shelbyt33]

According to my vet they have run any diagnostic panels they deemed necessary to determine if this is a disease, infection, etc.
I currently have him on a pine litter that is very soft and easy on his toes, and I am switching him over to an all wet food diet immediately in hopes it will help. The wet food I have him on is urinary health specific and has a wide range of proteins from chicken, fish, halibut, etc. The dry food he is on has also been a vitamin and wellness type so I'm not sure if and what essential nutrients he could be missing but I will definitely do more research.
Him reacting to my anxiety about his health could definitely be contributing but I've always been a very high anxiety person and as far as I can tell it hasn't effected him previously. While I have had a few major environmental changes in the last year or so, none of Loki's flare ups or symptoms happened around those times so I'm not sure if they contributed or not.
I'm sad to realize declawing can cause so much mental stress on top of the physical issues. I am in the states and desperately wish it were outlawed here considering how inhumane it is. The majority of my apartment is carpeted so luckily he has a pretty soft floor environment but are there any other ways I could try to ease any potential pain on his toes to see if it is contributing to his problems?
I have also tried to avoid going to the vet after the initial visits in order to reduce his stress, and so far they have been very considerate and have written prescriptions and such with just a phone call rather than visit.
After a little research on his medication (which is kitty Prozac) his lethargy and increase in aggression does make more sense as they are common symptoms, so that brings me some peace of mind.
Thank you both for your input, I am very worried about him and am grateful for any advice.