Research overview: feline idiopathic cystitis and Pandora syndrome

Feline idiopathic cystitis, a common cause of lower urinary tract signs in cats, is increasingly understood as a stress-related condition with systemic dimensions, sometimes termed Pandora syndrome. This overview surveys research linking the disorder to chronic stress, an exaggerated stress-response system and adverse early-life experience, rather than a primary bladder problem alone. It examines how affected cats often have other stress-associated conditions, how environmental stressors trigger flare-ups, and how multimodal environmental modification reducing stress can decrease recurrence. The survey discusses the involvement of the nervous and endocrine systems and the reframing of the condition as a manifestation of a sensitized stress response. By compiling this work, it presents feline idiopathic cystitis as a leading example of how psychological stress and environment shape physical disease in cats, motivating enrichment-based management.