As the question says, we have a 10 year old cat (spayed) about 4kg who seems prone to cystitis. This is her second occurrence we know of. Last time was about 3 months ago and we might not have recognised precious bouts if any.
We caught it early, it started yesterday and she was in and out of her litter tray many times. So the vet says it could be an infection, but there's no thickening he can feel (I think he said that!) and he thinks it probably isn't due to infection. He says it is more likely to be from stress or (irritating) crystals.
We think he is probably right. She didn't have an easy time for most of her life, and was essentially a rescue some years ago. She can be friendly and plays at times, but has never shaken off suspicion and defensiveness against humans, and "rowls" and hisses, and readily claws and bites at times, if annoyed or disturbed. (She does understand moderation, she paw bats, stares, flees or rolls over as well, so it's not like she is completely feral, and does at times come up to us for attention, if we are sleeping or she wants something).
We're used to this and understand it's her way, but the upshot is that it's rare for a day to pass without her showing signs of experiencing a lot of stress.
She doesn't seem to have ever really developed more than tentative and very fragile trust, or any usual degree of stress coping mechanisms, so although it's been a stable home for years, ordinary things stress her which wouldn't stress other cats: the door is shut, food is late, people make noise, people exist, people aren't playing with string for her when she wants it, a comb of any kind is nearby (she's long hair and needs daily combing to avoid hairballs), humans might be going to grab her for unknown reasons when treats are on offer, then chair she's on or place she's lying is needed by humans, and a hundred other things.
We live in a quiet apartment without children and without ,amy raised voices, and no other cats are around. She has a lot of leeway to "live and let live", but she feels stress at a lot of things, so the vet's suggestion that it could well be stress related makes a lot of sense. We do try to give her a stable routine and "safe" places, but that only goes so far.
We have used a "Feliway" calming plugin for a long time. Her usual routine for meals is a bowl of hard granules she can eat any time, chunks in jelly from a sachet twice daily, and if hungry a sachet of cat soup at lunchtime. We time her meals to ensure she isn't left hungry later on. Her appetite is good and she often asks for meals before it's time. The chunks and soup meals go fairly quickly after they are put out. Occasional treats (a few daily) include hairball and bladder treats, cat milk, and dried or fresh fish. She has fresh water out always, and a bowl of an appropriate kind of grass which she sometimes nibbles.
The first time she had cystitis the vet used antibiotic injection, metacam (a NSAID), and encouraged a much more liquid diet to dilute her urine. We stopped feeding her granules, added milk to her chunks and gave her soup daily. This time he has said the same but added "Cystaid Plus", a product said to help the bladder resist caustic urine and crystals and help manage the condition and reduce the incidence/discomfort. He says that anti-anxiety meds are available but would very much be a last resort. She doesn't need them right how and may not need them in future.
My question is, is there anything else we can do to help her, if this is a chronic condition and will recur? Is there anything that we can do either to improve things for her, or reduce her stress further, and reduce future vet visits or upset for her?
Helping would include anything that might cut down future incidents - even cutting it to once or twice a year if it's going to be regular, would help a lot.