This is one of my cats - Ripley. He'll be 4 years old next month. He's a bit of a special needs cat. Not long after he was allowed to start roaming freely in the garden (and in neighboring gardens) when he was 6 months old, someone in the neighborhood frightened him very badly. He's been very distrustful of strangers ever since.
I learned of this one day when raising my hand to scratch my head and he cowered. Other sudden movements would easily spook him and when friends called around, he'd panic and run off.
Around this time I noticed he was having difficulty in urinating. A visit to the vet identified that he was suffering from cystitis, a bladder inflammation that is frequently accompanied with a lower urinary tract infection that makes passing urine very painful.
Cystitis also makes him want to urinate frequently but little comes out leading to frustration and anguish. (People can suffer from the condition too).
The urine in the bladder can also be overly acidic, adding to the pain. The discomfort when urinating means that sufferers will try to hold off urinating as long as possible and that can lead to crystals forming within the bladder which can irritate the bladder lining, leading to bleeding and the cat passing quite bloody urine.
Stress is a well known trigger for cystitis in cats. And Ripley has suffered some quite severe bouts of it in the last 3 years, being hospitalized on a few occasions. In that time I've spent over $5,500 on vet bills. I didn't have pet insurance at the time of his first bout and insurance wouldn't have covered him for a pre-existing condition after that.
From tests that were run, it appears that Ripley has a genetic pre-disposition towards suffering from cystitis. That doesn't mean he would necessarily have suffered from the condition. Some factor stressed the poor cat and triggered the onset of the condition.
And that trigger apparently was some neighbor having a go at and threatening Ripley. As a result of that, he's hypersensitive to stress factors and simple things that wouldn't bother another cat can set send him on another round of cystitis.
And that's where is is right now. Three days ago, he was having difficulty urinating again (he'd been fine the day before). Another side-effect of the condition is spasm in the urethra - essentially the muscle used to open the urethra to pass urine spasms closed, preventing urination. Who knows what kind of psychological issues he has now in relation to urination after all his problems.
At least this time there's no blood in the urine and his special diet food controls the acidity of his urine and prevents the buildup of crystals in his bladder. He's on pain medication and medication to ease and eventually stop the spasms so he can urinate freely again.
And all of this caused by one unidentified neighbor who treated my cat badly.