Get

In Your Inbox

Catster is reader-supported. When you buy via links on our site, we may earn an affiliate commission at no cost to you. Learn more.

Pandora’s Syndrome in Cats: Causes, Signs & Treatment (Vet Answer)

skinny cat on the litter tray

Have you ever been stressed for a long time, and as a result of this had a bad skin break out or picked up a head cold? In many ways, cats aren’t too different to us. Chronic stress leads to many illnesses in people and cats alike.

Pandora’s Syndrome refers to a complex and challenging disease in cats, presumed to be related to chronic stress. Cats suffering from Pandora’s Syndrome have a long list of potential signs related to many different body systems. The urinary system is the most commonly involved. For this reason, Pandora’s Syndrome was previously referred to as “feline lower urinary tract disease” or “feline urological syndrome”, and stress or anxiety was believed to be one of the main causes of the urinary issues.

However, new research suggests that many other organs in cats are affected by chronic stress, including the heart, the digestive system, the respiratory tract, and even the skin. This article will explain Pandora’s Syndrome in cats—what’s behind the name, why it matters, and what can be done to improve their overall well-being.

divider 3 paws

Where Does the Name Originate?

In Greek mythology, Pandora opened a box that led to many complicated problems. The more we research cats, the more it seems that stress potentially plays a role in many of the poorly understood feline health problems.

Previously, many other names were given to the urinary issues associated with stress. Recently, a leading veterinarian in the field named Dr. C.A. Tony Buffington, proposed the name Pandora’s Syndrome, after years of research revealed that stress or anxiety was potentially affecting much more than just a cat’s bladder.

cat pee on carpet
Image Credit: New Africa, Shutterstock

What Is Pandora’s Syndrome in Cats?

Pandora’s Syndrome is an “umbrella” term used to describe cats with many diseases, potentially all stemming from chronic stress. These cats are in a constant state of “fight or flight”, and cannot appropriately control their stress response. This may be the result of maternal stress during pregnancy or early trauma experienced by the kitten; genetics and stressful home environments likely also play a role.

As a result of chronic stress, these cats develop “co-morbidities”. This term describes the presence of two or more different diseases at the same time. For example, the cat may have respiratory illness such as cat flu, while also having difficulty urinating due to an inflamed bladder. Or, they may have early heart disease and diabetes. Whatever the situation, stress is believed to be a key driver for all of the problems.

What Are the Signs of Pandora’s Syndrome in Cats?

This depends on which body system is involved. The most commonly involved body system is the urogenital or urinary system. Signs include:

  • Straining to urinate
  • Passing small amounts of urine
  • Urinating in abnormal locations
  • Frequenting the litter tray
  • Vocalizing while urinating

Behaviorally, affected cats are often excessively hiding, showing aggression, eating indiscriminately, and over-grooming. Other body systems can be involved, resulting in dental disease, heart disease, upper respiratory infections, diabetes, and chin acne.

It is worth mentioning that most signs of Pandora’s Syndrome “wax and wane”, meaning they are observed, then seem to subside, then manifest again, and this cycle tends to repeat itself. Regardless, any of the above signs warrant a trip to your veterinarian. Pandora Syndrome is a diagnosis of exclusion, so bladder stones, urinary crystals, and infections need to be ruled out, first.

If you need to speak with a vet but can't get to one, head over to PangoVet. It's an online service where you can talk to a vet online and get the advice you need for your pet — all at an affordable price!

PangoVet_Mention-in-Content for PangoVet2 save money

What Are the Causes of Pandora’s Syndrome in Cats?

At this stage, no single cause has been identified. There are a few theories as to why cats develop Pandora’s Syndrome:

  • Stress in utero. The mother of affected cats may have had illness or stress during pregnancy.
  • Stress in early life. Affected cats may have been abandoned, injured, or sick in their early days and weeks as a kitten, resulting in chronic stress when mature.
  • Genetics. Genetics may play a role, though more research is required.
  • Home environment. Multi-cat households lacking routine, quiet, food bowls, litter trays, and companionship may predispose a cat to Pandora’s Syndrome.

divider 1 paws

How Do I Care for a Cat with Pandora’s Syndrome?

Managing Pandora’s Syndrome often involves a combination of at-home changes to give the cat more control of their space, and appropriate medications to lower their stress threshold.

Environmental Modification

A full discussion of environmental modification is beyond the scope of this article, however, in short, cats should feel safe and comfortable in their home environment. Some rules of thumb are included below:

  • Every cat should have a hiding place
  • Every cat should have adequate social time with its owners
  • No cat should feel overly threatened by other cats or dogs in the house
  • Every cat should be able to eat in peace
  • There should be a food bowl and litter tray for each cat in the house, plus one “spare”. For example, a household with three cats should have four water bowls and litter trays.
  • Every cat should have stimulation in the form of toys
  • Similar to people, cats tend to like routine

Medications

Many affected cats benefit from anti-anxiety medications. The purpose of these is not to sedate the cat but to “take the edge off” or lower their stress threshold. Many options are available, such as gabapentin and alprazolam. These medications are considered off-label, meaning they must be discussed with, and prescribed by, a veterinarian.

cat examined by a vet
Image Credit: Dina Photo Stories, Shutterstock

divider 1 paws

Frequently Asked Questions

How Is Pandora’s Syndrome Diagnosed?

There is no definitive test to diagnose Pandora’s Syndrome. A diagnosis may be reached based on a history of the cat’s life, an assessment of their home environment, consideration of the signs they are showing, and the exclusion of other diseases.


What Is the Prognosis for Cats with Pandora’s Syndrome?

With appropriate home modification and medication, most cats have a good prognosis. The bigger concern may be that cats with Pandora’s Syndrome experience a poor quality of life if left untreated.

divider 3 paws

Conclusion

Pandora’s Syndrome is a tricky and often frustrating feline disease driven primarily by chronic stress. Stress has many detrimental effects on the body. In cats, this most commonly results in urinary issues, though heart disease, skin disease, dental disease, and respiratory disease may also be linked to Pandora’s Syndrome.

While more research is required, there are many steps that can be taken to reduce anxiety and improve affected cats’ quality of life.


Featured Image Credit: New Africa, Shutterstock

Want content like this delivered to you?

Sign Up For Our Newsletter

News, insights, expert advice, and everything cat

* By submitting, you agree to our Terms & Conditions and Privacy & Cookies Policy.

How useful was this post?

Click on a star to rate (you can leave written feedback after clicking submit)

Help us improve Catster for pet parents!

Your feedback really matters.

What did you like about this post? Also how can we improve it?

Join the conversation

Leave a Reply

You’re very welcome to leave a comment or question. Please know that all comments must meet our community guidelines, and your email address will NOT be published. Let’s have a positive and constructive conversation.

Talk With A Vet Online

Peace of mind,
anywhere, anytime

Affordable vet advice

Tortoiseshell Cat Appreciation Day 2025: When & What Is It?

Tortoiseshell cats are beloved felines around the globe easily recognized by their distinctive appearance. A tortoiseshell cat is not a breed itself, but...

How to Retrain a Cat to Use a Litter Box: 13 Vet-Approved Tips

Inappropriate elimination can be difficult to deal with, resulting in ruined belongings and strained relations between cats and their favorite people. It’s one...

9 Ways to Get Your Cat to Like Using the Litter Box – Vet Approved Methods

One of the great things about cats is that, unlike dogs, they usually don’t have to be potty-trained. Due to their instincts, they...

Why Is My Cat Suddenly Lethargic & Weak? 12 Vet-Verified Reasons

Cats don’t always make it obvious that they aren’t feeling well. They are notorious for concealing their symptoms until the health condition has...

More related

Cushzilla: Interview With the Cat Clothing Experts

Cat costuming is one of the finest of the feline arts — but it’s also one that’s exceptionally tricky to master. Most cats...

Long Hair Scottish Fold Cat: Info, Facts, Pictures & History

Adorable, fluffy, long-haired Scottish Fold cats have a unique look that makes them stand out. Their folded ears give them a sweet look...

How Far Can Cats Fall Without Hurting Themselves? What Science Says

It’s no secret that cats enjoy climbing. As owners, it has the potential to cause a great amount of anxiety to watch our...

How to Stop a Cat From Eating Litter: 6 Vet-Verified Methods

We might love our cats, but every now and again, they do something that makes us shake our heads. One of those things...

Keep reading

Primal Cat Food Review of 2025: Recalls, Pros & Cons

Primal Cat Food Review Summary Like their wild cousins, domestic cats are also obligate carnivores. This means that they do not only crave raw meat, but they also need it for optimal health. The gastrointestinal tracts of obligate carnivores are...

Primal Nuggets Review

Is It Cruel to Keep My Cat Indoors? Vet-Reviewed Verdict & Facts

Cats are inquisitive, adventurous animals that enjoy exploring their surroundings. However, they prefer sticking close to their home territory. Some cats are born outdoors and live a feral life on the streets with no human companions to care for them....

cat-meowing-or-trilling-by-the-door

Can Cats Drink Buttermilk? Vet-Approved Diet Facts & FAQ

Cats eagerly lapping up milk is a picture etched in most of our minds from old movies and children’s books. Milk used to be considered healthy for cats until we gained better knowledge and understanding of our beloved companions’ dietary...

Can Cats Drink Buttermilk

Can Cats Eat Pringles? Vet-Reviewed Facts & FAQ

Does your cat come running every time you pop open a can of Pringles because he loves the funny-shaped potato chips? If you’re wondering if cats can eat Pringles, you should know that Pringles and other chips aren’t good for...

Can Cats Eat Pringles

Why Do Cats Like Boxes So Much? 6 Vet-Reviewed Reasons Behind the Behavior

How many times have you cut a delivery box open only to turn around and find your cat has already made themself at home inside of it? Probably every time. A cat’s natural curiosity draws them in, and then their...

cat in a cardboard box

8 Best Cat Foods to Prevent Vomiting in 2025 – Reviews & Top Picks

One of the most frustrating things for a cat owner is when their cat is frequently vomiting. It will often be something simple like a hairball or a recent change in food and should pass quickly, but if it turns...

tabby cat eating from metal bowl

Average Cost of a Vet Visit for Cats in 2025: How Much You Can Expect To Pay

Cats require our love, care, an enriched environment to express their natural behaviors, and high-quality food to thrive. They also need to see the veterinarian regularly to ensure their health stays strong throughout their life. It is easy to tabulate...

Vet doctor holds cat in his arms and talking to the owner

Why Do Cats Like Nail Files? 4 Vet-Verified Theories & Possible Reasons

It isn’t odd for cats to rub against nail files or lick them and there are several reasons why this may occur. The most likely reason is that they enjoy consuming the left-over nail dust on the file. Although there...

Groomer using nail file on cat claws