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"Pain is the great mimicker," says Dr. Marchetti, stroking a nervous Siamese cat named Mochi in her Oakland clinic. "A cat that suddenly starts urinating outside the litter box isn't being spiteful. Spite is a human construct. That cat likely has feline interstitial cystitis—a bladder inflammation exacerbated by stress. Treat the bladder without addressing the stress, and the problem returns."

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