Stressy, Anxious, Narky Cat

Hello, I'm new here and am wondering if anyone can give me ideas to help my stressy siamese to chill out a bit. Sorry if this is long!
Tink is a 9 year old neutered siamese, and yes I know all siamese are often stressy and noisy, but I know lots of them and she is at least twice as anxious as any of the others. I am just worried she's not that happy. I have been wondering whether to consult a behaviourist to help but I thought I'd see if anyone has any ideas first. She had a full health check up a few months back incl bloods etc so I know it's not pain, and she has been the same in various different houses we've lived in so it's not the house particularly. There are no other cats around in this house (she doesn't like other cats) and she lives indoors.
Her stressiness results in compulsive, distressed miaowing (surprise surprise) and generally very high-energy - e.g. even if she's fast asleep you can't get up without her following you to the loo or whatever, she hardly ever goes in a different room to me or my OH, and can be a bit stressy if my OH and I are in different rooms. She gets really narky if you don't immediately sit down as soon s you get in the house, and is only calm once you do (but the miaowing returns if you get up again). She also poos outside of her litter tray if she is really cross, which is maybe a couple of times a week. I wouldn't dream of leaving her overnight without someone there, so have to pay my friend to come over for the weekend if I'm going away (I couldn't, for example, pay someone to just feed her as most people can with cats, she'd be impossible).
Often, her stressiness comes from being left while I'm out (3 days a week I am out of the house, but I try to limit the amount of time she is alone), but she sometimes gets just as narky when she's had me or the OH around.
She has a tonne of toys which are rotated, good quality food, clicker training, an enrichment procedure when I leave the house etc etc. I have a feliway but don't think it makes much difference on her. I try and keep a clear routine as much as possible.
Basically, her behaviour isn't technically that "bad" but I'm just worried she's not actually that happy and would like her a bit more relaxed. I sometimes wonder whether she would be happier in a home with a sedentary older person who doesn't go anywhere. But I don't know (and my OH in particular is incredibly attached to her).
Sorry this is long. Any thoughts or anythign else I can do???
Thank you in advance!

Sometimes cats will poo outside the box if they have a urinary tact infection, or are constipated. Was that all checked out by the vet as well? He is aware that this is a problem?

If the above was checked maybe try a different litter? Sometimes this helps. Big litter box, uncovered, and a fine grained scent free litter?

Cats can stress and sometimes a medication from the vet is required. However i think all else should be tried first. Cats need quite a bit of time and togetherness, some more than others. Hard play sessions with a want type toy such as dabird can also help. Windows where they can watch the outside activity is also good.

Have you tried another cat? I know you said she does not like other cats, but have you tried a young kitten around her? Introducing older cats can be very difficult, but i dont think i have ever had problems bringing in a young, like 8 week old kitten. The older cats normally act like moms If she is lonely this might help?

If nothing works, and you are at a loss, then a behaviorist might be a good idea.

Best of luck to you guys!

Hello and welcome to TCS. I've never had a Siamese, so I've not sure what is normal for the breed.

Have you tried Feliway, or calming treats/collars? Some members find them helpful.

Have you had her all 9 years? If so, I would think she'd be used to you routine and schedules by now. So she might not be so much unhappy, as just happy to be around you, when you're home.

TCS has some articles on cats and stress, and others, that might be helpful. Here are the links:

Is Your Cat Stressed Out?
Six Surefire Strategies To Reduce Stress In Cats

Bored Cat? What Cat Owners Need To Know (including 10 Actionable Tips)
25 Signs That Your Cat Loves You

Siamese cats do have a lot of personality, don't they? And, I think all of them have high social needs compared to most cats ( they're more like dogs that way, which makes sense to me, since they're a very old breed.) And, yes, sometimes they seem to want "their family" to all be in the same place. Freya sometimes will yell at me in the room I am in, run out, then run to where my wife is, yell at her, and repeat until we come put and all go to the living room with her.

Here are some things that helped my own Siamese cat, Freya, with her stress and anxiety issues. I'm sure that you've tried some, but one or two may be new.

Interactive play: Wand toys and fetch are great, but my Siamese also sometimes likes to play catch (I'll roll a ball to her, and she'll bat it back to me.) In other words, no mater how great a toy is, a human controlled toy si always 10 times as fun.

Safe places.... having places that feel safe to your cat can help. Cat shelves, especially on windows or extra high ( I have one that lets Freya sit on a "bridge" over a door between 2 6' high shelves. She loves them all, but when anxious the "bridge" is a particular favorite. Shew also really enjoys her "pod" ( A window shelf that is enclosed so it is like an elevated cave ( because, some cats like caves and trees... it is what she's in in my current profile picture) but, it doesn't have to be fancy, a box on top of a chair or table with some kraft paper inside works pretty well.

A water fountain. Seriously, when anxious she'll sometimes go up to it and have, what my wife and I call, " a soothing drink."

Puzzle feeders. They are great if you feed dry and your cat is willing to use them. They provide an experience that feels a lot like hunting. Once Freya got some, she needed less than half as much play time. They also slows them down a bit for better digestion ( read less cat vomit!)

For separation anxiety, when I leave, I tell Freya how long I will be gone. "I'll be back in 2 or three hours. I love you." is pretty much the usual (well sometimes it is half an hour or 4 hours, or what have you.) It seems to help... The ritual aspect, I think is a lot of it. After you do it a few times your cat will know what is happening, so they will know that they should just take a nap till you return.

Sleeping on me. Freya likes to sleep on my legs (especially if I have a fleece blanket over them. it calms her and makes her quite happy.

Talking to her. Sometimes she just likes me to talk to her, especially if I use a "story voice", like I would use when telling my nephew a story...

Kitty prozac. In my case, Freya required medication for some of her issues (it worked well for her, luckily). Most cats don't need it, but if you've tried everything else, it often does help, so don't be afraid to talk with your vet about the possibility.

Thanks guys, this is all super helpful. I'll have a think about everything you've all said and what I can integrate for her. Thanks so much for taking the time to share your thoughts!

Some cats are just more needy than others. I am around Feeby nearly 24/7, but there are still times she comes searching for me. She is almost always by my side when I am not gone or busy doing something. If she is in the mood, and I am busy, she will still squawk, calling out for me. Of course, that is as I said, when she feels like it.

But, the poop thing to me is something different. I may have missed something in your post, but is the pooping problem newer? I am assuming the attention calling has always been a part of her? Those little nuances matter in trying to determine if there is an issue or not.