A cat pees with blood - how to identify the cause and help your pet?

Bloody and discolored urine is a common reason why cat owners seek veterinary care.

It is incredibly unpleasant to see drops of blood in the cat's litter box, on the bedding or on the floor. Sometimes you cannot see blood until the urine is examined with a microscope or detected in a urinalysis. Fortunately, many cats that exhibit blood in their urine have signs that resolve quickly with relatively simple treatments. The two main causes of blood in a cat's urine are cystitis and feline lower urinary tract disorder, or FLUTD.

What is hematuria?

Blood in the urine is called hematuria. Hematuria can be determined by the presence of pink, red, brown or black urine or the presence of blood cells when the urine is analyzed under a microscope. A urine test is used to help determine whether the blood is due to a urinary tract disorder or the result of a body condition that affects clotting or bleeding. Blood tests are usually needed to rule out possible bleeding or bleeding disorders. The most common diagnosis for hematuria in cats is cystitis.

Diagnostics

To diagnose urocystitis and urolithiasis you will need:

• General urine analysis;
• Ultrasound of the bladder;
• BAC urine culture (not always);
• X-ray of the abdominal cavity (if urolithiasis is suspected).

For kidney inflammation:

• General urine analysis and protein/creatinine ratio in urine;
• Blood biochemistry;
• Ultrasound of the urinary system;
• BAK urine culture (not always).

For injuries:

• Ultrasound of the abdominal cavity;
• X-ray of the abdominal cavity;
• Clinical blood test.

For prostate diseases and orchitis:

• General urine analysis;
• Ultrasound of the genitourinary system;
• BAK urine culture (not always).

For diseases of the reproductive system in females:

• Ultrasound of the genitourinary system;
• General urine analysis.

For balanoposthitis:

• General urine analysis;
• Deep smear cytology;
• Ultrasound of the genitourinary system;
• TANK culture (not always).

What is cystitis?

Cystitis is a general term referring to inflammation in the bladder. The term cystitis does not imply a specific cause for this disease. In cats, diseases of the lower urinary tract, bladder and urethra are often classified under the term feline lower urinary tract disease or FLUTD. We use these commonly recognized medical terms because it can be difficult to distinguish between different bladder and urethral conditions, and many conditions affect the entire lower urinary tract. If your veterinarian eliminates all specific associated diagnoses for hematuria, the condition is called feline idiopathic lower urinary tract disease (iFLUTD). Some veterinarians may use feline idiopathic cystitis (FIC) to describe this condition. Idiopathic is a term that means the exact cause is unknown.

What are the symptoms of cystitis?

Typical symptoms of cystitis or FLUTD in cats involve inflammation and irritation of the lower urinary tract. General clinical signs:

• Increased frequency of urination, which is called pollakiuria.
• Difficulty urinating or dysuria. (Sick cats often spend a lot of time straining in the litter box, passing only small volumes of urine. Many cat owners confuse this with constipation.)
• Having bloody, strong-smelling, or discolored urine.
• Urinating in unusual places such as furniture, floors, and corners is called periuria.
• Excessive grooming or licking of the genital area.
• Inability to urinate. These cats strain to urinate, producing a few drops or no urine at all. If you suspect that your cat is in distress and unable to urinate adequately, this is a medical emergency. Urethral blockage, which is more common in male cats due to their narrow urethra, can be a life-threatening complication if the condition is left untreated for even a few hours.

How to collect urine for analysis

Before visiting the clinic, if possible, you should collect urine in a sterile jar for analysis. Of course, this procedure can also be done by a veterinarian using a catheter or a sterile syringe (cystocentesis), but such methods are quite traumatic, have a number of side effects and are used in emergency cases when the cat does not pass urine at all. In all other situations, urine can be collected at home.

Urine collection through a catheter is done in the clinic, but this method is traumatic and fraught with infection

Methods and rules for collecting material

To speed up the identification of the causes of illness, you need to independently prepare biomaterial for analysis. It is unlikely that you will be able to persuade your cat to pee directly into a clean jar - although some owners can even do this. Owners, taking into account the habits and character of their pets, use various methods of collecting urine:

• from the toilet, sink or bathtub - if the cat is used to peeing there;
• using a children's urine collector - this device is freely sold in pharmacies;
• from the cat litter box - the most common and reliable method.

To collect urine from the toilet or sink, they are covered with plastic bags or covered with film.

We can recommend that most owners use a regular cat litter box - a plastic tray - as an improvised urinal. This is convenient, reliable and not at all difficult to do if you follow the recommendations of the step-by-step instructions:

1. If possible, buy a new tray for collecting biomaterial - even a well-washed old cat litter box can retain residual salts and microorganisms on the walls, which will affect the accuracy of the analysis results.
2. Thoroughly wash and dry the tray and the inner grid, assemble the structure and place it in a place familiar to the animal.
3. Try to calm your pet and gently massage his bladder area if this does not cause severe pain.
4. Such preliminary actions will be enough if your cat is accustomed to pee on an empty tray - all you have to do is collect the urine.
5. If the animal refuses to go potty without litter, use one of the options for urine collection kits - they can be purchased at veterinary pharmacies, pet stores or online.
6. Sprinkle the filler from the kit in the tray as usual, and when the cat pees, carefully collect the urine - for this, the kit has a special pipette, but you can also use a regular syringe.
7. It is important to maintain maximum cleanliness when collecting urine so that unnecessary chemical and biological “additives” do not get into it - thoroughly wash your hands and all the equipment that you will use.
8. It is advisable to put the collected urine (in a test tube, syringe or special container) in the refrigerator and deliver it to the veterinary clinic as soon as possible - no more than five hours should pass between the time of collection of the biomaterial and the analysis.

The cat litter box is convenient to use for collecting biomaterial

“Craftsmen” sometimes replace plastic granules with finely chopped cocktail straws or oven-roasted corn kernels - according to reviews, this also works well.

Video: collecting cat urine for analysis

New products from the pet industry for monitoring urine parameters

In veterinary pharmacies, pet stores and via the Internet, you can now purchase many devices and consumables that help you easily collect cat urine for analysis, as well as independently monitor the condition of a cat that has already been diagnosed - for example, urolithiasis. Owners of sick animals are well aware of how important this is, but many of them are not even aware of the existence of such useful and convenient new products.

Table: products for the convenience of collecting urine and monitoring its composition

Urine collection kits, which have already become popular with many owners, make it possible to easily provide biomaterial for analysis to the clinic. They use non-absorbent fillers: hydrophobic sand or plastic granules. One set is enough for several studies.

Do not try to wash plastic granules in order to reuse them, as some overly zealous owners do - this will inevitably distort the analysis results. Pipettes and test tubes are also disposable, but they can be replaced with a sterile syringe, through the needle of which urine is easily collected and then brought directly to the clinic in the syringe.

Important: plastic granules are used only once and then discarded

Diagnostic fillers and express strips are very convenient for independent testing. But they are more often used not in emergency cases, but to monitor the condition of an animal with an already identified chronic disease. It is impossible to make a diagnosis on your own, relying only on their testimony - this must be done by a doctor, especially in case of hematuria.

Photo gallery: devices for collecting urine and monitoring its composition

Aromaticat diagnostic tray filler changes color from orange (normal) to blue (critical)

A urine collection kit with plastic granules is a convenient and relatively inexpensive device

A urine collection kit with hydrophobic sand is not cheap, but is well accepted by cats. Uripolian test strips are produced to study the most important indicators of the composition of urine. PrettyCat diagnostic litter for the tray is used together with any regular litter

Video: making it easy for yourself

What are the causes of cystitis?

Blood in a cat's urine can have many possible causes. Cystitis and FLUTD can cause severe inflammation of the bladder and/or urethra, leading to hematuria. While many young cats, under 10 years of age, will have bladder inflammation that can be difficult to explain, below are some of the obvious causes of blood in a cat's urine:

• Trauma or bodily harm;
• Blood clotting disorder;
• Kidney stones or bladder stones (approximately 20% of all cases in cats under 10 years of age);
• Bacterial infections (primary bacterial infections are rare in cats, although secondary infections can occur as complicating factors) - more common in cats over 10 years of age, many older cats will have bladder stones and a bacterial infection;
• Neoplasia (tumor of the bladder or lower urinary tract) - more common in older cats;
• Anatomical abnormalities—especially in young cats with chronic or persistent urinary tract problems;
• Urethral plugs are a blockage of the urethra with a mixture of crystals or small stones and inflammatory material.

Causes of blood

There are many reasons for the appearance of pathology, and the owner is unlikely to be able to determine what happened to the pet on his own. In most cases, treatment is required immediately. Every owner should know exactly what causes the appearance of blood in a cat’s urine.

© shutterstock

There are not very many main reasons when a cat’s urine begins to contain blood..

1. Kidney diseases . Inflammation caused by any reason and causing damage to the kidney tissue leads to the urine receiving blood released during injury. Its volume does not depend on the degree of inflammation, and therefore one cannot assume that if the blood admixture has a small volume, then the problem is not serious. Also, profuse bleeding is not always a sign of an extremely severe inflammatory process. The animal needs urgent treatment. In cats, bloody urine can persist for a long time.
2. Urinary system injuries . They occur more often in animals that have free access to outdoor exercise. Urine containing blood is the main symptom. In them, minor injuries are common and do not cause illness, but if the blow was strong, then the tissue of the kidneys or bladder may rupture, which causes bleeding. The cat requires immediate treatment, as otherwise a severe infection will most likely occur, which will cause sepsis and death of the animal.
3. Inflammation of the ureters . It occurs most often in urolithiasis, when, passing through the ureters, fractions injure them. In this case, there is usually not much blood, and the urine simply takes on a slightly pinkish tint. It is highly undesirable to delay treatment due to the high risk of complications. The cat's urine goes away completely after treatment. The presence of blood is the first symptom of the onset of ICD.
4. Cystitis (inflammation of the bladder). With this pathology, erosions occur on the mucous membrane of the bladder, which causes bleeding of varying intensity, and blood appears in the animal’s urine. The pet's condition requires mandatory and rapid treatment using various anti-inflammatory and antibacterial drugs.
5. Neoplasms of a malignant or benign nature in the urinary system. Most often, blood in the urine appears when the growth has reached a significant size. If the cat is old, this phenomenon usually indicates that there is an advanced cancerous tumor.
6. Urolithiasis disease . An admixture of blood occurs regardless of where the stones are located. The sharp cuts of the fractions cut the tissues of the organs of the urinary system, which causes internal bleeding, which leads to more or less blood appearing in the urine. The cat needs to get immediate help.
7. Taking a number of medications . This phenomenon occurs if the owner prescribes medications to the animal from his own medicine cabinet, without consulting a veterinarian. As a result of this, the cat becomes poisoned and experiences internal bleeding, including kidney bleeding, which causes blood to appear in the urine. It is strictly forbidden to give paracetamol and aspirin to animals. Gentamicin can be used with caution and strictly according to the veterinarian's recommendations if it is not possible to replace the drug with another one.
8. Systemic diseases - they affect the entire body, including the urinary system, which in some cases causes bleeding. In such a situation, the feces also become bloody.
9. Pathologies of the reproductive system - when the reproductive system is damaged, blood is often released, which is washed off with urine from the external genital organs and for this reason ends up in the tray. In such a situation, there is also an increased interest of the pet in licking itself, especially in the genital area.

In all cases, the cat should receive treatment as soon as possible, before its condition worsens to critical and life-threatening. It is better to visit a veterinarian and find out that the alarm turned out to be false than to discover that your four-legged pet has a serious illness. The problem of blood in urine cannot be called insignificant.

© shutterstock

How will blood in your cat's urine be diagnosed?

The initial diagnosis for a cat suffering from hematuria is based on the presence of symptoms consistent with lower urinary tract inflammation. A complete urinalysis with sediment examination is the most common diagnostic test used to confirm the presence of urinary tract inflammation or infection and is often performed in real time in practice. Other diagnostic tests for blood in urine include:

• Laboratory urine analysis;
• Bacterial culture and urine susceptibility;
• Blood tests to look for other signs of urinary tract disease, such as kidney disease or bleeding disorders;
• X-rays and/or ultrasound examination of the bladder and urethra.

Treating Blood in Your Cat's Urine

Treatment of feline hematuria is based on treatment of the primary problem. Some common therapeutic methods for blood in urine, cystitis and FLUTD:

• Bacterial lower urinary tract infections usually respond well to antibiotic therapy within two to four weeks.
• For cystitis or idiopathic cystitis, other treatments may be recommended, such as dietary changes, development of a special diet, anti-inflammatory drugs, environmental changes, encouragement to drink more water, and others.
• If a cat develops a urethral blockage, emergency treatment is required to remove the blockage immediately. In most cases, the cat is given a short-acting general anesthetic and the urethra is irrigated or catheterized. Urethral obstruction occurs almost exclusively in male cats. Other treatment options may be recommended based on your cat's specific urethral blockage.
• If bladder stones (urolithiasis) are present, they must be removed. Depending on the type of bladder stone, they may be dissolved with a special diet or supplements, or they may require surgical removal. In some cases, initial treatment can be determined by the results of a urine test.

There is no universal treatment for hematuria, cystitis, or FLUTD. Each case must be diagnosed and treatment prescribed taking into account the individual characteristics of the cat. Often, despite appropriate testing and treatment, clinical signs and hematuria may recur, requiring further therapy and additional clinical tests. Successful treatment of lower urinary tract disease in cats often requires patience and persistence.

Features of cat urine

Normally, urine in cats is almost colorless or has a faint yellowish tint. Its smell depends on the physiological state of the animal, as well as its age. In kittens and neutered cats, urine has a barely noticeable odor, while in uncastrated individuals during the heat period you can smell it a mile away. The appearance of a pungent odor in urine, which was not characteristic of it previously, indicates the proliferation of bacteria in the urinary tract or inflammation of the internal organs.

A change in the consistency or smell of urine is one of the first symptoms of urinary tract pathologies.

Signs of hematouria

It is very naive to think that blood in urine can be easily seen with the naked eye. Yes, this method certainly works in certain situations, but it is not universal. In some cases, it is possible to detect the presence of red blood cells in the urine of pets only with the help of a special blood test, since the number of red blood cells can be very small.

Traces of blood are not always obvious

This method allows you to avoid many diseases of the genitourinary system, but it is not at all utilitarian. Few owners come with their pets for general tests at least once a year. Therefore, the only method for identifying red blood cells in urine is their accumulation in such quantities that they become impossible to ignore.

Dark urine does not always indicate blood. It can be the result of a special diet, medication, or a pet’s basic love for beets.

Preventing Blood in Your Cat's Urine

We are always looking for ways to prevent conditions such as hematuria in advance. Unfortunately, it is impossible to completely prevent lower urinary tract disease in cats. We know that FLUTD/FIC appears to be more common in cats that have low water intake and are inactive or obese. These factors may partly influence how often your cat urinates. Controlling your weight and exercise and water consumption may provide some benefits in preventing cystitis and FLUTD. Having an enriched environment with clean and accessible litter boxes can also help with this issue. If bladder stones are the cause of blood in the urine, special therapeutic diets may help prevent recurrence. If you suspect that your cat may have blood in its urine, please contact your veterinarian immediately. The sooner you receive a diagnosis and proper treatment, the sooner your cat can return to a healthy, pain-free life.

If you have any questions or concerns, you can always visit or call our veterinarian - this is the best option for ensuring the health and well-being of your pets.

Treatment of hematuria

For the treatment of urocystitis, urolithiasis, nephritis, the following measures and groups of drugs are used:

• Antispasmodics;
• Painkillers;
• Drink plenty of fluids;
• Antibiotics (not always).

In case of urolithiasis, specialized diets and drugs that affect the pH of urine are additionally used.

For nephritis, intravenous infusions and several groups of antimicrobial drugs can be used simultaneously.

If your cat pees blood after an injury, you will need:

• Limited mobility;
• Painkillers;
• Hemostatic;
• Surgery may be required (for example, if the wall is torn).

For diseases of the reproductive system in cats, the following are used:

• Painkillers;
• Antispasmodics;
• In males, antihypertensive drugs that relax the urethra;
• Antibiotics;
• Operation (castration).

If a prompt visit to the veterinarian is not possible

If a cat is peeing with blood, the first thing you need to do is to provide the pet with peace. Set up a bed for him in a quiet, warm place, surround him with care. Place several bowls of fresh water near your pet.

Under no circumstances should you give medications from a human first aid kit without a doctor’s recommendation. First, many drugs cannot be used in animals. Secondly, dosages are completely different for cats and humans. Thirdly, many drugs have contraindications for use.

To properly provide first aid to your pet while you are unable to take it to the clinic, you can consult with a veterinarian online in the Petstory mobile application. The doctor will collect a detailed history, recommend how to help your pet at the moment, tell you what diagnostics should be carried out and what could be the reason for the appearance of red urine in your cat. You can download the application from the link.