A common reason a cat is brought to see me is their blood-tinged urine. Often bloody cat urine is accompanied by my patient urinating outside of the litter box. This behavior usually makes it easier for pet owners to identify the problem, but it is not the only sign of a possible urinary problem.
What color is cat pee?
In healthy animals, cat urine is yellow. Cat urine can be light in color or appear more amber, but it should be clear and not cloudy. If you notice cat urine that is cloudy or tinged with orange or red, it could be hematuria (blood in the urine).
What is hematuria (blood in the urine)?
If you notice any changes in the color of your cat’s urine, it could be hematuria (a medical term for blood in the urine). Sometimes hematuria is easy to see. For example, your cat’s urine may appear darker or reddish. However, sometimes there is such a small amount of blood in the urine that your vet must examine a sample under a microscope to be sure.
Signs of Hematuria in Cats
Pet owners often discover blood in cat urine when they notice other unusual grooming habits in their feline friend, such as:
- Pee outside their litter box
- Peeing more or less often than usual
- Changes in the amount of urine
- Meow while peeing
- Changes in urine odor and color
- Increased licking or cleaning around the genitals
What causes bloody urine in cats?
There are three common reasons for bloody urine: urinary tract infections, crystals in the urine, and interstitial cystitis. A urine sample may be needed to determine the specific cause.
Urinary tract infections
A urinary tract infection (UTI) is an infection of the bladder, kidneys, urethra, or ureter (the connecting tubes between the kidneys and the bladder) of a cat (or human ). The infection may be limited to the bladder or may involve one or both kidneys in the most severe cases.
In older cats, blood in the urine can be a sign of a UTI. In advanced cases of kidney infection, the owner/caretaker may tell me, “My cat tilts her head over the water trough but isn’t drinking much.
If a cat has a UTI, you may notice symptoms such as:
Treatment: Fortunately, bacterial urinary tract infections can usually be cleared with proper antibiotic therapy. In case of kidney infection, antibiotics will need to be given for at least four to six weeks.
Crystals in urine
In young cats, a common cause of bloody urine is the presence of crystals in the urine (crystalluria). These crystals can lead to a medical emergency when left undiagnosed and untreated.
Blocked urethra: In some male cats, the crystals can cause obstruction of the urethra. Because they cannot urinate through a blocked urethra, it creates a medical emergency, quickly leading to kidney failure and even death within 48 to 72 hours.
Rocks: In female cats and some male cats, the presence of mineral crystals in the urine (usually calcium oxalate or struvite) can lead to stone formation but not urethral blockage.
These stones can be found in the kidneys, ureters or bladder. Stones can cause symptoms such as:
- blood in urine
- Chronic or recurrent urinary tract infection
- Loss of the “upstream” kidney
Treatment: Fortunately, ureteral stones are relatively rare. Special diets can help manage crystalluria and stones. However, calcium oxalate stones may require surgery.
The third and most common cause of bloody urine is cystitis, which leads to inflammation of the bladder and urinary tract system. You may also have heard of this condition called feline interstitial cystitis, feline idiopathic cystitis (FIC), feline urological syndrome (FUS), or feline lower urinary tract disease (FLUTD).
Signs of feline interstitial cystitis include:
- Blood-tinged urine
- Increased frequency of urination
- Force to urinate
- Meow while urinating
Treatment: This disease is diagnosed by excluding crystalluria, urinary tract stones, and urinary tract infections via urinalysis, urine culture, and abdominal radiographs (X-rays) or ultrasound.
It is managed by modifying its diet, in particular by increasing canned food to increase the cat’s hydration and thus decrease the concentration of its urine.
Pain management can be an important part of treating cystitis. Additionally, environmental enrichment (more toys, cat perches, less stress) can help reduce the frequency of painful and bloody urination episodes caused by interstitial cystitis.
Other Causes of Blood in Cat Urine
Although rare, hematuria can also be a symptom of other conditions, so it’s important to consult your veterinarian if you notice any changes in your cat’s urine. In addition to UTIs, stones, and cystitis, bloody urine can be a sign of several other conditions, including:
- Pandora Syndrome
- Bacterial infection
- Bladder cancer
- Anatomical abnormalities in young cats
- Urethral obstruction
Diagnosing Bloody Urine in Cats
To better understand your cat’s health status, your veterinarian will gather information in the following ways:
- Medical background: Questions about past health problems and any physical or behavioral changes you have noticed
- Physical exam: Careful examination of your cat’s eyes, mouth, ears, coat and stomach
- Blood test: Small blood samples will be taken and tested in the laboratory
- Urinalysis and urine culture: Testing your cat’s urine to help identify or rule out certain conditions (like UTIs)
- x-rays and ultrasound: Equipment used to take pictures inside your cat’s body can help your vet locate stones
What to do if your cat pees blood
Although the cause of hematuria is often easily treatable, bloody urine can be a sign of a medical emergency or a more serious condition. So if you see blood in your cat’s urine or notice other behavioral changes, don’t wait to get it checked out by your vet.
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