Kitten sitting in a litter box

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Your cat's daily habits can tell you a lot about their health. Indoor cats use litter boxes, allowing you to look at their urine and feces to determine whether they need to see the vet. Noticing your cat has blood in their urine can be alarming. Blood in the urine is called hematuria, commonly indicating serious underlying illnesses in cats.

If your cat has blood in their urine, they should be examined by a vet immediately, especially if they're straining, experiencing pain, or having any other litter box issues. Blood in cat urine is not a diagnosis; it's a symptom of an underlying illness that can often be one of the first signs you notice.

Cat Urinating Blood: Signs To Look Out For

Cat urinating blood signs to look out for

If your cat is urinating blood, they may have other symptoms of underlying disease. In addition, they may only urinate a small amount of blood. In many cases, hematuria is diagnosed at the microscopic level, so it may not even be noticeable when you're cleaning their litter box. Of course, if your cat is urinating blood, you should look for other signs your cat is sick, including:

  • Increased drinking
  • Increased urination
  • Straining to urinate
  • Inability to urinate
  • Vocalizing while using the litter box
  • Accidents outside of the litter box
  • Going in and out of the litter box repeatedly
  • Bruising on the skin
  • Bleeding from mucous membranes
  • Blood in vomit or feces

Depending on the cause of your cat's illness, they may also experience abdominal pain.

Why Is My Cat Peeing Blood?

Common reasons why cats have blood in their urine

If you're wondering, "why is there blood in my cat's pee?", there are actually many possible causes. Since blood in your cat's urine is not normal, they should see a vet as soon as possible for diagnosis and treatment. Common causes of blood in cat urine include:

Feline Idiopathic Cystitis (FIC)

FIC is an inflammation of the urinary bladder, and unfortunately, the cause is unknown. Factors such as anxiety, hormones, infections, nutrition, and genetic traits may play a role in cats more prone to the disorder. Cats with FIC typically display symptoms such as:

  • Frequent urination
  • Blood in urine
  • Straining and vocalization while urinating
  • Accidents outside of the litter box

In addition, male cats can develop an obstruction in their urethra, which is considered an immediate medical emergency because it can affect the body's ability to eliminate toxins.2

Urinary Tract Infections (UTIs)

UTIs are fairly common in cats and result from normal skin and GI tract flora entering the urinary tract.3 Cats with UTIs are often asymptomatic, but any cat of any age can experience them. Older cats are more prone to UTIs because they're more susceptible to infection due to diminished immune system function.3 Common symptoms of UTIs in cats include:

  • Frequent trips to the litter box
  • Restlessness
  • Blood in urine
  • Straining to pee
  • Accidents4

Cats with UTIs may avoid the litter box because it hurts to urinate. UTIs occur due to bacterial infections that can come from the GI tract or through the urethra. Luckily UTIs are treatable with antibiotics. However, if left untreated, it can be fatal for male cats.4

Bladder Stones

Bladder stones occur when minerals combine and form tiny crystals in the cat's urinary tract. When these crystals clump together, they form urinary stones, also known as uroliths or calculi.5 These stones can develop in the kidney, bladder, urethra, or ureter, causing blockages, and the cause is not clear.5

These stones can block the urethra, making it impossible for the cat to urinate, causing severe pain and blood in the urine. Symptoms of urinary stones in cats include:

  • Straining to urinate
  • Frequent urination
  • Licking the genitals
  • Blood in urine
  • Obstruction
  • Accidents6

Cats can develop urinary stones at any age, but it's more common in older cats. Treatment of stones in cats is crucial and may involve a special diet to dissolve the stones, hydration, and flushing the bladder.6

Cancer

Cancer is another possible cause of blood in cat urine. Urinary tract tumors can develop anywhere in the urinary system, including the kidneys, uterus, bladder, and urethra, although bladder tumors are the most common. Unfortunately, there is no single cause of cancer in cats, but urinary tract tumors are more common in adult to senior-aged cats.

Rhabdomyosarcoma is a rare malignant type of tumor that can spread from the urinary tract to other parts of the cat's body. Symptoms of this type of cancer in cats may be similar to UTIs, including:

  • Blood in the urine
  • Straining to urinate
  • Frequent urination
  • Urinating in small quantities
  • Inability to urinate/straining to urinate7

Surgical removal of the tumor is the recommended treatment when possible since they can be highly invasive. However, tumors on the bladder cannot be surgically removed safely. Instead, vets may consider chemotherapy or radiation therapy. In addition, vets may prescribe cats antibiotics to treat inflammation or secondary bacterial infections.7

What Should I Do If There Is Blood In My Cat's Urine?

If there's blood in your cat's urine or they're experiencing any other signs of illness, you should contact your vet immediately.

Your vet will have your cat come into the office for a physical evaluation and several types of testing. You should be prepared to answer questions about your cat's symptoms, including what they are and when they started.

Diagnosing Hematuria

Your vet must diagnose the cause of blood in your cat's urine. Unfortunately, hematuria may be undetectable in regular urine samples, and identifying the cause of the disorder can be difficult since there are many possible causes.8

First, your vet will confirm there's blood in the cat's urine. Your vet will aim to distinguish red blood cells (RCBs) from other substances in the urine to diagnose hematuria.8 In most cases, they'll use dipstick colorimetric testing, which can show urine positive for blood. They will then rule out hemoglobinuria, which occurs when the level of hemoglobin in the blood rises too high and appears in the urine, and myoglobinuria, when there's an excess of myoglobin in the urine.8 Once a few potential causes of hematuria have been ruled out, the vet will evaluate the findings from the physical examination and medical history to identify the problem.

Vets may perform several types of diagnostic tests, including urinalysis, a complete blood profile, a chemical profile, and a blood count.

They will also consider your cat's diet, including supplements and treats that may be different from their regular kibble or wet food. Depending on what they believe to be the cause of blood in your cat's urine, they may also use ultrasound to look for a mass.1

Treating Hematuria

Treatment for blood in cat urine will depend on the underlying cause. For example, if your vet diagnoses your cat with a UTI, they'll put them on antibiotics to eliminate the bacteria causing the symptoms. Some common urinary health treatment options include:

  • Surgery
  • Medication
  • Diet

Here are the different treatment options available, depending on your cat's diagnosis:

  • FIC: FIC is typically treated with different medications to relieve pain and reduce anxiety. Your cat will also be given nutritional supplements and canned food to dilute the urine. Cats with FIC may experience flare-ups, so it's important to keep their stress levels low, clean their litter boxes, and provide enough mental stimulation. 9
  • UTIs: UTIs are treated with antibiotics.
  • Urinary Stones: Bladder stones are typically dissolved through a prescription diet or medications that will make the urine more acidic. However, some types of bladder stones require surgery.
  • Cancer: Cancer is treated in a few ways, depending on where the tumor is. Since some tumors are not always accessible via surgery, your vet might choose to use chemotherapy or radiation to shrink the tumor.10

Minimizing Urinary Issues In Cats

How to minimize the chance of urinary issues in catsUnfortunately, preventing urinary issues in cats isn't always possible, especially with illnesses that have unknown causes, such as FIC. However, keeping your cat healthy may help prevent several health conditions that can lead to blood in cat urine. Here are a few suggestions to reduce the likelihood of urinary issues:

  • Find the best diet for your cat: Talk through your cat’s health condition, habits, and preferences with your vet and work together to find the best diet that suits them.
  • Feed small meals frequently: Cats should have several small meals a day instead of giving them free access to food, which can cause several diseases in cats, ranging from urinary issues to diabetes. Consult your vet to learn about which commercial diets are acceptable and can improve your cat's urinary health.
  • Provide clean, fresh water: Flushing the urinary system can help remove harmful bacteria that lead to urinary tract infections, so giving your cat access to clean, fresh water at all times can help them take care of their urinary health.
  • Provide an adequate number of litter boxes in quiet areas: Every cat in your home should have their own litter box to prevent some cats from urinating outside the litter box. It's preferred to have at least one additional litter box in the home so everyone has their own space.
  • Keep litter boxes clean: Cats prefer their potty spaces to be clean and safe. Your cat's litter box should be cleaned daily, with litter changed weekly.
  • Minimize major changes in routine: Changes in your cat's routine can cause stress that contributes to several health issues. If you need to make a change to their schedule, do it gradually.
  • Reduce stress: Some cats are naturally more stressed than others, but you can reduce stress in your household by giving them a sanctuary space and consulting your vet if your cat experiences anxiety or panic attacks.11

Cat Has Blood In Urine: FAQs

What are the signs of a UTI in cats?

Signs of UTIs in cats include:

  • Blood in urine
  • Pain while urinating
  • Straining to urinate
  • Urinating in small amounts
  • Excessive licking of the genitals
  • Urinating outside of the litter box

Can a cat UTI go away by itself?

If your cat has the signs of a UTI, take them to the vet as soon as possible. Many signs of UTis in cats are symptoms of other illnesses, so you should have them diagnosed as soon as possible. Healthy cats with access to clean drinking water may be able to fight a mild UTI on their own if there are no symptoms. However, if your cat is experiencing pain or blood in their urine, it's unlikely for the UTI to go away on its own; your cat will need antibiotics from the vet.

How serious is blood in a cat's urine?

Blood in a cat's urine is never normal or healthy and is always a sign of illness. If your cat is experiencing blood in their urine, take them to the vet as soon as possible. Since cats often experience pain alongside other symptoms, you should get them treated quickly to prevent discomfort. In addition, early treatment improves your cat's chances of recovering from illness.

Cat straining in a litter box

Final Notes

Blood in cat urine is never a good sign and almost always indicates a serious health condition. Health problems that may cause blood in cat urine range from UTIs to cancer, and the treatment depends on the underlying cause. Remember, blood in urine is not a disease; rather, it's a symptom of a serious illness that may require immediate medical attention.

If your cat has blood in their urine, don't wait to consult a vet. When you notice blood in your cat's urine, you need access to a vet as soon as possible. Dutch can help. Dutch vets are available to pet parents after hours to help your cat get the care they need from the comfort of their own home.

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References

  1. “Blood in the Urine in Cats.” PetMD, https://www.petmd.com/cat/conditions/urinary/c_ct_hematuria.

  2. Brown, Scott A. “Noninfectious Diseases of the Urinary System of Cats - Cat Owners.” Merck Veterinary Manual, 18 Oct. 2022, https://www.merckvetmanual.com/cat-owners/kidney-and-urinary-tract-disorders-of-cats/noninfectious-diseases-of-the-urinary-system-of-cats.

  3. Dowling, Patricia M. “Bacterial Urinary Tract Infections - Pharmacology.” Merck Veterinary Manual, 18 Oct. 2022, https://www.merckvetmanual.com/pharmacology/systemic-pharmacotherapeutics-of-the-urinary-system/bacterial-urinary-tract-infections.

  4. “Utis in Cats (Urinary Tract Infections in Cats).” PetMD, https://www.petmd.com/cat/conditions/urinary/utis-cats-urinary-tract-infections-cats.

  5. Brown, Scott A. “Urinary Stones (Uroliths, Calculi) in Cats - Cat Owners.” Merck Veterinary Manual, 18 Oct. 2022, https://www.merckvetmanual.com/cat-owners/kidney-and-urinary-tract-disorders-of-cats/urinary-stones-uroliths,-calculi-in-cats.

  6. “Bladder Stones in Cats: Symptoms, Causes, and Treatments.” WebMD, https://pets.webmd.com/cats/bladder-stones-cats.

  7. “Urinary Bladder Cancer (Rhabdomyosarcoma) in Cats.” PetMD, https://www.petmd.com/cat/conditions/urinary/c_ct_rhabdomyosarcoma_urinary_bladder.

  8. “The Diagnostic Approach to Hematuria.” DVM 360, https://www.dvm360.com/view/diagnostic-approach-hematuria.

  9. Westropp, Jodi L., and CA Tony Buffington. "Feline idiopathic cystitis: current understanding of pathophysiology and management." Veterinary Clinics: Small Animal Practice 34.4 (2004): 1043-1055.
  10. Evgeniya, Tiplyashina. “How to Treat Hematuria in Cats.” PetMD, https://www.petmd.com/cat/conditions/urinary/how-treat-hematuria-cats.

  11. “Feline Lower Urinary Tract Disease.” American Veterinary Medical Association, https://www.avma.org/resources/pet-owners/petcare/feline-lower-urinary-tract-disease.

Frequently Asked Questions

Who is Dutch?

Dutch is an online veterinary pet telehealth service, created by pet parents and board-certified veterinary specialists. We use a science-backed approach to provide pets relief for their everyday physical and behavioral health issues. Dutch connects you with licensed veterinarians over video chat and messaging to help you get care for your dog or cat quickly wherever you are — without the stress or expense of a vet visit. We also partner with pharmacies who can deliver prescription medication (in applicable states only) and over-the-counter treatments directly to your door. Dutch isn’t a veterinary practice or pharmacy, but a company that helps facilitate these services for pet parents to make veterinary care more accessible to all.

What is a visit with Dutch like?

When booking a video call with a vet, you'll be asked a few questions about your pet’s health issue. Depending on the issue, you may also be asked to fill out a longer questionnaire about their symptoms and share photographs of them so our veterinarians can better understand what’s going on. You’ll then pick an appointment time that works best for you.

During your video call, one of our licensed veterinarians will talk to you about the symptoms your pet is experiencing, ask you questions, review your pet’s medical history if you’ve provided it, and answer any questions you have. The vet will ask to see your pet and their environment. And they may ask you to perform some simple checks on them if needed.

After your video call, the vet will send you a message with a custom treatment plan to help your pet feel better, including a link to buy any recommended prescription or over-the-counter medications. Place your order and we’ll ship it free.

How much will it cost for Dutch to treat my pet?

The Dutch membership starts at $15/mo for unlimited access to the vet. No more long waits for appointments or surprise bills.

In addition to the base membership plan, our veterinarians may also recommend additional medication (Rx and/or OTC) that you will have the option of adding to your plan at an additional cost.