What to Do if There Is Blood in Your Cat's Urine

cat litter box

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You are doing your normal scooping of the litterbox and you notice drops of blood outside or in the box, what does this mean?  Blood in your cat's urine is always a concern and can be due to a variety of issues from stress to lower urinary tract disease. 

What Is Hematuria (Blood in the Urine)? 

Hematuria is the medical term used to describe blood in the urine. When this happens, you may notice orange or red tinged urine or blood clots. In some cases, urine may appear normal and the bleeding can be on a microscopic level. In these cases, blood will be detected by diagnostics and laboratory analysis. 

Signs of Hematuria in Cats

When cats are urinating blood, the owner often discovers it because of the other symptom’s that tend to happen at the same time, these include

  • Urinating outside of the litterbox 
  • Urinating small amounts of urine 
  • Increased or decreased urination
  • Frequent trips to the litterbox 
  • Vocalizing or straining when urinating 
  • Change in color or odor of urine
  • Restlessness
  • Excessive grooming and licking of genital area

Causes of Blood in Cat Urine 

Blood in the urine is a symptom of an underlying issue and not a diagnosis. This symptom can be seen with a variety of heath conditions and if noticed, your cat should see a veterinarian.

Pandora Syndrome

 Bacterial UTI’s occur much less frequently in cats than in dogs, with only one to two percent of cats suffering from UTI’s in their lifetime. More commonly what cats have is Pandora Syndrome which does not in most cases have a bacterial component and treatment consists more of just an antibiotic.  

Disease of the lower urinary tract is one of the most common problem in cats. It involves inflammation and discomfort in the bladder and the urethra which is the tube leading from the bladder out of the body. This has gone by various names, FLUTD (Feline Lower Urinary Tract Disease) or FIC (Feline Idiopathic Cystitis, Idiopathic means the cause is unknown) and most recently, Pandora Syndrome. 

 Pandora syndrome, like the name implies, has no single cause. The underlying causes are likely due to multiple factors: among these include bladder and hormone abnormalities, obesity, environmental stressors, history of early adverse experience or severe stressful events, living with other cats, infections, urinary stones, and/or rock-hard collections of minerals formed in the urinary tract of cats which obstructs the normal flow. 

Cats with Pandora syndrome most often show signs of bladder inflammation, difficulty and pain when urinating, increased frequency of urination, urinating outside of the box and blood in the urine. Often cats who have Pandora Syndrome will have chronic urinary issues that wax and wane. 

Urethral Obstruction

A cause of blood in your cat’s urine that is an emergency is a urethral obstruction. This condition, is most common in male cats, but can be seen in female cats as well. This is because the urethra of a male cat is much longer and much narrower than that of a female cat, and so is more susceptible to becoming blocked.

A urethral obstruction occurs when there is an obstruction in the urethra, the tube that carries urine from the bladder to the outside of the body. The obstruction can be due to several causes, including, obstructions such as urethral plugs, urinary stones, strictures, or tumors and can occur secondary to urethral spasm or swelling secondary to inflammation in the lower urinary tract. When this happens, it is difficult or impossible for a cat to empty the bladder, making it a life-threatening emergency. If you cat is having trouble urinating, they should be seen by a veterinarian immediately. Left untreated, the urethral obstruction can lead to kidney failure and death within 24 to 48 hours. 

Other Causes 

Diseases such as diabetes and hyperthyroidism can cause lower urinary tract disease in cats Although, they are less common causes, hematuria can also be caused by constipation, tumors of the urinary tract, congenital abnormalities (birth defects), or injury to the urinary tract or spinal cord.

Diagnosis

If you notice blood in your cat’s urine, its best to contact your veterinarian immediately. At your veterinary visit, your vet will perform an exam and diagnostics to rule out the known causes of blood in urine and form a diagnosis. 

These include:

  •  History: Your veterinarian with the help of the veterinary technician will obtain a history on your cat. This will include your cats’ behavior, including any changes to the environment, cat’s routine and schedule, and any other symptoms you have observed at home. 
  • Physical Exam: Your veterinarian will perform a physical exam of your pet
  • Bloodwork and Urinalysis: By obtaining and running bloodwork and a urinalysis, your vet will be able to see how your cat’s internal organs are functioning as well as check for dehydration, bladder inflammation, and infection. 
  • Urine Culture and Susceptibility: A urinalysis sample should ideally be obtained via a cystocentesis which is a procedure where a needle is placed into the urinary bladder through the abdominal wall and a sample of urine is removed. A urine culture test is a method of identifying the specific bacteria that may be causing a urinary tract infection. It involves placing a urine sample on a special medium, incubating the sample so the bacteria can grow, and then identifying the bacteria. A second test (a sensitivity test) is usually conducted to determine the most effective antibiotics to use against the bacteria involved.
  • X-Rays and Ultrasound: These are done to assess if the bladder appears abnormal or contains bladder stones  

Treatment

Treatment for hematuria is based on the underlying cause and is tailored to the individual cat. Most treatments include pain medications, diet changes, increasing water intake,  anti-spasmodic medication to help the bladder relax, fluid therapy, and reducing stress. 

If your cat has a urethral obstruction, your vet will need to relieve the obstruction quickly. To do this, they will most likely need to sedate or anesthetize your cat and will place a urinary catheter along with managing your cats’ pain and other symptoms. 

Infections will be treated with antibiotics and bladder stones will need to be removed surgically or a prescription diet will be prescribed to break up the stones. 

How to Prevent Hematuria

You cant always prevent blood in your cats urine but there are factors that are known to increase the chances of your cat having blood in their urine which include obesity, decreased water intake, and one of the most common causes, stress. Read below to find out you can help prevent hematuria.

  • Monitor your cat's behavior and elimination patterns and be sure to alert your veterinarian to any changes or concerns.
  • Keep your cats active with play and food puzzle toys to help prevent obesity.
  • Increase water intake: Increasing water intake help prevent urinary issues in cats. You can encourage your cat to drink by providing various resources for water including water fountains, wide and shallow bowls, and having them on each floor in your home. Feeding wet food, a canned urinary prescription diet, and adding water to their food helps to provide your cats with more hydration. 
  • Enriched Enviorment: It is important to provide multiple and separated key environmental resources which include litter boxes, water, food, hiding spaces, places to perch, resting/sleeping areas, play areas, scratching areas and toys. This helps to decrease social tension and competition, decreases territorial motivations, decreases stress and fear, and provides choices which all help to prevent stress and create a safe environment.
  • Stress Reduction: There are a variety of ways to help decrease stress for your cat. Phermones, Feliway and Feliway Multicat, and classical music such as Through a Cats Ear can help create a relaxed cat friendly environment along with an enrichment environment. Do your best to provide your cat with a routine and consistent schedule and be aware of the stress caused by changes such as construction in the home, vacation, etc. 
  • Appropriate Litter Box setup: In many cases, a cat's litter box is not set up properly, which can lead to stress and urinary issues. When it comes to litter boxes, there should be one litter box per cat in the home, plus one extra. If there is more than one floor in the home, there should be at least one litter box per floor. The larger the box, the better, boxes should be 1.5 times the length of your cat, and boxes should be located in open, well-ventilated areas and should be kept clean.

Overall, blood in your cat’s urine can be caused a variety of issues that affect the bladder and urethra in cats. If you ever feel as though your cat is experiencing a urinary tract problem, especially if they are straining to urinate and seem uncomfortable, please seek veterinary attention.