Why Is My Cat Peeing Blood?

If you have ever seen your cat peeing blood, you know just how alarming it can be. While it isn't something one ever wishes to witness, blood in cat urine is actually quite common. Haematuria, the scientific name for having blood in the urine, can be caused by problems in the urinary tract or even disease processes elsewhere in the body that can affect the urinary tract or kidneys.

Blood in Cat Urine: Signs to Look For

While haematuria may be as obvious as blood or blood clots in the urine, it may not always be so visible. Most instances of haematuria are actually diagnosed at the microscopic level on what appears to be normal-coloured urine; in these cases, there's only a small amount of blood. Haematuria may cause urine to turn pink or red.

According to the American Veterinary Medical Association, some of the other signs you may see along with a change in the urine's colour include:

• Increased drinking
• Increased urination
• Straining to urinate
• Vocalising when in the litter tray
• Going in and out of the litter tray repeatedly
• Urinary accidents outside of the litter tray
• Inability to urinate altogether (a medical emergency)
• Bruising on the skin in the form of obvious bruises or small dots
• Bleeding from places such as the nose, gums, eyes, ears or rectum, and bloody vomit or faeces

Causes of Blood in Urine

Problems in the urinary tract can be in the upper part - the kidneys and ureters - or the lower part - the bladder and urethra, or, of course, both. All of these can cause blood in the urine. Most of the cases we see are in the lower part and we group these diseases together to call them Feline Lower Urinary Tract Disease or FLUTD.

Some causes of blood in the urine are much more common than others. The most common is something called Feline Idiopathic Cystitis or FIC. Lots of vets now refer to this more simply as ‘stress cystitis’ because it’s usually seen in cats that aren’t entirely relaxed in their home environment. We’ll talk about that more later. Another common cause is crystals or stones in the bladder or kidneys. These are commonly related to FIC and sometimes due to other problems in the body such as kidney disease or, rarely in cats, urinary infections.

In order to treat your cat as effectively as possible your vet will need to find out the exact cause of the blood in the urine or other signs your cat may have. This usually means getting a urine sample to check the pH, how concentrated the urine is and whether there are crystals or any infection present. They might also want to take a blood sample to make sure there are no major problems such as kidney disease. They will also need to know exactly how your cat lives because cats kept indoors and cats that live with other cats are much more likely to have stress cystitis than single cats with access to the outside. They’ll also want to know what your cat normally eats, as food is an important option for treating these issues.

Treating FLUTD and blood in the urine.

As with all things, the right treatment depends on the exact cause. Underlying diseases will need to be addressed but most cases of urinary disease benefit from a change in diet and special attention to water intake. Some foods are used to dissolve certain types of crystals and stones and stop them recurring. Some types of stones will need to be removed with an operation because they can’t be dissolved. These cases will normally go onto a food formulated to stop the stones coming back again. Foods for urinary issues have slightly altered mineral levels, omega oils added to help with inflammation and some also have natural additives with a calming effect.

Water intake is very important for all cats with urinary issues. Cats evolved from desert-living relatives and tend to have naturally very concentrated urine. This makes crystals and stones more likely to form. Ensuring they drink plenty helps flush the system and make recurrence less likely. Many cats only eat dry food, and this is fine, but wet food is an easy way to increase water intake if you haven’t tried it. Whether you feed wet or dry food, it’s also important to have plenty of fresh water in multiple places round the house. This means your cat(s) never have to go far to get a drink. Some cats also love to drink running water and cat fountains can really help.

When it comes to FIC and stress your vet may ask you to try and make some changes in the house too, to help the food to work and make your cat feel more relaxed. Things to consider include;

• Making sure all your cats have access to food and water that isn’t next to each other. The general rule is to have one bowl for each cat plus an extra one. These should be in lots of different locations so even the most timid cat can eat and drink in peace.
• Offer litter trays if you don’t already. Again, ideally have one more than the number of cats you have. They should be in quiet, secluded locations and away from food and water.
• Offer access to the outside is at all possible so your cats can explore and choose where to go to the toilet.
• Make sure there are plenty of high hiding places for all your cats. Putting shelves or furniture in corridors can also give cats opportunities to avoid other cats they don’t like very much!

Ensuring your cat eats a well-balanced food that's complete and balanced for his or her life stage (not simply "all" life stages) is very important. Some foods may have high levels of minerals that may contribute to the development of crystals and stones, which may then contribute to lower urinary tract disease.

While cats with FLUTD are common, if you ever notice a cat peeing blood, never make assumptions. Always seek veterinary care first to rule out treatable diseases, and remember that the inability to urinate is a life-threatening medical emergency.