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Cats love to have urinary problems. Well perhaps not love it, but it is very, very common.


Owners will often notice blood in the litter tray when their cat has a urinary issue. Other changes may include

  • Urinating frequently
  • Urinating in the wrong place such as – the bath mat, on plastic bags, in their owners bed
  • Crying when urinating
  • Licking at their genitals

Possible causes of blood in the urine

This is where it gets complicated. Cats do not always have a bacterial infection when they have blood in the urine…..but sometimes they do.

The different causes could be

  • FLUTD (Feline Lower Urinary Tract Disease) – a collective group of conditions which cause bladder inflammation. This can be started from
  • Bacterial urinary tract infection
    • Bacteria are more commonly seen in older cats with blood in the urine
    • Infections can be recurrent and difficult to treat
    • There may be underlying causes of infections such as bladder stones, polyps, tumours or problems with voiding urine

Investigation of blood in the urine

It is best to examine a urine sample prior to initiating treatment so we can begin to identify the cause. The best samples are obtained at the vet via cystocentesis where a needle is placed directly into the bladder. (This can be a surprisingly low stress procedure.)

At Pittwater Animal Hospital we have an advance urinalysis machine that can detect

  • bacteria (cocci or rods)
  • crystals
  • red blood cells
  • white blood cells
  • urinary casts that indicate kidney damage.
  • urine concentration
  • the presence of glucose in the urine

More advanced diagnostics may involve

  • urine culture for bacteria
  • Xrays of the bladder
  • Ultrasound of the bladder

How do we treat blood in the urine

There are numerous treatment approaches for blood in the urine of cats. When problems have numerous treatment options this usually indicates that the condition is complex and often frustrating to manage. 

Options include

  • Increased water intake – this dilutes the urine making cats void more often, and may help decrease crystal build up and inflammation. Adding water to wet food is very helpful. Start with a small amount each day, but over time cats can get used to 250ml water being added to their wet food.
  • Urinary health supplements – Supplements increase the healthy coating of the bladder to protect against pain and inflammation. They also contain natural antianxiety compounds.
  • Prescription diets – both Royal Canin® and Hills® make prescription diets aimed at improving urinary disease.
  • Increased activity – Blood in the urine appears to be more common in winter months and we suspect cats are not drinking as much and may be retaining urine. Pick them up from the comfy spot they love to lie in and put them somewhere else to go for a bit of a wander.
  • Decrease stressyes tricky. Urinary issues are more common in multi-cat households. Cats are often interacting poorly with each other or are frightened of neighbouring cats. When cats are stressed and worried, they need lots of high cubby holes to hide in. (Try Googling: enrichment for cats.)
  • Litter tray hygiene – Make sure that litter trays are clean an appealing and your cat has easy access. If you have multiple cats, make sure there are multiple litter areas so if there are any tensions between the cats, that they all have unrestrained access to clean litter. Sometimes cats prefer one type of litter more than others.
  • Clean any areas where your cat has urinated in the wrong place – Use detergent and water not strong smelling products.
  • Pain relief – inflamed bladders are very painful. Your veterinarian can prescribe pain relief in a consultation.
  • Antibiotics – if bacteria have been detected.
  • Anti-inflammatories to decrease the thickened bladder lining.
  • Antispasmodics –to decrease staining caused by spasm of the urethra.
  • Antianxiety medication to avoid further episodes.

What about male cats with blood in the urine?

Male cats have added risks with lower urinary tract disease. The male cat penis is a very narrow canal at the end of the urinary tract. The penis can easily get blocked with crystals or inflammatory debris or the canal walls can swell and block the urethra.

Male cats with blocked bladders that are not treated quickly can end up with a life threatening problem.

If you are unsure if your cat can pass urine it is best to seek immediate veterinary care. 

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