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Blood in Cat Urine: What Does it Mean?

Reviewed by Dr. Celeste Clements, DVM, DACVIM on Wednesday, November 4, 2015
Posted November 10, 2015 in Cat Diseases & Conditions A-Z

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Bloody and discolored urine is a common reason cat guardians seek veterinary help. It’s incredibly upsetting to see drops of blood in a litter box, on bedding, or on the floor. Sometimes you can’t see the blood until the urine is examined with a microscope or detected on urinalysis. Fortunately, many cats experiencing blood in their urine have signs that resolve quickly with relatively simple treatments. The two major causes of blood in a cat’s urine are cystitis and feline lower urinary tract disorder or FLUTD.

What is hematuria?
Blood in the urine is called hematuria. Hematuria can be identified by the presence of pink, red, brown or black urine or by the microscopic presence of blood cells. A urinalysis is used to help determine if the blood is from urinary tract disease or the result of a condition affecting coagulation or bleeding. Blood tests are usually needed to verify or exclude a bleeding or clotting disorder. The most common, general diagnosis for hematuria in cats is cystitis.

What is cystitis?
Cystitis is a general term referring to inflammation in the urinary bladder. The term cystitis does not imply a specific cause. In cats, diseases of the lower urinary tract, the bladder and urethra, are often categorized by the term feline lower urinary tract disease or FLUTD. We use these broad medical terms because it can be challenging to distinguish between the various diseases of the bladder and urethra, and many conditions affect the entire lower urinary tract. If your veterinarian eliminates all of the specific diagnoses for hematuria, the condition is called Feline Idiopathic Lower Urinary Tract Disease (iFLUTD). Some vets may use Feline Idiopathic Cystitis (FIC) to describe this condition. Idiopathic is a term that means the exact cause is unknown.

What are the symptoms of cystitis?
The typical symptoms of cystitis or FLUTD in cats are associated with inflammation and irritation of the lower urinary tract. The common clinical signs are:

  • Increased frequency of urination called pollakiuria
  • Difficulty urinating or dysuria. (Affected cats often spend a long time straining in the litter box while passing only small volumes of urine. Many cat owners confuse this with constipation.)
  • The presence of bloody, foul-smelling, or discolored urine.
  • Urinating in unusual places such as on furniture, floors, and corners, called periuria.
  • Excessive grooming or licking of the genital region.
  • Inability to urinate. These cats strain to urinate producing a few drops or no urine. If you suspect your cat is obstructed and not able to adequately pass urine, this is an immediate medical emergency. Urethral blockage, which is more common in male cats because of their narrow urethra (“the plumbing”), can be a life-threatening complication if untreated even for a few hours.

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Ernie has more than 20 years of experience in the veterinary industry and is a well-known veterinarian, media personality and author. He is also a founding member of IDEXX’s Pet Health Network team.