Reviewed by Dr. Fiona Lee

A frequent reason cats are brought to the vet is blood-tinged urine. Often, bloody cat urine is accompanied by urinating outside the litter box. This behavior usually makes the problem easier for pet parents to identify, due to the off color staining, but it’s not the only sign of a possible urinary issue.

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What color is cat pee?

A cat’s urine can range from different shades of yellow to brown, orange or even red. In healthy animals, a normal cat pee color is yellow. And while cat urine can be pale in color or appear more amber, it should look clear, not cloudy. If you notice cat urine that is cloudy or tinted orange or red, it could be hematuria (blood in the urine), and you’ll want to visit a veterinarian.1

Here’s a quick guide to what the different colors of your cat’s pee might indicate:

Any color other than light yellow should lead to a veterinarian visit, especially if the pee is orange, brown or red.

What is hematuria (blood in the urine)?

Hematuria is the medical term used for blood in urine. Sometimes, hematuria is easy to see. For example, your cat’s urine may appear darker or reddish. However, sometimes there’s such a small amount of blood in the urine that your vet will need to examine a sample under a microscope to be sure.

Signs of hematuria in cats

Pet owners often discover blood in cat urine when they notice other unusual bathroom habits in their feline friend, such as:

• Peeing outside their litter box
• Peeing more or less often than usual
• Changes in the amount of urine
• Meowing while peeing
• Changes to the smell and color of the urine
• Increased licking or cleaning around the genitals

What causes bloody urine in cats?

There are three common reasons for bloody urine: urinary tract infections, interstitial cystitis (inflammation of the bladder walls) or urinary stones. A urine sample may be needed to determine the specific cause.

1. Urinary tract infections

A urinary tract infection is an infection in a cat’s (or human’s) bladder, kidney, urethra or ureter (the connecting tubes between the kidneys and the bladder). The infection can be limited to the bladder or may involve one or both kidneys in more severe cases.

In cats of any age, blood in the urine may be a sign of a UTI. Older cats may be even more susceptible to UTIs if they have an underlying kidney disease that causes diluted urine.

In advanced cases of kidney infection, the pet parent may notice their pet failing to drink adequate water. This is because kidney infections are usually accompanied by clinical signs beyond urinary changes. For example, cats may have a fever, stop eating, be lethargic or have GI symptoms such as vomiting or diarrhea.

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If a cat has a UTI, you may notice symptoms like:

• Visible blood in the urine
• Weight loss
• Poor appetite
• Increased thirst
• Increased frequency of urination
• Straining to urinate

Treatment: Fortunately, bacterial urinary tract infections can usually be cleared with appropriate antibiotic therapy. In cases of kidney infection, antibiotics will need to be administered for at least four to six weeks.

2. Stones in the urinary tract

Urinary tract stones can lead to blood in your cat’s urine and cause concerning health issues that need to be treated right away.

However, it’s important to distinguish between stones and crystals in the urine. Sometimes, the presence of crystals in the urine (crystalluria) might be linked to stones, but not always. Often, crystals are in a cat’s urine simply as an artifact, especially if the tested urine was concentrated, or allowed to sit. The presence of crystals doesn’t automatically mean there’s a problem that needs treating. Your veterinarian will advise you on what to do.

In female cats and some male cats, mineral crystals in the urine (typically, either calcium oxalate or struvite) can sometimes lead to the formation of stones and even urethral blockage. In male cats, because they can’t urinate through a blocked urethra, this creates a medical emergency that can rapidly lead to kidney failure and even death within 48 to 72 hours.

Stones may be in the kidneys, ureters or bladder. They can cause symptoms like:

• Blood in urine
• Chronic or recurrent urinary tract infections
• Difficulty urinating or frequent, small amounts of urination
• Peeing outside the litter box
• Lethargy
• Abdominal pain or genital licking

Treatment: Special diets can help manage crystalluria and stones. However, many urinary tract stones require surgery.

3. Cystitis (FIC/FUS/FLUTD)

The third and most common reason for bloody urine is cystitis, which results in the inflammation of the bladder and urinary tract system. You may have also heard this condition called feline interstitial cystitis, feline idiopathic cystitis (FIC), feline urologic syndrome (FUS) or feline lower urinary tract disease (FLUTD).

Signs of feline interstitial cystitis include:

• Blood-tinged urine
• Increased frequency of urination
• Straining to urinate
• Meowing or pain while urinating

Treatment: This disease is diagnosed by excluding urinary tract stones and urinary tract infections via analysis of urine, urine culture and abdominal radiographs (X-rays) or ultrasound.

It is managed by diet modification, specifically by increasing canned food to increase the cat’s hydration and thereby decrease the concentration of the urine.

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Cystitis can also be managed by reducing a cat’s stress and anxiety, especially if you have a multi-cat household. Cystitis often occurs after something stressful happens, like a move or adding a new pet to the family.

Pain management can also be an important part of treating cystitis. Additionally, environmental enrichment (more toys, cat perches, less stress) may help reduce the frequency of episodes of painful and bloody urination caused by interstitial cystitis.

Other causes of blood in cat urine

While rare, hematuria could also point to other conditions, so it’s important to see your veterinarian if you notice changes in your cat’s urine. In addition to UTIs, stones and cystitis, bloody urine can point to several other conditions, including:

• Pandora syndrome (overly anxious cats who get sick because of an increased amount of stress hormones)
• Cancer of the bladder
• Anatomical abnormalities in young cats
• Diabetes (which can increase the risk of UTIs)
• Hyperthyroidism (many hyperthyroid cats also have renal disease)
• Injuries

Diagnosing bloody urine in cats

To better understand your cat’s health, your veterinarian will collect information through the following:

• Medical history: Questions about past health concerns and any physical or behavioral changes you’ve noticed
• Physical exam: Careful examination of your cat’s eyes, mouth, ears, fur and stomach
• Blood work: Small samples of blood are taken and tested in a lab
• Urinalysis and urine culture: Testing your cat’s urine to help identify or rule out certain conditions (like UTIs)
• X-rays and ultrasound: Equipment used to take pictures of the inside of your cat’s body can help your vet locate stones

What to do if your cat is peeing blood

While the cause of hematuria is often easily treatable, bloody urine can be a sign of a medical emergency or a more serious condition. So if you see blood in your cat’s urine or notice other behavioral changes, don’t wait to get them checked out by your veterinarian.

Pets Best can help you prepare for unexpected cat illnesses

Getting pet insurance is a great way to prepare for unexpected illnesses, like finding blood in your cat’s urine. At Pets Best, our cat insurance plans can be customized for your pet’s unique needs. In addition, Pets Best policyholders can speak to a veterinary expert anytime through a 24/7 Pet Helpline.

Sources/Citations

1. “How to Tell If Your Cat’s Urine Is Normal,” (4/2020), Catonsville Cat Clinic, https://www.catonsvillecatclinic.com/holmes-corner/how-to-tell-if-your-cats-urine-is-normal/, accessed September 20, 2023.

2. “Everything By No Means Needed to Learn About Cat Urine,” Phil Good (2/2023), Beyond Pets Animal Hospital, https://drgoodvet.com/pet_health/everything-about-cat-urine/, accessed September 20, 2023.

3. “Blood in Cat Urine,” Katie Grzyb (5/2023), PetMD, https://www.petmd.com/cat/symptom/blood-in-cat-urine, accessed September 20, 2023.

4. “A Complete Cat Urine Color Chart: What Pee Color Means for Your Cat’s Health,” Chantelle Pattemore (9/2023), Rover, https://www.rover.com/blog/cat-urine-color-chart/, accessed September 20, 2023.

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Category: WHY