Cat Bleeding When Urinating: Causes and Treatment

Although it can be alarming to spot blood in your cat’s urine, it is not an uncommon occurrence. It can present in both sexes at any age, and there are various causes for it. Thankfully, for most cats, the bloody urine lasts no longer than a few days, and the prognosis is excellent.

You may spot the blood in the litter tray, or perhaps when your cat urinates outside of their box and on the floor or in the bath. It is also possible to spot blood on the fur around the genitals, especially in lighter-furred cats.

Your veterinarian will work alongside you to determine the cause of blood in the urine and then tailor the treatment accordingly.

Understanding Why Cats Bleed When Urinating

The blood can come from several locations along the urinary tract and there are many reasons why bleeding can occur.

What is Haematuria and How Serious is It?

When blood cells leak into the urine, it can tint the urine a pink or red colour, or may even be seen as blood clots. While it can indicate a serious issue, it is typically something that resolves wholly and quickly.

How the Cat’s Urinary System Works

The kidneys filter the blood and produce urine, which travels down the ureters into the bladder. The bladder stores the urine, which is eventually passed through the urethra into the outside world when the cat chooses to urinate.

Common Causes of Blood in Cat Urine

There are many causes of bloody urine, and here is a list of the most common.

Feline Lower Urinary Tract Disease (FLUTD)

FLUTD is not a diagnosis, but is a description of the condition that causes cats to experience symptoms such as frequent urination, painful urination, and haematuria. Some of the causes include UTIs and stones.

Urinary Tract Infections (UTIs)

While owners often assume a UTI is the cause of haematuria, it is actually usually the case that bacteria are not involved. Still, they can play a role, particularly in senior cats or those with medical conditions such as diabetes.

Bladder or Kidney Stones

Uroliths (stones) can form in the kidneys or bladder and can even be found along the tracts (ureters or urethra), where they cause a blockage. Calcium oxalate and struvite stones are the culprits in 90% of cats. They can be linked with dehydration and infections.

Idiopathic or Stress-Induced Cystitis

Cystitis is a highly common medical issue in cats, characterised by inflammation of the bladder.

It is often linked with stresses such as a stay in a cattery, owners changing the routine, or a new baby. Individuals who develop cystitis tend to experience recurring episodes throughout their lifetime.

Trauma or Injury

Trauma would be a less common cause of haematuria, but certainly, if a cat is involved in a road traffic accident or has a fall from a height, this can cause internal bleeding and haematuria. Any injury like this requires immediate attention at the local emergency vet.

Growths

Tumours and benign growths (such as polyps) can cause bleeding when they bleed into the bladder, particularly if they are very large or highly vascular.

What Symptoms Should Cat Owners Watch for?

Owners may pick up on a range of signs, some of which are not immediately obvious and can be quite subtle.

Behavioural Signs in the Litter Tray

You may notice that your cat spends more time in their litter tray, constantly passes small amounts of urine, licks their genitals, or starts to urinate outside of their litter box.

Visible Blood, Dark Urine

Keep an eye on what your cat is passing, as you may see a visible colour change or clots of blood. For some cats, however, the bleeding is microscopic and not visible to the naked eye.

When Mild Symptoms Become an Emergency

Be aware that cats have the potential to develop life-threatening urinary blockages. These cats are unable to urinate and are highly distressed.

If there is a chance your cat cannot pass urine, do not wait to have them seen and contact a 24/7 emergency vet.

How Do Veterinarians Diagnose Blood in Cat Urine?

Your veterinarian will want to examine your cat from nose to tail and will also review their medical history.

Urine and Blood Tests

The urine will be analysed to check for any crystals, protein, or sugar. This may be a sample you bring in, or one that the vet expresses on the consult tablet or collects via a needle (cystocentesis). The urine may be sent to an external lab to identify any bacteria present.

A blood test may also be advised, as this can help identify inflammation, infection, or any kidney disease. A Full Blood Count can ensure the red blood cell count is not low and that the cat has adequate white blood cells.

Ultrasound and X-Ray Imaging

For some cats, imaging will be necessary. This will check for any bladder stones or masses. An ultrasound is particularly useful for identifying any thickening of the bladder wall.

What Treatments Are There for Cats Bleeding When Urinating?

Treatment will vary from patient to patient and will depend on the cause of the haematuria.

Medication

Many cats will be given several days of anti-inflammatories and pain relief to make them comfortable and reduce the inflammation within the bladder.

For some, antibiotics will be required. Importantly, these must be continued for a sufficient period (several weeks), and a urine culture should be performed upon completion to ensure they are not stopped too soon.

Special Urinary Diets Available in the UK

Your veterinarian may recommend a specific diet to address the primary issue. This can refer to a diet designed to alter urinary pH or prevent the formation of specific stones. Or, in some cases, it may be a renal supportive diet.

Dry diets can be linked to cystitis and stone formation and can reduce hydration levels. For most cats, wet diets will be the preferred option.

Hydration Support

Dehydration plays a significant role in the development of cystitis, urinary crystals, and stone formation. Maintaining adequate hydration every day goes a long way towards preserving urinary tract health.

Surgical Options for Severe Cases

Surgery is sometimes part of the treatment plan. Some bladder stones will dissolve with diet and time, but others require physical removal.

Surgery (perineal urethrostomy) may also be advised for cats who suffer from repeated blockages.

Caring for Your Cat During Recovery

Your aim will be to ensure your cat is comfortable, but also to prevent future episodes of haematuria from occurring.

Encouraging Hydration

There is a lot you can do to maintain good hydration:

• Add water to meals
• Offer cat soup or bone broth
• Provide a rehydration solution (such as Oralade) alongside water.
• Use a cat fountain
• Catch rainwater when it falls and offer this - they prefer this to tap water and drink it more willingly.
• Keep water bowls away from litter boxes and away from food bowls

Reducing Stress in Indoor Environments

Do what you can to minimise stress, whether this means providing your cat with a space away from children or other pets, keeping a consistent schedule, or offering ample mental and physical enrichment.

Monitoring for Recurrence

A cat who has experienced haematuria will be at risk of a recurrence. Monitor for early signs such as frequent urination or darker urine. You can use urinary dipsticks to check for the presence of blood.

How Can You Prevent Urinary Problems in Cats?

Certain lifestyle changes go a long way towards preventing issues.

Nutrition

Choose a diet that is appropriate for your cat’s life stage- ideally, a wet food. If you have been advised to feed a prescription food, this should be fed exclusively to give it the best chance at working.

Preventative healthcare, like daily supplements, can also play a supportive role. For example, those that contain glucosamine help rebuild the bladder GAG (glycosaminoglycan) layer in the bladder, while those with omega-3 fatty acids may help lower inflammation.

Litter Tray Hygiene and Access to Water

Cats should always have access to at least two clean litter boxes, as they may hold their urine if they don’t. Holding urine is a recipe for disaster, as this concentrated urine can cause crystals and stones to precipitate within the bladder.

Ensure your cat’s water bowl is always filled to the top. If they go even a few hours without water, this could lead to mild dehydration, which puts pressure on the kidneys and creates more concentrated urine.

Managing Weight and Activity Levels

We know that overweight cats are more prone to urinary tract issues, as are those that are less active. It helps to monitor calories being fed and to encourage movement with things like toys, laser pointers, wind-up mice, and cat trees.

When Should You Contact a Vet in the UK?

Schedule a veterinary check if you have any concerns for your cat’s urinary health or if they are experiencing haematuria.

Signs of Urinary Blockage or Severe Pain

Arrange an urgent appointment if you have any concerns about a urinary blockage. Signs can include straining to pass urine without passing any (often confused with constipation), howling, genital licking, a bloated abdomen, lethargy, and rapid breathing.

Learn More About Cat’s Urinating Blood

Contact us if you have any questions about your cat’s bloody urine or to schedule an appointment.

Cat Bleeding When Urinating FAQs

Why is my cat peeing blood?

Blood in a cat’s urine is usually caused by bladder inflammation (cystitis), urinary infections, or urinary stones. Stress and dehydration are also common triggers. A vet examination is needed to confirm the exact cause.

Is blood in a cat’s urine an emergency?

It can be. If your cat is still urinating, book a same-day vet appointment. If they are trying to urinate but nothing comes out, go to an emergency vet immediately — this could be a life-threatening blockage.

Can stress cause my cat to bleed when urinating?

Yes. Stress is one of the most common reasons for bloody urine in cats. It can inflame the bladder and lead to pain and frequent urination.

What should I do if I notice blood in my cat’s urine?

Contact your vet as soon as possible for an examination and urine testing. If your cat cannot urinate at all or appears distressed, seek urgent veterinary care.