Red blood cells in urine: normal for age, reasons for increased values

Bloody and discolored urine is a common reason why cat owners seek veterinary care.

It is incredibly unpleasant to see drops of blood in the cat's litter box, on the bedding or on the floor. Sometimes you cannot see blood until the urine is examined with a microscope or detected in a urinalysis. Fortunately, many cats that exhibit blood in their urine have signs that resolve quickly with relatively simple treatments. The two main 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 determined by the presence of pink, red, brown or black urine or the presence of blood cells when the urine is analyzed under a microscope. A urine test is used to help determine whether the blood is due to a urinary tract disorder or the result of a body condition that affects clotting or bleeding. Blood tests are usually needed to rule out possible bleeding or bleeding disorders. The most common diagnosis for hematuria in cats is cystitis.

Prognosis of feline hematuria

The veterinarian may need some information from you right before examining your cat to determine the cause of the disease. He will start by asking a few questions about the cat's behavior and health. Also, be sure to provide as much information as possible about the cat's pre-existing health conditions, injuries, and birth history that may have occurred. In addition, the doctor may also ask when symptoms first began and whether they have gotten worse recently.

Immediately after the veterinarian takes the medical history, he will examine the cat. You can also take a blood sample from your cat. A complete blood count, urinalysis, and biochemical profile may also be performed at this point. Additionally, the vet may also use a test strip to determine if the red spot in his urine is actually blood.

Some diagnostic tests, such as home x-rays, can also be used to diagnose the cause of hematuria in cats. An ultrasound may also be performed to provide further information, depending on what the doctor thinks the problem may be. Additionally, a contrast dye CT scan can also show a comprehensive picture of a cat's urinary tract. If your veterinarian palpates a mass in your cat's abdominal area, he or she may want to perform a biopsy. During this process, he could take a small sample of tumor tissue. This will be sent to a third party laboratory. This process is used to determine whether a tumor is malignant or benign.

What is cystitis?

Cystitis is a general term referring to inflammation in the bladder. The term cystitis does not imply a specific cause for this disease. In cats, diseases of the lower urinary tract, bladder and urethra are often classified under the term feline lower urinary tract disease or FLUTD. We use these commonly recognized medical terms because it can be difficult to distinguish between different bladder and urethral conditions, and many conditions affect the entire lower urinary tract. If your veterinarian eliminates all specific associated diagnoses for hematuria, the condition is called feline idiopathic lower urinary tract disease (iFLUTD). Some veterinarians 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?

Typical symptoms of cystitis or FLUTD in cats involve inflammation and irritation of the lower urinary tract. General clinical signs:

• Increased frequency of urination, which is called pollakiuria.
• Difficulty urinating or dysuria. (Sick cats often spend a lot of time straining in the litter box, passing only small volumes of urine. Many cat owners confuse this with constipation.)
• Having bloody, strong-smelling, or discolored urine.
• Urinating in unusual places such as furniture, floors, and corners is called periuria.
• Excessive grooming or licking of the genital area.
• Inability to urinate. These cats strain to urinate, producing a few drops or no urine at all. If you suspect that your cat is in distress and unable to urinate adequately, this is a medical emergency. Urethral blockage, which is more common in male cats due to their narrow urethra, can be a life-threatening complication if the condition is left untreated for even a few hours.

The cat is peeing in blood - what to do?

What to do if your cat is peeing blood?

Of course, go to the vet. Only he will be able to determine what the problem is and prescribe successful treatment.

If this is a serious disease, associated, for example, with kidney stones or tumors, then emergency surgery will be required, after which maintenance therapy will be required for a certain period of time.

If the whole point is an infection that has settled in the urinary tract, then antibiotics, antispasmodics and vitamins are prescribed. If the infection is not treated, unfortunately, in most cases it leads to major complications.

It is especially dangerous if the cat does not go to the toilet. Then, within 24 hours, urgent catheterization of the bladder is required. If this measure is not possible for one reason or another, then it is worth performing a urethrostomy operation.

In our clinic, experienced veterinary surgeons will provide prompt care to your pet, and then in the clinic the animal will receive reliable care and round-the-clock monitoring.

Bring your pet to our clinic - we will certainly help you cope with any illness and get better soon!

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What are the causes of cystitis?

Blood in a cat's urine can have many possible causes. Cystitis and FLUTD can cause severe inflammation of the bladder and/or urethra, leading to hematuria. While many young cats, under 10 years of age, will have bladder inflammation that can be difficult to explain, below are some of the obvious causes of blood in a cat's urine:

• Trauma or bodily harm;
• Blood clotting disorder;
• Kidney stones or bladder stones (approximately 20% of all cases in cats under 10 years of age);
• Bacterial infections (primary bacterial infections are rare in cats, although secondary infections can occur as complicating factors) - more common in cats over 10 years of age, many older cats will have bladder stones and a bacterial infection;
• Neoplasia (tumor of the bladder or lower urinary tract) - more common in older cats;
• Anatomical abnormalities—especially in young cats with chronic or persistent urinary tract problems;
• Urethral plugs are a blockage of the urethra with a mixture of crystals or small stones and inflammatory material.

Treatment Options

Therapy depends on the diagnosis. For almost every reason, antispasmodics, anti-inflammatory, and painkillers are first given. Antibiotics are prescribed only when the underlying disease is advanced. If necessary, use vitamins and medications that increase immunity and stop bleeding. A catheter is placed if there is difficulty urinating. The tumors are removed, and a special diet is prescribed for stones.

Even before going to the clinic, it is recommended to improve your pet’s well-being. You cannot help thoughtlessly; it is better to contact a veterinarian. Typically, home care involves moving the cat to a dry area, providing rest and access to water. Additionally, it is necessary to replace the food with liquid food, give decoctions of juniper and horsetail, bearberry or parsley.

How will blood in your cat's urine be diagnosed?

The initial diagnosis for a cat suffering from hematuria is based on the presence of symptoms consistent with lower urinary tract inflammation. A complete urinalysis with sediment examination is the most common diagnostic test used to confirm the presence of urinary tract inflammation or infection and is often performed in real time in practice. Other diagnostic tests for blood in urine include:

• Laboratory urine analysis;
• Bacterial culture and urine susceptibility;
• Blood tests to look for other signs of urinary tract disease, such as kidney disease or bleeding disorders;
• X-rays and/or ultrasound examination of the bladder and urethra.

Red blood cells in urine are normal

Normally, urine should be clear.
It becomes cloudy due to the admixture of red blood cells, leukocytes, and epithelial cells of the urinary tract. Urine can become reddish for two reasons: due to the admixture of blood (in this case, the level of red blood cells is tens of times higher than normal) or due to certain foods that can color urine (beets, blackberries, rhubarb). Therefore, if your urine has changed color, first remember if you have eaten meals with these foods in the last 24 hours - perhaps the reason for the changed color is not at all related to health problems. Normally, urine contains only a few red blood cells or none at all. The urine analysis of a healthy person contains no more than three red blood cells in the field of view of the microscope. The norm is the same for men and women.

For children, the normal limits are even slightly lower - 1-2 red blood cells per field of view. Exceptions are newborns, who during the first month of life can normally have up to 4 red blood cells in the field of view of the microscope. This is due to the functional immaturity of the glomerular membrane.

Treating Blood in Your Cat's Urine

Treatment of feline hematuria is based on treatment of the primary problem. Some common therapeutic methods for blood in urine, cystitis and FLUTD:

• Bacterial lower urinary tract infections usually respond well to antibiotic therapy within two to four weeks.
• For cystitis or idiopathic cystitis, other treatments may be recommended, such as dietary changes, development of a special diet, anti-inflammatory drugs, environmental changes, encouragement to drink more water, and others.
• If a cat develops a urethral blockage, emergency treatment is required to remove the blockage immediately. In most cases, the cat is given a short-acting general anesthetic and the urethra is irrigated or catheterized. Urethral obstruction occurs almost exclusively in male cats. Other treatment options may be recommended based on your cat's specific urethral blockage.
• If bladder stones (urolithiasis) are present, they must be removed. Depending on the type of bladder stone, they may be dissolved with a special diet or supplements, or they may require surgical removal. In some cases, initial treatment can be determined by the results of a urine test.

There is no universal treatment for hematuria, cystitis, or FLUTD. Each case must be diagnosed and treatment prescribed taking into account the individual characteristics of the cat. Often, despite appropriate testing and treatment, clinical signs and hematuria may recur, requiring further therapy and additional clinical tests. Successful treatment of lower urinary tract disease in cats often requires patience and persistence.

Treatment of red urine in cats

Treatment depends on the diagnosis. Your veterinarian may prescribe one or more of the following treatments for your cat:

• Antibiotics for possible bacterial infections of the urinary or genital tract.
• Diet changes for certain types of stones
• Hydrotherapy for dehydration
• Vitamin K for anticoagulant rat poison use

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Preventing Blood in Your Cat's Urine

We are always looking for ways to prevent conditions such as hematuria in advance. Unfortunately, it is impossible to completely prevent lower urinary tract disease in cats. We know that FLUTD/FIC appears to be more common in cats that have low water intake and are inactive or obese. These factors may partly influence how often your cat urinates. Controlling your weight and exercise and water consumption may provide some benefits in preventing cystitis and FLUTD. Having an enriched environment with clean and accessible litter boxes can also help with this issue. If bladder stones are the cause of blood in the urine, special therapeutic diets may help prevent recurrence. If you suspect that your cat may have blood in its urine, please contact your veterinarian immediately. The sooner you receive a diagnosis and proper treatment, the sooner your cat can return to a healthy, pain-free life.

If you have any questions or concerns, you can always visit or call our veterinarian - this is the best option for ensuring the health and well-being of your pets.