Hematuria is the presence of red blood cells in the urine. It is a symptom of an underlying disorder and isn’t a disease in itself. As are many causes of hematuria in cats ranging from mild to severe and life-threatening, prompt veterinary attention is required.
It can be classified as microscopic or gross. Microscopic hematuria is where the urine appears normal but upon microscopic examination, red blood cells are found to be present. Gross hematuria is where the cat’s urine is visibly discoloured due to the high numbers of red blood cells.
There are many possible causes of hematuria in cats, some of which include:
- Kidney stones
- Kidney tumour
- Trauma such as car accident or a heavy fall
- Blood clotting disorders such as disseminated intravascular coagulation, thrombocytopenia (low blood platelets) or rat poisoning
- Bladder stones
- Bladder tumour
- Bladder infection
- Urinary tract infection
- Congenital urinary tract abnormalities
- Cancer of the urinary tract
- Poisoning (such as rat poison which leads to blood clotting disorders
- Polycythemia (increased red blood cells)
- Certain medications
- Idiopathic (no known cause)
Other symptoms which may accompany hematuria:
Hematuria may often be accompanied by other symptoms, some of which include:
- Pollakiuria (frequent passage of small amounts of urine)
- Straining to urinate
- Abdominal pain
- Urinating outside the litter tray
- Genital licking
- Bleeding from the gums or nose
- Anorexia (loss of appetite)
How is hematuria diagnosed?
Your veterinarian will perform a physical examination of your cat and obtain a history including accompanying symptoms you may have noticed.
Blood which is present only at the beginning of urination may suggest bleeding from the lower urinary tract, bleeding which is present at the end of urination may point to bleeding from the upper urinary tract and bleeding that is present throughout the urine is likely to originate from the kidneys, ureters or bladder. These can all help your veterinarian narrow down the cause of hematuria.
He may wish to run the following tests to determine the cause of the hematuria:
- Urinalysis. The presence of white blood cells may indicate urinary tract infection. Protein in the urine may indicate kidney disease.
- Complete blood count to check for anemia, white blood cells, red blood cell casts, and cancer cells.
- A biochemical profile to check the kidney function.
- Abdominal ultrasound to evaluate for stones, tumours, and kidney size.
- Intravenous pyelogram (IVP). This is a contrast x-ray examination of the kidneys, ureters, and bladder. A contrast material is injected into the patient and collects in the kidneys and urinary tract. This allows the veterinarian to assess the kidneys and urinary tract.
- Blood clotting tests such as prothrombin time or activated partial thromboplastin time.
How is hematuria treated?
Treatment depends on the cause of the hematuria and may include:
- Antibiotics to treat a urinary tract infection.
- Change in diet if the cause is urinary crystals/stones. This may include a prescription diet available from your veterinarian or a wet diet of either canned or raw food which results in your cat consuming more water, which helps to keep the urine less concentrated.
- Surgery to remove bladder or kidney stones.
- Surgery and or chemotherapy to treat cancer.
- Vitamin K is used to treat blood clotting disorders/rat poisoning. This is administered via injection.
- Blood transfusion may be required for cats with blood clotting disorders.
- Corticosteroids to slow down platelet destruction in cats with primary thrombocytopenia.