Seeing pink or red in your cat’s litter box is alarming — and for good reason. While not every cause is life-threatening, blood in a cat’s urine (hematuria) always signals that something is wrong and needs veterinary attention.
If you’re wondering “Is my cat going to die?” or “Do I need to rush to the ER?” — here’s the bottom line:
- If your cat is straining, vocalizing, or unable to pass urine, this is an emergency.
- If blood is present but your cat seems otherwise normal — call your vet today.
This guide explains the key signs, common causes (from urinary tract infections to stones and serious blockages), what happens at the vet, and the steps you can take right now.
By the end, you’ll know exactly when to treat it as urgent, what to expect in terms of care and cost, and how to prevent future episodes.
How to Identify Blood in Your Cat’s Urine (photos & examples)
If your cat’s urine looks pink, red, or brown, that’s blood — and it’s never normal. Sometimes you’ll see bright red streaks or clots, other times just a faint rosy tinge or tea-colored stain on the litter. In some cases, the urine looks clear but still contains microscopic blood, only detectable on a vet’s urinalysis.
Along with color changes, watch for straining, frequent trips to the box, or crying when urinating — but remember, even cats acting normal can still have serious issues.
What to do right now:
- Take a photo of the urine on a plain, light-colored surface (avoid patterned litter).
- Collect a fresh sample if possible: use a clean, dry container and aim for a sample within 2–4 hours.
- Store it properly: refrigerate in a sealed container, label with the time, and bring it to the vet within 24 hours.
- Call your vet the same day and describe the color, frequency, and any behavior changes.
Any blood in your cat’s pee — visible or not — is abnormal. Document it, don’t delay, and let your vet decide the urgency.
Immediate Steps If You See Blood in the Litter Box
Blood in your cat’s urine is not normal, but the other signs you see determine how urgent it is. Some symptoms mean a same-day vet visit, while others demand an immediate trip to the ER. Watch closely for:
- Emergency red flags: straining >10 minutes with little or no urine, collapse, nonstop crying, severe vomiting, or pale gums.
- Urgent same-day signs: frequent litter box trips, passing only drops, licking genitals, loss of appetite, or lethargy.
- Lower-risk but still abnormal: a single pink episode with normal behavior (still call your vet).
Dr. Canaan Shores, DVM: “Urethral obstruction is a true emergency. If an owner sees these clinical signs in their cat, they should take their cat to a veterinarian right away.”
Cats often hide pain, so “acting normal” doesn’t mean safe. Document urine color, frequency, and appetite, and collect a sample if possible.
Why Is My Cat Peeing Blood? Common Causes
Blood in your cat’s urine (hematuria) can stem from several conditions. Some are treatable with prompt care, while others—like urinary blockage—are life-threatening emergencies.
Below are the most common causes, who they usually affect, how they look, and what action to take right away.
Feline Lower Urinary Tract Disease (FLUTD) / Idiopathic Cystitis
This is one of the most common reasons for blood in the urine, especially in young to middle-aged, indoor, or stressed cats. It causes bladder inflammation without infection, often linked to stress and poor hydration.
Cats may strain, pass only small amounts, or urinate outside the box. While not always fatal, it can progress to obstruction in males, so a same-day vet visit is crucial. Vets typically run urinalysis and recommend pain relief, hydration, stress reduction, and sometimes diet changes.
Urinary Tract Infection (UTI)
True bacterial infections are less common in healthy young cats but more likely in seniors, females, or cats with diabetes or kidney disease. UTIs cause blood-tinged urine, frequent trips, straining, and sometimes fever. Left untreated, they may spread to the kidneys.
A vet visit the same day is essential for urinalysis and culture, with antibiotics prescribed based on results.
Bladder Stones or Crystals (Urolithiasis)
Minerals in urine can form crystals or stones that irritate the bladder or block the urethra. Cats may show frequent attempts to urinate, blood in the litter box, and discomfort. Risk factors include diet, genetics, and prior urinary issues.
Stones can sometimes dissolve with diet, but often require surgery. If your cat is straining with little or no urine, treat it as an emergency; otherwise, book an urgent vet visit for imaging and urinalysis.
Urinary Blockage (Urethral Obstruction)
Almost exclusively affecting males, this is a true emergency. The urethra becomes blocked by plugs, stones, or swelling, preventing urine flow. Signs include repeated straining with no urine, loud crying, vomiting, and collapse.
Without immediate treatment, toxins build up and can be fatal within hours. Emergency care involves catheterization, IV fluids, and hospitalization. If you see these signs, go to the ER now.
Bladder Cancer (Transitional Cell Carcinoma)
Though rare, bladder cancer can cause persistent hematuria, frequent urination, weight loss, and discomfort—often in older cats over 10 years. Because it mimics FLUTD or stones, diagnosis requires an ultrasound and biopsy. Prognosis varies, but early detection helps. A same-day vet visit is needed for proper workup and treatment planning.
Anatomical or Other Causes
Less commonly, blood in urine may result from congenital issues like ectopic ureters, trauma, clotting problems, kidney disease, or even toxins. These cases often appear in younger cats with unusual histories or when standard causes are ruled out. Your vet may recommend specialized tests to uncover the problem.
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How Veterinarians Diagnose the Cause
When your cat pees blood, vets follow a clear, stepwise path to pinpoint the problem. It starts with a physical exam (checking bladder size, hydration, vitals) and a quick urinalysis (within minutes) to see if blood, crystals, or infection signs are present.
If infection is suspected, a cystocentesis-collected sample is sent for urine culture (48–72 hrs) to identify bacteria and guide antibiotics. Bloodwork may follow, especially in sick or blocked cats, to check kidney values and electrolytes. Imaging (x-ray or ultrasound) helps confirm stones, plugs, or tumors.
Most results come fast, some take days, but every test builds the puzzle. Bring photos, a fresh urine sample, and notes on appetite and behavior—these speed up diagnosis and treatment.
Treatment Options for Cats Peeing Blood
Treatment depends on the cause. A blocked male cat needs emergency catheterization and IV fluids; a cat with a confirmed bacterial UTI requires culture-guided antibiotics; cats with FLUTD (idiopathic cystitis) benefit most from pain control, hydration, and stress reduction.
Stones may dissolve with prescription diets (struvite) or require surgery (calcium oxalate). Tumors demand oncology planning.
Never treat at home with human meds—they’re dangerous. Long-term prevention usually combines a urinary prescription diet, wet food or fountains to boost hydration, and stress-reducing enrichment.
If your cat strains without passing urine, head to an ER immediately; otherwise, call your vet the same day for safe treatment.
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Final Thoughts
Blood in your cat’s urine isn’t “just a phase.” Acting quickly — documenting what you see, collecting a sample, and contacting your vet — gives your cat the best chance for a fast, full recovery.
Early intervention can prevent severe pain, kidney damage, or life-threatening complications. Many causes are treatable when diagnosed promptly, and proactive care reduces recurrence.
Do these three things right now:
- Document it — take a clear photo and note the time and any symptoms.
- Collect and store a sample — refrigerate and label if possible.
- Call your vet — say: “Hi, my cat has blood in the urine and is [describe behaviour]. Should I bring them in now?”
Acting fast improves outcomes. If your cat is straining or not producing urine, go to the nearest ER immediately.
Founder of Cats Question, a veterinarian (DVM), and lifelong cat enthusiast with hands-on experience in feline care. Passionate about helping cat owners through expert-backed, compassionate advice inspired by years of living and learning alongside cats.
