Peeing blood, no diagnosis

[birdlady99]

So my brother‘s/our family‘s cat Oreo is about 18-19 years old and my brother said he’s peeing blood. But like a lot of red blood, not just pink tinged urine. He is diabetic and has been on insulin for about 4 years. He also had a surgery to remove bladder stones about 7 years ago. He is no longer on the urinary diet but eats wet food.

He has had x-rays, bloodwork, and a urinalysis and everything was (mostly) normal. They want him to come back in next week for an ultrasound because they saw something in his bladder but believe it’s a blood clot. He did just have x-rays a couple weeks ago for the same issue and they came back clear. He got better so it was assumed to be stress related because they just moved in February but now he’s peeing blood again. He also is not an easily stressed cat.

Any ideas? I was thinking possibly something in his urethra that they can’t see on an x-ray?

 

[JamesCalifornia]

~ All I can suggest is that in human males bright red blood at the end of the stream is prostate related — usually an infection or broken vessel due to enlargement. I would ask the veterinarian if it could be the same for kitty ...

 

[FeebysOwner]

Hi. Can you be more specific with the timeline? Was he peeing a lot of red blood before the last set of tests he had, or is this new?
Why do they think it is a blood clot?

 

[birdlady99]

He first peed blood around March 29th so he went in to have x-rays and a urinalysis. They didn’t find anything wrong so they said it’s most likely inflammation from stress. It didn’t happen again until today and he just had the x-rays and urinalysis again today as well as bloodwork.

I’ll mention the potential prostate issues to my brother. Any suggestions are welcome, it can’t hurt to ask the vet at least.

 

[birdlady99]

This was the pee from the 29th. You can see how red it is even in the litter. When he had bladder stones you couldn’t even see the blood in the litter, it was only if he dripped outside the box.

 

[FeebysOwner]

X-rays, if they were of the entire urinary tract should have included the prostate. That is probably where you need to head - what was included in the x-rays and where exactly was this purported blood clot seen?

 

[fionasmom]

My last German Shepherd lived to be 16 and in his old age he started doing exactly what you’re describing your cat is doing. It was not every day but it did repeat itself. I would proceed with the imaging if I would you were you and I’m going to mention a couple of other things that you can bring up to the vet and simply ask their opinion.

Upper urinary tract problem of any kind.
Idiopathic renal hematuria
Any clotting issue with the blood
Blood vessel problem within the kidneys usually with dilation
Prostate, as was mentioned
Inflammatory conditions of almost any kind

 

[birdlady99]

Thank you both. I’ll ask my brother what the x-rays covered. The suspected blood clot he said was in the bladder, I’m not sure of more specific than that. His kidney levels were good on the blood work but I’m guessing that doesn’t completely rule out kidney issues?

 

[catsknowme]

You have received great suggestions so far! Please keep us updated. I love the picture that you selected - it would be a great "caption this" social media post.

 

[birdlady99]

They believe it’s cancer. They just did the ultrasound today and they said based on how it looks they don’t think it’s benign and they can’t remove it. He is really old so it was something I suspected but we’ve lost multiple cats to cancer over the years and it really sucks. My brother said he’s still acting normal for now. Is there anything we can do to keep him comfortable for as long as possible?

 

[silent meowlook]

I am sorry.

Was it a specialist who did the ultrasound and suspected bladder cancer? Bladder cancer in cats is very rare. I have seen it before. Usually it is transitional cell carcinoma, but it can be other cancers. At his age I am assuming that you don't want to pursue treatment at an oncologist. I have seen cats his age treated for cancer with chemotherapy, and do alright for a brief time, but if it was my cat, I wouldn't do it. Also, if I am not mistaken, you don't have an actual diagnosis, right? I am by no means suggesting you do anything to get an actual diagnosis. If he was my cat, I wouldn't do anything that he would have to be anesthetized for.

I have seen Piroxicam used to treat bladder cancer before, but it is not without some serious side effects. It would have to be something that you discussed with your vet obviously and preferably a specialist. Regular veterinarian usually doesn't have enough specialized schooling to manage a patient with cancer properly.

I would imagine keeping him well hydrated would be best. Administering subcutaneous fluids at home is a great way to keep a cat hydrated. Although this must be discussed with your vet especially at his age because you can accidently give to many fluids and cause congestive heart failure.

When I worked at the cat hospital, the vet would treat with sq fluids at home, vitamin C injection, and Piroxicam I believe. Both those can cause issues and the risks and benefits have to be weighed out. for pain, I believe she prescribed buprenorphine.

A canned only diet is best. Your vet may recommend a urinary diet based on his urinalysis.

It is important that if they do another urinalysis, they do not do it with a cystocentesis, which is a needle being inserted into the bladder to obtain the urine sample.

Do you know if there were abnormalities in his urine microscopic? I have seen samples from pets with bladder cancer and you can often see the epithelial cells being clumped together and often very large, when looking in the microscope. I am wondering if they saw this, also leading them to suspect cancer.

Did they send any medications home for you.

This is one case that I think you might find a holistic veterinarian beneficial. if you have one near you.

I apologize for this post being all over the place.

Please keep us updated as to how he is doing.

 

[silent meowlook]

This is an interesting study

https://onlinelibrary.wiley.com/doi/full/10.1111/jvim.15656

 

[birdlady99]

I believe it was a specialist and that’s why he had to wait a week for the ultrasound. It hasn’t been biopsied or anything. His urinalyses were normal and he does eat canned food now, he refused it for most of his life. Oreo is my brothers cat so I’m getting this info secondhand and I’m not actually there with him. I agree about the chemotherapy, to me it’s not just about extending their life but actually making sure they're not suffering that whole time and chemo is rough. We had one cat, Sam, who we let suffer way too long because we didn't find out until the very end what was actually wrong (he had a tumor surrounding his entire heart). I’ll never put an animal through that again.

My brother is asking about the fluids because the bleeding is becoming more frequent and the fluids seem to stop it. He still seems happy and not in pain but Oreo is a very tough cat so I’m sure he is hiding it to some extent. Also asking about pain medicine, he has some now but my brother said it makes him very tired.

The study is definitely interesting. But very sad to see the survival times even with treatment. Another thing is Oreo’s brother Cookie passed from a brain tumor.