Cat-Kidney Problem cont...

Question
Hello,
I am Rose, the one I talked to you about the kidney problem of my cat.
This morning he peed with red blood although at night, I woke up and saw some pee yellow with very light red.
Is it normal that he sometimes pee with little blood and at other times he pees with more blood?

I am thinking of making him sleep, many people told me that it is fatal as you said.

Thank you,

ROSE


Answer
Hi Rose.  It's never "normal" for urine to contain any blood, as you know.  When there is a problem with the urinary tract, a cat can pass urine that is close to normal, and then pass urine with more blood in it.  But there are a lot of factors involved.

For one, did your vet give the cat fluids under the skin or intravenously, or did your cat drink plenty of water?  If so, this may have helped produce more normal-looking urine during the night last night.  The more water the cat drinks, the more diluted his urine will be.  The longer he goes without drinking or having fluids under the skin, the more concentrated his urine will be, and you'll be able to see the blood more easily.  As I mentioned in previous answers, it's very important to keep your cat well hydrated.  You may want to switch him to regular Pedialyte, a drink containing electrolytes to help keep children hydrated, instead of water. It's available in the baby food section of the grocery store.

Another factor could be how long he's held his urine.  The longer he holds it (say, during his sleep), the longer blood has to accumulate.  Therefore, urine coming after hours of sleeping may contain more blood.

Could be that a small blood vessel has burst due to the irritation, which may or may not indicate that the disease is progressing.

It's also possible that his condition has worsened, just overnight.  Many cats don't show any symptoms at all until kidney failure leaves them with only a few days to live. So when kidney failure is diagnosed, there are chances the cat will go downhill very quickly, even overnight.

But cats can suffer from a few conditions that cause urine in the blood sometimes, and normal urine other times, aside from kidney failure.  One of these conditions is called FUS, which stands for Feline Urologic Syndrome.  There's not any one cause known for FUS.  It causes the bladder to bleed, causes kidney/bladder stones, and urinary crystals.  In many ways, the condition mimics kidney failure.  This is a reason I feel it's so important to follow up a physical exam with blood work, to determine whether it is truly kidney failure, or some other urinary tract disease.

FUS is nowhere near as dangerous as kidney failure, as long as you treat it.  Treatment includes a special diet, like the one you're feeding, to prevent stones from forming, antibiotics, to prevent infection, and anti-inflammatories, to relieve pain.  If not treated, FUS can lead to kidney failure.

It's also possible your cat has kidney or bladder STONES.  These are very painful and cause very large amounts of blood in the urine.  They can be suspected based on a urine test and physical exam, but an x-ray is really necessary to determine if stones are present, where they are, and if they need to be removed surgically.  Fortunately, if stones are removed, most animals make a full recovery.  They do usually have to stay on a urinary tract diet for life.  But allowing stones to go too long can also cause kidney failure.

I really would urge you to do an x-ray and some further testing before deciding to put your kitty to sleep.  I just feel so uncomfortable making that decision without knowing exactly what I am dealing with.  

A few months ago, I brought a cat to the vet who was very sick.  The doctor thought it was end stage kidney failure, and that she had only a day or so to live, and that it would be very painful for her.  We decided to put her to sleep, and we had an autopsy performed to find out what caused her kidney failure.  Only it turns out her kidneys were perfectly healthy.  A viral illness was to blame.  If we had only known that, we may have been able to treat her symptoms differently, and maybe she would still be here today.  If it were my kitty and he was still eating and showing any interest in life, I would certainly perform more tests to find out if his illness could be managed, before putting him to sleep.  If the tests show that he is in end stage kidney failure, then you know you can put him to sleep with peace in your heart.

Of course, the decision is yours.  Only you know what is best for your kitty.  Even vets don't know, sometimes, what is best for an animal.  I had a cat with lymphoma, and my vets told me I could do chemotherapy, but they didn't recommend it.  They said it was difficult for the cat and not very effective.  But I did it anyway, and it was the best decision I ever made in my life.  The cat recovered and was back to his old self within a month.  Even the vets now say that they would encourage anybody who is interested to do chemo for lymphoma.  So, you see, you need to follow your heart rather than what anyone may tell you.  Your love for your cat will help you make the right decision.