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This guide helps you triage; it does not replace your veterinarian's exam. When in doubt, call us at 514 223-1197.
Go now: the pictures that cannot wait
Any single one of these is enough. None of them depends on species or sex: what matters is what your pet is doing. Settle them into a carrier or onto a stable surface, keep the ride calm, and call on the way.
- Straining to urinate and producing almost nothing: a few drops, a small puddle, sometimes tinged pink or red. Those drops still count. A passage that narrows gives drops first, before it closes: something coming out does not mean the way is clear.
- Straining, then stopping, without a real stream ever coming out. That is not an improvement. A pet that settles after pushing for a long time is often a pet that is getting worse.
- Lying down, limp, cold to the touch, vomiting, hiding, refusing food. In a blocked animal those signs come late: do not wait to see them, and if they are here, leave now.
- Dark brown urine, the colour of tea or cola, with weakness, laboured breathing, or pale or yellowish gums. This is probably not blood from the bladder, and it is at least as serious.
- Bleeding somewhere else at the same time: gums, nose, black stools, bruises on the skin. Or possible access to rat poison, even days ago: the bleeding shows up long after.
- A recent impact: hit by a car, fell off a balcony, caught in a door. A pet that has been hurt and is passing blood leaves now, even if it seems fine.
- An unspayed female, cat or dog, with any discharge, or blood you assume is coming from the urine, along with thirst, a smaller appetite, or dullness. It does not matter how long ago her last heat was. A uterine infection does not always produce visible discharge.
- Straining, and you are thinking "constipation". Do not try to tell the difference: from behind, a pet pushing to urinate and a pet pushing to defecate look remarkably alike. If there is straining and there is blood, call.
Reading this at night or on a weekend?
Do not set an alarm for opening time. If we are closed, a 24/7 emergency centre takes over and you can call them right now: describing the situation over the phone costs nothing and commits you to nothing.
This page starts with cats
The scenario that kills within hours is feline: a cat straining and producing almost nothing. That is why it comes first. The dog section is further down, and it is complete: if you are here for a dog, go straight to it. The signs above apply to both.
What actually triages, and it is not the colour
A colour is what brought you here. It is also the least useful piece of information tonight, and it can mislead you both ways: reassuring when it should not, alarming when there is no need.
Quantity does not equal severity
A tiny amount of blood colours a lot of urine. And the most urgent picture of all, the pet who can no longer urinate, shows up with very little urine, and therefore very little visible blood. Never read severity from the depth of the colour.
In cats: watch whether it comes out
Feline urinary problems all look alike: blood, trip after trip to the box, small amounts, sometimes crying. They cannot be told apart at home. What triages a cat is not the blood, it is whether urine is coming out normally.
In dogs: flow is not enough
Do not transpose this one. A dog can pass a strong, full, perfectly normal stream and still be bleeding from somewhere else: the uterus, the prostate, or from everywhere at once if the blood is no longer clotting. In a dog, normal flow is not reassurance.
We will not ask you to name the shade
Pink, red, brown, orange: those shades cannot be read reliably by eye, not even by us. Red urine may contain no blood at all, and may come instead from red cells destroyed elsewhere in the body or from damaged muscle. That is why the plan never depends on colour, but on what your pet is doing and on the look of their gums.
The straining cat: cystitis or a blockage?
This is the scenario that shapes the whole page. Two very different problems open with exactly the same signs, and only one of them kills. The good news, in a way: you do not have to tell them apart. Nobody can at home, and neither can we over the phone. That is precisely why we want to see him.
Cystitis
Inflammation of the bladder, genuinely painful, often stress-linked. The cat goes back to the box again and again, passes small and sometimes tinged amounts, starts going beside the box, and may cry. It is treatable, and it is preventable.
A blockage
The way out closes off. The cat makes exactly the same trips, the same cries, the same small tinged amounts. Except the urine no longer comes out, and the kidneys and the heart begin to suffer. We are talking hours, not days, and nobody can tell you in advance how many yours has left.
"It is probably just stress"
That sentence is true, and that is exactly what makes it dangerous. Stress really does cause cystitis: it is not "in his head", the bladder wall genuinely inflames. A move, a new pet, renovations, a relocated litter box can be enough. But a blockage opens with the same signs as cystitis. So we triage first, and we talk about stress after: that conversation goes very well once we know the way is clear.
The trap: the cat who stops going to the box
You watched him strain all afternoon. Now he is quiet, lying down, no longer going back to the box. This is the exact moment when many people decide to wait until morning. But a cat who has been blocked for hours stops trying: he goes limp, he vomits, he hides, he refuses food. He is not better, he is worse. If he strained without a real stream coming out, the calm changes nothing.
"I have not seen him pee all day"
On its own, that sentence means very little. When perfectly healthy cats are filmed, it turns out their owners only ever catch a fraction of their trips to the box: not having seen him urinate is ordinary daily life for a great many people. So do not build your decision on a count of hours you have no reliable way of keeping. Build it on what you can see: is he straining? Is anything coming out? A freshly emptied litter box will teach you more in an hour than your memory of the whole day.
What not to do, however good the intention
Every one of these reflexes comes from a good place, and every one of them costs time or makes things worse.
- Do not press on the belly and do not try to make your pet urinate. A very full bladder can rupture.
- Do not give a laxative, oil, or an enema. This is not constipation, and you would be spending the hours that matter.
- Do not take the water away. The reflex is common when a pet is urinating everywhere or straining: it is exactly backwards.
- Do not give any leftover sedative or painkiller, even one prescribed to this same pet before. A sedated animal stops straining, and that false calm will cost you the night.
- Do not delay leaving in order to collect a sample. Do not change the litter, do not wait for the next attempt, do not hunt for the right container: the sample is taken at the clinic, and that is where it will be most useful.
- Do not induce vomiting, even if you suspect something was swallowed.
- For the ride: a carrier for a cat, a stable surface for a dog in pain. Do not lift a cat by the scruff. And let us know you are on your way.
- Wash your hands after wiping up a puddle or a stain, and keep children away from it. Without scrubbing everything either: a fresh stain sometimes tells us something.
Call today, and tonight if we are closed
Between "leave now" and "this can be scheduled" there is no watch-and-wait zone once there is blood. What changes from case to case is the speed, never whether you call. And the date gets set during the call, not by closing this page.
- Your cat is passing normal amounts, but the urine is tinged, and he is otherwise entirely himself.
- Your dog is urinating normally and feels well, but you can see blood.
- You noticed blood a few days ago and it has since disappeared. Bleeding that stops is not a problem that is solved: many causes come and go, and come back.
- He is urinating more often, in smaller amounts, or licking himself a lot, without visible blood every time.
- She is going beside the box or in the house after being reliably clean. That is not misbehaviour: we rule out a medical cause first.
These move up a notch: call now
- A kitten or a puppy.
- A senior pet, or one followed for a chronic illness: kidneys, diabetes, liver, heart.
- A pet on medication, especially an anti-inflammatory or a steroid. In a diabetic or steroid-treated pet the usual signs of infection are often missing: their absence is not reassurance.
- An unspayed female, cat or dog, or a female who might be pregnant.
- An unneutered male dog.
- A pet who has been blocked before, or who has just been unblocked and come home. The watch starts over from zero: if he begins straining again, come back, even if it was yesterday.
- A pet who may have had access to something: antifreeze, rat poison, a plant, a dropped pill.
And if it is 9 p.m.?
"Today" stops meaning much once the evening comes. If we are closed, call a 24/7 emergency centre: they triage over the phone too, and they will tell you honestly whether this holds until morning. Do not let the clock make the decision for you.
Get your call ready (2 minutes)
- How long have you been seeing blood, and is it every time he urinates?
- Is he straining? Does anything come out, and roughly how much?
- Is he eating? Drinking? Vomiting? Is he as bright as usual?
- Is he neutered or she spayed? And for an intact female, when was her last heat?
- Current medications, known conditions, and anything that could have been swallowed.
- A photo, if and only if it does not slow you down.
If the cost is what is worrying you
The call itself costs nothing and commits you to nothing. If money is part of your hesitation, say so on the phone. It is a conversation we have often, it does not shock us, and it is far more useful before than after. What we want to avoid is silence turning into a way of waiting.
In dogs
Everything above applies to him too, starting with the very first flag: a dog straining without producing is an emergency, exactly like a cat. What follows is what belongs to him.
The dog who strains without producing
In males, the outflow passage runs through a groove of bone and narrows there: that is often where things lodge. But do not go looking for the mechanism. There are several, and your dog may not match any story you have heard. Hold on to what he is doing instead: he stops at ten posts, he pushes, and little or nothing comes. As in cats, a few drops do not mean the way is clear.
Urinary infection: common, but never a wait
It is the most ordinary cause of blood in a dog, and it treats very well. It cannot be diagnosed from a distance, though: it takes a urinalysis, because stones, inflammation, and a tumour produce exactly the same signs. In a female and in a neutered male, it is a routine infection. In an unneutered male it is less common, and that is precisely what makes it a signal: we start looking at the prostate.
Stones
In dogs, a good share of stones form in the wake of an infection, which is why the two so often travel together. Some dissolve with the right diet, others do not. It is the urinalysis and the imaging that settle it, never the colour of what you are seeing.
The unneutered male: blood that is not in the urine
Here is the picture many owners never recognise as "blood in the urine", and it is what makes them wait: drops of blood falling outside of urination, stains on the floor, on the bed or on his cushion, blood at the tip of the sheath. It often comes from the prostate. And this has to be said properly: the prostate here is a place that bleeds, not a diagnosis. Several very different things happen there, some harmless and some not, and none of them resolve on their own.
One thing to distinguish: a little yellowish or whitish fluid at the sheath is normal in a male. Blood is not.
While you are looking, check his testicles. If one has changed, is larger or softer than the other, or if he never had two, mention it on the phone. This is not a breeding question: it is a lead, and it matters when a dog is bleeding.
And to settle a very common hesitation: having him examined commits you to nothing. We are looking for where the blood is coming from, that is all.
For him, leave immediately if
- He has a fever, his belly hurts, he is walking hunched.
- He is struggling to pass stool, or pushing without success.
- He collapses, his gums are pale or grey, he is breathing fast.
- He is straining to urinate and producing almost nothing.
Repeat urinary infections that never really clear
A dog treated three times for the same "infection" deserves a longer look. Most often we end up finding an anatomical quirk that keeps feeding the problem, and that can be corrected. Sometimes something else. Either way, what matters is not setting off on a fourth blind course of treatment.
Give no home medications
This section exists for one very specific reason: there is a product, sold over the counter in nearly every pharmacy, designed for exactly what you are looking at. It is made for humans.
Human urinary painkillers (AZO, Uristat, Azo-Standard)
Those tablets that turn urine orange are sold without a prescription to soothe a human urinary infection. They are not made for your pet: in cats especially, they attack the red blood cells. And because they dye the urine, they also erase the one piece of information we were after.
Acetaminophen (Tylenol)
Fatal to cats, even a single tablet. There is no safe dose. A cruel detail: the poisoning itself darkens the urine, so the very act meant to bring relief ends up looking like the problem.
Ibuprofen (Advil), naproxen (Aleve), aspirin
Never, and least of all here: a pet who cannot urinate may already have kidneys in trouble, and these are precisely the products that go after kidneys.
Leftover prescriptions
The other pet's antibiotic, or the one from an episode six months ago. Some products that are perfectly routine in a dog damage a cat's eyesight. And treating blind makes the urinalysis uninterpretable at the exact moment we need it most.
Cranberry, D-mannose, over-the-counter "urinary" supplements
We wish we could say they help. In dogs it has not been shown; in cats it is barely studied at all. And in a pet who forms certain kinds of stones, it can be exactly the wrong choice.
Nothing by mouth, and here is the real reason
It is not that everything is poison. It is that the time and the place are wrong. Easing the pain of a pet passing blood is a genuine priority, and it is a clinic decision: it gets made once we know what we are treating and what shape the kidneys are in. Tonight, your job is not to treat him. It is to bring him to us.
Frequently asked questions
The questions we hear most on the phone, and two people do not always dare to ask.
The blood went away on its own since yesterday. Is it sorted?
How do I know whether it is really blood, or just dark urine?
My cat had this before and it sorted itself out. Can I wait it out again?
It is the middle of the night. Can this wait until morning?
My dog is not spayed and had her heat a few weeks ago. Could the blood be coming from that?
What is this going to cost, and what if I cannot pay tonight?
I waited two days before calling. Did I harm my pet?
Also worth reading
The honest triage, in one sentence
Straining and producing almost nothing, straining that stopped without a real stream, limp or cold, dark brown urine with pale gums, a recent knock, an intact female with discharge: go now. Urinating normally but you can see blood: call today, tonight if we are closed. And in every case, there is no version of this page where we tell you to watch it for a few days and see.
You see blood and you are hesitating?
Stop hesitating: call, and we will triage together. If an appointment is enough, we will say so; if it is more pressing, we will point you straight where you need to go, here or to a centre that is open.