Hello, my name is***** and I have over 20 years of experience as a veterinarian. I am sorry to hear that Brownie has blood in her urine and has taken to urinating in multiple areas around the house.
While cats can get urinary tract infections they aren't common. They do however suffer the effects of inflammation due to crystal formation, very concentrated urine, and lack of a proper mucous barrier. They can form urinary tract calculi which can also cause a urinary tract inflammation, bleeding and discomfort.
If they start to associate pain with their litter box they will often go elsewhere to avoid discomfort.
Treatment will be based upon why she is having these symptoms. It may be anti-inflammatories, anti-spasmodic medication, antibiotics and fluids. We do want to check a urine culture and perhaps radiograph her abdomen or have her abdomen examined with an ultrasound to look for any abnormal thickening of the bladder or signs of calculi. Symptoms can be episodic depening upon whether she is passing a stone or not.
If she is having repeated episodes of these types of symptoms we need to be very careful about diet, keeping her well hydrated, and in fact trying to get more fluids into her than usual, and possibly using supplements to help.
I recommend feeding your girl only canned foods, and I would add water to them to make sure that she is getting plenty of fluids. I would stick with Hills Science diet, or Royal Canin brands.
You might also get her a kitty water fountain. Cats tend to drink more from a fresh, moving water source then from stagnant bowls.
Cats that have a faulty mucous layer that protects the bladder wall from urine (which is a mucous membrane irritant) can benefit from glucosaminoglycans (like adequan) because they are postulated to help as they are a building block for this mucous. It isn't something that the drug companies can advertise or label the drug for as they would need to do extended testing and trials and there simply aren't enough cats affected to make this worthwhile for them. This is something we do for these cats as we have some anecdotal evidence (reports from other veterinarians that have tried it) that it works.
Another option for reducing inflammation and improving bladder health is giving omega 3 fatty acid (like 3V Caps or Derm Caps). I recommend an omega 3 fatty acid dose based upon the EPA portion (eicosapentanoic acid) of the supplement as if we do that the rest of the supplement will be properly balanced. Give her 20mg of EPA per pound of body weight per day. For example an 8 pound cat could take 160mg of EPA per day.
Likewise we know that by decreasing stress these cats do better and have less episodes in the long run.
More play time and exercise can help relieve stress and improve her health in general.
I also tend to recommend feliway too as a stress reliever, especially if we believe that there are other pets in the home or outdoor animals that are causing her stress. This is a synthetic analog of a calming pheromone that cats use to mark things as safe or home.
If all of that is not enough sometimes we need prescription anti-anxiety medication. Amitriptyline is very good at relieving anxiety in some cats so we use it for this purpose as well. Buspirone is another good option.
I can tell you I have one patient that did very well for a number of years on amitriptyline, glucosamine/chondroitins and omega 3 fatty acids. The owners reported that she was a new cat on this regimen.
For now we need to treat her situation seriously, and focus on long term prevention once we know the primary cause.
Please let me know if you have any further questions.