Cat weeing blood - any thoughts/advice please

[Thewindsofchange]

We’ve had an ongoing issue with our 3yo cat; the vets are stumped and so I thought I’d see if anyone else had had something similar.
It started at the end of last year when our cat started weeding in the house outside the litter tray every so often (he goes outside in the day and is inside at night). To start we didn’t think much of it but after a few instances it looked slightly pink so I took him off to the vet. The vet thought it was stress related. Gave him a week of Metacam, recommended supplements for stress annd urinary and off we went. It started happening again and this time his wee was definitely bloody. I ran a sample to the vet, they did tests and said there were crystals in it. More metacam.
It kept going so he went in for a blood test, scan and ultrasound. There they found a growth in his bladder but couldn’t identify it. More metacam, longer term now. Scanned again a while later and it had shrunk. A few weeks later (still on Metacam) and it seemed to have disappeared. Vet couldn’t identify the cause, said probably cystitis of unknown cause (can happen in young cats apparently) and to stick with the Metacam until it runs out, try to encourage him to drink more and go back if any issues.
A few months later, last week, the metacam runs out. 2-3 days later I see blood in his wee and he wees on the floor. Straight back to vets. They are still stumped. Just said to put him back on the metacam long term and see if it happens again when it runs out. Tonight he sprayed bloody wee up the wall.
I’m so fed up. The house stinks. We’re have to keep doors shut again to limit the rooms he can see in. Dh is increasing annoyed (he didn’t want another cat).
Thank god we’ve got insurance as we’re now hitting £1,500 in vets bills but are still no closer to getting an answer.
Does anyone have any ideas please?
At this stage I’m tempted to give him up but the dc would be devastated. Plus it’s just passing the problem on.

Mine won't touch anything fishy funnily enough. She had UTI as a young cat twice which the vet treated. Nothing since then touch wood.

Fluid fluid fluid. Get the urine as dilute as possible. So no kibble, water the wet food a little, add a water fountain or cat milk occasionally, make sure there is a water collection bowl outside as a lot of cats prefer rain water. Vet friend says there is an increase in cases of uti in cats in very hot weather or very cold weather due to outdoor water sources drying up.

Stress can be a major component so make sure no cats can get in your house and give him plenty of places to seek safety. Metacam very commonly used for urinary issues, my old cat used to get it. As I know to my cost cystitis is very painful!

Argh I just typed a big reply to everyone and lost it all!!

I’ll try again…..
Thanks everyone for ask the suggestions. I will certainly try those.

When I posted and commented about giving him up I was very tired and very fed up (lots going on elsewhere). I’m trying to do the best for him as I know there is something wrong but don’t know what to do. I’ve been to the vet so many times and doing everything they’ve said and it’s not improving hence asking wider on here. I will definitely look into and implement some of these suggestions. But I’m at my wits end, worried for him and all I can smell is cat spray, which is the most fucking awful smell, so please forgive me for not feeling all lightness and positivity atm.

Yes he is neutered but cat wee still smells and he is also spraying, outside usually but he’s also been going inside when it flares up (I thought neutered cats didn’t spray, apparently they still do but it’s not as potent. His is bad enough).

i got him a water fountain but he scared of it, won’t go near it. I’ve kept in just in case but also still got his bowl of water and I add loads of water to turn his wet food into a sort of soup. He has mostly wet but some dry food, maybe I will cut that out and will certainly look at the specialist food for him.

i can’t remember if he had antibiotics right at the beginning. I think he might have. I’ll will look back over our invoices.

one of the tests definitely said he has crystals in his wee. I don’t remember if they gave him anything specifically for that, I’d need to look back over his vet invoices but he defo didn’t have an operation.

he has a urinary supplement every day called Yumove, which the vet recommended. I’ll look into the other one recommendation on here.

i tried varies plug ins, calming sprays and calming supplements but they didn’t do anything.

his food I think is poultry based not fish but I will check.

https://www.amazon.co.uk/Feliway-D79310B-FELIWAY-Cystease-Capsules/dp/B00BWTP7QA

This is the stuff. It can be sprinkled on food. 2 doses per day is what we use when he’s having a flare up, 1 dose per day is a “maintenance”. It was what cracked it for us.

He’s also on Royal Canine Urinary Food which we get on prescription from the vets.

Thanks. I’ve already ordered the cystease and it arrives tomorrow. I’ve also ordered a urinary food that someone upthread posted. When I first got him he was on RC wet food and it make him throw up all the time so I’m going to try to avoid that brand.
fingers crossed this helps a bit but I’m also going to check with the vet what they did to treat the crystals as I can’t find it on the paperwork (I’m missing a few invoices). I had’t realised the crystals were actually shards that would be weed out and cause pain, no one at the vet explained that!!

Has he had blood tests to check for kidney issues, infection and diabetes? I'd be unimpressed that vet just dishes out metacam for pain relief (which can damage kidneys increase bleeding in humans, assume similar for cats).

Can you ask to see a different vet?

Try to up his fluid to help flush crystals out. Add a little water to his food or try diluted cat milks or soups.

Do you notice him licking / chewing his genitals a lot? Has the vet had a look there for any damage/ deformity?