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Blood in Dog Urine: What to Know about Hematuria

If there is blood in your dog's urine, seek veterinary care immediately. Hematuria may be a sign of a more severe underlying health condition.

A small, brown, curly dog lifts his leg to pee on some grass.

If there is blood in your dog's urine, seek veterinary care immediately. Hematuria may be a sign of a more severe underlying health condition.

By: Dr. Juli, DVM 

As dog parents, we often set our own schedules around our pup’s feeding and potty schedules. Part of responsible dog ownership is monitoring for changes in your dog’s daily habits and recognizing when there is a medical problem. Our bond with our dogs is unique, and sudden changes or illnesses can be terrifying, especially when blood is involved.

Bleeding from any part of your dog is concerning, including blood in your dog’s urine. In many cases, the cause is treatable; however, pet owners must understand the causes, signs, and actions to take when a dog is peeing blood.

A small, brown, curly dog lifts his leg to pee on some grass.

What is Hematuria in Dogs? 

Hematuria is the medical term used to describe the presence of red blood cells in a pet’s urine. Bloody urine can be identified microscopically, through specialized testing, or by observing red-colored urine. The presence of blood can be challenging to recognize, especially in dogs who urinate in wooded areas or on thicker grass. Placing a pee-pad or white piece of paper under a dog’s urine stream can make it easier to notice if blood is present. However, in some cases, dogs with hematuria will have normal, yellow, colored appearing urine. 

Common Causes of Hematuria

Hematuria can indicate various medical problems within the urinary tract or a systemic problem, like a toxin or blood clotting disorder. Bloody urine is not a disease diagnosis but a sign of underlying medical issues. The upper urinary tract, like people, includes the two kidneys and ureters, which are the tubes connecting the kidney to the bladder.

Upper urinary tract causes for bloody urine are uncommon and may include: 

  • Kidney infection
  • Kidney cancer
  • Kidney stones, which are uncommon in dogs
  • Tumors
  • Telangiectasia (widening of the kidney’s blood vessels)
  • Unknown causes (i.e., idiopathic hematuria

The lower urinary tract includes the bladder and urethra, the tube that releases urine from the body. Problems with the lower urinary tract are more commonly diagnosed in dogs with hematuria, including:

  • Cystitis (bladder inflammation): causes include polyps, infection, and anatomical abnormalities, especially in female dogs.
  • Urinary tract infection (UTI): this is one of the most common causes of hematuria in dogs and can result from various problems, including bacterial infections, skin allergies, anatomical abnormalities, hormone-related incontinence, or improper diet. 
  • Bladder stones, or crystals: genetics, nutrition, infections, or cancer can cause stone formation. Bladder stones can irritate the bladder wall, leading to painful, bloody urination.
  • Enlarged prostate (hyperplasia): Unneutered male dogs have an increased risk for an enlarged prostate, which places pressure on the urethra. Neutering is curative for associated hematuria
  • Trauma: Injury to the bladder or any part of the urinary tract can cause bloody urine.  
  • Bladder cancer: Transitional cell carcinoma (TCC) is the most common cancer affecting the bladder. TCC can also affect other portions of the urinary tract and spread throughout the body.

Dogs who are peeing blood may also have other underlying health issues affecting red blood cell health and function, including:

  • Toxin exposure (i.e., rodenticides)
  • Clotting disorder
  • Thrombocytopenia (low blood platelets) can result from various infections, toxins, diseases, and immune dysfunction.  

Signs of Hematuria

Red-colored urine is the most obvious sign that your dog suffers from hematuria. However, not all dogs with hematuria will exhibit a change in urine color. Some affected dogs may have dark, yellow-colored urine or visually normal urine. Depending on the underlying cause, affected dogs will likely have other associated signs, which may include:

  • Frequent urination, often small amounts of urine each time
  • Incontinence (dribbling of urine)
  • Excess licking of the genitals
  • Scooting or rubbing
  • Decreased appetite
  • Vomiting
  • Lethargy
  • Fever
  • Pain or vocalization during urination attempts
  • Pale gums  

When to Seek Veterinary Care for Hematuria

Dogs with hematuria should receive veterinary care as soon as possible. Many underlying causes are painful and can lead to more severe problems. Additionally, dogs who attempt to urinate without success should receive immediate emergency veterinary care. Although rare in dogs, bladder stones or excess crystals can result in urethral blockage, which can be life-threatening without treatment.  

Diagnosing and Treating Hematuria

Diagnosing hematuria and the underlying cause requires a veterinary examination. Depending on physical examination findings and concurrent clinical signs., several diagnostic tests may be recommended. In some cases, a urinalysis, or examination of the urine cells and content, may provide your veterinarian with a UTI diagnosis. However, other testing may be required, including:

  • Blood chemistry test: This evaluates organ function, including kidney disease
  • Complete blood count (CBC): A CBC evaluates red and white blood cell values. Dogs with clotting disorders will likely have an abnormal CBC.
  • Imaging: An X-ray and/or ultrasound may be required to rule out bladder stones, prostate problems, cancer, or other urinary tract issues.
  • Urine culture and sensitivity: Dogs with a severe UTI may require a more in-depth analysis to determine the best antibiotic to treat the infection.

Treatment options will depend on the underlying cause of bloody urine and may include:

  • Oral antibiotic medication
  • Pain medication
  • Antiinflammatory medication
  • Surgery to remove bladder stones
  • Chemotherapy or radiation cancer treatment
  • Specialized diet to acidify urine and decrease stone or crystal production
  • Neutering intact male dogs
  • Blood transfusion for a low red blood cell count
  • Intravenous fluid therapy to prevent dehydration and correct electrolyte imbalances 
A white dog is examined by a veterinarian and a nurse.

Hematuria Prevention Tips

Hematuria is not always preventable in dogs, but there are ways to decrease the chances of your dog suffering from bloody urine. Early recognition will provide your pup with the best chances of recovery. Follow these hematuria prevention tips:

  • Bring your dog for yearly or more frequent veterinary checkups. Regular bloodwork and urine tests can aid in early disease detection.
  • Feed your dog an AAFCO-approved complete and balanced diet to ensure proper organ function and pH levels. 
  • Regularly monitor your dog’s urination output, frequency, and urine color.
  • For dogs with recurrent UTIs, consider adding a veterinary-approved urinary health supplement, like Native Pet Bladder Chews. Always check with your DVM before giving any supplement to your pup.   

Observing your dog peeing blood can be a terrifying discovery for any pet owner. Fortunately, common causes, like UTIs and bladder stones, are treatable, and most dogs will fully recover with proper treatment.

For more information and tips on your dog’s health, check out the Native Pet blog.

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