Help, There is Blood In My Dog’s Urine!

It isn’t always obvious when your dog is sick. Sometimes, they can hide their pain or discomfort very well, or you might not see that there is something off when they are running and playing.

More obvious signs like blood in your dog’s urine are difficult to hide. But what could this mean for your dog? What should you do if you see blood in your dog’s urine?  

There are many different causes forhematuria which is the medical term for blood in the urine. One of the simplest causes is urinary tract infection. Bacteria that exist outside of the urinary tract and can enter the body and migrate up to the urinary bladder, which is supposed to be devoid of bacteria or sterile.

The most common types of bacteria implicated in urinary tract infections are the kind found in your dog’s feces likeE. coli. When present, the lining of the inside of the bladder becomes inflamed and can bleed, causing your dog’s urine to appear red or pink-colored.

There are many other causes forcystitis, aka bladder inflammation. Dogs can form bladder stones just like humans. Nutrition plays a key role but there are other factors that can lead to an increased risk of stones, including genetics.

Stones start out as small crystals that form in urine that is either too acidic or too alkaline. Crystals will attach to bacteria and then accumulate around them, causing a stone to form. Stones can be irritating to the lining of the bladder, especially if the stones are sharp and pointed like calcium oxalate stones. Diet change and sometimes surgery are often warranted.

Blood in the urine can also come from other parts of the body. For example, dogs with kidney disease or kidney infections can have blood in their urine. Female dogs that are in heat may appear as though they have blood in their urine, but this is only because urine passes through bloody vaginal discharge and typically isn’t a cause for concern.

If your dog has a blood clotting disorder, you might see blood in his urine because blood vessels cannot clot like they usually do.

Certain toxins like rat poison affect the way that your dog’s blood clots, and so rat poison ingestion can cause significant hematuria. If your dog has cancer or is being treated with certain chemotherapeutic drugs that impact the bladder, you must be on the lookout for blood in your dog’s urine.  

It is also worth mentioning that not all red urine is an indicator of hematuria. Hemoglobinuria and myoglobinuria are also possible. Hemoglobin is a protein on red blood cells that carries oxygen while myoglobin is a protein that stores oxygen in muscle cells.

Hematuria is when there are red blood cells in a urine sample, but if there is a condition that causes red blood cells to rupture (e.g. immune-mediated hemolytic anemia), your dog’s urine will be red because of hemoglobin. If your dog has had strenuous exercise, prolonged seizures, or trauma, he may have myoglobinuria due to the break down of muscle.

If you see blood in your dog’s urine, it is best to make an appointment with your veterinarian within the next 24 to 48 hours. If your dog cannot urinate or seems to be painful while urinating, this is a medical emergency and he should be seen immediately. 

You will also want to keep a thorough medical history for your dog. Know the name of the food and treats that he takes daily and be sure to list any medications or supplements that your dog is on. 

If your dog has had any recent unusual exposures like plants, human medications, rodenticide, trash, etc. then report this to your vet. Human foods like garlic and onions can cause hemoglobinuria due to anemia, and grapes and raisins can cause hematuria due to kidney failure.

It is helpful to collect a urine sample for your vet if you can. The best urine sample is one that is collected first thing in the morning. The first urine sample of the day is the most concentrated and will give your vet the best idea about what is going on in your dog’s bladder. As the day progresses, urine becomes more dilute, so if your dog has a problem with urinary crystals, your vet might not identify them in a sample that was collected in the evening. 

When collecting a sample, use a clean container with a lid. If you can’t bring the sample to your vet the right way, keep the sample in your refrigerator. Samples that are left out at room temperature for more than 30 minutes may form “false” crystals and collect bacteria and other contaminants. A urine sample can stay good in a refrigerator for up to 24 hours.

Once your dog is brought to your veterinarian, she will perform a physical exam to evaluate the abdomen and bladder. Kidneys can sometimes be palpated in lean, small dogs, and male dogs should have their prostate checked, especially if they are straining to urinate. Your vet will perform testing on your dog’s urine sample to look for bacteria, white blood cells, red blood cells, urine pH, crystals, protein, etc. 

In some cases, particularly if there are crystals in the sample, your vet will recommend an x-ray to look for bladder stones. Certain stones like struvites and calcium oxalates are easily detected via x-ray but there are other types that may appear invisible like cysteine and urate stones. Blood work is also useful because it is used to evaluate kidney function.

If your vet suspects a simple urinary tract infection, she will recommend antibiotics. If crystals are found, a therapeutic veterinary diet may be prescribed. These diets are formulated so that dogs are encouraged to drink more water, thus diluting their urine, and can prevent further formation of crystals. 

If many bladder stones are detected on x-rays, surgery may be recommended to remove them. This is especially the case if your dog is very uncomfortable and having trouble urinating. Other causes of red urine like kidney disease and toxin ingestion may require aggressive hospital care with medications and intravenous fluids. 

Advanced imaging like abdominal ultrasound may be necessary to rule out tumors, polyps, other types of bladder stones, and uterine or prostatic disease.

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There are so many different causes of hematuria that whole sections of urology textbooks are detected to the subject! Your veterinarian may need a minimum database of lab work to get started, but a good medical history from you is extremely important. You can also help get a jump start by collecting the urine sample yourself and bringing it in with you. 

Your veterinary staff will love you for it, and it will help get your dog on the fast track to feeling better. Make sure to use all prescribed medications and diet as directed, and it is also important to follow up with your vet to make sure that the treatment was effective. Failure to do so could result in a recurrence of symptoms, so make sure to go back for that recheck! 

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