Blood In Your Dog’s Urine? Here’s What To Do

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When you see blood in your dog’s urine, it might make you panic … understandably! But before you start to worry too much there are two things you need to know …

  1. There are a lot of different reasons your dog could have blood in his urine. 
  2. The most common reasons aren’t emergency situations and are very treatable. 

There are also a lot of ways vets can diagnose and remedy these problems. But some of the options can do more harm than good. 

Aome of the reasons you might find blood in your dog’s urine are described below. You’ll also find out about some of the diagnostic tools vets use … and which ones you may want to avoid. 

Causes Of Blood In Your Dog’s Urine 

When dogs have bloody urine (hematuria), it will look amber, orange, red or brown. It isn’t always easy to see a change in color unless your dog pees on something light colored like snow … or a rug. If you think you see discoloration, place a paper towel or white cloth under your dog the next time he pees. 

If you do see blood in your dog’s urine, here are some of the more common reasons for it.

1. Urinary Tract Infection (UTI)

UTIs are one of the most common reasons to see blood in your dog’s urine. Most people think bacterial infections cause UTIs but … a lot of the time it’s actually inflammation. That’s why many holistic vets refer to UTIs as urinary tract inflammation instead of infection. 

Other Signs Of UTIs

  • Cloudy urine 
  • Straining or whimpering while peeing 
  • Accidents in the house 
  • Needing to go out more often 
  • Licking genitals 
  • Restlessness 
  • Waking up during the night to go out 
  • Fever 

If your dog has had UTIs in the past, he’s more likely to have another one. If this is the first time he’s shown these symptoms, you might want to talk to your holistic vet. Or, you may also want to contact your vet if your dog has a history of UTIs but this is the first time you’ve seen bloody urine. 

Conventional treatment for UTIs is antibiotics. But antibiotics can wreak havoc on your dog. That’s because they don’t just kill the bacteria causing the UTI (assuming it’s really an infection). They also damage the beneficial bacteria in your dog’s gut … forever. 

Overuse of antibiotics is creating antibiotic resistant bacteria. This is a global threat that has led to conditions like MRSA, which is extremely difficult to treat (1).

And antibiotics may not solve your dog’s UTI … especially if your dog doesn’t have a bacterial infection, but inflammation as mentioned earlier. So antibiotics may provide temporary relief by suppressing the symptoms, but they don’t treat the deeper cause. That’s why many dogs who have UTIs once will continue to get them. 

Fortunately, there are many natural solutions that can help you soothe your dog’s UTIs. And they can do it without destroying beneficial bacteria and creating resistance. 

RELATED: Read about home remedies for dog UTIs …

2. Poisoning

Another common cause of blood in dog urine is poisoning. There are many different substances that can cause accidental poisoning in dogs. Antifreeze is a common one. But the most common poison that causes urine in the blood is rodenticide … meaning rat or mouse poison (2). 

Rodenticides work by preventing blood from clotting in mice, rats and other pests. Because the poison stops blood clotting, the pests will hemorrhage and bleed to death. If your dog swallows rodenticide (or an animal that’s eaten it), it will cause blood in his urine.

Other Signs Of Rodenticide Poisoning

  • Lethargy 
  • Coughing (sometimes with blood)
  • Exercise intolerance 
  • Difficulty breathing 
  • Pale gums 
  • Low pulse 
  • Joint swelling 
  • Vomiting (with or without blood)
  • Dark bloody stools 

This type of poisoning is an emergency. If your dog got into rodenticide or another poison or shows these symptoms, contact your vet immediately

Your vet will make a diagnosis based on the information you provide. If you know your dog ate something poisonous, your vet will start treatment immediately. If you don’t know what’s wrong but the vet believes it could be poisoning, they may run tests. 

Treatment for rodenticide poisoning may include …

  • Activated charcoal to induce vomiting
  • Vitamin K1 supplementation (over the counter medication and whole foods may not be enough) 
  • Intravenous (IV) fluids to improve electrolyte, calcium, and phosphorus levels 
  • Blood or platelet transfusions to assist clotting
  • Phosphate binders – help reduce the absorption of phosphate from the rodenticide 

You shouldn’t try to manage poisonings at home. Different poisons need different treatments, so follow your vet’s guidance. 

3. Urinary Tract Stones 

Stones are also one of the most common causes of bloody urine, especially in female dogs. Some breeds are also more predisposed to stones than others. This includes Dalmatians, Shih Tzus, Miniature Schnauzers and Yorkshire Terriers. 

If your dog has stones he’ll likely show other symptoms. These will vary depending on the location of the stones in the urinary tract. 

Signs Of Bladder Stones

  • Straining to urinate 
  • Small, frequent pees 
  • Abdominal discomfort 
  • Accidents 

Signs Of Urethral Stones

  • Dribbling urine 
  • Straining to urinate
  • Trying to pee but nothing comes out

Signs Of Urethral Stones Specific To Females

  • Abdominal discomfort 
  • Decreased appetite 
  • Lethargy 
  • Vomiting

Signs Of Kidney Stones

  • Fever
  • Abdominal discomfort
  • Kidney pain
  • Blood in the urine (hematuria)
  • Altered urine production (increased or decreased)
  • Lethargy
  • Poor appetite
  • Vomiting
  • Weight loss

If your vet suspects stones, she may run tests to find out the type of stone and location. Once your vet has located the stone and confirmed the type, she’ll provide treatment options. This can include …

  • Prescription diets low in protein and magnesium
  • Antibiotics 
  • Surgery 
  • Other non-surgical procedures, such as using a catheter and liquid to flush the stones out.

But these are not the best choices for your dog. Read about diets and natural remedies that help with different types of stones.

4. Kidney Disease (Renal Failure)

Kidney disease is becoming more and more common in dogs. It’s more often seen in older dogs but can also affect younger pets.  There are two types of kidney disease …

Acute kidney disease, which can be potentially fatal so you must treat it immediately. This type of kidney failure is usually caused by a buildup of waste and toxins.

Chronic kidney disease, which is the gradual loss of kidney function. It’s linked to infection, diet, vaccines, and kidney stones, as well as other factors. Early detection is critical to limit damage and maintain quality of life. 

Other Signs Of Kidney Disease

  • Vomiting 
  • Lethargy 
  • Loss of appetite
  • Lack of urine when peeing 
  • Increased drinking and urination 
  • Dry or flakey skin and coat 
  • Bad breath 
  • Anorexia
  • Nausea
  • Weight loss 
  • Sunken eyes

Conventional treatments will depend on how far into the disease your dog is. In late stages, the kidneys may have damage beyond repair. But if caught early enough, conventional vets have some solutions.

One solution vets offer is prescription diets. But holistic vets don’t recommend these low-protein diets. They say that what your dog needs is not low protein, but a high-quality species-appropriate diet with easily digestible protein and other foods that promote healthy kidneys.

So it’s best to work with a holistic vet who’ll help you find the best diet for your individual dog with kidney problems.

5. Prostate Issues In Male Dogs 

Blood in your male dog’s urine could also be a sign of prostate problems. According to Oklahoma State University, 50% of intact males will experience benign prostatic hyperplasia (BPH) by 4 years of age. BPH is the most common prostate issue but … there are many different prostate diseases that could cause bloody urine. 

Other Signs Of Prostate Problems

  • Prolonged urination 
  • Produces a thin stream of urine (due to obstruction)
  • Difficulty passing bowel movements 
  • Straining to urinate and defecate 

Because there are many different prostatic diseases, treatment options vary … but there are natural optionsSo no matter the diagnosis … be sure to do your research before you commit to conventional treatment.  

The above are 5 of the most common reasons your dog will have blood in his urine. But there are a few others you should take note of …

Other Possible Causes Of Blood In Your Dog’s Urine 

Some other reasons your dog may have bloody urine will be more obvious. This includes: 

Estrus 

When your female dog is in heat, she may look as if she has blood in her urine. If you didn’t spay your dog, her vulva is swollen and there are drops left behind when she sits, she’s likely in heat. 

Recent Surgery 

If your dog had surgery near the urinary tract, irritation and inflammation can lead to light bleeding. Check in with your vet to find out whether this should be cause for concern. 

Trauma

If your dog has experienced trauma, it could cause bloody urine. Some traumas (like getting hit by a car), will trigger an ER visit before you begin to see symptoms. In other situations you may not take him to the vet if you don’t notice any physical damage.  

If your dog has a physical trauma followed by bloody urine, contact your vet. He could have internal bleeding.

Other Signs Of Physical Trauma

  • Weakness 
  • Trouble breathing 
  • Pale gums 
  • Distended Abdomen 
  • Collapse 
  • Vomiting 
  • Loss of appetite

There are a few other reasons for dogs to have blood in their urine. These are less obvious but very serious … and fortunately much rarer. 

Cancer 

Cancer of the urinary tract is rare in dogs. The most common type of urinary tract cancer is transitional cell carcinoma (TCC). It accounts for less than 1% of cancers in dogs. There are also some breeds prone to urinary tract cancer …

  • West Highland White Terriers 
  • Scottish Terriers 
  • Shetland Sheepdogs
  • Beagles

Other Signs That Could Indicate Cancer

  • Weight loss 
  • Loss of appetite
  • Depression 
  • Fever 
  • Abdominal pain 
  • Vomiting 
  • Lethargy 
  • Swelling of the abdomen 
  • Increased urination and drinking 
  • Difficulty urinating 
  • Frequent daytime urination
  • Painful urination
  • Frequent urination with little urine
  • Intractable secondary bacterial tract infections 
  • Incontinence 

But remember, cancer is a much more unlikely reason for bloody urine than other urinary tract issues. 

Clotting Disorders 

When your dog gets injured and starts to bleed, his blood vessels narrow to slow the flow of blood. This allows the blood to clot, which protects the wound and limits blood loss. 

But sometimes there’s a problem with your dog’s blood that prevents clotting. It could be an external factor like rodenticide, described earlier. Other times, your dog’s body may misuse or be deficient in the proteins that help with blood clotting. Certain diseases, like tick borne illnesses, can also affect the blood’s ability to clot. 

Other Signs Of Clotting Disorders

  • Bleeding gums 
  • Red spotting on teeth 
  • Black stool 
  • Nosebleeds 
  • Large bruises 
  • Prolonged bleeding after injury or injection

What To Do If There’s Blood In Your Dog’s Urine

If you see blood in your dog’s urine, and your dog doesn’t have a history of UTIs or isn’t in heat, give your holistic vet a call.  Holistic vets take a more natural and noninvasive approach to your dog’s health. Many of the most common causes for bloody urine have natural alternatives. These options are safe and effective, without the risks of conventional treatments. 

If your vet does want your dog to come in, she’ll most likely want a sample of your dog’s pee for diagnostics. If you can, bring a sample with you. It’s best to get a first morning sample and refrigerate it until the appointment time. 

Once you arrive at the vets, she’ll do a diagnosis. Depending on the symptoms and your dog’s medical history, this may mean a variety of tests. 

How Vets Diagnose The Cause Of Bloody Urine 

One of the first things your vet will do when you arrive is a physical examination of your dog. She’ll check the genital area and feel the abdomen, bladder and kidneys. In male dogs your vet will also palpate the prostate. 

Your vet may want to do further tests, depending on what she finds. Here are some of the more common tests.

Urinalysis 

urinalysis looks at the physical and chemical properties of your dog’s urine, including color, clarity, pH, glucose, ketones, and more.  If you don’t bring a urine sample, your vet may collect one. How invasive this test is depends on the collection method. 

Voluntary Sample – The vet collects urine in a sterile cup as your dog pees. This method may be a bit awkward for you and your pooch but it’s noninvasive. 

Catheterization – The vet passes a catheter up the urethra and into the bladder. A syringe is then used to draw a sample through the catheter. This method is more invasive and may be necessary if you can’t get a voluntary sample. 

Cystocentesis – The vet will use a needle to collect urine directly from the bladder. This can sometimes leave traces of blood in the sample, which can skew results. But it also ensures a sterile sample as it avoids contamination from debris in the lower urinary passage. This method doesn’t sound like fun, but holistic vet Dr Randy Kidd DVM PhD says most dogs aren’t bothered by it. 

Urine Protein-Creatinine Ratio 

Your vet may do this test if your dog’s urinalysis is negative for protein. It’s also a common diagnostic tool to determine the degree of kidney failure if your dog has kidney disease. 

To determine this ratio the vet may test your dog’s urine sample for protein and creatinine. Your vet will also likely do a Blood Urea Nitrogen (BUN) and Serum Creatinine test, as well as a BUN-Creatinine ratio. These are blood tests that will help your vet understand how your dog’s kidneys are working.

Culture Test 

A culture test identifies which bacteria are in your dog’s urine (if there are bacteria). It lets your vet determine which antibiotic to use. If you’re not going to give antibiotics, you don’t need to do a culture.

Ultrasound And Radiographs

Ultrasounds and radiographs (x-rays) let your vet look at your dog’s internal organs to see if there is damage or other causes for concern. Ultrasounds and x-rays are commonly used for poisonings. This helps the vet see if there’s blood in the chest or abdomen or damage to organs. Imaging may also be helpful for …

  • Identifying the location of urinary tract stones
  • Diagnosing cancer
  • Identifying prostate problems

If you have the option, an ultrasound is the better option, as radiographs expose your dog to radiation. But not all vet clinics have their own ultrasound machine.

Blood Pressure Measurement 

Vets may use blood pressure tests if your dog has kidney disease. It will help determine the degree of kidney failure. Your vet may also check your dog’s blood pressure if he has kidney stones. It will show whether the stones are a symptom of kidney disease. 

Blood Tests 

Blood tests help veterinarians identify certain diseases and conditions. They can show how your dog’s organs are functioning and how far along certain diseases are. This may include specialized tests for specific diseases, like the BUN and Creatinine tests I mentioned earlier.

But there are more generalized blood tests as well. One of the most common types of blood test is a complete blood count (CBC). This test looks at red and white blood cells, as well as platelets (cells that help blood clot). This is useful for looking at …

  • Hydration
  • Anemia 
  • Blood clotting ability 
  • Infection 
  • Inflammation 
  • Allergy 

Some blood tests will also include a test for electrolyte levels. This will look at the risk of stone formation and whether your dog has kidney disease. Your vet may also do a CBC for  kidney disease and kidney stones to look at how the kidney is functioning. 

Blood tests are also common for poisoning. For example, with rodenticide poisoning blood work will identify prolonged blood clotting times. 

More Invasive Tests Your Vet May Suggest 

So far, most of the tests we have looked at are noninvasive. But there are other diagnostic tools your vet may recommend that are much more invasive

Cystourethroscopy 

Cystourethroscopy is an endoscopic examination of the urinary tract. Your dog will be anesthetized and then the vet will guide a tube with a camera into your dog’s body to look at the organs and tissue.  Vets may suggest a cystourethroscopy for something as common as a UTI. This is usually an unnecessary stress for your dog.

Cystourethroscopies are also recommended for cancer diagnostics. Even then, there are tests that you can request that are much less invasive, such as ultrasounds and x-rays.. 

Cytology tests may also be an early alternative to cystourethroscopy. A cytology is the examination of urine for cancer cells.

Veterinary Bladder Tumor Antigen (VBTA) tests can screen urine for signs of cancer. But dogs with bladder infections can test positive for this test, even if they don’t have cancer. 

If a cystourethroscopy is recommended for any reason, ask your holistic vet for her opinion. While the risk of long term effects is minimal, this procedure is invasive and other options may be available. 

Biopsies 

Vets use biopsies to confirm a diagnosis of urinary tract cancer. It involves taking a tissue sample from the urinary tract for examination. Samples are often collected through surgery or by using a urinary catheter. They’re also sometimes done during a cystourethroscopy. 

It’s best to avoid needle biopsies, as the needle can stir up cancer cells. 

But there’s a new alternative called liquid biopsies (3). This method examines bodily fluids for signs of cancer. In the case of urinary tract cancer, you would simply need a urine sample. The sample is then examined for indicators of cancer, such as the BRAF mutation (4, 5). Liquid biopsies are non-invasive procedures and have shown success with detection at early stages

If your conventional vet recommends a biopsy, ask your holistic vet for advice or inquire about a liquid biopsy. 

Exploratory surgery

Exploratory surgery is when vets do surgery to investigate your dog’s body. It’s used when vets can’t diagnose the problem through other available alternatives.  But even with exploratory surgery, there’s a chance your vet won’t find a cause. 

The Bottom Line 

There are many reasons why your dog could have bloody urine but the most common causes are treatable. If you do find blood in your dog’s urine, speak with your holistic vet. She’ll help you diagnose and treat the cause, without the risk of long term side effects.

It’s also important to research any recommended tests before you agree to them. Not all tests are necessary and many have non-invasive alternatives that will ultimately be better for your dog. 

References
  1. Medina E, Pieper DH. Tackling Threats and Future Problems of Multidrug-Resistant Bacteria. Curr Top Microbiol Immunol. 2016;398:3-33.
  2. Safdar A Khan DVM MS, PhD, DABVT, Mary Schell DVM, DABVT, DABT. Rodenticide Poisoning. Merck Veterinary Manual. October 2020.
  3.  Wiley C, Wise CF, Breen M. Novel Noninvasive Diagnostics. Vet Clin North Am Small Anim Pract. 2019 Sep;49(5):781-791. 
  4. Grassinger JM, Aupperle-Lellbach H, et al. Nachweis der BRAF-Mutation bei kaninen Prostataerkrankungen [Detection of BRAF mutation in canine prostatic diseases]. Tierarztl Prax Ausg K Kleintiere Heimtiere. 2019 Oct;47(5):313-320. German.
  5. Mochizuki H, Breen M. Comparative Aspects of BRAF Mutations in Canine Cancers. Vet Sci. 2015 Aug 24;2(3):231-245. 

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