Hematuria in Dogs

Just as in human medicine, the word hematuria itself refers to the presence of blood in the urine. It usually points to conditions in the genitourinary system.

Below, we'll find out why it can occur, along with the symptoms that can accompany it and the treatment it calls for. Let's get to it.

What Is Hematuria?

Hematuria isn't a condition in itself, but a symptom or sign referring to the presence of blood in the urine. As mentioned, it usually points to some problem linked to a disease of the urinary or genital tract. This system includes the genital tract, kidneys, ureters, bladder, and urethra in its various sections.

It will rarely be a condition that puts our animal's life at risk. Only in very severe cases, such as trauma from being hit by a car, or kidney-related cases leading to shock, will it be dangerous for its life.

Main Causes of Hematuria

There's a wide range of causes or conditions that can cause this sign. Some of these are:

• Stones. These can be caused by different types of crystals in the kidneys, ureters, bladder, or urethra. Although based on my professional veterinary clinical experience they tend to be located more in the bladder and urethra. There's a breed predisposition, as in Dalmatians with ammonium urate stones. But the ones that occur most often are struvite and calcium oxalate stones. Stones are usually accompanied by pain when urinating. Some of these stones simply dissolve with diet, others require surgery.
• Bladder tumors. These are masses that, due to their location, can cause the bladder wall to bleed, which shows up in the urine.
• Trauma: for example, from being hit by a car, injuries can occur in the urinary tract, resulting in blood coming out through the urine.
• Prostate conditions: these occur in unneutered dogs. Prostate inflammation can cause pain and hematuria, among other symptoms we'll describe below.
• Cystitis. This is inflammation of the bladder wall. Just as in humans, severe cystitis can cause hematuria in our pet.
• Infectious diseases such as Lyme disease or leptospirosis.
• Coagulopathies such as disseminated intravascular coagulation, hemophilia, rodenticide poisoning, thrombocytopenia, or low platelet count.

How to Know If a Dog Has Hematuria? Symptoms

As hematuria indicates, the main sign or symptom will be blood present in the urine, to a greater or lesser degree. This can appear as clots or dissolved abundantly and uniformly in the urine. As well as in a wide range of colors, from pinkish, to brown, to reddish.

This is normally accompanied by pain when urinating or when the bladder is pressed externally, as well as caudal abdominal pain, possibly expressed through abnormal postures. The dog may urinate and drink more water than normal.

Diagnosis

First, the vet will get an idea of the case through a history of our pet. Following this, they'll perform a general physical exam to get an initial idea of how serious the situation is.

The results of the history and physical exam often help locate the disease in the urinary tract (upper or lower), but as with many conditions, additional tests will be needed. As a general rule, hematuria at the start of urination is usually linked to problems in the genital tract and urethra (closer to the exit opening). On the other hand, hematuria at the end of urination can be linked to bladder problems.

A urinalysis will be needed to determine whether it's cystitis. Ideally, this is done through cystocentesis (obtaining a urine sample with a syringe and needle through the skin, guided by ultrasound).

This will be checked with a urine test strip, which may show a basic pH (above 7), the presence of white blood cells, etc. Urine density can be assessed with a refractometer. In dogs, it should be between 1015-1045. Centrifuging the urine and later analyzing the sediment will help spot the possible presence of crystals in the urine.

Through an abdominal X-ray, the vet will be able to see the size of the prostate and check whether there are stones in the bladder, kidneys, urethra…

An abdominal ultrasound will be quite useful diagnostically for spotting stones not visible on X-ray, and for assessing kidney, prostate, urethral, and bladder shape…

What Is the Treatment for Hematuria?

Hematuria needs to be assessed to determine the source of the bleeding and the underlying cause, so the right treatment can be recommended.

If the cause is trauma and there's a damaged organ, surgery may be needed, generally the same as with tumors.

In cases of stones, it will depend on their size and location. Some of these can be dissolved with fluid therapy and diet. Others will need to be removed surgically, as in the previous case. Urethral catheterization may be needed to move stones lodged in the urethra into the bladder and remove them surgically from there.

If the hematuria is due to cystitis, treatment will be aimed at treating the infection with antibiotic therapy and anti-inflammatories such as meloxicam.

As you can see, an exact diagnosis can't be made at home without taking the pet to a vet clinic. So if you notice hematuria in your furry friend, the best thing is to ask a professional whose job is exactly this.