My Dog’s Hematuria Could Be Bladder Cancer (TCC) — A Complete Guide from Causes to Treatment

ImmunityDiseasesMeongsiljang Veterinary Advisory Board

We’ve compiled evidence-based veterinary information on transitional cell carcinoma (TCC), the most common type of bladder cancer in dogs, covering its causes, early symptoms, and diagnostic and treatment methods. Early detection can significantly improve survival time.

What Is Canine Bladder Cancer (Transitional Cell Carcinoma, TCC)?

A veterinarian performing an ultrasound examination on a puppy's lower abdomen.

In dogs, bladder cancer most commonly refers to transitional cell carcinoma (TCC), a malignant tumor arising from the urothelium—the mucosal lining of the bladder. The key to successful management is early detection. If symptoms such as hematuria (blood in the urine) or difficulty urinating persist despite treatment for simple cystitis, do not dismiss them as merely a bladder infection; instead, an abdominal ultrasound is strongly recommended. TCC develops when the urothelial cells of the bladder and urethra undergo malignant transformation. Because the stage and extent of the disease at diagnosis significantly influence treatment options and prognosis, recognizing any changes in your dog’s urination habits as early as possible is paramount.

Causes and Risk Factors

Transitional cell carcinoma is generally thought to arise not from a single cause, but from the combined effects of genetic predisposition and various other factors. Veterinary textbooks cite cases where urinary tract epithelial tumors were suspected in specific breeds, such as Scottish Terriers, highlighting breed predisposition as a risk factor. Additionally, bladder and urethral carcinomas are reported to be relatively more common in neutered animals. If your pet exhibits recurrent lower urinary tract symptoms or is older, it’s wise to consider the possibility of a tumor. We recommend consulting with your veterinarian to assess your pet’s specific risk factors.

Early Symptoms That Are Easy to Miss

Symptoms of transitional cell carcinoma (TCC) closely resemble those of simple cystitis, making misdiagnosis common. If symptoms do not improve with antibiotic treatment, a tumor should be considered. - Hematuria: The end portion or the entire stream of urine may appear red, and the urine color may become cloudy or change. - Dysuria: Frequent trips to the litter box (pollakiuria) with only small amounts of urine passed each time. - Painful urination: Straining, vocalizing, or maintaining a urination posture for an extended period while urinating. - Urinary incontinence: Accidental urine leakage during sleep or difficulty holding urine. - Systemic symptoms: As the tumor progresses, abdominal pain, decreased appetite, vomiting, and lethargy may also occur.

A puppy that has been in the urination posture for an extended period

When to Seek Immediate Veterinary Care

If your pet is unable to urinate at all or if blood in the urine persists, it could be an emergency. A tumor blocking the urethra can cause urinary obstruction, preventing urine from being expelled and leading to increased pressure toward the kidneys, which may result in acute kidney damage such as hydronephrosis or ureteral obstruction. In such cases, elevated blood potassium levels (hyperkalemia) can rapidly worsen the overall condition, posing a life-threatening risk. If your pet shows signs of abdominal pain when touched, a sudden loss of appetite, or vomiting, seek immediate care at a 24-hour veterinary clinic.

Diagnostic Process

Diagnosis involves several steps. A simple urinalysis alone is rarely enough for a definitive diagnosis, so imaging and cellular or tissue examinations are also performed. - Abdominal ultrasound/imaging: This basic test checks the condition of the bladder wall and the location of any tumors. - Urinary sediment/cytology: This test looks for abnormal urothelial cells in the urine, which can raise suspicion of a tumor. - BRAF gene test: This non-invasive screening test detects a genetic mutation found in about 95% of transitional cell carcinomas (TCC) using naturally voided urine. It has high sensitivity and specificity and can be performed without anesthesia. - Tissue biopsy/advanced imaging: A tissue sample is directly collected to confirm the diagnosis, while imaging evaluates whether the cancer has spread to lymph nodes or other areas. It usually takes about 3 to 7 days to receive the results from a tissue biopsy.

Treatment Options — Vary by Location and Stage

TCC (transitional cell carcinoma) tends to develop in the trigone of the bladder (where the ureters and urethra open), and it can invade the ureteral orifices or the prostatic urethra, making complete surgical removal difficult in many cases. Therefore, treatment is often centered on medication rather than surgery. - Nonsteroidal anti-inflammatory drugs (NSAIDs, such as piroxicam): These are frequently used as first-line drugs, with a response rate of about 18% when used alone and about 35% when combined with chemotherapy. - Chemotherapy: Drugs such as doxorubicin, cyclophosphamide, mitoxantrone, cisplatin, and carboplatin are administered according to the individual case. - Surgical resection: Surgery is limited to select cases where the tumor is localized, due to the risk of tumor cell seeding (spread) to the abdominal wall and other areas. - Radiation therapy: Successful applications have been reported for localized tumors, and it is considered for palliative purposes. The veterinarian will determine the appropriate drug combinations and schedule based on whether metastasis has occurred and the patient’s overall health status.

A veterinarian preparing a puppy for cancer treatment.

Home Care Tips

Proper home care for a dog undergoing treatment is directly linked to their quality of life. Consistent daily management alongside medication helps maintain their overall condition. - Frequent water changes: Replace the water with fresh water several times a day to encourage hydration. - Increase opportunities for walks and urination: Encourage frequent urination to prevent urine from stagnating in the bladder for extended periods. - Minimize irritation: Reduce exposure to environments that may irritate the lower urinary tract and maintain cleanliness. - Stress management: Maintain a consistent daily routine to help your dog feel secure and calm. - Regular follow-up visits: Schedule follow-up examinations, such as ultrasounds, at intervals determined by your veterinarian to monitor any changes.

Important Information for Scottish Terrier, West Highland White Terrier, and Shetland Sheepdog Owners

Veterinary textbooks report transitional cell carcinoma (TCC) in Scottish Terriers and Shetland Sheepdogs, making these breeds particularly prone to the disease. Other terrier breeds are also considered high-risk, so it’s a good idea to discuss your dog’s breed-specific predispositions with your veterinarian. For middle-aged and senior dogs, we recommend regular urinalysis and abdominal ultrasounds. Early detection expands treatment options and can improve prognosis. If you’re concerned about breed-specific genetic conditions, you can find more detailed information in our Breed-Specific Health Care Guide.

Reviewed by a veterinarian

Dr. Tony — Punnawat Phongkittirak

Veterinarian

A veterinarian who majored in veterinary medicine at Khon Kaen University, Thailand, and completed the IVSA program at North Carolina State University in the United States. Drawing on clinical experience at animal hospitals, he works in the pet healthcare field and is dedicated to building a digital care environment that connects pet parents with veterinarians.

Frequently Asked Questions

Can bladder cancer in dogs be cured?

While a complete cure remains difficult with current medical standards, this condition is managed as a chronic disease through a combination of medication and regular check-ups. Cases have been reported where survival time has been extended when the disease responds to treatment, and early detection is beneficial for improving the prognosis.

Does blood in the urine always mean bladder cancer?

Not necessarily. The most common causes of hematuria are cystitis, bladder stones, and prostate disease. However, if blood in the urine persists after two weeks of antibiotic treatment, or if the dog is senior, it is essential to rule out the possibility of tumors.

What is a BRAF gene test?

This noninvasive screening test analyzes urine samples to detect genetic mutations commonly associated with transitional cell carcinoma (TCC). These mutations are found in approximately 95% of TCC cases, and the test boasts high sensitivity and specificity. Since it can be performed using naturally voided urine without anesthesia, it is particularly useful for routine health screenings in high-risk breeds.

How long can a pet live with bladder cancer?

While there is significant variation among individual dogs, studies have reported a median survival time of approximately seven months to one year for those that respond to medication. Outcomes can vary depending on whether the cancer has metastasized, the tumor’s location, and the response to treatment, so please discuss a tailored treatment plan with your veterinarian.

Is there a way to prevent it?

While there’s no guaranteed way to prevent it, overall health management—such as maintaining a healthy weight and ensuring adequate hydration—can help. For high-risk breeds, the most practical preventive measure is early detection through regular urinalysis and abdominal ultrasounds once they reach middle to senior age.

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References

[1] Withrow, S.J., Vail, D.M., Page, R.L. Withrow and MacEwen's Small Animal Clinical Oncology, 5th Ed (Urinary Bladder Tumors Chapter)

[2] Kustritz, M.V.R. et al. Veterinary Surgical Oncology, 2nd Ed

[3] Knapp, D.W. et al., Naturally-occurring canine transitional cell carcinoma of the urinary bladder: A relevant model of human invasive bladder cancer, Urologic Oncology, 2014

[4] Mutsaers, A.J., Widmer, W.R., Knapp, D.W., Canine transitional cell carcinoma, J Vet Intern Med, 2003