Causes of Hematuria in Dogs and Emergency Response

UrinarySymptomsMeongsiljang Veterinary Advisory Board

If you notice blood in your dog’s urine, it could be due to a range of causes, from cystitis to thrombocytopenia. Here’s a guide to assessing the urgency based on urine color and how to respond in an emergency.

What If You See Blood in Your Dog’s Urine?

Illustration of a dog with a worried expression standing in front of a pee pad.

Blood in your dog’s urine is never normal. Because the urgency depends heavily on the underlying cause, it’s safest to visit a veterinary clinic as soon as possible once you notice hematuria. Hematuria can stem from a wide range of causes, including urinary tract conditions like cystitis and urolithiasis, as well as systemic or blood disorders such as thrombocytopenia. According to veterinary textbooks, urine color alone isn’t enough to determine the cause; it’s more helpful to assess the urgency and likely cause by looking for accompanying symptoms, such as pain during urination or bleeding from other areas.

Urgency Assessment Guide by Urine Color

It’s difficult to accurately determine the cause or urgency based on urine color alone. Veterinary textbooks note that the appearance of urine doesn’t always reflect the actual condition, so consider color as a reference only. If you notice blood in the urine, it’s safest to have it checked at a veterinary clinic regardless of the color.

Urine Color	Possible Causes	Urgency
Light pink	Possible lower urinary tract diseases such as cystitis or urinary tract infections; even if it seems mild, evaluation is necessary	Visit the vet as soon as possible
Dark red	Bladder stones, severe cystitis, bladder tumors	Visit the vet as soon as possible
Brown or dark reddish	Upper urinary tract (kidney) bleeding, hemoglobinuria due to hemolysis	Seek veterinary care promptly
With blood clots	Severe bleeding, coagulation disorders (e.g., rodenticide poisoning)	Immediate emergency visit

Check for These Symptoms Alongside Hematuria

Check for any of the following symptoms alongside blood in the urine.

Whining while urinating: This indicates pain during urination and is highly suggestive of cystitis or urinary tract stones.

Frequent, small-volume urination: Bladder irritation causes frequent, small amounts of urine. This is a hallmark symptom of lower urinary tract disease.

Straining with no urine output: The urethra may be obstructed by a stone. This is especially dangerous in male pets.

Lethargy and decreased appetite: These signs indicate a decline in overall health and may suggest kidney disease.

Pale gums: This raises concern for severe bleeding or hemolysis and requires an immediate emergency visit.

Illustration of a pet owner and a puppy checking for symptoms

Go to the Emergency Clinic Immediately If Your Dog Cannot Urinate

If your dog is unable to urinate at all or is straining repeatedly without producing urine, take them to an emergency veterinary clinic immediately. Urethral obstruction can rapidly progress to acute kidney failure, and if left untreated, it can lead to severe systemic complications. Male dogs are at higher risk of obstruction due to their narrower urethra, which makes them more susceptible to blockages from urinary stones. If vomiting, lethargy, or loss of appetite are also present, these are signs that your dog’s overall condition is deteriorating.

Cause of Hematuria ① Urinary Tract Disease

The most common cause of hematuria in dogs is urinary tract disease.

Cystitis: Bacterial infection causes inflammation of the bladder wall, leading to bleeding. It is more common in females and is diagnosed through urinalysis and bacterial culture, then treated with antibiotics.

Urinary stones: Stones in the bladder or urethra irritate the mucous membrane, causing bleeding. Treatment involves dietary management or surgery, depending on the stone composition.

Bladder tumors: Recurrent hematuria in middle-aged to senior dogs may indicate bladder tumors, which require confirmation via ultrasound.

Prostate disease: In intact males, prostate enlargement or infection can cause hematuria.

Cause of Hematuria ② Systemic and Blood Disorders

Hematuria can also result from causes unrelated to the urinary tract.

Immune-mediated thrombocytopenia: The immune system destroys the body’s own platelets, leading to a bleeding tendency. Veterinary internal medicine textbooks classify thrombocytopenia as one of the systemic diseases that can cause hematuria.

Rodenticide poisoning (anticoagulant poisoning): The active ingredients in rat poison interfere with blood clotting, causing bleeding from multiple sites such as urine, feces, and gums. If your pet ingested a foreign substance while walking, this should definitely be suspected.

Kidney disease: Damage to the upper urinary tract, including the kidneys, can cause painless hematuria. The urine often appears pink to brown.

Illustration of a puppy receiving a full-body examination at a veterinary clinic

Prepare Like This Before Your Vet Visit

Bringing the following information to your vet visit can help speed up the diagnosis.

Bring a urine sample: If possible, collect urine in a clean container. The fresher the sample, the more accurate the test results will be.

Take a photo of the urine color: Color can provide important diagnostic clues. Take a picture as soon as you notice any changes.

Record when symptoms started: Note when you first noticed blood in the urine, how often it occurs, and any other accompanying symptoms.

List of medications and supplements: Inform your vet about any medications or supplements your pet is currently taking.

Pay Special Attention to Unspayed Females

Unspayed females may experience genital bleeding during their heat cycle, which can mix with urine and resemble hematuria. However, if bleeding occurs outside of the heat cycle, it could indicate a serious condition such as pyometra, so it is essential to have your pet examined by a veterinarian. For unneutered males, it is also advisable to check for potential prostate issues.

Preventive Habits for Maintaining Urinary Tract Health

While it’s difficult to completely prevent hematuria, maintaining urinary tract health can help reduce the risk.

Adequate hydration: Drinking plenty of water dilutes urine, reducing the concentration of bacteria and stone-forming substances. Place clean water bowls in multiple locations.

Regular opportunities to urinate: Holding urine for long periods allows bacteria to multiply in the bladder. Ensure regular walks for bathroom breaks.

Routine urine tests: Including a urine test during regular health checkups can help detect hidden hematuria at an early stage.

Managing hazardous substances: Prevent your pet from ingesting foreign objects during walks, and keep rodenticides out of reach at home.

Illustration of a healthy puppy drinking clean water.

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

My dog had blood in his urine just once. Should I take him to the vet?

Yes, if your pet has ever had blood in their urine, it's a good idea to visit the vet. If you can see blood in the urine, it means there's already some level of bleeding. A simple urine test can help quickly identify the cause.

Is there a difference in the likelihood of hematuria between male and female pets?

Anatomical differences between males and females can lead to variations in the presentation of related conditions. Lower urinary tract diseases, including bacterial cystitis, can occur in both sexes, but because the underlying causes vary depending on each individual’s condition, an accurate veterinary examination is essential. On the other hand, urethral obstruction requires particular attention in male animals. If your pet is straining to urinate but nothing comes out, seek emergency veterinary care immediately.

How is a hematuria test conducted?

We start with a basic urinalysis to check the urine’s color, pH, bacteria, and crystals. Depending on the case, we may also perform a bacterial culture, blood tests, abdominal ultrasound, or X-rays. Your veterinarian will determine the appropriate scope of testing based on your pet’s symptoms.

My dog’s urine is orange—could it be blood in the urine?

Orange urine may not indicate blood in the urine; it can be caused by dehydration or certain foods. However, if the urine is pink, red, or brown, you should suspect hematuria. If you're unsure about the color, take a photo and show it to your veterinarian.

Is there any first aid I can do at home if my pet has blood in their urine?

There’s no effective way to treat this at home. The most important thing is to get to a veterinary clinic as quickly as possible. Collecting a urine sample and taking photos of its color can help with diagnosis. If your pet isn’t producing any urine at all, go to an emergency vet immediately.

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References

[1] Clinical Medicine of the Dog and Cat, 4th Ed — Chapter 2.11: Pigmenturia / Hematuria

[2] Clinical Medicine of the Dog and Cat, 4th Ed — Chapter 2.5: Dysuria and Lower Urinary Tract Disease

[3] The Veterinary Workbook of Small Animal Clinical Cases — Case 18: The Cat with Hematuria

[4] Small Animal Internal Medicine, 6th Ed — Section: Diseases of the Lower Urinary Tract