How to Assess Blood in Your Dog’s Urine (Hematuria): Causes, Urgency, and Treatment

Blood in a dog’s urine can come from urinary tract infections, stones, trauma, cancer or bleeding disorders. This guide helps you assess urgency, what to observe, and what to expect at the vet.

Is This an Emergency?

Yes — sometimes. Blood in your dog’s urine (hematuria) can range from a minor, quickly treatable infection to a life-threatening problem. Seek immediate veterinary care if any of the following are present:

• Your dog cannot pass urine or is straining with little/no urine produced (possible urinary obstruction).
• Very large amounts of bright red blood or visible blood clots in the urine.
• Pale, white or tacky gums, weakness, collapse, rapid breathing or fast heart rate (signs of significant blood loss or shock).
• Severe abdominal pain, distension, or collapse.
• High fever, persistent vomiting, or severe lethargy.

Note: Although this article focuses on dogs, be aware that a male cat that is straining and not producing urine is a life-threatening emergency (obstructive urethral blockage) and requires immediate veterinary attention within 24–48 hours. Do not delay for cats.

(Information summarized from Merck Veterinary Manual and ACVIM guidance.)

Common Causes (ranked by likelihood)

• Most common in older or female dogs and those with underlying conditions. Bacteria invade the bladder lining causing inflammation that can produce visible blood.

• Minerals form stones that irritate or scratch the bladder or urethral lining, leading to bleeding. Some types (struvite, calcium oxalate, urate) are common.

• Noninfectious cystitis (sterile inflammation) can occur from irritants, stress, or idiopathic causes; commonly causes blood-tinged urine and frequent urination.

• Direct trauma to the abdomen, pelvis, or urinary tract (e.g., hit by car) may cause bleeding from the kidneys, bladder or urethra.

• Prostatitis, benign prostatic hyperplasia, or prostatic abscesses and tumors can cause hematuria in intact male dogs.

• Rodenticide poisoning, platelet disorders, or liver disease can lead to bleeding in the urinary tract among other sites.

• Transitional cell carcinoma (bladder cancer) and other neoplasms are more likely in older dogs and can cause intermittent bleeding.

• Infection or inflammation of the kidneys can lead to blood in the urine, often accompanied by systemic illness.

• Sticks, grass awns, or urethral strictures can mechanically injure the tract and lead to bleeding.

What to Observe (information to gather before calling the vet)

When you call or present to your veterinarian, having the following details will help triage and diagnosis:

• Exact appearance of urine: pink, red, rust-colored, bright crimson, or brown. Note if there are clots.
• How long you've seen the blood and whether it’s continuous or intermittent.
• Frequency of urination and whether your dog is straining or producing small amounts.
• Any changes in appetite, drinking, vomiting, coughing, fever, or activity level.
• Any recent trauma, medication changes, or exposure to toxins (rodenticides, certain supplements).
• Whether your dog is intact or spayed/neutered, age, breed and any prior urinary issues (stones, recurrent UTIs).
• Photo or sample of the urine if possible (see Home Monitoring).

Home Monitoring (what owners can safely do while waiting)

Important: Never try to diagnose or treat a urinary condition at home. Do not give antibiotics, painkillers, or anti-inflammatories unless prescribed by your veterinarian.

Safe actions you can take while waiting for veterinary care:

• Keep your dog calm and limit vigorous activity to reduce further irritation or bleeding.
• Provide fresh water to encourage urination and hydration unless your vet instructs otherwise.
• Try to collect a fresh urine sample in a clean, dry container (glass or plastic). A shallow cake pan or clean jar can work. Label with time and date. Many vets prefer samples collected at the clinic by cystocentesis (sterile needle into bladder) for accurate culture, but a fresh voided sample is still useful for urinalysis.
• Take photos or a short video of the urine and your dog’s behavior (straining, posture).
• Note the amount and timing of any bloody urine episodes.
• Avoid giving over-the-counter human medications (NSAIDs, aspirin) — these can worsen bleeding or cause kidney damage.

Veterinary Diagnosis — What to Expect

Your veterinarian will combine a focused history and physical exam with targeted tests. Typical diagnostic steps include:

• Physical exam: abdominal palpation, bladder expression, rectal exam (especially in males to assess the prostate), and assessment of pain, vitals and hydration.
• Urinalysis: dipstick chemistry and microscopic sediment exam to confirm red blood cells, white blood cells, bacteria, crystals or casts.
• Urine culture and sensitivity: especially if infection is suspected. Sterile cystocentesis is preferred for culture to avoid contamination.
• Bloodwork: CBC (checks anemia, infection), chemistry panel (kidney function, electrolytes), and sometimes coagulation tests if a bleeding disorder is suspected.
• Imaging: abdominal radiographs (x-rays) to look for radio-opaque stones, and abdominal ultrasound to evaluate bladder wall, prostate, kidneys and masses. Ultrasound is particularly useful for detecting ureteral or renal causes and soft-tissue masses.
• Advanced diagnostics: cystoscopy and biopsy if a bladder tumor is suspected; CT in complex cases.

Treatment Options — Overview

Treatment targets the underlying cause and may include one or more of the following:

• Antibiotics: for confirmed bacterial UTIs. Antibiotic choice should be guided by culture and sensitivity to avoid resistance.
• Fluid therapy and supportive care: IV fluids for dehydration or to maintain urine flow and kidney perfusion.
• Stone management: medical dissolution diets (for struvite stones), urohydropropulsion or surgical removal (cystotomy) for larger stones. Some stones (calcium oxalate) require surgical removal as they cannot be dissolved.
• Surgery: for traumatic injuries, bladder rupture, removal of tumors or large stones.
• Cancer therapy: may include surgery, chemotherapy, NSAIDs like piroxicam (in specific protocols), or palliative care depending on tumor type and stage.
• Treatment for bleeding disorders: vitamin K for rodenticide toxicity, transfusions for severe blood loss, or specific therapies for immune-mediated or inherited clotting disorders.
• Pain control: appropriate veterinary-prescribed analgesics — pain relief may improve comfort and reduce straining.

Prevention — How to Reduce Recurrence Risk

• Encourage free access to fresh water to increase urine dilution and frequency.
• Regular urinalysis for dogs with prior stones, recurrent UTIs, or systemic disease (diabetes, Cushing’s).
• Diet management: prescription diets can help dissolve certain stone types and alter urine pH to reduce recurrence (under veterinary guidance).
• Prompt treatment of infections and monitoring to ensure complete resolution with culture-guided antibiotics.
• Avoid high-mineral treats and excessive dietary supplements that could promote stone formation.
• Neuter status and prostate health: discuss with your vet — intact males are at higher risk for some prostate conditions.
• Minimize exposure to toxins (rodenticides) and seek immediate care for any trauma.

Red Flags - Seek Emergency Care Immediately

• Straining to urinate with little or no urine passed (possible obstructed urinary tract).
• Very heavy bleeding, large clots in urine, or signs of collapse/shock.
• Pale gums, rapid heartbeat, rapid breathing, weakness or fainting.
• Severe abdominal pain, distended abdomen, vomiting, or high fever.

Key Takeaways

• Blood in a dog’s urine (hematuria) has many causes: UTIs, stones, trauma, prostate disease, tumors, kidney disease and bleeding disorders.
• Some cases are urgent: inability to urinate, heavy bleeding, pale gums or collapse require immediate emergency care.
• Collect relevant observations (urine appearance, frequency, behavior changes) and a fresh sample if possible, but do not attempt home treatment or give medications without veterinary instruction.
• Diagnosis typically involves urinalysis, urine culture, bloodwork and imaging; treatment is cause-specific and may include antibiotics, fluids, surgery or long-term management.
• Prevent recurrence through hydration, diet management, routine monitoring and prompt treatment of infections.

Frequently Asked Questions