Blood in a dog's urine (haematuria)

Recognise the signs

• Visible pink, red, brown, or rust-coloured urine — the colour depends on how much blood is present and how long it has been in the bladder.
• Blood only at the start of the urine stream — suggests a urethral or prostate source rather than the bladder itself.
• Blood only at the end of the stream — more typical of bladder wall bleeding (cystitis, stones, or tumour at the bladder neck).
• Blood throughout the entire stream — indicates bleeding higher up in the bladder or kidneys.
• Visible blood clots in the urine — suggests more significant or ongoing haemorrhage; always warrants same-day vet contact.
• Straining and squatting frequently, producing only a few drops — the bladder is irritated and feels constantly full.
• Increased frequency of urination with small amounts passed each time — a hallmark sign of cystitis or urethral obstruction beginning to develop.
• Accidents in the house in a previously house-trained dog — urgency and discomfort mean the dog cannot hold on as normal.
• Licking persistently at the genitals — a response to discomfort or discharge from the urinary opening.
• Crying or yelping when urinating — indicates significant pain and should prompt urgent vet contact the same day.
• Note: dark brown or port-wine coloured urine without visible red blood is a different sign — it can indicate myoglobin (muscle damage after seizures, collapse, or severe exertion) or haemoglobin from a red blood cell breakdown disorder, not simple haematuria. Mention this distinction to your vet.

First aid steps

1. Phone your vet the same morning — explain you can see blood in the urine and describe the colour and frequency. Most practices will triage this as same-day.
2. Collect a urine sample before you go. First thing in the morning is ideal as the urine is most concentrated. Let your dog start to urinate normally, then slide a clean container (a clean yoghurt pot or a purpose-made collection tray works well) under the stream to catch a mid-stream sample. Avoid touching the genitals with the container. Transfer to a clean, sealed jar or the practice-supplied pot, refrigerate immediately, and bring it within two hours — or within four hours if kept cold with an ice pack.
3. Photograph the urine against a white background (pour a small amount onto a white piece of paper or a white tile). This gives the vet a reference for colour even if the sample has changed by the time you arrive.
4. Check your dog's gum colour. Lift the lip and press a finger briefly on the gum — it should flush pink within two seconds and look salmon-pink at rest. Very pale or white gums alongside bloody urine suggest significant blood loss or rodenticide poisoning and require emergency treatment immediately.
5. Do not give your dog any supplements, medications, or food additives until the vet has assessed the cause — some products can interfere with test results or worsen certain conditions.
6. Keep your dog calm and restrict vigorous exercise until assessed — activity can increase bleeding from inflamed tissue.

Common causes

• Urinary tract infection (UTI) — the most common cause, especially in female dogs. Bacteria travel up the urethra and inflame the bladder lining (cystitis), causing pain and bleeding.
• Bladder or kidney stones (uroliths) — mineral crystals that clump together and irritate or ulcerate the urinary tract lining. Certain breeds are genetically predisposed.
• Prostate disease — in entire (unneutered) male dogs, an enlarged, infected, or cystic prostate presses on the urethra and can cause blood in the urine or in prostatic discharge.
• Transitional cell carcinoma (TCC) — a bladder tumour that tends to arise near the neck of the bladder. More common in older dogs, particularly Scottish Terriers, and often mimics a persistent UTI.
• Trauma — a knock to the abdomen, a road traffic accident, or vigorous exercise can cause bleeding from the kidneys or bladder.
• Rodenticide poisoning (warfarin-type anticoagulants) — interferes with blood clotting, causing bleeding in multiple sites including the urinary tract. Often accompanied by bleeding from the gums, nose, or into the skin.
• Pyometra in unspayed females — a life-threatening uterine infection that can cause a blood-tinged discharge sometimes confused with urinary blood; true haematuria can also occur alongside.
• Immune-mediated thrombocytopenia (IMT) — the immune system destroys platelets, leaving the dog unable to clot normally. Blood appears in urine, on the gums, and as pinpoint bruises on the skin.
• Post-surgical or post-catheterisation bleeding — mild haematuria for 24–48 hours after bladder surgery or urinary catheter placement is expected; persistent or heavy bleeding is not.

What the vet will need to know

• Exact colour of the urine and when you first noticed it — hours or days
• Whether blood appears at the start, end, or throughout the stream
• Presence of blood clots or a change in urine smell
• Frequency of urination and how much is produced each time
• Any other signs: vomiting, lethargy, increased thirst, bleeding elsewhere on the body
• Spay or neuter status, and if entire female, where she is in her season cycle
• Any access to rodenticides, slug bait, or other poisons in the past two weeks
• Current medications, supplements, and diet

Aftercare

• UTI: complete the full course of antibiotics even if signs resolve within a day or two — stopping early risks recurrence with resistant bacteria. Follow-up urine culture 5–7 days after finishing the course confirms clearance.
• Bladder or kidney stones: dietary management with a prescription urinary diet is usually required long-term to prevent recurrence; stone-forming breeds need annual urine checks and sometimes ultrasound monitoring.
• Prostate disease in entire males: neutering is often curative for benign prostatic hyperplasia and significantly reduces prostate infection risk. Post-neutering recovery typically takes 4–6 weeks for the prostate to reduce in size.
• Rodenticide poisoning: vitamin K1 treatment must continue for the full course prescribed (often 4–6 weeks for second-generation rodenticides) — stopping early is dangerous. Recheck clotting times before stopping.
• Transitional cell carcinoma: management usually involves a combination of anti-inflammatory medication (piroxicam), chemotherapy, and supportive care. Regular ultrasound monitoring tracks disease progression.
• Immune-mediated thrombocytopenia: immunosuppressive treatment with steroids and sometimes additional drugs is required; platelet counts are monitored weekly initially. Activity restriction is important until platelets recover.

Prevention

• Ensure constant access to fresh water and encourage drinking — dilute urine is less likely to allow bacterial growth and reduces crystal concentration. A pet water fountain can significantly increase daily water intake in reluctant drinkers.
• Feed a diet appropriate for your dog's urinary risk profile — stone-prone breeds benefit from a veterinary urinary diet that controls mineral levels and urine pH. Discuss with your vet before switching.
• Have entire males neutered — neutering eliminates the risk of benign prostatic hyperplasia and dramatically reduces prostate infection, which are leading causes of haematuria in intact male dogs.
• Book an annual urinalysis (urine dipstick and microscopy) for dogs at higher risk — stone-prone breeds, dogs with previous UTIs, and any dog over eight years old. Early crystal or cell changes can be acted on before visible bleeding begins.
• Secure rodenticides completely — use lockable bait stations and check regularly; even secondary poisoning from eating a poisoned rodent can cause life-threatening haemorrhage.
• Minimise trauma exposure where possible — keep dogs on leads near roads, avoid rough play that risks abdominal blows, and ensure any surgery is performed at an appropriate facility with post-operative monitoring.

Breed-specific notes

• Dalmatian — genetically predisposed to urate stones due to a defect in uric acid metabolism. Urate stones can obstruct the urethra rapidly. Dalmatians should be fed a low-purine diet, have routine urine checks, and drink plenty of water throughout their lives.
• Miniature Schnauzer — one of the breeds most prone to calcium oxalate stones, which cannot be dissolved with diet and often require surgical or laser removal. Routine annual urinalysis and ultrasound from middle age is recommended.
• Bichon Frise — particularly susceptible to struvite (magnesium ammonium phosphate) stones, which are strongly linked to UTIs. Prompt treatment of any UTI and urinary pH management reduce recurrence risk.
• Scottish Terrier — carries an 18-fold higher risk of developing transitional cell carcinoma (bladder cancer) compared with other breeds. Persistent haematuria or recurrent apparent UTIs in a Scottie should prompt urgent investigation for TCC rather than just repeated antibiotic courses.

Frequently asked questions

Related topics

• Male dog unable to urinate (urinary obstruction)
• Pyometra in unspayed female dogs (womb infection)
• Dog has eaten rat poison (rodenticide)