Blood in Urine (Hematuria/Hemoglobinuria/Myoglobinuria) In Dogs

Dogs with bloody urine require prompt veterinary care
Other symptoms associated with bloody urine include straining to urinate, urinating frequently in small amounts, or painful urination
The first step in diagnosing apparently bloody urine is to determine what is present in the urine to give it a red color
Healthy urine that appears dark may be mistaken for bloody urine
If testing shows traces of blood are actually present in the urine, this indicates a variety of potentially serious medical conditions
Treatment protocols for apparently bloody urine depend on the underlying condition diagnosed, and vary widely

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A closer look: Blood in Urine (Hematuria/Hemoglobinuria/Myoglobinuria) In Dogs

Blood in the urine is common in dogs, but indicates potentially serious diseases including tumors, bleeding disorders, infections, and traumatic injury. Dogs with red, pink, or brown-tinged urine require prompt veterinary care.

Possible causes

Urine appears bloody as a result of the presence of either whole red blood cells in the urine or compounds from the breakdown of blood cells or muscle tissue.

Red pigment in urine falls into three general categories: hematuria, hemoglobinuria, and myoglobinuria. Each of these are associated with different underlying conditions.

Hematuria is a result of bleeding into the urinary tract.

Conditions associated with hematuria include

Thrombocytopenia

Vasculitis

Rat Bait Poisoning (Anticoagulant Toxicosis) in Dogs Kidney and Bladder Stones (Uroliths) in Dogs Congenital Kidney Disease in Dogs Bacterial Infection of the Kidneys (Pyelonephritis) in Dogs Chronic and Acute Kidney (Renal) Failure in Dogs Lower Urinary Tract Cancers in Dogs Lower Urinary Tract Infection (Bacterial Cystitis) in Dogs

Injuries

Prostate Gland Enlargement (Benign Prostatic Hyperplasia) in Dogs Prostate Inflammation (Prostatitis) in Dogs

Vaginal or uterine disease

Estrus (heat)

Hemoglobinuria usually occurs when. red blood cells are destroyed, and free hemoglobin is excreted into the urine through the kidneys.

Hemoglobinuria is indicative of the following conditions

Acetaminophen (Tylenol) poisoning

Babesiosis (Piroplasmosis) in Dogs Zinc Poisoning in Dogs Onion Poisoning (Allium Toxicosis) in Dogs Coral Snakebite Poisoning (Elapid Envenomation) in Dogs Pit Viper Snakebite Poisoning (Crotalid Envenomation) in Dogs Immune Mediated Hemolytic Anemia in Dogs Heatstroke in Dogs

Neonatal isoerythrolysis

Myoglobinuria occurs when myoglobin is released into the bloodstream after muscle damage and is similarly filtered out by the kidneys.

Myoglobinuria indicates:

Extreme exertion or extreme body temperature
Muscle infection
Muscle damage from toxins or traumatic injury
Genetic diseases that affect muscle

Abnormal bleeding disorders (coagulopathies) may also lead to blood in urine.

Risk factors

In general, the color of bloody urine does not indicate the severity of the underlying condition. Urine with hemoglobinuria is more likely to be pink to red-brown compared to hematuria, which is typically a brighter red.

In some cases, bloody urine is an emergency. Dogs showing the following symptoms, along with bloody urine, require immediate emergency veterinary care.

Emergency symptoms include

Pale Gums in Dogs Difficulty Breathing (Dyspnea) in Dogs Lethargy in Dogs

Testing and diagnosis

The first step in diagnosing bloody urine is to identify which of the three categories the blood traces in the urine point to.. Once the source of the red color is categorized, further diagnostics are required to determine what the underlying condition is.

These include, but are not limited to:

Physical exam
Routine blood tests
Urine protein/creatinine ratio evaluation Blood clotting profiles
Diagnostic imaging like x-rays and ultrasound
Urine culture
Genetic testing
Biopsy

Treatment for hematuria, hemoglobinuria, or myoglobinuria depends on the underlying condition identified.

Similar symptoms

Bloody urine, whether due to whole blood or hemoglobin, is easily identified by owners. In some cases, dark brown or chocolate-colored urine can be mistaken for bloody urine. This usually results from genetic conditions or toxicities that lead to the presence of methemoglobin in the urine. Dark urine with no traces of blood may also be healthy and not indicative of a problem at all.

Associated symptoms

The symptoms most often seen alongside bloody urine are

Straining to Urinate (Stranguria) in Dogs Excessively Frequent Urination (Pollakiuria) in Dogs

Painful urination (dysuria)

Dogs exhibiting any of these symptoms require prompt veterinary care.

Some dogs with bloody urine show no other symptoms.

References

Haematuria

Harriet Syme, BSc, BVetMed, PhD, FHEA, DACVIM, DECVIM, MRCVS - Writing for Veterinary Partner

Blood in Dog Urine: What Should You Do?

Dr. Patty Khuly - Writing for Hill's Pet Nutrition

Hematuria (Blood in Urine) in Dogs

Dr. Bari Spielman - Writing for PetPlace

Blood in the Urine in Dogs

PetMD Editorial - Writing for PetMD

Hematuria and Hemoglobinuria and Myoglobinuria

Smith, F.W.K., Tilley, L.P., Sleeper, M.M., Brainard, B.M. - Writing for Blackwell’s Five-Minute Veterinary Consult: Canine and Feline. Seventh Edition.