Hematuria in Dogs
Hematuria, characterized by the presence of blood in the urine, can signal underlying serious medical conditions. Familial hematuria, a hereditary condition found in specific animal families, commonly affects young dogs, whereas cancer tends to be the primary cause in older dogs. Female dogs face a higher susceptibility to urinary tract infections, which can result in blood in the urine compared to males.
Symptoms
Hematuria manifests with observable signs, chiefly the presence of blood in the urine. Urine will typically display a reddish tint, accompanied by either normal or increased frequency of urination. Individuals with cancer may exhibit palpable masses during physical examination. Male dogs may experience prostate gland enlargement and/or discomfort upon palpation, while some patients may manifest abdominal pain.
Patients with blood clotting disorders might display subdermal skin hemorrhages, such as petechiae and ecchymoses, resembling bruises. These discolorations will appear as round, purplish, flat patches on the skin.
Causes
- Systemic causes are generally due to coagulopathy (clotting)
- Low number of platelets or thrombocytes in the blood (a condition known as thrombocytopenia)
- Diseases of the upper urinary tract are caused by inflammation of the blood vessels (known as vasculitis)
Upper urinary tract – the kidneys and ureters:
- Structural or anatomic disease, such as cystic kidney disease and familial kidney disease
- Metabolic diseases, such as kidney stones
- Neoplasia
- Infectious diseases
- Nephritis
- Idiopathic causes
- Trauma
In the lower urinary tract:
- Infectious disease
- Inflammatory disease in the kidney
- Unknown cause
- Trauma
Lower Urinary Tract ‒ bladder and urethra:
- Structural or anatomic issues such as bladder malformations are implicated in bringing on hematuria
- Metabolic causes, such as stones, are possible
- Neoplasia
Infectious disease (such as bacterial, fungal, and viral disease):
- Idiopathic causes
- Trauma
- Chemotherapy can elicit hematuria
- Unknown cause
- Trauma
Issues involving the genitalia include metabolic conditions:
- Heat cycle, or estrus
- Neoplasia
- Cancer or tumors
- Iinfectious disease such as from bacteria and fungus
- Inflammatory disease
- Trauma
Diagnosis
To diagnose hematuria in your dog, it’s essential to provide a detailed history of your pet’s health, including symptom background and any potential triggering incidents. This information can guide your veterinarian in identifying which organs may be involved in causing secondary symptoms. A comprehensive physical examination will be conducted, along with various tests including a complete blood profile, chemical blood profile, complete blood count, and urinalysis. For male dogs, examination of an ejaculate sample helps in identifying prostatic disease.
Differential diagnoses for blood-tinged urine will explore other potential causes of urine discoloration. Standard urine reagent strip tests target red blood cells, hemoglobin, or protein. Dietary factors will also be taken into account. If you’re supplementing your dog’s diet with vitamins or anything beyond regular kibble, informing your veterinarian is crucial, as high doses of vitamin C (ascorbic acid) could yield false-negative results on reagent test strips.
Ultrasonography, radiography, and contrast radiography are valuable diagnostic tools. If mass lesions are suspected, a biopsy might be necessary for a definitive diagnosis. In female dogs, vaginoscopy, and in male dogs, cystoscopy can help rule out neoplasia and lower urinary tract issues.
Treatment
The treatment of hematuria hinges on addressing the primary or associated diseases underlying the condition. Hematuria may be linked to urinary tract infections, urinary tract stones (urolithiasis), cancer, or systemic conditions like excessive steroid production by the adrenal glands or diabetes. Resolving a systemic generalized condition is crucial before addressing hematuria.
Surgical intervention may be necessary for cases involving urinary tract stones, neoplasia, or traumatic injuries to the urinary tract. Blood transfusions might be required if your dog’s red blood cell count is severely low. Fluid therapy can help combat dehydration, while antibiotics are prescribed for urinary tract infections and generalized bacterial diseases (bacteremia). Dietary modifications may be necessary to prevent relapse in cases of urolithiasis and kidney failure. In instances of clotting disorders, the blood thinner Heparin may be administered to regulate clotting.
Living and Management
As hematuria can signal a serious underlying disease process, continued management will be contingent upon addressing the primary or associated diseases linked to it.