Blood in the Urine or Hematuria: male dogs

Blood in a male dog’s bladder, which is called hematuria (heme=blood and uria=urine), is distressing and there dozens of possible causes. With so many possible causes of hematuria, this condition can be difficult to diagnose.  Your veterinarian will consider all the following:

• kidneys
• ureters
• bladder
• prostate
• infection
• stones
• drug side effects
• genetic predisposition to hematuria
• blood clotting abnormalities
• trauma and
• cancer.

Your veterinarian will take a thorough history and do a thorough exam to determine the cause of hematuria. It also may be necessary to include several laboratory tests. The history and general physical, general exam and genitourinary exam can include the following:

History and Physical

• Genetic information—breed
• Current medications
• History of accident or trauma
• History of strenuous exercise
• History of previous incidents of hematuria, bladder or kidney problems
• Examination of the entire body, including exam for bruising or jaundice
• Examination of the genitalia: prepuce, penis, bulbus glandis
• Palpation of bladder and prostate
• Blood Pressure (BP), heart rate, respiratory rate, capillary refill time

General

• Clotting time
• CBC with differential
• Blood protein level

Genitourinary tests

• Observation of urination—is blood present at the end of urination or during the urination? Does the dog strain to urinate, (stranguria), urinate frequently (pollakiuria), have painful urination (dysuria)?
• Comparison of urine taken from the bladder directly with a cystocentesis to urine voided through the urethra
• Urine tests for blood, protein, pH, stones, bacteria (E coli, leptospirosis), parasites (Capillaria)
• Urine culture. Specifically request Ureaplasma, which is difficult to culture
• Urine specific gravity
• X-ray of kidneys, ureters, bladder
• Double contrast cystogram which fills the bladder with dye and air and illuminates stones that can’t be visualized on normal X-rays
• Ultrasound (US) of prostate

Tomorrow, the blog will examine how this information fits together to yield a diagnosis.

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