Why Does My Dog Have Bloody Urine?

There are multiple causes of bloody urine that include; trauma, infections, bladder stones, cancer of the bladder or kidney, and in cats stress. Bladder stones and infections of the bladder are by far the most common causes of bloody urine. 

If your pet has bloody urine a visit to the veterinarian is advised. With a physical exam, urinalysis and image of the urinary tract; cause and proper treatment can be determined. 

Focusing in more on bladder stones, which are fairly common, a case example will be presented. First of all there are several types of stones and causes. Stones can be caused by infections, diets, and genetic predisposition. In some cases infections lead to by-products that form into stones. In other cases the kidney allows certain minerals to pass into the bladder in excess, that leads to stone formation. 

Regardless of cause, bladder stones irritate the bladder wall, cause bloody urine and discomfort for the patient. Further stones in the bladder can lead to urethral obstruction when the stone moves from the bladder into the urethra. Urethral obstruction is life threatening and is characterized by the patient straining to urinate without success.

Recently, a dog named “Lucky” presented to our hospital with a history of previous bladder stones and surgeries to remove those stones. All previous stones were “calcium oxylate stones” which tend to be recurrent. Radiographs confirmed that more stones had formed and surgery was scheduled.

This would be Lucky’s fourth surgery! At the time of surgery the urinary bladder was opened; and using a urethral catheter the stones were flushed up and out of the bladder. The bladder and urethra were checked and double checked and all was clear. Surgery was thought to be complete, until the post-operative radiograph revealed one remaining stone.

Back into surgery for Lucky! Upon inspection the bladder was again found to be clear, yet just outside the bladder lodged in the left ureter, very near the bladder wall was the missing stone. Fortunately our surgical specialist was on his way to our practice. A specialist was needed for this most unusual stone location. We kept “Lucky” warm and stable under anesthesia while we waited for the surgeons arrival. 

Shortly the specialist arrived and we were back to work on our patient. We confirmed the stone was indeed lodged in the ureter (the tube connecting the kidney to the bladder). Should the ureter be incised to remove the stone or was there another way?
The specialist found another way! A small instrument was passed from inside the bladder up into the ureter and the stone was retrieved. Urine began to flow from the left ureter into the bladder, all was working well. 

The bladder was closed routinely followed by lavage of the bladder and abdomen. The post-operative radiograph was perfect and “Lucky” was on his way to recovery.

This was an interesting case demonstrating the unpredictability and variety of clinical presentations in veterinary medicine. Not only is this an interesting case, it gives a window into the life of a veterinary hospital as well. 

Hopefully “Lucky” will recover well, and be managed with diet to prevent further stone formation.

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