Question from Sharon Harris:

My dog aged 10 has on a couple of times been weeing blood he does one long one which is ok then just walks round weeing bits but that’s when the blood starts he is wanting to go out more often than he usually does ,drinking more still eating and his usual self but have noticed a lump that is inside lower stomach but has lumps all over his body but many wiems have these lumps could it be infection or something more

Answer from Shanika Winters:

Hi Sharon, thank you for your question regarding your 10 year old dog who is passing blood in his urine (wee) this symptom is called Haematuria. It sounds like your dog is still bright and happy in himself, it is possible that his haematuria is due to an infection but can also be related to bladder disease, kidney disease or prostate disease.  It is really important to get your dog examined by your vet as soon as possible.

What will happen when I take my dog to the vet?

Your vet will ask a lot of questions to form a history of what is going on with your dog, including drinking and urinating habits which you have already listed in your question.  It is very helpful to bring in a urine sample in a clean container when the condition relates to the urine.  It can be tricky to catch a urine sample from your dog, especially if they prefer to wee when off the lead but a clean bowl and some perseverance should eventually mean you can get a sample.  Your vet can collect a sample by passing a urinary catheter (long thin soft plastic tube placed into the bladder) but this can be uncomfortable and may require sedation/hospitalisation for your dog.

Your vet will also take into consideration whether or not your pet has been neutered(castrated) as in older male dogs the influence of sex hormones(produced by the testicles) can affect the prostate gland which can lead to haematuria.  The prostate gland is found in male dogs around the neck of the bladder and it produces various secretions which go into semen (the liquid sperm is in).  The prostate gland is usually small and inactive in neutered male dogs, but in entire male dogs the prostate can become enlarged, infected and or cancerous.  Many of the diseases of the prostate gland can lead to haematuria.  Your vet can often feel the shape and size of your dog’s prostate gland by examining your dog internally and externally.

The kidneys are the organ which actually produces urine, your dog has two and they filter his blood to remove toxins and waste products which are then lost in the urine.  So haematuria could be blood coming from the kidneys either due to infection, kidney stones or cancerous changes in the kidneys or the tubing from the kidneys to the bladder (the ureters).

The bladder is a stretchy bag made of muscle and lined with a delicate membrane (layer) which stores the urine produced by the kidneys and empties out through a tube called the urethra.  Haematuria could be blood from the bladder or urethra due to infection, stones, polyps, trauma (accidents) or cancerous changes.

Your vet will thoroughly examine your dog paying extra attention to the back end of the abdomen, will also check your dog’s penis and likely examine your dog internally (via his bottom).  This helps to give information about the kidneys, bladder and prostate gland.

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What will happen to the urine sample?

The first thing your vet will do is look at the colour of the urine sample, this may or may not show visible blood, sometime only tiny traces of blood are present in the urine sample and can be picked up on a dip stick. A urine dip stick is a card strip that has lots of little coloured patches on it; they each detect different chemicals and substances in the urine and give a quick result.  Most veterinary practices can also examine urine samples under the microscope to look for unusual cells and or crystals. If the result and rest of your dog’s examination suggests infection then your vet may suggest trying a course of antibiotics.  If however your vet thinks there may be more going on a carefully collected urine sample may be sent for laboratory analysis which involves culture and sensitivity, this looks at what bacteria are present and which antibiotics are likely to work on them.

What further test might my dog need?

Your vet may suggest blood tests to check that your pet has not lost too much blood, how its general health is and how well its body organs are functioning.  Blood tests do not always show up a lot of changes but this still gives us information as to how your dog is.

X-rays may be taken conscious or under sedation or general anaesthesia, this gives a picture of what is happening inside of your dog, in the case of the bladder and prostate gland we sometimes add a contrast (chemical or air) to help show up details of the tubing and bladder lining.

Ultra sound scans are another way of looking more closely at what is happening inside your dog, in order for these to be performed an area of fur will be clipped away, the skin cleaned and then a gel placed onto it to help p the ultrasound probe to make good contact and pick up details.  Ultrasound scans can be particularly useful for looking at the kidneys and bladder.

What possible treatments might my dog need?

The exact treatment your dog has will depend on what disease process is found in in what part of your dog it is.

Urine tract infection:
This is usually treated with a course of antibiotics and repeat urine samples tested to see when the infection has cleared.

Bladder stones/urine crystals:

This can be treated using special diets to reduce stone/crystal formation, surgery to remove stones, medications to help dissolve stones/crystals along with antibiotics and pain relief as required.

Bladder growths/polyps:
These can be surgically removed and analysed to give an idea of they are likely to return or cause further problems.

Kidney infection: 
This is usually treated by intensive antibiotics along with intra venous fluid therapy (drip line into your dog) to help keep the kidneys flushed through and functioning.

Kidney growth/abnormalities:
If the growth is cancerous and might spread then the kidney might be surgically removed. If the kidney is diseased e.g. polycystic then it will be left in place and your dog given medications and diets to help preserve what is left of its kidney function.

Prostate enlargement/growths:
If your dog is entire then surgical or chemical castration might be advised along with surgery to de bulk the growth if appropriate.

I hope that my answer has helped you to understand how complex something as simple as blood in the urine can be.  Hopefully with your vets help, your dog will be on his road to recovery soon.

Shanika Winters MRCVS (Online vet)

If you have any worries about your pet, please make an appointment with your vet, or try our Symptom Guide.

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