Question from Jaamal Dupas:

I have a 7-month-old female dog. When she squats to pee the first time, it’s normal. Then she tries again and only a few drops. And I noticed a drop of blood the last time she went. Could this be a UTI or her going into her first heat? I have a vet apt in a few days but was just curious.

Answer: Pee Problems – dribbling and blood

Hi Jaamal, thanks for your question about your dog’s urinating. To answer your question, I’m going to discuss the “symptoms” she’s showing, the possible causes, and then talk about how your vet will go about deciding which one of these conditions is the cause, and the treatment options.

What are the symptoms?

Technically, in animals they’re called clinical signs, not symptoms, but it means the same thing. In the case of your dog, she’s able to urinate, but it’s taking her two or more goes to empty her bladder. This is technically called “pollakiuria.”

The other problem you’ve noticed is that there was a drop of blood in the urine last time she went-this is called “haematuria.”

What are the possible causes?

Before your vet can determine what the exact cause is, they’ll need to make what’s called a “differential list”-this is a list of the possible conditions that could cause the clinical signs observed.

In your dog’s case, we can factor in her age and sex to narrow it down a little bit. So, what are the likely possibilities?

1) A urinary tract infection

This is probably the most likely cause! Urinary tract infections in bitches are quite common (more so than in male dogs, because the urethra, the tube that leads from the bladder to the outside world, is shorter and wider). The typical symptoms are an increased frequency and urgency of urination, with some blood in the urine. Your vet may want to do some more tests to confirm it (see below), but it is the most likely explanation.

2) Bladder stones or crystals

Sometimes, due to diet, infection or genetics, the crystals that can form in the bladder enlarge and become stones blocking the urethra. These can be very painful, and often mean it’s difficult for the dog to urinate. I don’t think it’s that likely in your dog’s case because it sounds like she passes urine quite easily, but it is a possibility. In dogs, many crystals and stones are actually due to untreated infections!

3) Her season (oestrus)

As you’re aware, some blood from the vulva is quite normal in bitches during their season (usually every 6–8 months or so)-see here for more info on them: https://vethelpdirect.com/vetblog/2014/12/16/ask-a-vet-online-what-age-do-seasons-stop/. It isn’t usually associated with passing drops or dribbles of urine though, so although I can’t rule it out, I don’t think it’s the most likely cause.

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4) Trauma or injury

Obviously, anything that makes it uncomfortable to urinate may make her stop and start when she’s going. Cuts or bruises around the vulva would account for the signs, but I think there would be more obvious issues, such as obvious pain or swelling or visible wounds.

5) A womb infection

A womb infection can leak brown or red pus that looks very like blood; however, if it occurs it’s usually a few weeks after a season, and you obviously don’t think she’s had her first yet. Although it’s unlikely, I’d always keep it on the list until it can be ruled out, because dogs can become very sick very fast.

6) A bladder or urethra tumour

This is a theoretical possibility, but in a 7 month old I would have to have ruled EVERYTHING else out before I considered it!

Where next?

You’ve already made an appointment with your vet, which is very sensible. As we suspect a urinary infection, I’d advise you to catch a sample of urine before you go in (as fresh as possible, caught in a CLEAN pot), as your vet may well want to do some tests.

Once you get to the vets, they’ll ask you some questions to determine if there are any other symptoms or signs (for example changes in drinking), then they’ll examine her. They may want to take a swab from her vulva to see if she is in fact in season or not; they’ll also have a good feel of her abdomen and bladder to see if they can feel any abnormalities; and look at her vulva for signs of infection or injury.

My experience is that in simple urinary infections, there’s often nothing abnormal on the physical exam-quite often there won’t even be a temperature! That’s why the urine sample is so important. The vet (or their nurse or tech) will usually do a dipstick to look for blood, protein, acidity and so on, which can be suggestive of infection. If there are any abnormalities, they’ll often look at the urine down the microscope, looking for bacteria and white cells, which will confirm the presence of an infection; and for crystals which may indicate a problem with crystals or stones.

If their findings suggest an infection, and there are a lot of antibiotic resistant bacteria in your area, the vet may choose to send away the sample to check which antibiotic is most effective. However, if it is a simple urinary tract infection, in most cases it will resolve quickly with a course of antibiotics and possibly some painkillers.

I hope my answer has helped you understand the possibilities, and that with your vet’s help, she’s soon getting better!

David Harris MRCVS

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