My dog has blood in her urine and it won’t go away. What is the cause and treatment?

Original Question: Recently Bella had signs of blood in her urine and we rushed her to the emergency vet where she was given X-ray and ultrasound. She was diagnosed with a UTI and crystals and prescribed Aventiclav for 7 days, plus a pain med and completed her medications. During this time Bella had a urine leak while resting at my feet - she didn’t even move. I called the vet and was told it is possible that she was having some incontinence and prescribed Stilbestrol. She has since had 2 more accidents. I had her urine re-tested last Thursday and it came back completely clear and we also changed her to a urinary tract food. This past Monday, our dog walker noticed blood in her urine again. I obtained another urine sample and you could clearly see there was blood in it. I took her back to the vet and was told that she had crystals again but wanted another urine sample so that they could culture. I was able to obtain enough urine sample to culture and they once again put her back on Aventiclav and Metacam. Today I was advised that the culture came back clear. The vet wants to do another X-ray of her bladder when full which we will be doing tomorrow to see if they are able to see anything. They advised that if it comes back that they can’t see anything they want to do another ultrasound. Today when we got home we noticed droplets of blood on a chair that she sits on and we also saw this on Wednesday but thought that it may have been there from before as we keep it covered with a towel. I’m reaching out to you to ask your opinion. We are at a loss as we feel that treating her is trial and error. She is in great spirits, eating, drinking, playing however she is licking herself quite a bit which we try to stop. Is it possible that with her licking she is putting the bacteria back into her system? We love our little girl and feel so helpless and would really appreciate your input. Thank you in advance - Shelley, Jim and Bella Brown - Shelley

My dog has blood in her urine and it won’t go away. What is the cause and treatment? Jan 20, 2019

Hi Shelley,

I have great concern when I read your question.

Clearly everyone is thinking there is an infection going on. So you’re using antibiotics and it’s coming back. But what is extremely disturbing is when you say ‘you collected the sample’ and that you collected ‘enough to culture’. These statements have so much wrong with them. If you perform an actual urine culture and not just a urinalysis, why are you collecting the sample? If you collect the sample, you are obviously catching it in a container which shouldn’t be done because that urine will have flowed out of your dog, passing over skin that has bacteria on it and being collected in a container with bacteria in it. No matter what, this is now a contaminated sample. So it further makes me think that you may not even be running a urine culture but a simple urinalysis which cannot identify the bacteria, which may be the reason the infection is not going away on these short and simple courses of antibiotics.

Here’s what you should discuss with your veterinarian…

  • Have them collect a sample of urine by cystocentesis (which collects it by needle right from the bladder so it’s not contaminated).
  • Send it for an actual ‘culture and sensitivity test’. This test requires swabbing the urine with a sterile q-tip-like collection device that is then inserted into a tube with a transport medium that preserves the bacteria. I question whether you are actually doing this test because it can be done with a drop of urine, there’s no need to collect a significant amount.
  • Stop thinking that her licking is doing anything. Just do the test and confirm once and for all whether there is an infection first.

If the tests are negative after being collected, handled and submitted the correct way, then start to consider other possible causes. Since the ultrasound was negative, that would eliminate things like stones in the bladder, polyps or masses of concern.

I hope this helps,

Dr. Clayton Greenway

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My dog has blood in her urine and it won’t go away. What is the cause and treatment?
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My dog has blood in her urine and it won’t go away. What is the cause and treatment?
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Clearly everyone is thinking there is an infection going on. So you're using antibiotics and it's coming back. But what is extremely disturbing is when you say 'you collected the sample' and that you collected 'enough to culture'. These statements have so much wrong with them.
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