Koji the Dog — Bloody Urine and Bladder Stones

It is not unusual for owners to report finding blood in the urine of their companion animal pets. There are a number of causes of blood in the urine, or hematuria, in dogs and cats. One of the most common causes is a lower urinary tract infection, but other causes include bladder tumors, prostatic disease in dogs, interstitial cystitis in cats, and bladder stones.

When Koji’s owners, Crystal and Hung Nguyen, returned from vacation they were surprised that Koji seemed to be “marking” in the house but were also alarmed to find blood in his urine. They brought Koji, a seven-year-old Shiba Inu in to be examined. Dr. Hsu performed a full urinalysis on Koji, and, in addition to red blood cells, many white blood cells were found in his urine in the absence of bacteria.

Since bacteria can sometimes be difficult to see, a culture was set up for any present bacteria to grow. Staff also took radiographs (x-rays) to identify a possible underlying issue. The radiographs showed that there were many uroliths, or bladder stones, in Koji’s bladder.

Some types of bladder stones can be dissolved over time by specific prescription diets. However, it could not be determined if these uroliths would respond to a dietary change, and due to the high quantity and Koji’s obvious discomfort his owners elected to have immediate surgery to remove the uroliths. Furthermore, male dogs are especially at risk for urinary obstruction if the uroliths empty out of the bladder and get lodged in the urethra. Dr. Hsu performed a cystotomy the next day to remove the uroliths. Happily, Koji recovered well and is back to his normal, spirited self.

Owners often assume that blood in the urine is always a sign of infection. But as this case demonstrates, there can be other causes. Koji’s urine culture was negative proving that he did not have an infection. Also, even if a lower urinary tract infection is confirmed, especially if recurrent, there could be an underlying issue. Diagnostics always start with a urinalysis, but radiographs or even ultrasound is often needed for a complete evaluation.