Diagnostic approach to hematuria in dogs and cats

Hematuria indicates the presence of urogenital disease in dogs and cats. Persistent hematuria (macroscopic or microscopic) should be evaluated to determine the source of bleeding and the underlying cause so that appropriate treatment can be recommended. Results of the history and physical examination often help to localize disease to the urinary tract (either upper or lower) or genital tract. Additional diagnostic evaluation, including laboratory testing (eg, urinalysis, urine culture), diagnostic imaging (eg, abdominal radiographs, ultrasound), and collection of tissues for cytologic or histopathologic evaluation may be needed to identify the underlying cause. If a thorough evaluation fails to reveal the source or cause of hematuria, exploratory celiotomy should be considered, especially if idiopathic renal hematuria is possible.