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Dr. Peter
Dr. Peter, Veterinarian
Category: Dog Veterinary
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Experience:  12 years of internal medicine, surgery, and preventive care.
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Bilirubin in dog urine

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We have a very large dog, Rottie mix, 15 years old, 95 lbs. Due to a car accident years ago, he only has three legs. Due to that, recently he's taken some very hard falls on the outdoor steps. Once this started to happen, we installed a ramp and use a harness. We did worry about internal injury. Problem - he has started having brown urine. We've had 4-5 x-rays, did not show masses or stones. Had blood test and a urine test. Some ultrasound. His urine shows bilirubin in it - moderate. The vet thinks that his liver "might" be enlarged, thought prostate felt somewhat larger, too. Not definitive. Blood work fine. Other than urine, he's acting completely normal. Eating, drinXXXXX, XXXXXe doggy. His urine is constantly changing, sometimes clearer, sometimes dark. We know cancer can cause may symptoms - besides cancer - what could cause excessive bilirubin in urine?
Submitted: 4 years ago.
Category: Dog Veterinary
Expert:  Dr. Peter replied 4 years ago.

Hi, I am Dr. Peter and would like to help.

 

1- Has your vet done blood work?

2- Was the ultrasound done after the bilirubin was noted in the urine?

3- Can you look at the white portion of his eyes and see if it is white or yellow?

Customer: replied 4 years ago.
Blood work was done a few months ago after a bad fall. He had some bleeding in his urine, cleared up in a few days. Test was fine, a few off but only slightly. Clear since Feb.

Ultra sound was done at vet hospital same day bilirubin was found. Not by a radiologist.

His eyes look look good, white. His stools are also normal.
Customer: replied 4 years ago.
First urine bacteria test found Streptococcus pyogenes. BUT it was a free catch and because that is so unusual - vet thought the urine was tainted. Did put him on 3 weeks of Clamamox just in case. This new test did not show bacteria just bilirubin - but he had just come off another round of antibiotics administered just in case.
Expert:  Dr. Peter replied 4 years ago.

Bilirubin is sometimes normal in the urine of male dogs. The way bilirubin is formed in the body is by metabolism of dead red blood cells (RBCs), this is a normal process. As the red blood cells die due to age, the body recycles its products and in the process produces bilirubin, this all happens in the blood. When bilirubin is made the liver than picks it up to be excreted via the feces (stercobilinogen) and urine (urobilinogen).

When we see abnormal elevation of bilirubin in the urine as a result of elevated bilirubin in the blood this is caused by one of 3 scenarios:

1- Destruction of Red Blood Cells is too much and the amount of bilirubin being made is overwhelming the liver.

2- The liver is sick and unable to pick up the bilirubin from the blood.

3- There is an obstruction in the liver that does not allow to eliminate the bilirubin causing a sort of a back flow into the circulation.

 

The above is a summary of all possible causes of bilirubin production. If your vet has done an abdominal ultrasound and blood work and does not find problems in the liver or evidence of RBC destruction, then the bilirubin in the urine is normal.

 

If you have additional questions I will be glad to answer them.

 

Dr. Peter

Customer: replied 4 years ago.
The doctor at the vet hospital said that this could just be a "normal" part of aging? Hard to see how brown urine, flucuating daily is normal . . .. ? The original vet who saw our dog two weeks ago at the hospital was an intern, she thought that the liver looked enlarged. But the vet who called us with the results did not seem to agree that it was much of an issue. But then again - given his age and size I do think that there is some of . . . he's lucky to be alive, why put him through anything. He is a very healthy, vibrant dog. Surprisingly. We have not had a full ultrasound by a radiologist.

Can it be "normal" for an older male dog to have brown urine with bilirubin? Should we just relax?
Customer: replied 4 years ago.
One more question - what would cause a destruction of Red Blood Cells? And what other symptoms might we look for?
Expert:  Dr. Peter replied 4 years ago.

The brown urine could be related to not drinking enough. Yes, it could be normal in a male dog to have bilirubin in the urine. If the blood work did not show elevation of bilirubin and there no evidence of red blood cell destruction, this is normal.

Causes of red blood cell destruction could be:

1- Auto immune (body destroying it).

2- Infections.

3- Innocent by standers.

4- Cell membrane damage (could be normal).

5- Splenic tumors.

 

Customer: replied 4 years ago.
I will tell you, he's not drinking much water for some reason. Not like he used to. When I give him water with broth he happily drinks it and his urine looks much better. If I don't give it - it's dark. Like a Coke color.

The one thing that was slightly off on his blood test was the platelet count. A touch low, this was in Febuary. Would that signify red cell damage? Do we need a new blood test?

Expert:  Dr. Peter replied 4 years ago.
No, low platelet will not cause bilirubin increases. It seems from your history he just needs to drink more water. Repeating blood work is a good idea to recheck the platelet. But, not related to bilirubin.
Customer: replied 4 years ago.
I can't tell you how great it is to talk to you, wish you practiced in CA!

He's old, I know. It's a miracle given his size and breed. He looks 7. We feed him a whole food diet, holistic. My last question and thank you for being here!! > I wonder - his urine test in Fed. did not show a bilirubin issue. But 5 months later - it does.

This could still be age related and lack of drinking enough water (which is new)?
Expert:  Dr. Peter replied 4 years ago.
The lack of water will cause the urine to become darker, which is normal as the kidneys are preserving water. Offer more of the chicken broth and his urine will become lighter.
Dr. Peter, Veterinarian
Category: Dog Veterinary
Satisfied Customers: 20689
Experience: 12 years of internal medicine, surgery, and preventive care.
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