What you see. The starting point for addressing any equine health related issue is your observation.


Urine appears Red, Bloody or Blood Clots in Urine


Horses can bleed from anywhere in their urinary tract, including the kidneys, ureters, bladder, and urethra. Blood in the urine can appear as blood clots interspersed with normal colored urine, or can appear as consistently red urine.

Generally the lower down the urinary tract the bleeding is coming from, the less mixing there is of urine and blood, and the more the blood appears as clots. Urine of a consistent reddish color (wine color) can also result from the presence of hemoglobin, the oxygen containing pigment of red blood cells. This happens when there has been rupture of red blood cells within the blood vessels of the general circulation. It can result from a wide variety of life-threatening causes.

  • Code Red

    Call Your Vet Immediately, Even Outside Business Hours
    • If the horse has no appetite and is obviously depressed.
    • If it seems that there is a large quantity of blood.
  • Code Orange

    Call Your Vet at Their First Available Office Hours
    • If you consider this a chronic and relatively mild problem that is not changing rapidly.
    • If the results of the Whole Horse Exam (WHE) suggest the horse is otherwise normal.
You also might be observing
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your role


What To Do

Assess your horse's general health using the Whole Horse Exam (WHE), paying particular attention to attitude and appetite. Try to carefully assess the appearance of your horse's urine. Does it appear to have blood clots in it or is it a uniformly red-colored or wine colored throughout? Is the horse having any other urination related problems? Do you notice any other problems? If you can, catch a sample of urine for your vet to analyze. Share your findings and concerns with your vet.

What Not To Do

Do not confuse the color of the urine stream with the color of the urine after it pools in snow, shavings or on the ground. Often this evacuated urine will turn a dark orange or red color as part of the normal oxidation of certain plant pigments.

your vet's role

Your vet uses physical exam to determine involvement of other body systems. Urinalysis provides information about the nature of the blood within the urine. Endoscopy (cystoscopy) is commonly used to visualize the urinary tract to determine bleeding sites.
Questions Your Vet Might Ask:
  • What is the horse's age, sex, breed and history?
  • Is the horse a mare, gelding or stallion?
  • How is the horse's attitude and appetite?
  • Where do you notice the blood in the urine stream?
  • Is the horse showing straining, slow or painful urination?
  • What are the results of the Whole Horse Exam (WHE)?

Diagnoses Your Vet May Consider

The cause of the problem. These are conditions or ailments that are the cause of the observations you make.

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Treatments Your Vet May Recommend

A way to resolve the condition or diagnosis. Resolving the underlying cause or treating the signs of disease (symptomatic treatment)

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Author: Doug Thal DVM Dipl. ABVP