The most common lower urinary tract disease in dogs over 7 years of age is incontinence related to a weak urinary sphincter muscle, enabling urine to “leakage” out. Bacterial infections are also typical. Endocrine diseases such as adrenal disease and diabetes mellitus can incline dogs to bacterial infection of the lower urinary tract.
Urinary tract infections (UTIs) and urinary tract stones are common in dogs. Due to the fact that these conditions can be painful, it’s crucial to understand what to expect in your dog.
Symptoms of Urinary Tract Problems in Dogs
When dogs get UTIs, they may strain or have difficulty urinating, it may hurt for them to urinate, and they might have blood in their urine.
Breaking housetraining is another possible sign of a bladder problem. You may not know that there’s blood in your dog’s urine unless you see a pinkish stain on the carpet where he had an accident. Or you might see that when you’re gone, your typically well-behaved dog is peeing near the door and producing a large volume of urine. It helps to be very observant about your dog’s urination routines so you will notice if he seems to be straining or taking longer than regular to urinate.
Take your dog to the veterinarian if you observe the following signs:
- Frequent urination
- Breaking housetraining
- Blood in the urine
- Dribbling urine
- Crying out while urinating
- Straining to urinate
- Regularly or fanatically licking the genital area
What Causes UTI in Dogs?
To get a diagnosis, your vet will have to examine a urine sample for the presence of leukocyte, which indicate infection, or crystals, which suggest that the dog might have bladder stones. A urinalysis is a start, however culturing the urine — taking a sample and letting bacteria grow– allows us to understand for sure if there’s an infection and recognize the bacteria triggering it. It generally takes a few days to get the results of a urine culture.
Without a culture, your veterinarian cannot understand precisely which antibiotic to prescribe or perhaps if one is needed. Because of the risk of developing antibiotic-resistant bacteria, we don’t prefer to recommend antibiotics unless they are absolutely required and we understand exactly which bacteria to target.
A culture likewise tells us other things about what may be causing the issue. For example, it’s a long, hard slog for bacteria to make it all the way up the male urethra. We do not view as many bladder infections in males since of that, so when they do have one, we know that something more serious may be going on, such as kidney or prostate infection or stones that are affecting the urinary tract.
Dogs can develop numerous kinds of urinary tract stones. We commonly see struvite stones, which frequently form in conjunction with bladder infections. We likewise see calcium oxalate stones. Any dog can get these, however small types such as Shih Tzus, Lhasa Apsos and Yorkshire Terriers seem to be predisposed to them, as are Miniature Schnauzers and Bichons Frises.
Some types are understood for a predisposition to particular types of stones. Male Dalmatians are prone to urate stones, and Scottish Deerhounds and some Dachshunds and Bulldogs are likely to develop cystine stones.
If we believe bladder stones, blood work and radiographs can help us to make a diagnosis. Sometimes, though, stones are hard to discover. Then we use more sophisticated treatments such as radiographs with dye, ultrasound or cystoscopy, which lets us take a look around inside the urethra and bladder.
Making an appropriate diagnosis is essential. We never ever want to presume that a dog has a garden-variety urinary tract infection and miss the real issue.
How to Treat Urinary Tract Infection in Dogs?
As soon as we have a diagnosis, we can prescribe a specific antibiotic when it comes to an infection or advise an unique diet to liquify stones. In some cases both are needed. For example, struvite stones normally liquify easily with an appropriate diet, and antibiotics may be had to treat an accompanying urinary tract infection.
Medications that Help
Many UTIs can be successfully treated with a course of antibiotics that lasts between 7 and 14 days. Antibiotics for dogs, like Cephalexin or Clavamox, are the most common treatment for UTIs due to their ability to ruin and hinder the growth of bacteria. Some vets recommend a follow-up urine culture after antibiotic treatment is complete to validate that the infection has been eradicated.
In some cases family pets with predisposed conditions might have to be on a long-lasting low-dose antibiotic treatment to prevent recurrent infection. Long-lasting use of any antibiotic comes with certain risks such as developing a resistance to antibiotics, so thoroughly discuss this option with your vet. Make sure to get all of the info and talk about side effects with your vet prior to administering any medication.
Drugs Commonly Used to Treat Urinary Tract Infections in Dogs
|Drug||Suggested Dosage||Typical Antimicrobial Activity|
|Amoxicillin||11 mg/kg (5 mg/lbs), PO, bid-tid||Staphylococci, streptococci, enterococci, Proteus, some E coli|
|Ampicillin||25 mg/kg (11 mg/lbs), PO, tid||Staphylococci, streptococci, enterococci, Proteus, some E coli|
|Amoxicillin-clavulanic acid||25 mg/kg (11 mg/lbs), PO, tid||Staphylococci, streptococci, enterococci, Proteus, some E coli|
|Cephalexin/cefadroxil||20–30 mg/kg (10-12 mg/lbs), PO, bid-tid||Staphylococci, streptococci, Proteus, E coli, Klebsiella|
|Cefovecin||8 mg/kg (4 mg/lbs), SC, every 14 days||Proteus, E coli|
|Cefpodoxime||5–10 mg/kg/day (3-4 mg/lbs/day) , PO||Proteus, E coli|
|Ceftiofur||2 mg/kg/day (1 mg/lbs/day), SC||Proteus, E coli|
|Choramphenicol||Dogs: 25–50 mg/kg (11-23 mg/lbs) , PO, bid-tid||Staphylococci, streptococci, enterococci, E coli|
|Doxycycline||5 mg/kg 2 mg/lbs) , PO, bid||Streptococci, some activity against E coli, staphylococci, and enterococci at high urine concentrations|
|Enrofloxacin, orbifloxacin, marbofloxacin, pradofloxacin (cats only)||2.5–10 mg/kg/day (1-4 mg/lbs/day) , PO||Staphylococci, E coli, Proteus, Klebsiella, Pseudomonas, Enterobacter|
|Gentamicin||4–6 mg/kg/day (2-2.5 mg/lbs/day) , SC||Staphylococci, some streptococci, some enterococci, E coli, Proteus, Klebsiella, Pseudomonas, Enterobacter|
|Nitrofurantoin||5 mg/kg (2 mg/lbs) , PO, tid||Staphylococci, some streptococci, enterococci, E coli, Klebsiella, Enterobacter|
|Tetracycline||18 mg/kg (7.5 mg/lbs), PO, tid||Streptococci, some activity against E coli, staphylococci, and enterococci at high urine concentrations|
|Trimethoprim-sulfa||15 mg/kg (6 mg/lbs) , PO, bid||Streptococci, staphylococci, E coli, Proteus, some activity against Klebsiella|
Most bacterial infections of the lower urinary tract respond rapidly to antimicrobial treatment; however, urinary tract infections (UTI) related to problems in the host immune system (complicated UTI) frequently stop working to react or recur after antibiotic withdrawal and can be a restorative difficulty.
Detailed Information Regarding Canine Urinary Infection
The most typical bacterial pathogens related to UTI in the dog include Escherichia coli, Klebsiella, Staphylococcus, Enterococcus, Proteus, Pseudomonas, Enterobacter, and Streptococcus, according to veterinarycalendar.dvm360.com. These are dermal or intestinal plants that rise the urethra and after that adhere to the mucosa of the bladder and increase. Although many enteric organisms are anaerobes, the oxygen stress in urine probably prevents the growth of rigorous anaerobic bacteria, and therefore, anaerobic UTI is rare. A current study of recurrent and relentless UTI in dogs showed that 25% of culture-positive urine specimens had two or more bacterial types separated. Mycoplasmal infections are relatively rare but have been associated with recurrent or persistent UTI in dogs. Mycoplasma must be thought about in dogs with consistent pyuria and negative urine culture, dogs with persistently alkaline urine and unfavorable urine cultures, and dogs with relentless or reoccurring UTI that don’t respond to suitable standard antibiotic treatment.
Normal host defense mechanisms
The status of host defense reaction appears to be the most important aspect affecting the pathogenesis of UTI. Normal voiding is an efficient natural defense reaction versus UTI. Mechanical washout as a result of complete voiding is accountable for eliminating greater than 95% of non-adherent bacteria that get entryway into the urinary bladder. Increased urine production and frequency of voiding boost washout of bacteria. Disorders that reduce the frequency and/or volume of voided urine, or that result in an increased urine recurring volume may predispose animals to UTI. Normal urine residual volume for dogs is less than 0.2 to 0.4 ml/kg body weight.
Bacteria are typically present in increasing numbers from the mid to distal urethra, however hardly ever do these organisms cause UTI in normal dogs. The high-pressure zone in the mid urethra and spontaneous urethral contractions help avoid ascension of bacteria. Differences in epithelial morphology (decreased epithelial receptor websites) also assist reduce bacterial colonization in the proximal and mid urethra. The length of the urethra and bactericidal prostatic secretions in male dogs are believed to decrease the occurrence of UTI compared with female dogs; however, almost equivalent gender circulation in recurrent/persistent UTI has actually just recently been reported. In both sexes, the valve-like nature of the vesicoureteral junction helps protect versus bacterial ascension to the upper urinary tract.
Colonization of vulval and preputial luminal mucous membranes by nonpathogenic flora serves to reduce colonization by uropathogens. Normal flora occupy most of the epithelial receptor sites, produce bacteriocins that interfere with uropathogen metabolism, and have a high affinity but low requirement for essential nutrients required by uropathogens. Mucosal secretions also assist prevent adherence of uropathogens to epithelium; immunoglobulins coat pathogenic bacteria and glycosaminoglycans form a protective barrier over the mucosal surface area.
The antibacterial property of urine is an extra crucial host defense mechanism against UTI. Urine is frequently bacteriostatic and often can be bactericidal depending on its composition. Low pH and high concentrations of urea and weak natural acids in focused urine prevent bacterial growth. Although polyuric disorders may increase the washout of non-adhered bacteria from the bladder, UTI may take place due to decreased antibacterial properties of urine.
Complex vs uncomplicated urinary tract infections
Uncomplicated UTI are infections without noticeable underlying structural or practical irregularities in the host’s defense reaction. This kind of infection is most convenient to deal with and is usually cleared soon after proper antibiotic treatment is initiated. Complex UTI is connected with a problem in the host’s defense reaction; i.e., interference with normal micturition, anatomic flaws, damage to mucosal barriers, changes in urine volume or structure, or systemic immunocompromise. In nearly all cases, the underlying problem must be fixed in order to get rid of the UTI.
Abnormal micturition frequently leads to incomplete voiding and retention of urine, which enables reproduction of bacteria within the urinary tract. Damage to mucosal barriers might result in UTI, depending upon the extent of the lesion and concurrent intro of uropathogens. It is intriguing to keep in mind that pathogenic bacterial shot of the urinary bladder in speculative animals usually stops working to develop a UTI unless the uroepithelium is first damaged by a chemical or mechanical insult. At any time the urinary bladder is catheterized; bacteria are brought up the urethra to the bladder. If the catheter is inserted too far and damages the bladder mucosa, the possibility of infection boosts. Anatomic flaws might enable ascending migration of bacteria (e.g., indwelling urinary catheters or an ectopic ureter) or may harm mucosal barriers (e.g., urolithiasis, neoplasia, urachal residue, thickened bladder wall due to chronic inflammation). Modified urine structure (glucosuria or excretion of irritating drugs like cyclophosphamide) can enhance the environment for bacterial growth. In addition to the above local elements, systemic conditions such as kidney failure, hyperadrenocorticism, extended steroid administration, neoplasia, and diabetes mellitus can lead to complex UTI. In a current retrospective study, aerobic urine cultures from 159 dogs with diabetes mellitus yielded bacterial growth in 34 cases (21%).
Removal of clinical and laboratory signs of complex UTI with antibiotic treatment is normally not possible; symptoms either persist throughout antibiotic treatment or recur soon after antibiotic withdrawal. Although antibiotic treatment is the cornerstone of management, the status of host defense mechanisms is thought to be the single essential determinant of the outcome of UTI treatment. In complex UTI, antibiotic treatment ought to manage the pathogenic bacterial growth for a period enough to permit host defense reaction to prevent colonization of the urinary tract without additional antibiotic administration.
Reoccurring urinary tract infections
Reoccurrence of scientific and laboratory signs of UTI can be classified into two groups: relapses and reinfections. Regressions are infections caused by the exact same types of bacteria usually within several days of cessation of treatment. In this case the previous antimicrobial treatment failed to remove the infection. Relapses might be because of utilize of incorrect antibiotic or dosage, introduction of drug-resistant pathogens, or failure to remove inclining causes that change normal host defense mechanisms and enable the perseverance of the bacteria. Urinary tract infections that relapse are frequently associated with a higher degree of antimicrobial resistance compared to the original infection. Regressions in male dogs may be triggered by chronic prostatic infections.
On the other hand, recurrent UTI might be reinfections. In this case, the previous antibacterial treatment cleared the first infection and the urinary tract has actually consequently become infected with other bacteria. For the most part, the time between reinfections is higher than the time between regressions. Reinfections often indicate failure to get rid of inclining causes that modify normal host defense reaction. Additionally, reinfections may be iatrogenic (follow-up catheterization) or spontaneous. Reinfections with less invasive bacteria (e.g., Pseudomonas aeruginosa) normally suggest the host’s body immune system is jeopardized.
Typical Procedures Veterinarians Follow to Treat Urinary Tract Infection in Dogs
It is necessary to try to identify those patients with body immune system flaws; for that reason a complete physical exam must be performed on all animals that provide with signs of UTI. If a simple UTI is thought, bacterial sensitivity results are not readily available; antibiotic treatment option must be based on bacterial recognition or the gram-staining characteristics of the bacteria. Medical experience at several different veterinary teaching healthcare facilities suggests that smart choices might be made about bacterial vulnerability to antibiotics. Without benefit of bacterial level of sensitivity testing, the following are the drugs of choice for the bacteria noted: E. coli – enrofloxacin; Proteus – amoxicillin-clavulanic acid; Staph – amoxicillin-clavulanic acid; Strep – amoxicillin-clavulanic acid; Enterobacter – tetracyclines; Klebsiella – enrofloxacin; Pseudomonas – tetracycline. If bacterial recognition is unidentified, treatment is best based upon the gram-staining characteristics, i.e., ampicillin/amoxicillin or amoxicillin-clavulanic acid for gram-positive bacteria and trimethoprim-sulfa or enrofloxacin for gram-negative bacteria. In cases of believed or understood complicated UTI or in cases of persistent UTI, bacterial culture and level of sensitivity of the urine are essential.
Cystocentesis is the favored method of collection for urine culture and sensitivity. The urine sample ought to be sent in a sealed container for culture as quickly as possible. Refrigeration is suggested if a hold-up in culture is expected. Lots of practices inoculate a blood agar plate with urine and then send the plate for recognition and level of sensitivity if there is bacterial growth after incubation. Minimum inhibitory concentrations (MIC) and Kirby-Bauer agar diffusion tests can be used to figure out bacterial sensitivity. The Kirby-Bauer approach is appropriate for many UTI; nevertheless, the MIC strategy is frequently helpful with apparently resistant UTI.
The period of treatment of lower UTI must be embellished and ought to be based on the cessation of medical signs and removal of unusual urine sediment along with an unfavorable urine culture. In basic, uncomplicated lower UTI should be treated for 2 to 3 weeks, while complicated UTI ought to be treated for a minimum of 4 weeks. Verification of appropriate choice of antibiotic therapy can be made after three to five days of therapy, by guaranteeing that the urine is sterile. The urine sediment, nevertheless, may be still unusual at this time.
Persistent UTI needs to always be examined by urine culture and level of sensitivity. Furthermore, efforts must be heightened to determine defects in the host body immune system. Double contrast cystography and ultrasonography may be used to eliminate anatomic problems and mucosal sores of the bladder. In male dogs, semen and prostatic wash cytology and culture, as well as ultrasonographic evaluation, should be utilized to dismiss bacterial prostatitis. Excretory urography, ultrasonography, and renal biopsy may validate the presence of pyelonephritis; nevertheless these parameters might be normal in chronic pyelonephritis. Finally, consideration should be offered to the possibility of otherwise asymptomatic hyperadrenocorticism triggering persistent UTI, especially infections associated with low varieties of WBCs and RBCs in the urine sediment.
Prognosis for Dog’s UTI
The prognosis for complex UTI is constantly protected in comparison to straightforward UTI. The single crucial treatment for a complicated UTI is a correction of the underlying flaw in the host defense mechanisms. If inclining elements can not be recognized or remedied, regressions and reinfections prevail. For animals with regular infections, which can not be treated, low dosage (1/3 to 1/2 of the conventional daily dosage) antimicrobial administration at bedtime might be recommended after the urinary tract has actually been decontaminated with standard dose antibiotic treatment. This enables the drug to be present in the bladder overnight supplementing the animal’s defense reaction.
Low (sub restorative) dosages of antibiotic might minimize infections by disrupting bacterial fimbria production and therefore, uroepithelial attachment. For recurrences due to gram-positive bacteria, penicillins are suggested; while for recurrences caused by gram-negative bacteria, trimethoprim-sulfa or enrofloxacin is recommended. It needs to be noted nevertheless, that long-lasting, sub healing antibiotic treatment might predispose the animal to a resistant UTI. Any “break-through” UTI ought to be treated with therapeutic antibiotic dosages on the basis of bacterial culture and level of sensitivity.
Prevention of UTI in Dogs
Can you do anything to prevent UTIs or stones in your dog? It’s not a silver bullet, but I constantly advise a drinking water fountain for family pets. Getting more water into your dog is never a bad thing. Many pets are brought in to running water, so a water fountain might encourage them to drink more. And for particular kinds of stones, we definitely wish to see the dog drinking plenty of water and urinating regularly, since that’s going to clean the crystals out prior to they can get together and start becoming stones.
Often nutraceuticals can be handy accessories to UTI treatment. Based on successful studies in women, your veterinarian may suggest probiotics to assist prevent recurring UTIs. Probiotics are thought to help by displacing the bacteria causing the infection and boosting the immune system’s response to infection-causing bacteria.