49 Urinary Tract Infection
2. What signs will a dog with a UTI show?
• Animals with a lower UTI may show pollakiuria, hematuria, stranguria, dysuria, or inappropriate urination.
3. What clinical signs are associated with pyelonephritis?
• May be asymptomatic, depending on whether the condition is acute or chronic, unilateral or bilateral.
5. What factors can affect urinalysis results?
• Urine should be collected and pH should be measured and sediment should be examined within 15 to 60 minutes of collection. Both struvite and oxalate crystals can form in vitro if urine is refrigerated or sits for prolonged periods.
• In vitro factors such as temperature, time, evaporation, urine pH, and growth of microbial contaminants that produce urease can all influence the formation of crystals in urine samples.
• Samples should be refrigerated after sample collection if evaluation is delayed. Refrigeration will preserve many of the physical and chemical properties of urine as well as the morphology of urine sediment while minimizing in vitro growth of microbes. Refrigeration may allow increased formation of magnesium ammonium phosphate and calcium oxalate crystals with storage time.
6. What organisms are typically involved in urinary tract infections?
The most common bacterial isolates in UTIs in dogs is Escherichia coli, followed by Staphylococcus spp., Proteus spp., Klebsiella spp., Enterococcus spp., Streptococcus spp., Pseudomonas spp., Mycoplasma, and Enterobacter spp.
7. What antibiotics are commonly used for treating bacterial infections?
• Antibiotic therapy should provide activity at the site of infection and should exceed the amount needed to inhibit the growth of the bacteria involved or kill the bacteria.
• Antibiotics chosen should reach urinary concentrations that exceed the minimal inhibitory concentration (MIC) of the isolated bacteria by at least fourfold, be easy to administer to ensure client compliance, have few side effects, have a low risk of toxicity, and be relatively inexpensive.
• Ideally, antibiotic selection should be based on culture and sensitivity testing from urine culture.
• If sensitivity test results are not available, predictions can be made based on the expected sensitivities of a particular organism. Many urinary tract pathogens have predictable susceptibilities to one or more antibiotics.
• Staphylococcus spp., Streptococcus spp., Enterococcus spp., and Proteus mirabilis are usually susceptible to penicillins (ampicillin, amoxicillin).
• E. coli, Klebsiella, and Enterobacter are capable of changing their susceptibility patterns within a single bacterial generation, so susceptibility testing should ideally be performed, although a cephalosporin such as cephalexin or a fluoroquinolone is likely to be effective.
8. What underlying diseases or conditions may predispose to development of UTIs?
• Animals with an underlying disease such as diabetes mellitus or hyperadrenocorticism or those receiving corticosteroids or antineoplastic drugs are more susceptible to UTIs.
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