Cystitis Flashcards
define cystitis
nonspecific inflammation of the bladder
Primary cause of cystitis in dogs
bacterial invasion and multiplication within urine and potentially bladder wall
Risk factors for development of bacterial cystitis
- females b/c urethra is shorter
- inability to maintain functional urethral sphincter (incontinence)
- Anatomic abnormalities that alter the urethra or urethral sphincter (ectopic ureters)
- compromised mucasa (neoplasia of bladder, cystic calculi damage)
- compromised immune system (diabetes mellitus & hyperadrenocorticism)
Where does bacteria originate from?
fecal matter
How do bacteria often gain entry to lower UT?
contamination of prepuce or vagina –> urethra
Special characteristics some bacteria may have to help them colonize lower UT
- Specialized adherence structures that allow bacteria to attach to urinary epithelial cells
- Secretion of hemolysin which damages urinary epithelial cells, promotes inflammation, and decreases effectiveness of local immunity
- Prevention of phagocytism by immune system via production of a substance by the bacteria’s capsule
List clinical signs associated with bacterial cystitis
pollakiuria
stranguria
dysuria
hematuria
What pathologic effect does bacteria infection have on the bladder?
Bacteria stimulate inflammatory reaction within urinary bladder walls –> vasodilation of local blood vessels –> edema and swelling –> pain receptors stimulates +/- mild to moderate hemorrhage into urine
Why does pollakiuria occur?
any accumulation of urine within bladder stimulates inflammatory response which in turn stimulates the bladder to contract
Why does stranguira occur?
continued inflammation causes spasms of bladder muscle resulting in straining to urinate
Why doe dysuria occcur?
Pain associated with inflam. response causes difficult and abnormal urination patterns and vocalization during urination
Why does hematuria occur?
blood vessel damage in bladder wall
Alterations to CBC/Chem and why
normal
b/c rxn usually is local (not systemic)
alterations to UA
WBC present
Bacteria present
Cystocentesis
- preferred method of collection
- urine from bladder is sterile
- don’t need to surgical prep, but good idea to change needle before putting sample into tube due to possible skin contamination
Urinary catheter problems with sample collection
- may get contamination with bacteria not causing infection b/c tip must pass from outside body to distal urethral into bladder
- may introduce bacteria to the bladder that wasn’t there before
Why is free catch urine really not ideal for culture and sensitivity?
urine must pass thru distal urethral and repro region where it WILL pick up bacteria; environmental opportunities for contamination also present due to long fur/being outside
Approach for first time infections
- Culture & sens not always done b/c not likely to have resistant organisms
- Antibiotic based off of ability of antibiotic to be excreted by kidneys and concentrated in urine (penicillins or cephalosporins)
- Tx for 10-12 days
Approach for recurrent/persistent infections
- culture and sens required
- Tx for 21-28 days
- ideally retest culture 7-10 days into Tx an 5-7 days after Tx has ended to make sure no growth
How treatment approach differs in intact male dogs
- assumed prostate is involved
- pick antibiotics via culture and sens
- antibiotics given for 21-28 days
- recommend neuter b/c difficult to eliminate bacterial prostatitis with high lvls of testosterone present