UTIs Flashcards
sporadic bacterial cystitis
bacterial cystitis WITH clinical signs
< 3 UTIs in 12 months
no known urinary tract or systemic comobidities
recurrent bacterial cystitis
bacterial cystitis WITH clinical signs
> 3 UTIs in 12 months
2 UTIs in 6 months
often associated with systemic comobidities
subclinical bacteriuria
positive urine culture WITHOUT clinical signs
what are the lower urinary tract signs
pollakiuria
hematuria
stranguria
dysuria
periuria
what is the ideal sampling and evaluation method of urine cultures
cystocentesis
plate immediately after collection (can refrigerate up to 24 hours)
urine sediment indication of UTI
bacteriuria
pyuria
may not need to culture if owner is financially limited
when should a CBC/chem be performed in a patient with LUTS
signs of systemic illness
recurrent UTIs
automated dilution susceptibility testing
measures the least amount of the antibiotic needed to inhibit 90% of bacterial growth
multidrug resistance
resistance to >3 antibiotic classes
common comorbidities that result in reinfection
immunosuppression
renal disease
metabolic diseases (hyper/hypothyroidism)
niduses that can cause relapse of UTI
foreign bodies
bladder polyps
proliferative urethritis
neoplasia
sequestered UTIs
deep seated tissue infections
uroliths
stents
how do uroliths cause relapse of UTI
bacteria can be incorporated into the mineral layers –> shed into urine
what bacteria is good at forming biofilms in the urine
E. coli
do dogs with normal ultrasounds need to be sent for cystoscopy
not unless they have clinical signs beyond the LUTS
indications for bladder biopsy
must have ALL three:
- LUTS
- no antibiotic treatment in the past 3-5 days
- negative urine culture
goal is to check for deep seated infection despite sterile urine sample
when is cystoscopy indicated
- abnormalities ID’d on ultrasound
- normal US but animal is clinically unwell
MOA of cranberry
PAC compounds; inhibits the adhesion of pathogen to the uroepithelium
is prostatic disease more common in dogs or cats
dogs
NOT seen in cats
do all intact dogs get BPH
YES - all intact dogs have benign prostatic hyperplasia but NOT all are clinical for it
5 a-reductase
converts testosterone into 5a DHT
5a DHT
principal androgen; higher affinity and slower dissociation than testosterone
what are the protective mechanisms that a normal prostate has against bacterial colonization
- high urine flow
- high pressure
- bactericidal fluid
- local IgA production
clinical signs of prostatic disease
- urethral discharge - bloody
- tenesmus
- hematuria
- dysuria
- fever, vomiting, anorexia, weight loss
ddx for symmetric and nonpainful prostate on rectal exam
BPH
ddx for asymmetric or painful prostate on rectal
neoplasia vs prostatitis
benign prostatic hyperplasia (BPH)
hypertrophy and hyperplasia or the prostatic cells
seen in older intact dogs
what causes BPH
low 5aDHT and testosterone
high estradiol
estradiol causes cells to get bigger and more numerous
BPH treatment
castration > medical therapy
castration is the most rapid treatment option for involution
medical BPH treatment
5a reductase inhibitors
causes atrophy of the glandular and stromal parts
takes longer to involute and will return to previous size once medication is stopped
prostatitis/prostatic abscess
infection of the prostate from ascending infection from the urethra
occurs most often secondary to BPH, squamous metaplasia, or neoplasia
pathogens that cause prostatitis
E. coli
mycoplasma
staph
strep
klebsiella
proteus
pseudomonas
brucella
clinical signs of prostatitis
prostatic pain
fever
lethargy
hematuria
diagnosis of prostatitis
enlarged prostate on rectal and ultrasound
urine culture
prostate aspirate - most diagnostic
treatment for prostatitis
enrofloxacin 4-6 weeks
