UTIs & Stones Flashcards
who are the only ones who are “allowed” to get UTIs
female dogs
what is the most common agent in UTIs?
E coli or staph
clinical signs of a UTI include
hematuria, stranguira, pollakiuria, dysuria, urge incontinence, stinky urine, cloudy urine
if pyelonephritis, will have systemic signs like fever
if you have an active sediment +/- bacteria AND you have clinical signs of a UTI, then…
you likely have a UTI
if you have a recurrent/complicated UTI, the two categories of why this happens are…
relapse/persistent/refractory: the same organism is causing the infection and something is causing that bacteria to stick around (hooded vulva, wrong antibiotic, compliance issue, etc)
reinfection: a new organism is causing signs likely due to a suppressed immune system (cushings, CKD, diabetes, prednisone use, obesity, neoplasia, etc)
Princess Barkarella the 5yo FS dog comes to you with hematuria, stranguria, and seemingly needing to pee way more often per the owner. You do a urinalysis and find active sediment. the dog has never had a UTI before. what antibiotic do you want to prescribe? which ones should you avoid?
amoxicillin or TMS for 2-5 days
DO NOT USE: fluoroquinolones, 3rd gen cephalosprins, cefovecin
when is generally the most appropriate time to culture the urine?
you dont need to culture if it seems to be a sporadic cystitis in a female dog, but for recurrent bacterial cystitis, then you need a culture FO SHO
Princess Barkarella the 5yo FS dog was sent home with amoxicillin for 5 days, but she comes back with what seems like recurrent cystitis. besides a urine culture, what should you screen her for?
endocrinopathies, CKD, pyelonephritis, uroliths, abnormal vulvar conformation, neoplasia
a recessed or hooded vulva can be responsible for
recurrent cystitis/UTIs
what is the proper way to treat recurrent/complicated UTIs, either from chronic disease like cushings or from pyelonpehritis, etc?
4-6 weeks of the proper antibiotic based on culture, and a recheck culture 1 week after to make sure negative, then 3-5 days at the end of treatment
why do we need to repeat urine cultures when treating recurrent/complicated cystitis?
because we don’t want the animal on an antibiotic that doesn’t work! this would just be wasteful and could cause resistance
Wiggles McSlobberpants seems to have recurrent cystitis and you decide to do a urine culture. The report comes back as E coli and enterococcus. whats the deal with enterococcus?
it’s usually a contaminant and not a true pathogen, especially when it’s one of two bacteria that was cultured.
you have a female dog named Captain Snifflebutt with clinical signs of a UTI and no stones but the culture is coming back negative. do you believe it?
heck no, cultures are not 100% sensitive! treat her anyway you dinkus
Wiggles McSlobberpants has recurrent cystitis so you send her home with an antibiotic based on culture results. how should you monitor her after treatment is completed?
once the treatment is completed, do a recheck urinalysis every 3 months (this is approximate and can change depending on the case)
the two types of urinary stones most common in dogs and cats are
struvite and calcium oxalate
how do crystalluria and urolith differ?
crystalluria simply means crystals in the urine and it can sometimes be harmless and not clinically relevant
urolith=one or more crystallized minerals + organic matrix. Nidus is the nucelus, and then they have a shell.
male dogs like to get which stones?
female dogs like to get which stones?
who likes to get urate stones?
male dogs: oxalate>struvite
female dogs: struvite>oxalate, can be associated with UTIs
dalmations and bulldogs: urates
male cats like to get which stones?
female cats like to get which stones?
which cats like to get urates?
male cats: more calcium oxalates
female cats: 50/50, but struvite stones usually sterile
siamese: urates
Meowington von Purrface comes in with hematuria, stranguria, and some urinary incontinence. On PE she has a thickened bladder wall. Her CBC is normal and her chem panel is also normal. her UA shoes an INACTIVE sediment. what do you suspect? what diagnostics would you like to perform?
uroliths
either abdominal rads (the best choice) or ultrasound
list some characteristics of calcium oxalate, struvite, and urate stones to help you differentiate which is which (by the way you are an absolute queen and I love you so much)
calicum oxalate: rough, rosette/star shaped, and opaque on rads
struvite: smooth, round, a little bit opaque on rads
urate: smooth, round, more radiolucent on rads
what is the connection between struvite cyrstals and urase producing bacteria in DOGS?
for most stones when you do a urine culture, it comes back negative, but for struvite it comes back positive for urase producing bacteria, such as: staph, proteus, enterococcus. (this is for dogs). For these bacteria to grow there has to be an increase in pH.
for struvite crystals in cats, what is special about them?
they are not infection related and are usually associated with sterile urine. it can be due to diets high in certain minerals and protein. they can also be normal in the urine IF the urine is concentrated and there’s few of them.
risk factors for struvite crystals in female dogs is
UTIs
struvite uroliths should me medically dissolved in dogs and cats UNLESS:
- medications or dissolution foods can’t be administered or are contraindicated
- the urolith cannot be adequately bathed in modified urine from the diet OR
- there is an ucontrollable infection
