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                                                                                                                                                                                                          Urinary Tract Infections

                                                                                                                                                                                                          UTIs are extremely common among cats and dogs.  There can be many causes of UTIs and there are different ways of treating them based on the cause and underlying conditions.  We will first talk about UTIs in dogs and then in cats.

                                                                                                                                                                                                          Dogs

                                                                                                                                                                                                          Most simple UTIs occur from bacteria (mostly E.coli) that travels up the urethra into the bladder.  Because female dogs have shorter urethras, they are more prone to UTIs.  Dogs with allergies or other inflammatory processes, diabetic dogs, those on steroid therapy or those with underlying bladder or kidney disease are also predisposed.

                                                                                                                                                                                                          Symptoms of a UTI include:
                                                                                                                                                                                                          • Frequent urination
                                                                                                                                                                                                          • Straining to urinate; urinating in small amounts
                                                                                                                                                                                                          • Blood-tinged urine
                                                                                                                                                                                                          • Increased water consumption
                                                                                                                                                                                                          • Accidents in the house
                                                                                                                                                                                                          • Excessive licking in the genital area
                                                                                                                                                                                                          If any of these symptoms occur in your dog, the first test we will perform is a urinalysis.  From testing the urine we can see if there are any bacteria or inflammatory cells in the urine, how concentrated the urine is, what the pH of the urine is, and if there is any evidence of underlying bladder stones or bladder cancer.  Simple UTIs are treated with a minimum of 2 weeks of antibiotics.  It is important to have your dog rechecked BEFORE the last dose of antibiotic to make sure a third week of treatment is not needed.  In dogs that have recurrent UTIs one reason is that antibiotic therapy is stopped before the infection is completely cleared.  This can lead to antibiotic resistant infections.

                                                                                                                                                                                                          If we see crystals on your dog's urine sample, this could indicate a bladder stone issue.  Depending on the type of crystal, we may recommend bladder x-rays or ultrasound, a diet change, or just a course of antibiotics and a recheck in 2 weeks as some urine crystals can be caused by UTIs.  On the other hand, some UTIs can be caused by the presence of crystals so it is important to decipher which is the primary cause of your dog's problems! 

                                                                                                                                                                                                          If there are any abnormal cells in your dog's urine we will recommend a bladder ultrasound to check for inflammation or potential bladder cancer.

                                                                                                                                                                                                          With recurrent UTIs in dogs, it is important to understand why this is happening.  Bladder cultures with antibiotic profiles are important to see if we need to change to a different antibiotic, and sometimes additional testing is needed.  Underlying allergies, diabetes, and kidney disease need to be treated as well so bloodwork may be necessary in addition to urine cultures.

                                                                                                                                                                                                          Most dogs either have simple UTIs or bladder stones/crystals.  Simple UTIs usually resolve with a few weeks of antibiotic therapy and do not reoccur.  Some bladder stones can be dissolved with diet change and some will require surgery to remove them with a diet change to a food that will help prevent their formation in the future. 

                                                                                                                                                                                                          Bladder stones and crystals can also cause blockage of the urethra (more common in male dogs) which can be a life-threatening situation. If your dog has not urinated within 12-24 hours and/or is straining to urinate, is showing abdominal pain, or is laying on his/her side breathing heavily, immediate veterinary attention is needed.

                                                                                                                                                                                                          Cats

                                                                                                                                                                                                          Cat UTIs are a little more challenging than those in dogs.  Young, middle-aged and older cats tend to be more prone to different causes of symptoms of UTIs and diagnostic testing and treatment can be different for each age range.  Symptoms of urinary tract infections include:
                                                                                                                                                                                                          • Frequent urination
                                                                                                                                                                                                          • Straining to urinate, urinating in small amounts
                                                                                                                                                                                                          • Blood-tinged urine
                                                                                                                                                                                                          • Increased water consumption
                                                                                                                                                                                                          • Urinating outside the litter box or in inappropriate places
                                                                                                                                                                                                          • Excessive licking in the genital area
                                                                                                                                                                                                          • Absence of urine production 
                                                                                                                                                                                                          ****NOTE - if you have not seen any urination within 24 hours your cat needs to have immediate veterinary attention****

                                                                                                                                                                                                          Most younger cats (<7 yrs of age) who present with symptoms of UTIs will not have an actual bladder infection at all; rather, they have what is referred to as feline idiopathic cystitis.  This basically means that, for reasons usually unknown, their bladders have become inflamed and painful and cause similar signs as true bacterial infections.  Treatment for these cats includes anti-inflammatory medications instead of just antibiotics.  Cats with recurrent cystitis issues are usually switched to a prescription diet to help prevent future flare-ups. 

                                                                                                                                                                                                          Middle aged cats are more prone to true bacterial UTIs that are often caused by long-term cystitis issues or bladder stones, or secondary to diabetes.  Treatment is different depending on the cause, so just as with the dogs a urinalysis is the first test we perform.  This will help us see if there is an infection, just inflammation, or if crystals are present in the urine.  A blood glucose check is also important if we suspect diabetes.  Dietary therapy is usually indicated if there is recurrent inflammation or crystals present. 

                                                                                                                                                                                                          Certain types of bladder stones/crystals have been correlated with an increased incidence of chronic kidney disease and failure in cats so early intervention and detection is very important! 

                                                                                                                                                                                                          Bladder stones and crystals can also cause blockage of the urethra (more common in male cats) which can be a life-threatening situation. If your cat has not urinated within 12-24 hours and/or is straining to urinate, is showing abdominal pain, or is laying on his/her side breathing heavily, immediate veterinary attention is needed.

                                                                                                                                                                                                          Older cats also get UTIs and UTI symptoms which can occur secondary to bladder stones or bladder cancer, or from diabetes or kidney disease.  In older cats we usually recommend bloodwork in addition to a urinalysis to check the kidney function.  Treatment depends on the underlying cause. 

                                                                                                                                                                                                          Feline idiopathic cystitis can be a frustrating challenge to treat, both for pet owners and veterinarians.  If your cat is having problems with this condition, please be patient and don't hesitate to consult with us about how your treatment plan is going.  We usually try therapies in a step-wise fashion and it may take several months to find a solution.  Some cats, despite dietary and environmental therapy, will still have occasional flare-ups so it is important to recognize the signs and intervene early.
                                                                                                                                                                                                           
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