[NAGDU] FW: [] article Pets can mask symptoms of urinary tract infections

[Becky Frankeberger]

article Pets can mask symptoms of urinary tract infections

 

Here’s an article that may be of interest.  Link and text below. 

http://www.postandcourier.com/article/20160311/PC1209/160319962/1117

Pets can mask symptoms of urinary  tract infections

Mar 11 2016 12:01 am 

Pet Docs 

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Pet Docs 

Website: 

http://www.postandcourier.com/section/PC120306 

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I (Perry Jameson) often see patients for urinary tract infections and only some of them are showing symptoms.

It is surprising to me the number of times I have diagnosed a urinary tract infection in an asymptomatic pet.

They are so good at masking symptoms and I hate to think they have been suffering when I could have helped.

Pets can mask symptoms of urinary tract infections - Post and Courier 

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Pets can mask symptoms of urinary tract infections - Post and Courier

I was taught by Dr. Craig Greene at the University of Georgia that urine is “liquid gold.” I could write an entire article about the information that could be obtained from a urine sample, but I will try to focus on that which applies to infection.

In humans, we complain about the burning sensation when trying to urinate or having the feeling of having to urinate and yet only being able to produce a small volume of urine.

In pets, typical signs associated with a urinary tract infection are increased frequency of urination, urinating small amounts and an increased urgency. Sometimes, this is noted at home by seeing accidents in the house or seeing only small spots of urine after multiple times stopping to squat (or lift a leg).

You can even see straining to urinate associated with a urinary tract infection as well as a change in the urine odor or color.

These are the obvious signs and in these cases, we will typically collect a sterile urine sample and submit it for analysis and culture.

In simple, first-time cases, we will occasionally treat empirically with an antibiotic for 10-14 days as this is often enough to resolve the infection. In complicated cases, the work-up and treatment is much more intense.

A urinary tract infection is often labeled as “recurrent” if there are several (three or more) in a short period of time (several months to a year).

An initial evaluation of these cases involves checking the previous treatments and making sure the dose and duration was appropriate for the pet’s weight.

If a urine culture has previously been performed, we also will look to see how the sample was obtained and see if any additional information can be gleaned from the urinalysis.

That information includes looking at the urine pH and looking at the sediment for white and red blood cells as well as abnormal cells or crystals. In addition, we can see glucose (sugar) and protein in the urine that can indicate that an underlying disease might be present.

Once we have established that previous treatments should have been effective to clear a basic infection, we will often recommend basic blood work. I know this sounds odd because you would not think that blood work has anything to do with urine, but it gives us a lot of information as to possible metabolic conditions that can predispose a pet to a urinary tract infection. Conditions commonly associated with urinary tract infections include diabetes and Cushing’s disease.

Kidney disease also can be identified on blood work. We often see acute exacerbations of kidney failure in patients with previously stable kidney values if they develop an infection.

Another important part of the work-up of recurrent infections is imaging. Abdominal X-rays are useful in helping rule out stones in the urinary system that can be a nidus for infection. Unfortunately, not all stones can be visualized by X-rays.

Abdominal ultrasound can be used to look at the urinary tract in more detail. It can show stones in the urinary system as well as tumors or benign growths in the bladder that can be contributing to recurrent infection.

Stones and masses contribute to infection by having many nooks and crannies into which bacteria can lodge. This allows for persistence of infection, even in the face of antibiotics.

Tumors and growths also can result in bleeding, which creates an ideal environment for bacteria to grow. Another sign noted on ultrasound is a thick bladder wall. This is often seen in patients with chronic urinary tract infection. Sometimes while performing an ultrasound for another reason, I find this change. It always prompts me to recommend checking a urinalysis if one has not been performed to screen for infection.

Treatment of recurrent infections involves long-term antibiotics and management of any underlying predisposing condition. The choice of antibiotic is based on an initial urine culture and drug sensitivity panel.

Typical treatment duration is four to six weeks. Often, we will recheck a urine sample during the course of treatment to be sure that the sample is sterile and that our therapy is effective. Additionally, we will recheck a sample after the course of the therapy to be sure that the condition has resolved.

Occasionally, some infections are due to bacteria that are resistant to the normal antibiotics. In these cases, we will often run an extended spectrum antibiotic sensitivity panel.

The antibiotics needed to treat these infections often have more side effects and have to be given via injection as well as carry greater expense. Additional treatments recommended with antibiotics to help clear infection can include a cranberry supplement and increasing the amount of water your pet consumes. Dietary therapy can be useful in patients who have developed stones.

An observant owner can notice signs associated with a typical infection, but in some cases, even the keenest of eyes can miss subtle signs. If your pet is not acting right, seems lethargic or has diabetes or Cushing’s, a simple urinalysis might be warranted and could make the difference in their comfort.

Dr. Henri Bianucci and Dr. Perry Jameson are with Veterinary Specialty Care LLC. Send questions to petdocs at postandcourier.com.