Chronic and/or Recurrent Urinary Tract Infections

Urinary tract infection (UTI, cystitis) refers to a condition in
the urinary bladder (sometimes also involving the kidneys)
caused by infection, usually with bacteria. In people, the
condition is most often seen in women and girls, but in dogs it
is common in both males and females. UTI is uncommon in cats. In
people the signs of UTI often include fever, feeling sick, back
pain, lower abdominal (bladder) cramping, an uncontrollable urge
to urinate frequently, and passage of small amounts of urine.
Blood is sometimes present in the urine.

Dogs most often have no signs that can be seen by either the
owner or the veterinarian. When signs are present in dogs, they
include an obvious need to urinate more frequently than normal
(frequent attempts to urinate on walks, asking to be let outside
more often). Cats may use the litter box more often than is
normal and may spend more time in the litter box. Both dogs and
cats may be seen to pass bloody urine. Some owners may notice
that their pet has increased thirst or a change in the odor of
its urine when UTI is present.

Your veterinarian can make a diagnosis of UTI by taking a small
sample of urine from your pet. The sampling procedure may
involve introducing a catheter into the bladder through the
pet’s urethra, but is most easily done by inserting a small
needle on a syringe into the bladder through the abdomen from
the outside. This can easily be accomplished by your
veterinarian with essentially no pain or risk to your pet. The
urine sample must be obtained in a sterile manner that does not
result in contamination of the sample by bacteria from outside
the urinary tract. For this reason, owner-obtained samples of
urine (catch samples) are not appropriate for determination of
the presence or absence of UTI.

Your veterinarian will analyze the urine (urinalysis) and
examine a small amount of the urine under a microscope. If
bacteria and/or white blood cells (WBCs, “pus cells”) are seen
during this examination, your veterinarian will suggest that the
urine be cultured. In some instances your veterinarian will send
the urine sample to a laboratory for examination and/or culture.

If bacteria are grown on culture, it means that an infection is
present and an antibiotic “sensitivity test” may be performed on
the bacteria. This determines the antibiotics to which the
infection is most sensitive. In this way, your veterinarian can
select the right antibiotic to kill the infection. It may take 2
or 3 working days before complete information is available to
your veterinarian.

The antibiotic that your veterinarian selects will usually be in
pill, capsule, or liquid form for oral use (for you to give to
your pet). Depending on the antibiotic, you will need to give
medicine to your pet from once to three times each day for at
least 2 weeks (sometimes longer than 2 weeks but rarely
shorter). Your veterinarian, or a technician who works at your
veterinary hospital, can show you how to give the antibiotic to
your pet and can answer any questions you have regarding the
technique involved, side effects of the antibiotic, and so on.

Your veterinarian should reculture your pet’s urine during the
second week of antibiotic treatment. This culture is to be
certain that the antibiotic is working to kill the bacteria
causing the UTI. The results should be negative (no bacterial
growth). A second reculture 10 to 14 days after completion of
treatment is also recommended. Results of this culture tell your
veterinarian whether, as sometimes happens, the UTI has come
back after treatment.

If the result of this culture is also negative, your pet is not
likely to have another UTI, at least in the near future. If
infection is present, however, at either recheck, a new
antibiotic susceptibility test must be performed and, in all
likelihood, a new antibiotic selected on the basis of results of
the test.

If the pet has three or more episodes of UTI in the course of 1
year, the infections are said to be recurrent. In this special
and uncommon case, after an infection has been eliminated
(culture-negative urine), a daily dose of an antibiotic is often
given on a long-term basis (6 months is recommended) to prevent
future episodes of UTI. This low-dose, preventive treatment is
usually effective in preventing future UTI. Frequent urine
cultures are necessary, however, to verify this fact for the
individual pet.

It is not known why pets have UTI. It is known that certain
diseases, certain types of medicines, and certain breeds of dogs
are associated with UTI more often than normal. It is also known
that it is important to recognize and treat UTI because, if left
untreated, UTI can cause serious kidney ailment and bladder
stones, as well as potentially serious infections in other parts
of the body.

The above is general veterinary information. Do not begin
any course of treatment without consulting your regular
veterinarian. All animals should be examined at least once every
12 months.