Thursday, May 9, 2013

Three things I learned: urinary tract infections in dogs and cats

Haematuria or blood in the urine is a symptom of a urinary tract infection in dogs and cats.

Urinary tract one enjoys having one and they can be challenging to treat. Tonight I attended a seminar by medicine specialist Fiona Park at the Animal Referral Hospital on the diagnosis and rational treatment of UTIs in cats and dogs.

Dr Park drew heavily on the recent guidelines for treatment of UTIs, published by the International Society for Companion Animal Infectious Diseases (ISCAID). The guidelines can be downloaded for free from here.

What did I learn?
1) Where the patient is an intact male, assume you are treating a complex UTI because of the likelihood of prostatitis as the inciting cause. I know prostates can be troublesome, and I guess because of widespread neutering I don't meet many entire male patients, but worth remembering.

2) Polypoid cystitis is more likely to cause lesions on the cranioventral aspect of the bladder than transitional cell carcinomas.

3) FQs and trimethoprim-sulfonamides are the most useful antimicrobials when treating pyelonephritis.

I was also reminded that procanthocyanidins are the things in cranberry juice that are meant to stop E. coli from adhering to one's bladder, but we don't have good evidence that they work in animals. Dr Park also mentioned the use of methenamine to "disinfect" the bladder as this is converted to formalin. 

I like the idea of cleaning out a chronically infected bladder. I think cystotomy is underutilised in this regard - how about you guys? I've met some really angry looking bladders in my time and I think surgical exploration and flushing (+/- biopsy if wall lesions are present) is really helpful.