ArticleLiterature Review

Diagnosis of urinary tract infections

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  • The University of Georgia
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Abstract

Urinary tract infections (UTIs) are a common cause of urinary tract disease and may be associated with systemic disease. Diagnosis cannot be made on urinalysis and other findings alone. A urine culture is the "gold standard" for diagnosis of UTI. Antimicrobial susceptibility testing performed as part of a urine culture aids in selection of appropriate treatment for patients with confirmed bacterial UTI.

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... In UTIs, the microscopic evaluation of stained urinary sediment has demonstrated higher diagnostic performance than wet-mount evaluation, for both cytomorphologic identification and bacteria detection [1][2][3]. However, urine culture nowadays represents the gold standard for diagnosing bacterial UTIs in small animals [4] and remains an essential step, as it allows for the determination of antimicrobial resistance rates [5]. Current UTI Guidelines suggest performing urine cultures both for sporadic and recurrent UTIs [5]. ...
... Sci. 2022, 9, from a true UTI but also from subclinical bacteriuria, or secondary contamination, occurring during collection, conservation, or processing [4]. This important distinction between UTIs and subclinical bacteriuria leads to completely different therapeutic approaches, since only true infections should be treated with antimicrobials [5]. ...
... Otherwise, among asymptomatic dogs, 25 out of 55 (45.4%) were male, and the remaining 30 (54.6) were female. The median age in the symptomatic group was nine years (range 0. [4][5][6][7][8][9][10][11][12][13][14][15][16], and in asymptomatic group it was 8.1 years (range 0.5-15.2). There was not a statistically significant difference in age between symptomatic and asymptomatic dogs (p value = 0.6253). ...
Article
The diagnosis of urinary tract infections (UTIs) requires a concomitant evaluation of clinical signs and urine culture, which is of fundamental to start an appropriate antibiotic treatment. Several factors, such as subclinical bacteriuria or pre-analytical errors, may make the interpretation of urine culture difficult. The aim of the study was to evaluate the association between the finding of neutrophils and bacteria in unstained and stained canine urine sediment and the presence of clinical signs and positive urine culture. Urine samples from 35 dogs with clinical signs of UTI and 55 asymptomatic dogs with risk factors for UTI were prospectively collected by cystocentesis, divided into three aliquots, and submitted for: (1) physical and chemical Dipstick analysis and unstained urinary sediment (casts, crystals, bacteria, leucocytes, cells, parasites); (2) stained urinary sediment (extra/intracellular bacteria, degenerated and non-degenerated neutrophils); (3) qualitative and quantitative urine culture and antimicrobial sensitivity-test. The association between unstained and stained findings of urinary sediment and urine culture was tested. Sensibility, specificity, and positive/negative predictive values in diagnosing positive urine cultures of bacteria at unstained and stained evaluation were compared. Both wet-mount bacteriuria and the cytological presence of intracellular and extracellular bacteria, neutrophils, and degenerated neutrophils were successively associated with positive urine culture (p < 0.001). The presence of intracellular bacteria was the only independent predictor of positive urine culture. Total bacterial count did not differ significantly between symptomatic and asymptomatic dogs. Detection of extracellular and intracellular bacteriuria at stained urinary sediment significantly improved the sensibility of predicting positive urine culture. Cytologic evaluation of urinary sediment may be helpful in detecting signs of active inflammation, thus enhancing the clinical relevance of a positive urine culture.
... diabetes mellitus (DM), HC) or dogs treated with cyclosporine or glucocorticoids are even more frequently affected, with rates of 15-74%. 3,4,12,19,27,35,38 Nowadays, a positive urinary culture is still a leading reason for the use of antimicrobials in small animal practice. 17 Regarding treatment, the previous guidelines of the International Society for Companion Animal Infectious Diseases (ISCAID) supported treatment of animals with subclinical bacteriuria and comorbidities such as diabetes mellitus or hypercortisolism. ...
... A result of ≥ 10 3 cfu/mL of urine was considered to indicate bacteriuria. 4 For all positive bacterial cultures, susceptibility testing was performed. The following antimicrobial classes were included: aminopenicillins, potentiated aminopenicillins, 1 st -4 th generation cephalosporins (only 1 st , 3 rd and 4 th ), aminoglycosides, tetracyclines, sulfonamides and combination preparation (trimethoprim), fluoroquinolones, amphenicols, macrolides, nitrofurans, polymyxins, steroid antibiotics, lincosamides, ansamycins and nitroimidazoles. ...
... Urine bacterial culture from aseptically collected urine samples was used to diagnose bacteriuria, which is considered the gold standard for diagnosis. 4 Microscopic evaluation of urine sediment revealed bacteria in only 17 of 24 cases with positive bacterial culture (respectively, in 2 of 4 cases with clinical signs of cystitis and positive bacterial culture), underlining that bacterial culture should always be performed if bacterial cystitis is suspected. The most frequently isolated uropathogen in this study was E. coli (58%), which is consistent with previous studies. ...
Article
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Introduction: Dogs with hypercortisolism are predisposed to developing bacteriuria associated either with clinical signs of cystitis or without clinical signs (subclinical bacteriuria). Based on current guidelines, dogs with subclinical bacteriuria should not be treated with antibiotics because there is no evidence that treatment improves outcome and because unnecessary treatments should be avoided. Before these guidelines were published in 2019, dogs with hypercortisolism and bacteriuria were commonly treated with antibiotics irrespective of clinical signs. Comprehensive data on the frequency of bacterial cystitis, subclinical bacteriuria and the outcome of antimicrobial treatment in dogs with hypercortisolism is sparse. The aims of this study were to investigate dogs with hypercortisolism for the presence of bacterial cystitis and subclinical bacteriuria, to address the pathogens involved, and to assess the outcome of antibiotic treatment. Dogs newly diagnosed with hypercortisolism between 2005 and 2015 from which a urine bacterial culture was available were included. Statistical analysis was performed with non-parametric tests. Of the 161 client-owned dogs included, 29 (18%) showed bacteriuria, which was subclinical in 24 (83%) cases. Escherichia coli was the most commonly isolated pathogen (58%). Bacteriuria was not associated with sex or neutering status. In 14 dogs, follow-up data was available, of which 13 (93%) were treated with antimicrobials for 14 to 28 days. Follow-up bacterial culture (1 to 118 days after cessation of therapy) was negative in 10 (77%) treated dogs; a negative follow-up culture was not associated with gender, age or duration of treatment. Bacteriuria persisted in three treated dogs and the one untreated dog. The prevalence of positive bacterial urinary culture in dogs with hypercortisolism was lower than previously reported. In the majority of dogs, bacteriuria was subclinical. Most dogs had a negative bacterial culture result after antimicrobial treatment; however, more resistant bacteria were detected in persistently positive urine.
... Urin pošljemo v mikrobiološko preiskavo takoj po odvzemu. Le v izjemnih primerih ga hranimo v hladilniku pri 4 o C od 6 do 12 ur, saj se število bakterij v ugodnih pogojih pri sobni temperaturi podvoji vsakih 20-45 minut (Bartges, 2004). V okoliščinah, ko smo s protimikrobno terapijo že začeli brez urinske kulture, je potrebno pred odvzemom vzorca za mikrobiološko preiskavo prenehati z zdravljenjem od treh do petih dni (Bartges, 2004;Bartges, 2011a). ...
... Le v izjemnih primerih ga hranimo v hladilniku pri 4 o C od 6 do 12 ur, saj se število bakterij v ugodnih pogojih pri sobni temperaturi podvoji vsakih 20-45 minut (Bartges, 2004). V okoliščinah, ko smo s protimikrobno terapijo že začeli brez urinske kulture, je potrebno pred odvzemom vzorca za mikrobiološko preiskavo prenehati z zdravljenjem od treh do petih dni (Bartges, 2004;Bartges, 2011a). Z mikrobiološko preiskavo določimo število mikroorganizmov v 1 ml urina in vrsto mikroorganizmov ter testiramo njihovo občutljivost za različna protimikrobna zdravila in vitro. ...
... V mehurju zdravih psov praviloma ni bakterij, zato pomeni kakršnokoli število bakterij v urinu, odvzetem s cistocentezo, zelo verjetno okužbo. Ker pa je ponavadi majhno število bakterij v 1 ml urina povezano s kontaminacijo in ker so okužbe sečil ponavadi povezane z Patogeneza okužb urinarnega trakta je odvisna od razmerja med uropatogenostjo povzročitelja in odpornostjo organizma gostitelja, saj je za nastanek okužbe potrebna naselitev bakterij na epitelnih celicah sluznice (Bartges, 2004;Pressler in Bartges, 2010;Barsanti, 2012). Glavni mehanizmi obrambe gostitelja pred okužbami sečil so normalno praznjenje mehurja, normalna anatomija sečil, intaktne sluznice, površinski glukozaminoglikani, eksfoliacija celic, normalna mikroflora, tvorba lokalnih protiteles, protimikrobne lastnosti epitelijskih celic in urina, hiperosmolalnost in kislost urina idr. ...
Thesis
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V naši raziskavi smo proučevali pogostost obolenj psov z znaki bolezni sečil in diagnostično vrednost različnih kvalitativnih in kvantitativnih parametrov. Ovrednotili smo dejavnike tveganja za posamezne bolezni in poudarili pomen celovite obravnave pacienta oziroma vpogled v različna klinična stanja. V prospektivni epizootiološki raziskavi smo obravnavali 191 psov, pri katerih smo zbrali anamnestične podatke, opravili klinični pregled in ultrazvočno preiskavo trebuha, osnovno analizo in mikrobiološko preiskavo urina, ter v indiciranih primerih še kvantitativno analizo urolitov, hematološke preiskave, biokemijske preiskave krvi, rentgensko slikanje trebuha in/ali prsnega koša, pregled prostatičnega izpirka in redkeje druge preiskave. Najpogostejši diagnozi pri psih z znaki bolezni sečil sta bili bakterijska okužba sečil, ki je predstavljala 34,4 odstotka diagnoz, in urolitiaza, ki je predstavljala 14,3 odstotka diagnoz. Okužba je bila pogostejša pri kastriranih živalih, pri samicah, starejših živalih in živalih s sočasnimi boleznimi. Najpogostejši povzročitelji urinarnih okužb psov so bile enterobakterije, ki so predstavljale 55,9 odstotka izolatov, in stafilokoki, ki so predstavljali 27,1 odstotka izolatov. Najpogostejša enterobakterija je bila E. coli, ki je predstavljala 39,0 odstotkov izolatov. Okužbo je večinoma (pri 90,7 odstotka psov) povzročila ena vrsta bakterije. V 95,4 odstotka primerov okužb smo v 1 ml urina ugotovili > 106 kolonijskih enot (CFU). Za vsa testirana protimikrobna zdravila je bilo občutljivih 29,4 odstotka izolatov, sekundarno odpornih proti eni skupini protimikrobnih zdravil je bilo 25,2 odstotka, proti dvema skupinama 17,6 odstotka, večkratno odpornih pa je bilo 27,7 odstotka izolatov. Pri psih, ki so bili predhodno zdravljeni s protimikrobnimi zdravili, so bile bakterije pogosteje odporne proti eni, dvema ali več skupinam protimikrobnih zdravil kot pri psih, ki predhodno niso bili zdravljeni. Med večkratno odpornimi bakterijami so bili diagnostično in terapevtsko bolj zahtevni primeri okužb z bakterijo Staphyloccus pseudintermedius, odporno proti meticilinu (MRSP) in E. coli z betalaktamazami širokega spektra (ESBL/AmpC). Najpogostejši uroliti pri psih so bili struvitni (44,4 odstotka), redkejši pa oksalatni (26,7 odstotka) in uratni (11,1 odstotka). Za pravilno postavitev diagnoze in odločitev za zdravljenje so bili v 11,5 odstotka vseh primerov potrebni rezultati mikrobiološke preiskave in kvantitativne analize urolita. This study was designed to examine the frequency of the diseases presenting with signs of urinary tract disease and diagnostic value of different qualitative and quantitative parameters. Predisposing factors were evaluated and complete consideration of patients was emphasized. This prospective epizootiologic study included 191 dogs with signs of urinary tract disease. Anamnestic data were collected and clinical exam, abdominal ultrasonography, urinalysis and urine culture were performed. When indicated, quantitative urolith analysis, hematology, serum biochemistry, radiography, cytology and culture of prostatic wash, or other were also conducted. Urinary tract infection (in 34.4% of all diagnosis) and urolithiasis (in 14.3%) were most commonly diagnosed. Urinary tract infection was more common in castrated animals, female dogs, older dogs and animals with concurrent diseases. Most commonly, urinary tract infections were caused by enterobacteria (55.9% of isolates), with E. coli isolated in 39.0% of the cases and staphylococci (27.1% of isolates). A single species of microorganism was isolated in 90.7%. More than 106 colony forming units (CFU) of causative agents in 1 ml of urine were cultured in 95.4%. The causative agents were in 29.4% susceptible to all tested antimicrobials. Acquired non-susceptibility to one group of antimicrobial drugs was noticed in 25.2% and to two groups of antimicrobials in 17.6% of isolated microorganisms. In 27.7% bacteria were multi-drug resistant. Resistant bacteria were more commonly isolated from dogs, previously treated with antimicrobials. Among multi-drug resistant bacteria the cases involving infection with methycillin resistant Staphylococcus pseudintermedius (MRSP) and E. coli with extended spectrum beta-lactamases (ESBL/AmpC) were diagnostically and therapeutically more complicated. In dogs with uroliths, struvites were most numerous, they accounted for 44.4% of uroliths. The oxalate uroliths were found in 26.7%, and urate uroliths in 11.1%. In 11.5% of all cases, results of microbiology and quantitative urolith analysis were needed for correct diagnosis and treatment decision.
... Urine samples for bacteriological tests should be collected by cystocentesis to eliminate the risk of contamination from the lower urinary tract (Kruger et al. 1996b;Bartges 2004;van Duijkeren et al. 2004;Barsanti 2006). Researchers differ in their opinions regarding bacterial counts that have a positive predictive value for urinary tract infection. ...
... In our study, the average age of cats with urinary tract infection was 8.9 years, which is higher than the 5.1, 5.6 and 6.7 years reported by other authors (Buffington et al. 1997;Saevik et al. 2011;Dorsch et al. 2014;respectively). Bartges (2004) and Barsanti (2006) found a correlation between the age of feline patients and the prevalence of urinary tract infection. In their study, urinary tract infection was diagnosed in 45% of cats older than 10 years with symptoms of FLUTD, and 17% of cats were diagnosed with both urolithiasis and urinary tract infection (Bartges 2004). ...
... Bartges (2004) and Barsanti (2006) found a correlation between the age of feline patients and the prevalence of urinary tract infection. In their study, urinary tract infection was diagnosed in 45% of cats older than 10 years with symptoms of FLUTD, and 17% of cats were diagnosed with both urolithiasis and urinary tract infection (Bartges 2004). In most reports, females are more susceptible to urinary tract infection (Lekcharoensuk et al. 2001;Bailiff et al. 2008;Litster et al. 2009). ...
Article
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This paper describes the results of a retrospective study performed on 385 cats with feline lower urinary tract disease. The study was conducted to obtain epidemiological data and to evaluate clinical symptoms and the results of laboratory tests in a population of Polish cats with symptoms of lower urinary tract disease. The analysed population comprised feline patients of the veterinary clinic at the University of Warmia and Mazury in Olsztyn who had not been treated prior to admission. Medical history was obtained for all patients. Urine samples were collected mostly, but not solely, by cystocentesis. Feline idiopathic cystitis was diagnosed in most cats (60.7%), while urinary tract infections were noted in only 7.8% of patients. Urethral obstruction caused by mucus plugs was observed in 17.4% of animals. Urolithiasis was observed in 13% of cats, 5% of whom were also diagnosed with urinary tract infections. Hyperplastic changes were identified in only 1% of the studied population. In 59% of cats, feline lower urinary tract disease was accompanied by urethral obstruction. Cats with feline idiopathic cystitis were the youngest animals in the analysed population, and the risk of urinary tract infections and neoplasia increased with age. Our results, obtained over a period of six years in a Polish feline population, show that sex, neutering, age, living conditions and diet influence the type of urinary tract disease, data which are consistent with those obtained in other countries.
... 6,10 The diagnosis of pyelonephritis is usually presumptive and based on the presence of compatible clinical signs, urinalysis findings, a positive aerobic bacterial urine culture, improvement in degree of azotemia after antimicrobial treatment, and compatible ultrasonographic, excretory urography findings or both modalities. 6,9,11 Ideally, diagnosis should be confirmed by a positive bacterial culture collected by pyelocentesis or by renal biopsies; however, because both are considered invasive, they are rarely performed in cases of pyelonephritis. 2 The objectives of this retrospective study were to evaluate the prevalence of pyelonephritis in a population of dogs presenting to an academic referral hospital, to describe the clinical signs and the diagnostic test results in dogs with pyelonephritis diagnosed by histopathology, as well as to identify any concurrent disorders in order to determine potential risk factors for pyelonephritis in dogs. ...
... 12 Pyuria was considered relevant when more than 0-5 white blood cells (WBC) per hpf where present in the sediment of urine samples collected by cystocentesis, and when more than 5-10 WBC where observed in the sediment of urine samples collected by catheterization or voiding. 11 Sediment examination was considered normal when bacteria, hematuria, and pyuria were absent. An active sediment was defined as a sediment in which bacteria, hematuria, pyuria, or any combination of those were present. ...
... As with any UTI, whether or not an infection is established depends on both bacterial virulence factors and host defense mechanisms. 5,11 To the authors' knowledge, uncomplicated pyelonephritis have not yet been described in dogs. ...
Article
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Background: The clinicopathologic aspects of pyelonephritis have not been reported in companion animals. Hypothesis/objectives: To evaluate the prevalence of pyelonephritis diagnosed in dogs in a academic referral population, describe the clinical signs and the diagnostic test results in dogs with pyelonephritis, and identify concurrent disorders in order to determine potential risk factors for pyelonephritis. Animals: Forty-seven dogs with a histopathologic diagnosis of pyelonephritis from the teaching hospitals of three Canadian veterinary colleges. Methods: Retrospective case series. Review of medical records and renal histologic sections. Results: Pyelonephritis was diagnosed in 0.4-1.3% of the cases at necropsy. Clinical signs included anorexia or inappetence (n = 27, 57%), lethargy (n = 24, 51%), vomiting (n = 17, 36%), and dehydration (n = 12, 25%). Thirty-five dogs (75%) had concomitant disease(s). Escherichia coli was the most common pathogen isolated (37%). Pyelonephritis was classified as acute (n = 12, 26%), subacute (n = 9, 19%), and chronic (n = 26, 55%) disease; and mild (n = 7, 15%), moderate (n = 11, 24%), and severe (n = 28, 61%). Fever was significantly associated with histopathologically subacute pyelonephritis (P = 0.01). Conclusions: In referral hospitals, pyelonephritis has a very low prevalence at necropsy. Nonspecific clinical presentation, concomitant diseases, and high variability in the diagnostic tests results make the antemortem diagnosis of pyelonephritis challenging. Neither the histopathologic stage nor the severity of the pyelonephritis was associated with fever, lumbar pain, or signs of a urinary tract infection (ie, lower urinary tract infection, upper urinary tract infection, or both) except for subacute pyelonephritis which was associated with fever.
... Bakteriurie ist die spezifischste Auffälligkeit der Sedimentuntersuchung. Sie kann detektiert werden, wenn > 10 000 koloniebildende Einheiten (KBE) pro Milliliter stäbchenförmige Bakterien bzw. > 100 000 KBE/ml Kokken vorliegen (7). Hierbei ist es entscheidend, dass ein gefärbtes Sediment untersucht wird, denn die Untersuchung eines ungefärbten Sediments hat eine relativ geringe Sensitivität (76 %) und Spezifität (57 %) (54,76,94). ...
... Da die Bakterienanzahl bei Raumtemperatur innerhalb weniger Stunden ansteigt, sollten Urinproben für eine bakteriologische Untersuchung im Kühlschrank gelagert und innerhalb von maximal 6-12 Stunden angesetzt werden (72,74,82). Bei Katzen ist ein Wachstum von > 10 3 KBE/ml bei Zystozentese-und Katheterproben sowie von > 10 5 KBE/ml bei Mittelstrahlproben signifikant (▶ Tab. 4) (7,48,89). Die meisten Uropathogene können nach einer Bebrütungsdauer von 18-24 Stunden kulturell nachgewiesen werden. Allerdings wachsen einige der HWI-auslösenden Bakterien (z. ...
... In den letzten Jahrzehnten ist auch in der Kleintiermedizin der Anteil multiresistenter Bakterien deutlich angestiegen (67,75 Tab. 4 Interpretation der quantitativen Kultur in Abhängigkeit von der Methode der Urinprobengewinnung (7, 48, 89) Table 4 Criteria for determining infection in urine specimens based on the collection method (7,48,89). tenzen gegen die meisten der evaluierten Antibiotika zunahmen, blieben diese in den darauffolgenden Jahren (2009-2014) stabil oder sanken sogar ab (21,96). Die in den letzten 5 Jahren stabile bzw. ...
Article
Zusammenfassung Bei Harnwegsinfektionen (HWI) handelt es sich um die Anheftung und Multiplikation von Erregern im Harntrakt. Acht bis 19 % der Katzen mit klinischen Symptomen einer Erkrankung der unteren Harnwege leiden an einer HWI. Bei Katzen mit einer subklinischen Bakteriurie kann eine signifikante Anzahl an Bakterien im Urin nachgewiesen werden, obwohl keine entsprechenden Symptome vorliegen. Die Prävalenz der subklinischen Bakteriurie in der Katzenpopulation beträgt 1–29 %. Neben dem am häufigsten isolierten Uropathogen Escherichia coli werden oft Streptokokken, Enterokokken und Staphylokokken nachgewiesen. Harnwegsinfektionen sind ein häufiger Grund für den Einsatz von Antibiotika. Um der zunehmenden Resistenzentstehung vorzubeugen, sollte ein Antibiotikum mit möglichst engem Wirkspektrum basierend auf den Ergebnissen der Kultur und des Antibiogramms gewählt werden. Aktuell ist die Studienlage zur Behandlung der subklinischen Bakteriurie unzureichend. Die meisten Experten empfehlen, nur Patienten mit einem erhöhten Risiko aufsteigender Infektionen antibiotisch zu behandeln.
... It is estimated that 14% of dogs will develop a urinary tract infection (UTI) at some stage of life (WONG et al., 2015). Failure of host defence mechanisms and the ability of infectious agents to adhere, multiply and persist in the upper or lower urinary system are contributing factors (BARTGES, 2004;OLIN;BARTGES, 2015). ...
... These agents can access and colonize the urinary system through the ascending pathway of the distal urogenital system, or through the haematogenous or lymphatic pathways. The consequences are pyelonephritis, urethritis, cystitis, prostatitis and/ or urethritis (BARTGES, 2004;THOMPSON et al., 2011). ...
... Biochemical identification of isolates was performed according to Quinn et al. (1994). The antibiogram of the isolates was performed by the disk agar diffusion test (BARTGES, 2004), with the following antimicrobials: ...
Article
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Infections of the genitourinary system are among the most frequent in the clinical routine of small animals. Treatment with the most appropriate antimicrobial therapy, according to the uropathogen susceptibility test, can avoid the spread of bacterial resistance to antimicrobials. A clinical study was performed in 32 canines, of both sexes and differing ages, who attended the Veterinary Teaching Hospital. Urine samples underwent culture, with the objective of evaluating urinary tract infection in dogs with renal disease, identifying the associated bacterial pathogens, and verifying their antimicrobial susceptibility in vitro. Urine culture was positive in 10 dogs, mostly males, with no predisposition for breed, and a mean age of 8.28 years. Most of the urinary tract infections (UTIs) were monobacterial, with the most common microorganisms being Pseudomonas sp. and Staphylococcus sp. The antimicrobials imipenem and meropenem had the best overall sensitivity profile, and ampicillin showed the highest resistance. The variation in epidemiological profiles, and susceptibility to uropathogens, reinforces the importance of the veterinarian in the prevention and control of infection, in addition to the need for further research to identify new antimicrobial agents.
... Proteinuria was observed in 19 (86.33%) out of 22 cases (Table 1) which was in agreement with Cetin et al. (2003) and Bartges (2004) whereas proteinuria was recorded in hundred percent cases by Bailiff et al. (2008) and Jasim (2012). Categorization of proteinuria revealed presence of mild, moderate and severe proteinuria in 3 (13.63%), 5 (22.7%) and 11 (50%) cases, respectively. ...
... Proteinuria was not only an indicator of renal diseases but also associated with rate of progression of diseases and inflammation of urinary tract as suggested by Raila et al. (2011). Haematuria was positive in 15 (68.17%) cases and mild, moderate and severe haematuria was observed in 4 (18.18%), 5 (22.72%) and 6 (27.27%) dogs, respectively which was similar to the findings of Bartges (2004), Raila et al. (2011) and higher than as reported by Seguin et al. (2003) and Jasim (2012). ...
... On microscopic examination, haematuria, epithelial cells, pyuria, cylindriuria and crystalluria were the major findings. Similar observations were reported by Cetin et al. (2003) and Bartges (2004). Clinically relevant haematuria (>10 cells per high-power field) was present in 15 (68.18%) of cases during urinalysis (Fig. 1). ...
Article
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Urinalysis is a simple, rapid, non-invasive, economical laboratory test that can provide insight into renal dysfunction. Urine samples from the 22 dogs, suspected for urinary tract infection were collected aseptically by catheterization or cystocentesis, and were subjected to physical, chemical and microscopic examination. The urine of affected dogs varied from pale to dark yellow with cloudy to turbid in appearance having a mean urine specific gravity of 1.014. Major observations with dipstick urinalysis were haematuria, bilirubinuria, proteinuria and pyuria. Haematuria, epithelial cells, pyuria, cylindriuria and crystalluria were the major microscopic findings. Struvite crystals (31.81%), calcium crystals (18.18%) and bilirubin crystals (4.54%) were the crystals recorded. It is concluded that urinalysis is a reliable test for diagnosis of UTI in dogs.
... In the United States of America (US), previous studies showed that the most common sources of MDR bacteria of dogs included the respiratory tract, urinary tract, and skin (7)(8)(9). It was also estimated that UTI affects ∼14% of dogs during their lifetime (10). The most common bacteria isolated from canine UTI were Escherichia coli, Staphylococcus sp., Enterococcus sp., Proteus mirabilis, Pseudomonas aeruginosa, Streptococcus sp., and Klebsiella sp. ...
... Best practices for UTI diagnosis and management in companion animals involve the bacterial culture and sensitivity testing of isolated pathogens from urine before starting treatment (10,20). However, antimicrobial treatment of UTI is often started empirically to relieve clinical symptoms, without performing these practices (20,21). ...
... Consideration of the collection method is important in evaluating the need for antimicrobial therapy as low levels of bacteria from free catch samples may represent contamination and is not indicative of a need for antimicrobial therapy. Cystocentesis is the most reliable and recommended method for urine sample collection for bacterial culture to prevent contamination of samples (10). However, cystocentesis may not always be feasible in some clinical settings because it requires client consent and depends on the patient's condition. ...
Article
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The emergence of antimicrobial resistance (AMR) in dogs constitutes a threat to animal and human health. There is a lack of studies in Illinois that evaluated the prevalence of AMR among urinary bacterial pathogens. In the study, we included 803 isolates (299 Gram-positive and 504 Gram-negative) that were isolated from 2,583 canine urine samples submitted to the Veterinary Diagnostic Laboratory, the University of Illinois between 2019 and 2020 from dogs suspected of urinary tract infections (UTI). The most common Gram-positive isolates included Staphylococcus pseudintermedius (17.93%), Enterococcus faecalis (9.46%), Streptococcus canis (6.10%), and Enterococcus faecium (3.74%), while Gram-negative isolates included Escherichia coli (45.58%), Proteus mirabilis (11.08%), Klebsiella pneumoniae (3.11%), and Pseudomonas aeruginosa (2.99%). Among the Gram-positive isolates, Staphylococcus pseudintermedius isolates showed a very high prevalence of resistance to penicillin (56.94%), a high prevalence of resistance to trimethoprim-sulfamethoxazole (31.94%), enrofloxacin (29.17%), and oxacillin (27.08%). Among Gram-negative bacteria, Escherichia coli isolates showed a high prevalence of resistance to ampicillin (31.42%). Considering the high prevalence of resistance to antimicrobials commonly used to treat UTI in dogs, urine samples should be collected for bacterial culture and susceptibility testing before treatment initiation to prevent treatment failures and the development of multidrug resistance. Given the possibility of zoonotic transmission of antimicrobial-resistant bacteria, veterinarians when treating UTI cases, should inform dog owners of the potential transmission risk.
... In dogs, lower urinary tract disease (LUTD) include various diseases that affect the bladder, urethra, and prostate. The most common clinical signs related to these diseases in dogs are hematuria, strangury, pollakiuria, urinary incontinence, or urine that burns the skin (Bartges 2004). However, none of these signs is indicative of a specific disease, such as bacterial urinary tract infection, urolithiasis, micturition disorders or prostate diseases. ...
... In small animal veterinary medicine, few epidemiological studies have been published that have studied these pathologies. Bartges (2004) in USA reported that LUTD occurred more frequently in cats (7.3%) than in dogs (3%), in dogs the most common diseases were urinary tract infection (14%) and urolithiasis (3%). Inkelmann et al. (2012a) in Brazil studied necropsied dogs with lesion in the urinary tract system, and reported 26.2% lesions of the lower urinary tract and the nonspecific inflammatory lesions, obstructive and acquired anatomic alteration at the most common lesions. ...
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Lower urinary tract diseases (LUTD) include different conditions that affect the urinary bladder, urethra and prostate. The objective of this study was to determine the frequency of different related diseases, to characterize the population affected, and to determine risk factors in dogs. The clinical cases were diagnosed with LUTD through physical examination, and clinical laboratory and imaging studies. Male dogs had a greater predisposition to present a LUTD. Dogs from 3 months to 18 years with a median of 8 years were affected, and the most affected breeds were Poodle, Labrador, German shepherd, Schnauzer, Cocker Spaniel and Chihuahua. The LUTD presented with the following frequencies: bacterial urinary tract infection 34.02%; micturition disorders 22.68%; urolithiasis 20.61%; prostatic disease 14.43%; traumatic problems 8.24%. Sixty-seven per cent of the cases were specific diseases, such as uncomplicated and complicated bacterial urinary tract infections, urinary retention of neurologic origin and silica urolithiasis.
... Για να γίνουν ορατοί στο μικροσκόπιο οι βάκιλλοι (Εικόνα 3) και οι κόκκοι, ο αριθμός τους θα πρέπει να υπερβαίνει τις 10.000/ml και τις 100.000/ml ούρων, αντίστοιχα, ενώ, διάφορα άμορφα συστατικά των ούρων (π.χ. φωσφορικά άλατα), μιμούνται την άτακτη κίνηση των κόκκων στα νωπά επιχρίσματα (Osborne and Stevens 1999, Christopher 2003, Bartges 2004). Η καλλιέργεια ούρων ύστερα από κυστοκέντηση, αποτελεί την πλέον ευαίσθητη και ειδική μέθοδο για την επιβεβαίωση της βακτηριουρίας (Osborne and Εικόνα 5. Kύτταρα του πλακώδους επιθηλίου σε ίζημα ούρου σκύλου (νωπό επίχρισμα, x 400). ...
... ALATZAS D.G., MyLONAKIS M.E., POLyZOPOuLOu Z.S., KOuTINAS A.F. ουρεϊκού αμμωνίου, κυστίνης) ή ο μεγάλος αριθμός κοινών κρυστάλλων σε επανειλημμένες αναλύσεις ούρων (μείωση των πιθανοτήτων in vitro δημιουργίας κρυστάλλων) μπορεί να έχει κλινική σημασία (Bartges andKirk 2009, Houston andMoore 2009). Το είδος των κρυστάλλων εξαρτάται από το ειδικό βάρος, το pH και τη θερμοκρασία των ούρων (Zinkl 2008). ...
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Microscopic examination of the urine sediment is an integral part of urinalysis and a useful, cost-effective diagnostic tool in the everyday practice. Diagnostic investigation of urinary diseases and several systemic metabolic diseases make the microscopic evaluation of urine sediment a priority along with the physical and biochemical examination of urine. The different methods of urine collection (midstream voiding, catheterization or percutaneous cystocentesis) have advantages and disadvantages and the clinician has to decide on the best fitted method of urine collection, according to the medical background of the animal and the case-specific objectives of urinalysis. Proper handling and timely analysis of urine sample are essential for a valid microscopic evaluation. The microscopic examination of urinary sediment is usually conducted in stained or unstained “wet-mounted” preparations; occasionally, air-dried Giemsa-stained sediment smears are examined.Normal urine is sterile and may contain small numbers of cells (white and red blood cells, epithelial cells), few crystals, occasional casts, fat droplets and spermatozoa (male animals). In contrast, large numbers of cells or casts, presence of unusual types of crystals, neoplastic cells, parasites and microorganisms comprise abnormal findings, necessitating a more specialized diagnostic approach. This review focuses on the technical aspects pertaining to the proper sediment microscopic examination, the normally expected elements of sediment and the clinically relevant interpretation of abnormal findings.
... Key words: canines; uremia; uropathy INTRODUCCIÓN Las uropatías del tracto urinario inferior de los perros incluyen varias enfermedades que afectan la vejiga, la uretra y la próstata; siendo los signos clínicos más comunes en estas enfermedades la disuria, hematuria, estranguria y polaquiuria (Bartges, 2004). Dentro de estas enfermedades, la obstrucción uretral es una patología que ocurre con mayor frecuencia en los machos, generalmente asociada con enfermedades benignas o malignas. ...
... Las primeras pueden ser causadas por urolitiasis, disinergia refleja y uretritis granulomatosa (Moroff et al., 1991;Diaz-Espineira et al., 1998;Hostutler et al., 2004), además de neoplasias y traumatismos, los cuales generan estenosis uretral, que pueden llevar a la muerte del paciente por un cuadro de uremia posrenal. Bartges (2004) indica que las infecciones urinarias y la urolitiasis son las enfermedades más frecuentes en perros de los Estados Unidos; sin embargo, Inkelmann et al. (2012) reportaron mayor frecuencia de lesiones inflamatorias y uropatías obstructivas en perros del Brasil. ...
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El presente estudio muestra el caso de un canino macho de 7 años que ingresó de emergencia a la consulta de la clínica veterinaria “Vet Center”, Bucaramanga, Colombia, por un presunto cuadro de envenenamiento. El paciente mostraba signos de depresión, disuria, estranguria, hematuria y vómito. La valoración hematológica y urianálisis revelaron un cuadro de deshidratación e infección urinaria. La química sanguínea demostró insuficiencia y azotemia posrenal, y el examen ecográfico mostró la presencia de un urolito y repleción de la vejiga urinaria, confirmando el diagnóstico de uropatía obstructiva. Para la estabilización del paciente se colocó sonda urinaria Nelaton para vaciado de la vejiga e hidropropulsión; así como aplicación de soluciones endovenosas de mantenimiento con NaCl al 0.9%, antibióticos y antiinflamatorios. Finalmente, se realizó cistotomía para remoción del urolito, además de una uretrostomía debido a la recurrencia de la obstrucción.
... This is in agreement with Dunning and Stonehewer (2002) and Papini et al., (2006). Major clinical signs observed in this present study might be due to lower UTIs and which were in accordance with the studies of Bartges (2004). General physical examination findings such as abdominal pain on palpation, tachycardia (> 120 beats/min), respiratory rate of > 20 breaths / min and body temperature of > 39.2° C were suggestive of systemic inflammatory response syndrome (Fransson et al., 2007). ...
... In this study, all urine samples were obtained by cystocentesis and observed bacterial count of more than >10 4 and >10 6 which indicated significant bacteriuria as opined by Dunning and Stonehewer (2002) and Bartges (2004) who concluded that > 10 3 CFU/ml was indicative of significant bacteriuria in dogs. However, Gatoria et al., (2006) noticed that isolation of more than 10 2 CFU/ml in a urine sample obtained by cystocentesis could be indicative of UTIs. ...
Article
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The main object of this study was to determine the urinary tract infections among dogs that were admitted to the University Veterinary Hospitals at Kokkalai and Mannuthy during 2 year period from 2010 to 2012. A total of 2545 dog cases, 66 cases with clinical signs suggestive of urinary tract infections were selected. The major clinical signs in the study were pyuria, stranguria, haematuria, anorexia, pollakiuria, foul smelling urine or dark yellow urine and emesis. Elevated rectal temperature, respiratory rate and tachycardia were observed on general clinical examination. The most common bacteria isolated from urine sample were E.coli followed by Proteus mirabilis, Staphylococcus aureus, Klebsiella pneumoniae and Streptococci spp. Ultrasonographically, thickness of the urinary bladder was the most common feature. Hyperechoic particles in the urinary bladder, thickened kidney cortex, hyperechoic kidney with reduced corticomedullary distinction and hyperechoic renal pelvis and diffuse increase in echogenicity of prostatic parenchyma were also observed. Haematobiochemical changes such as markedly increased ESR values, total leucocyte count and neutrophils values, hypoalbuminemia and increased urea concentration were observed.
... Klebsiella spp is a leading pathogen of nosocomial infections, as well as UTIs which are often responsible for resistance [5]. Bacteriological culture, especially in combination with the antibiotic susceptibility test, has become an essential part of diagnosis of UTIs and the best tool for initiating therapeutic decisions for individual dogs [6,7]. Periodic testing of susceptibility trends of organisms isolated from UTIs is the first-line of effective therapy of choice, and it can also be used to track the presence of resistant organisms. ...
... Rising antibiotic resistance in canines is of concern as it significantly affects dog treatment, which leads to medication failure, increase in high morbidity, mortality, and UTIs management cost. Moreover, it is indeed a public health issue for zoonotic diseases [6,9] The milestones of UTIs therapy . are antimicrobials yet many patients with recurrent UTIs are poorly treated with multiple antimicrobial agents, thus potentiating the resistance of the microorganisms. ...
Article
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The most widespread ailments in dogs are urinary tract infections (UTIs) caused by bacterial species. It is necessary to recognize the prevailing bacterial pathogens and their susceptibility to antimicrobial agents to effectively treat UTIs. The present study aimed to classify the bacterial organism that causes UTIs in dogs and their patterns of antimicrobial resistance. A total of 141 urine samples were collected from diseased dogs in Veterinary Clinical Complex LUVAS in Hisar, India. Culture, biochemical and sensitivity testing were performed for each of the urine samples based on standard method. Of the total 141 urine samples from dogs, 21 (14.9%) isolates were identified as Klebsiella spp. The isolates were found to be highly resistant to ampicillin (100%), penicillin G (100%), oxytetracycline (100%), enrofloxacin (85.7%), chloramphenicol (80.6%), ceftriaxone (76.2%) and cloxacillin (71.4%), while susceptibility was observed against gentamicin (100%), amikacin (100%) and neomycin (90.5%). In the current study, 19 out of 21 identified isolates were found to be multidrug-resistant. This study indicates that dogs in the study area are found to harbor highly resistant Klebsiella spp. Therefore, when deciding on the antibiotic regimen for UTIs cases, Vets should consider resistance profile of chosen antibacterial agents before usage in order to discourage dissemination of resistant organisms in the study area.
... 80 Growth of ⩾10 3 CFU/ml in urine specimens obtained by cystocentesis or catheterisation is considered significant in cats ( Figure 3; Table 3). [81][82][83] Most uropathogens can be cultivated over an 18-24 h incubation period. However, some slow-growing pathogens, such as Corynebacterium species, may require a longer time to appear in cultures. ...
... Culture of urine obtained by pyelocentesis is ideal for identifying the bacteria involved in pyelonephritis. 70,72,81 Otherwise, cystocentesis (repeated cultures may be needed) or blood cultures may be used depending on the assumed infection route. Blood cultures should be considered in immunosuppressed cats, and in the presence of fever and azotaemia in cats with negative urine cultures and no abnormalities in the urine sediment. ...
Article
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Practical relevance Urinary tract infection (UTI) is an important cause of feline lower urinary tract disease (FLUTD), particularly in female cats older than 10 years of age. In addition to cats with typical clinical signs of FLUTD or upper UTI, many cats have subclinical bacteriuria, but the clinical relevance of this is currently uncertain. UTIs are one of the most important indications for antimicrobial use in veterinary medicine and contribute to the development of antimicrobial resistance. Adherence to treatment guidelines and confinement to a few first-line antimicrobial agents is imperative to avoid further deterioration of the antimicrobial resistance situation. The decision to treat with antimicrobials should be based on the presence of clinical signs, and/or concurrent diseases, and the results of urine culture and susceptibility testing. Clinical challenges Distinguishing between cats with bacterial cystitis, and those with idiopathic cystitis and concurrent clinical or subclinical bacteriuria, is challenging, as clinical signs and urinalysis results may be identical. Optimal treatment of subclinical bacteriuria requires clarification as there is currently no evidence that demonstrates a beneficial effect of routine treatment. Management of recurrent UTIs remains a challenge as evidence for most alternatives used for prevention in cats is mainly anecdotal, and no preventive treatment modality is currently recommended. Evidence base This review draws on an extensive literature base in veterinary and human medicine, including the recently updated guidelines of the International Society for Companion Animal Infectious Diseases for the diagnosis and management of bacterial urinary tract infections in dogs and cats. Where published evidence is lacking, the authors describe their own approach; notably, for the bacteriuric cat with chronic kidney disease.
... Urinary tract infection (UTI) is commonly diagnosed in dogs (Weese et al., 2011), and the diagnostic process poses several challenges. Clinical signs of UTI are not pathognomonic, and although urinalysis and microscopic examination increase the index of suspicion, quantitative bacteriological culture remains the reference standard for confirming bacteriuria (Bartges, 2004;Weese et al., 2011;Smee et al., 2013). Several pre-analytical and analytical factors could affect bacterial counts obtained by culture, e.g. ...
... This has led to the concept and definition of 'significant bacteriuria' to imply clinically relevant bacterial counts, applied in both veterinary and human medicine (Kass, 1957;Bush, 1977;Kivisto et al., 1977;Weese et al., 2011). In dogs, a cut-off value for significant bacteriuria in voided specimens of ≥100,000 colony forming units (CFU)/mL, independent of other characteristics, has been proposed on several occasions (Bush, 1978;Carter et al., 1978;Bartges, 2004;Weese et al., 2011). Nevertheless, the use of voided specimens for bacteriological culture in dogs is generally discouraged due to the risk of contamination, and according to the guidelines on the treatment of UTI proposed by the International Society for Companion Animal Infectious Diseases (ISCAID), voided specimens should be regarded as non-diagnostic (Weese et al., 2011). ...
Article
The use of voided urine specimens for bacteriological culture in dogs is discouraged because contamination from external genitalia could lead to misinterpretation of laboratory results. Quantitative culturing and defining significant bacteriuria could increase the usefulness of voided specimens. However, limited evidence exists for the cut-offs currently recommended. The aim of this study was to evaluate the accuracy of current veterinary cut-off values for significant bacteriuria in voided canine urine. A secondary aim was to investigate if accuracy improved when applying qualitative criteria used in humans. Paired urine specimens were collected by both cystocentesis and voiding, and quantitative bacteriological cultures were performed within the same day. Cystocentesis was used as the reference standard with a cut-off for significant bacteriuria of ≥1000 colony forming units (CFU)/mL. Voided specimens were compared to cystocentesis using: (1) the veterinary cut-off of ≥100,000 CFU/mL; and (2) various cut-offs depending on qualitative criteria (sex, clinical signs and complicating factors), adapted from human guidelines. Ninety-four dogs with suspected urinary tract infection (UTI) were included for analysis. The veterinary cut-off yielded an accuracy of 94% with a sensitivity and specificity of 94% (95% confidence intervals [CI] 0.81, 0.99) and 94% (95% CI 0.86, 0.98), respectively. Applying the human guidelines did not improve overall accuracy (89%), and yielded a sensitivity and specificity of 97% (95% CI 0.86, 1.00) and 86% (95% CI 0.77, 0.92), respectively. The veterinary cut-off value of ≥100,000 CFU/mL for voided urine is appropriate for determining significant bacteriuria in the majority of dogs with suspected UTI if specimens are refrigerated and cultured on the day of collection.
... Most likely, a combination of these factors and others have potential negative consequences on animal and human health. Microbiological culture associated with antimicrobial susceptibility testing are essential to properly diagnose UTIs and are the gold standard for guiding treatment decisions in individual pets [5,6]. Moreover, Blondeau and Tillotson have developed a useful formula to prescribe an appropriate antimicrobial agent based on the prevalence and antimicrobial susceptibility of uropathogenic isolates [7]. ...
... To reduce environmental contamination that could confound the interpretation of results and to increase the comparability of data obtained, only samples collected by cystocentesis were included in this study, as used by Weese et al. [8] who state that cystocentesis is the diagnostic approach of choice in bacterial UTIs. Only isolates from urine with significant bacterial growth (!10 3 CFU/mL) were included [6]. Animals included in the study had been treated with antimicrobial drugs, mainly b-lactams and quinolones, within 1 month from urine sample collection but treatment was discontinued !10 days before the urine sample was collected by cystocentesis. ...
Article
Objectives: This work characterizes the antimicrobial susceptibility of uropathogens isolated from empirically treated dogs and cats. Within-household transmission of uropathogens can involve humans and companion animals. Knowledge on the prevalence and susceptibility pattern of isolates from canine and feline urine samples and the impact of prior antimicrobial treatment is important to prevent the dissemination of antimicrobial resistance. Methods: A retrospective study was conducted selecting antibiotically treated companion animals. Urinary samples were collected by cystocentesis and submitted to an Italian diagnostic laboratory over a two years' period (2013-2015). The antimicrobial susceptibility of the isolates was analyzed using both the Clinical and Laboratory Standards Institute guidelines and the formula to help select rational antimicrobial therapy. Results: Gram-negative bacteria were clearly prevalent. Gentamicin had the highest impact factors. Amoxicillin/clavulanic and doxycycline appear to be the most effective compounds against Gram positive infections, while marbofloxacin may be an useful option against Gram negative UTIs as well as doxycycline and trimethoprim-sulfamethoxazole in cats and dogs, respectively. Consulting published studies, it seems likely a comparable overall trend concerning bacterial species incriminated in canine and felice UTIs and their susceptibilities, in spite of different circumstances where studies were conducted. Conclusions: Companion animals are potential reservoirs of drug resistant uropathogens. The judicious use of antibiotics is necessary for maintaining the efficacy of antimicrobials in human and veterinary medicine. For this reason, antimicrobial susceptibility monitoring programs are essential to facilitate the choice of antimicrobial agent that is most likely to be effective, particularly in case of prior antimicrobial treatment.
... Dogs did not receive any medication at the time of referral and during diagnostic applications. The inclusion criterion was the presence of at least one type of bacteria greater than or equal to 1000 CFU/ml in each urine sample (Bartges 2004;Ettinger and Feldman 2010). Dogs were excluded from the study if they had obstructive, prostatic, or congenital urinary tract diseases. ...
Article
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Dogs with uncomplicated lower urinary tract infection (LUTI) are usually treated with appropriate antibiotics for 10−14 days. In humans, a single dose of ceftriaxone is employed in the treatment of uncomplicated LUTI. The purpose of the current study was to compare the efficacy of a single dose of ceftriaxone with multiple dose (14 days) enrofloxacin administration in dogs with uncomplicated LUTI. Forty-seven non-pregnant client-owned dogs with LUTI signs were enrolled in this prospective, controlled, randomised, blinded clinical trial. The inclusion criteria were the presence of at least one type of bacteria greater than or equal to 1000 CFU/ml in each urine sample. Dogs were assigned randomly to Group ENR (n = 23) enrofloxacin treatment (5 mg/kg, s.c., s.i.d., for 14 days) and Group CEF (n = 20) ceftriaxone treatment (25 mg/kg, i.v., once). The time needed for disappearance of clinical signs ranged from 4−9 days and 1−5 days for Group ENR and Group CEF, respectively. Clinical signs significantly improved earlier in Group CEF than in Group ENR (P < 0.0001). Urine culture with less than or equal to 1000 CFU/ml was achieved on Days 17−21 after the first day of treatment in all dogs. Although a single dose of ceftriaxone can be considered as an alternative treatment to alleviate the signs of uncomplicated LUTI in dogs, its status as drug of last resort is a limiting factor for its extensive use in clinical practice.
... The reported prevalence of LUTI in female dogs is approximately 26.6%, and the lifetime risk for LUTI in dogs is 14%. 1,2 The risk of a positive urine culture is 2.5 and 1.5 times higher in spayed and intact female dogs, respectively, than in neutered male dogs, 3 and older spayed females are at the highest risk. 3 Most LUTI are monomicrobial, 4 with Escherichia coli being the most commonly isolated bacterial pathogen. ...
Article
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Background: Lower urinary tract infections are common in dogs, and Escherichia coli is the most common bacterial pathogen isolated. The literature has conflicting evidence regarding the inhibitory effects of urine concentration and pH on E. coli growth. Hypothesis/objectives: To determine the effect of different pH and urine concentrations on E. coli growth in vitro. Animals: Voided urine samples from 10 apparently healthy spayed female dogs were used. Methods: A matrix of 9 urine specific gravity (USG; 1.010, 1.020, and 1.030) and pH (5.5, 7.0, and 8.5) combinations was prepared by diluting and titrating filtered voided urine samples. Three E. coli isolates were obtained from urine of female dogs with signs of lower urinary tract infection and cultured at different urine pH and USG combinations in wells of a microtiter plate. The number of E. coli colony-forming units (CFU) per mL of urine was calculated after aerobic incubation of the urine at 37°C for 18 hours, and statistically compared. Results: Significant differences were identified in the mean log CFU/mL among different combinations of pH and USG. The lowest log CFU/mL were observed in alkaline concentrated urine (pH 8.5 and USG 1.030). Conclusions and clinical importance: Escherichia coli in vitro growth was higher in neutral to acidic and diluted urine compared to alkaline and concentrated urine. The impact of non-alkalizing diluting diets on the incidence of E. coli lower urinary tract infections should be further explored.
... Renal disease may be considered a disease that compromises normal defense mechanisms against UTI, 1 and it has been hypothesized that compromised host defenses might prevent the development of clinical signs. 27 However, 1 study 28 found that isosthenuria is not a risk factor for the development of UTI in cats with systemic disease, and another 29 found that performing a urine culture on the basis of isosthenuria alone in dogs is not costeffective. Recommendations from human infectious disease experts include not treating patients with asymptomatic bacteriuria, with specific exceptions such as pregnant women or people undergoing invasive urologic procedures. ...
Article
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OBJECTIVE To determine the prevalence of bacteriuria (ie, a positive microbial culture result for ≥ 1 urine sample) in dogs with chronic kidney disease (CKD) and characterize findings of subclinical bacteriuria (SBU), bacterial cystitis, or pyelonephritis in these patients. DESIGN Retrospective, observational study. ANIMALS 182 dogs. PROCEDURES Medical records from January 2010 through July 2015 were reviewed to identify dogs with CKD that underwent urinalysis and urine microbial culture. Signalment, clinicopathologic data, stage of CKD according to previously published guidelines, results of urinalysis and urine culture, and abdominal ultrasonographic findings were recorded. Dogs with positive urine culture results were categorized as having SBU, bacterial cystitis, or pyelonephritis on the basis of these data. Prevalence of bacteriuria was calculated. Associations between CKD stage, presence of bacteriuria, and diagnosis category were analyzed statistically. RESULTS 33 of 182 (18.1%) dogs (40/235 [17.0%] urine samples) had positive culture results. All dogs received antimicrobials on the basis of culture and susceptibility test findings. Most positive culture results (18/40 [45%] samples) were found for dogs with SBU, followed by dogs with pyelonephritis (16/40 [40%]) and cystitis (6/40 [15%]). Escherichia coli was the most frequently observed isolate (29/40 [73%] cultures from 25/33 dogs). The CKD stage was not associated with presence of bacteriuria or diagnosis category. CONCLUSIONS AND CLINICAL RELEVANCE The prevalence of positive urine culture results in dogs with CKD was lower than that reported for dogs with some systemic diseases that may predispose to infection. Prospective research is needed to assess the clinical importance of SBU in dogs with CKD. © 2018, American Veterinary Medical Association. All rights reserved.
... Bacterial urinary tract infection (UTI) is one of the most common disorders in dogs and cats, caused by an imbalance between natural host defense mechanisms of the urinary tract and virulent bacteria (Olin & Bartges, 2015). This infection causes inflammation of the bladder with various degrees of lower urinary tract signs, for example frequent urination (pollakiuria), urinary incontinence, difficult to urinate (dysuria), pain when urinating (stranguria), blood in the urine (hematuria) and inappropriate urination (Bartges, 2004). This infection has been reported in up to 14% of all dogs visiting animal hospitals during their lifetime (Hall et al., 2013). ...
Article
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The present study aimed to estimate the proportion of bacterial urinary tract infection (UTI) in dogs and cats, assess risks associated with bacterial UTI, and to determine bacterial isolates' antimicrobial susceptibility and resistance pattern from the urinary tract of dogs and cats with urologic problems. The medical records from animals visiting Chiang Mai University Small Animal Veterinary Teaching Hospital between January 2012 and December 2016 were reviewed. In total, 203 dogs and 49 cats with urinary tract diseases that had samples submitted for bacterial culture were identified;198 and 24 bacterial isolates were recovered from dogs' and cats' submitted samples, respectively. At least one episode of bacterial UTI was detected in 75.4% (95% CI: 69.4–81.3) of dogs and in 40.8% (95% CI: 26.6–55.1) of cats with UTI and submitted urine cultures. Of 242 submitted urinary samples from dogs and 60 urinary samples from cats, bacteria were identified in 74.0% (95% CI: 68.4–79.5) and 38.3% (95% CI: 26.0–50.6), respectively. The most common pathogen of bacteria positive cultured from dogs was Staphylococcus spp. (30.3%), followed by Escherichia coli (16.7%), and Proteus spp. (13.6%). For cats, the most common pathogen was Pseudomonas spp. (25.0%), followed by E. coli (20.8%) and Proteus spp. (16.7%). Staphylococcus spp. isolates from dogs and Proteus spp. isolates from cats were highly susceptible to Amoxicillin/clavulanic acid (AMC) at 88% and 75%, respectively. Of all isolated bacteria, 67.1% of the bacteria from dogs and 83.3% from cats were multidrug‐resistant (MDR). The proportion of MDR‐bacterial urinary tract infections in dogs and cats with urologic problems in this study was high. This observation raises concerns regarding the potential of zoonotic transmission of MDR‐bacteria from these companion animals. The results suggested that AMC remains a good empirical drug for treating UTIs in dogs in this region.
... After incubation at 37 C for 24-48 h under atmospheric conditions, colonies were quantified and scored as having significant bacteriuria according to the urine sample collection method as defined elsewhere. 13 Samples were included in the study regardless of the type of UTI. ...
Article
Objectives: To evaluate temporal trends in antimicrobial resistance, over 16 years, in bacteria isolated from dogs and cats with urinary tract infection (UTI) and the clonal lineages of bacteria harbouring critical antimicrobial resistance mechanisms. Methods: Antimicrobial susceptibility testing was conducted for 948 bacteria isolated from dogs and cats with UTI (1999-2014). Resistance mechanisms were detected by PCR, namely ESBL/AmpC in third-generation cephalosporin (3GC)-resistant Escherichia coli and Proteus mirabilis, mecA in methicillin-resistant staphylococci, and aac(6')-Ieaph(2″)-Ia and aph(2″)-1d in high-level gentamicin-resistant (HLGR) enterococci. Resistant bacteria were typed by MLST, and temporal trends in E. coli and Enterobacteriaceae antimicrobial resistance were determined by logistic regression. Results: Enterobacteriaceae had a significant temporal increase in resistance to amoxicillin/clavulanate, 3GCs, trimethoprim/sulfamethoxazole, fluoroquinolones, gentamicin and tetracycline (P < 0.001). An increase in MDR was also detected (P < 0.0001). 3GC resistance was mainly caused by the presence of blaCTX-M-15 and blaCMY-2 in E. coli and the presence of blaCMY-2 in P. mirabilis. Two major 3GC-resistant E. coli clonal lineages were detected: O25b:H4-B2-ST131 and ST648. The mecA gene was detected in 9.2% (n = 11/119) of Staphylococcus spp., including MRSA clonal complex (CC) 5 (n = 2) and methicillin-resistant Staphylococcus epidermidis CC5 (n = 4). A temporal increase in MDR methicillin-resistant Staphylococcus pseudintermedius was detected (P = 0.0069). Some ampicillin-resistant and/or HLGR Enterococcus spp. were found to belong to hospital-adapted CCs, namely Enterococcus faecalis ST6-CC6 (n = 1) and Enterococcus faecium CC17 (n = 8). Conclusions: The temporal increase in antimicrobial resistance and in MDR bacteria causing UTI in dogs and cats creates important therapeutic limitations in veterinary medicine. Furthermore, the detection of MDR high-risk clonal lineages raises public health concerns since companion animals with UTI may contribute to the spread of such bacteria.
... In our study, the total number of the collected and In dogs, UTIs were diagnosed in 2-3 % of the animals and was more frequent in females than in males; particularly affecting the older dogs. In cats, the positivity was lower than 1 % and the infections were more frequent in older individuals, at the age of 10 or more years [3]. However, tomcats suffered more frequently from urogenital infections than the females due to the anatomical structure of the urethra that is narrow and long. ...
Article
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The diseases of the urinary tract in small animal medicine, especially in dogs and cats, occur frequently with different etiologies. The most common cause of urinary tract infections (UTIs) are bacteria which enter upwards through the urethral opening. UTIs occur in hosts with compromised defence mechanisms in which the virulent microbes can adhere, multiply and persist in the urinary tract. In addition to bacteria, also viruses or fungi may infect the urinary tracts. Bacterial infection can develop in the upper (kidneys and ureters) or lower (bladder, urethra) urinary tract and are manifested by various clinical signs such as: frequent or difficult and painful urination, presence of blood in the urine, or its foul odour. The symptoms in sick animals are often accompanied by fever, discomfort, and loss of appetite. The UTIs in dogs and cats are caused by both Gram-negative (e. g. Escherichia coli, Pseudomonas aeruginosa, Klebsiella spp., Proteus spp.) and Gram-positive (e. g. Staphylococcus spp., Streptococcus spp., and Enterococcus spp.) bacteria. The properly performed aseptic sampling of the urine is one of the most important steps in bacteriological diagnostics. In this study, 105 urine samples were collected from dogs and cats. The cultivation, microscopy and biochemical examinations were used for species identification. Finally, the bacteriological examination included also determining the susceptibility of pathogens against antibiotics by the disc-diffusion method. The results were processed and expressed as a percentage according to identified pathogens, animal species, sex, breed and age. The uropathogens were diagnosed mainly in males aged 7—10 years. The most commonly identified pathogens were Escherichia coli, Streptococcus spp. and Staphylococcus spp. Tests of bacterial susceptibility to antibiotics showed that enrofloxacin, cefotaxime, and cephazolin were the most effective against uropathogens.
... Dogs did not receive any medication at the time of referral and during diagnostic applications. The inclusion criterion was the presence of at least one type of bacteria greater than or equal to 1000 CFU/ml in each urine sample (Bartges 2004;Ettinger and Feldman 2010). Dogs were excluded from the study if they had obstructive, prostatic, or congenital urinary tract diseases. ...
Article
Full-text available
Dogs with uncomplicated lower urinary tract infection (LUTI) are usually treated with appropriate antibiotics for 10−14 days. In humans, a single dose of ceftriaxone is employed in the treatment of uncomplicated LUTI. The purpose of the current study was to compare the efficacy of a single dose of ceftriaxone with multiple dose (14 days) enrofloxacin administration in dogs with uncomplicated LUTI. Forty-seven non-pregnant client-owned dogs with LUTI signs were enrolled in this prospective, controlled, randomised, blinded clinical trial. The inclusion criteria were the presence of at least one type of bacteria greater than or equal to 1000 CFU/ml in each urine sample. Dogs were assigned randomly to Group ENR (n = 23) enrofloxacin treatment (5 mg/kg, s.c., s.i.d., for 14 days) and Group CEF (n = 20) ceftriaxone treatment (25 mg/kg, i.v., once). The time needed for disappearance of clinical signs ranged from 4−9 days and 1−5 days for Group ENR and Group CEF, respectively. Clinical signs significantly improved earlier in Group CEF than in Group ENR (P < 0.0001). Urine culture with less than or equal to 1000 CFU/ml was achieved on Days 17−21 after the first day of treatment in all dogs. Although a single dose of ceftriaxone can be considered as an alternative treatment to alleviate the signs of uncomplicated LUTI in dogs, its status as drug of last resort is a limiting factor for its extensive use in clinical practice.
... The QBC results were categorized as negative, minimal growth, or marked growth according to previously recommended definitions. 9,15 If obtained via cystocentesis, bacterial growth ≥10 3 CFU/mL was considered to be marked growth. For samples collected via catheter, bacterial counts ≥10 4 CFU/mL in males and ≥10 5 in females were considered to be marked growth. ...
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Background: Quantitative bacterial culture and susceptibility testing is the gold standard diagnostic for determining bacterial urinary tract infection. Transport of samples to external reference laboratories is common practice in veterinary medicine. Objective: To compare bacterial culture and susceptibility results from clinical urine samples when streak plate inoculation is performed immediately after sample collection versus after transport to a reference laboratory. To determine the clinical implications of discrepant culture results. Animals: One hundred and ninety-four canine and 45 feline urine samples that were submitted for urinalysis and urine culture and susceptibility testing. Methods: This was a prospective, cross-sectional study. Streak plate inoculations were performed on urine samples immediately after collection and also after transport to a reference laboratory. Samples were stored in plain sterile tubes and refrigerated up to 24 hours before transport. Culture results were compared, and discordant results were evaluated for clinical relevance. Signalment, comorbidities, lower urinary tract signs, and antimicrobial history were recorded. Results: Kappa coefficient for agreement between plating methods was 0.884. Twenty-two (71%) of 31 discrepant results were determined to have no clinical impact. Though 35% of clean midstream samples had discrepant culture results, only 8% of these had clinical impact. Conversely, 8.6% from cystocentesis were discrepant, but 41% of these had clinical impact. Conclusions and clinical importance: Provided urine samples are stored and transported appropriately, the immediate preplating of urine for culture and susceptibility testing is unnecessary in the majority of cases. Despite more discrepancies in plating methods for midstream samples, the minority were of clinical importance.
... (1) pyuria (defined as >5 WBCs per high power field) 23 ; (2) positive urine culture; (3) resolution of clinical signs with antibiotic treatment. ...
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Background: Urinary tract infections (UTIs) are common in female dogs and recurrent infections often require investigation by transurethral cystoscopy. Hypothesis/objectives: Describe the findings of transurethral cystoscopy in dogs presented for recurrent urinary tract infections (RUTI). Animals: Fifty-three client-owned dogs with RUTI were included in the study. Methods: Retrospective study. Data collected from medical records included signalment, clinical findings, bladder wall culture, cystoscopic, and histopathologic findings. UTI was defined as: presence of compatible clinical signs and at least 2 out of 3 of the following criteria: (1) pyuria, (2) positive urine culture, (3) resolution of clinical signs with antibiotic treatment. Recurrence of UTI was defined as at least 2 episodes of UTI within 6 months or at least 3 or more in 1 year. Results: The mean age at presentation was 3.8 years with a majority of female dogs (48/53), 40/48 of which were spayed. Main breeds were Labrador (10/53), Australian Shepherd (4/53), and Miniature Schnauzer (3/53). A hooded vulva was noted in 33/48 of females. Transurethral cystoscopy showed anomalies in 45/53 of cases: mucosal edema (19/53), vestibulovaginal septal remnant (15/48), lymphoid follicles (8/53), short urethra (6/53), and ectopic ureter (5/53). Urine culture at the time of cystoscopy was positive in 13/49. Bladder wall edema and ulceration were the most common findings on histopathology (25/39). Conclusion and clinical importance: RUTI occurred more frequently in spayed female dogs. Transurethral cystoscopy is useful in the diagnosis and treatment of anomalies in dogs with RUTIs.
... Therefore, many articles were written using a retrospective approach: A plethora of variables were taken into consideration to evaluate how this phenomenon can be limited [2,10]. Microbiological culture and antimicrobial susceptibility tests are considered the gold standard methods to achieve a correct diagnosis and to reach an individualized treatment based on a decision-making process [11][12][13]. ...
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Antimicrobial stewardship programs (ASPs) have been suggested to reduce antimicrobial resistance phenomena in veterinary medicine, as antibiotics are commonly used without microbiological confirmation. The aim of the present study is to design a specific working flow for a tailored antimicrobial treatment in the case of canine and feline urinary tract infections (UTIs). Urine samples were collected by cystocentesis from 16 dogs and 12 cats presenting acute signs of UTI. The therapy was decided according to the minimal inhibitory concentration, and it was possible to monitor 14 dogs and 11 cats. Rescue therapy (amoxicillin and clavulanic acid) was included in emergency cases. Escherichia coli, Proteus mirabilis, and Streptococcus canis were isolated in dogs, and Escherichia coli, Staphylococcus pseudintermedius, and Staphylococcus aureus were isolated in cats. No multidrug-resistant strains were detected, but all Staphylococci were methicillin resistant. Only one cat received rescue therapy, and only one dog was recruited. Dogs were treated with tetracycline (1/14), fluoroquinolones (6/14), beta-lactams (6/14), and gentamicin (1/14), while cats received fluoroquinolones (3/11), nitrofurans (1/11), clindamycin (1/11), and beta-lactams (6/11). The success rate was very high. Our findings are interesting because this is the first ASP in Italy, and it may be used as a model to develop ASPs for other pathologies.
... Urinary tract infections (UTI) are relatively common in dogs (Ling, 1984;Bartges, 2004;Passmore et al., 2007). They are more common in neutered dogs, females, older dogs and dogs with weakened defence mechanisms due to concurrent diseases. ...
Article
Predisposing factors for different types of urinary tract infections (UTI) were evaluated and prevalence of causative agents and their resistance were identified. A prospective epidemiologic study (2007 to 2012) included 191 dogs with signs of urinary tract disease. Anamnestic data were collected and clinical examination, abdominal ultrasonography, urinalysis and aerobic bacteriologic urine culture were performed in all dogs. Other diagnostic procedures were conducted when indicated. UTI was more common in neutered female dogs, older dogs and dogs with concurrent diseases. Using culture as the gold standard, sensitivity of urine sediment examination to detect bacteriuria increased from 89.9% to 98.1% with staining and specificity increased from 69.8% to 96.4%. A single species of microorganism was isolated in 90.7%. Most common causative agents of UTI were E. coil (39.0% of isolates), staphylococci (27.3% of isolates), Proteus sp. (13.5% of isolates), and enterococci (8.5% of isolates). Prevalence of the causative agents varied in regard to sex and concurrent diseases. The causative agents were in 29.4% susceptible to all tested antimicrobials and were multi-drug resistant in 27.7%. All methicillin resistant Staphylococcus pseudintermedius (MRSP) strains were isolated in 2010-2012. Resistant bacteria were more common in dogs previously treated with antimicrobials. Due to increased specificity and sensitivity of urine sediment examination, staining the sediment in practice is mandatory. Data on uropathogens and their resistance in regard to concurrent diseases is of crucial importance for diagnosis, treatment and prevention of complications in dogs with UTI. Wide intercountry variability in bacterial susceptibility has been confirmed. Also, the onset of MRSP urinary strains in the country has been identified.
Article
Aims: To identify and describe culture and antimicrobial resistance (AMR) patterns in bacteria isolated from canine urinary samples submitted to a New Zealand veterinary diagnostic laboratory. Methods: Records from a veterinary diagnostic laboratory were examined for bacterial isolates cultured from canine urine samples between January 2005 and December 2012. Culture and susceptibility results were compiled with information on the age, sex and breed of dog. Repeat submissions were removed. Susceptibility results were assessed using the Kirby-Bauer disk diffusion method, for a standard panel including amoxicillin clavulanic acid (AMC), cefovecin (from 2010-2012), cephalothin, clindamycin, enrofloxacin and trimethoprim-sulphonamide (TMS). Results: A total of 5,786 urine samples were submitted for analysis, and 3,135 bacterial isolates were cultured from 2,184 samples. Of these 3,135 isolates, 1,104 (35.2%) were Escherichia coli, 442 (14.1%) were Staphylococcus spp., 357 (11.4%) Proteus mirabilis and 276 (8.8%) were Enterococcus spp. The frequency of culture-positive samples increased with increasing age in both female and male dogs (p<0.001). The percentage of E. coli isolates resistant to AMC and cephalothin increased between 2005 and 2012 (p<0.001), as did resistance to enrofloxacin (p=0.022), but there was no change in resistance to TMS (p=0.696) or clindamycin (p=0.629). Enrofloxacin was the antimicrobial with the least resistance shown by the four most common bacteria isolated during the course of the study. Conclusions: AND CLINICAL RELEVANCE: The results of this study provide important regional information regarding the prevalence of bacterial uropathogens and their susceptibility patterns. There was an increase in resistance to some commonly used antimicrobials in the treatment of urinary tract infections. Having access to regional antimicrobial susceptibility results is crucial when forming guidelines for the use of antimicrobials for the treatment of urinary tract infections. Given changes in practising habits and antimicrobial usage over time, ongoing monitoring and surveillance of resistance in pathogens is needed.
Chapter
In both children and adults, open surgery for removal of lower urinary tract calculi and small masses has been almost entirely replaced by minimally invasive techniques. In small animal patients, laparoscopic techniques have been shown to be feasible for removing lower urinary tract calculi as well as small bladder masses in both male and female dogs and cats of varying sizes. Proper patient selection is paramount for success of these procedures. Identifying the correct location and approximate number of calculi and the correct location of a bladder mass preoperatively is critical. Surgical failure and complications can often be avoided when careful attention is paid to both patient factors (species, breed, age, sex, concurrent disease), stone characteristics (location, size), and mass characteristics (location, size). Traditional open laparotomy and cystotomy are typically reserved for patients with very large calculi or large, invasive masses.
Article
Urinary tract infection (UTI) is commonly encountered in small animal general practice. Within the past 5 years, there have been changes to terminology, such as the renaming of asymptomatic bacteriuria to subclinical bacteriuria, as well as paradigm shifts in the management of UTI. In general, there is an emphasis for responsible antimicrobial stewardship and selecting treatment based on urine culture and sensitivity and treating symptomatic bacterial UTI with a shorter duration of antimicrobials. In addition, for most cases, treatment of subclinical bacteriuria is not indicated.
Article
In order to evaluate the role of sedimentoscopy of urine samples in the diagnosis of bladder diseases, were evaluated 46 dogs, 23 males and 23 females with clinical sign of bladder disease or by request of checkup. Sedimentoscopy proved to be a diagnostic test with 100% specificity and positive predictive value, 93.5 % accuracy and 82.4 % negative predictive value for bladder disease cases. It was concluded that this examination must be included in the evaluation of the urinary tract in dogs.
Article
Bacterial urinary tract infections (UTIs) are a common cause of disease in dogs, cats and humans. Although Gram-positive bacteria such as Staphylococcus spp., Streptococcus spp. and Enterococcus spp. are linked with UTIs, Gram-negative bacteria (Escherichia coli, Proteus spp., Klebsiella spp., Pseudomonas spp. and Enterobacter spp.) account for 75% of the cases. This study aimed to determine the frequency of different genera of bacteria in UTIs of dogs and cats as well as their susceptibility to antimicrobials used in clinical routine. Therefore, urine samples from 100 dogs and cats suspected of UTI were collected aseptically. Samples underwent to microbiological evaluation through qualitative and quantitative methods, and urinalysis. All isolates were tested for antimicrobial susceptibility. UTI was confirmed in 74% of animals, with no predominance in one gender. With regard to age, 85% of dogs and 87% of cats were older than six years. Ninety-five bacterial strains were isolated with higher frequency of Escherichia coli (55% of total) of serogroups O6 and O2. High levels of antimicrobial resistance were found. Gram-positive strains had the highest resistance to tetracycline (46.1%), enrofloxacin, cotrimazol and streptomycin (42.3% each), while above 50% of Gram-negative were resistant to amoxicillin and tetracycline. Multidrug resistance has been observed in more than 50% of the major genera isolated. Considering the zoonotic potential of E. coli strains and its strong participation in antimicrobial resistance dissemination, the important role of the veterinarians in the prevention and control of animal UTIs and their contribution to public health must be emphasized.
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Background: Immunosuppressive treatment with glucocorticoids and cyclosporine increases the risk for positive urine cultures (PUCs) in dogs. Objective: To investigate the prevalence and incidence of PUC in dogs diagnosed with cancer and treated with antineoplastic chemotherapy while distinguishing between subclinical bacteriuria (SB) and urinary tract infection (UTI). Animals: Forty-six client-owned dogs with nonurogenital cancer treated with antineoplastic chemotherapy. Methods: Prospective observational longitudinal clinical study. Dogs in which a urine culture was performed before the start of and at least once during antineoplastic chemotherapy were included. A McNemar's test was used to investigate if the prevalence of PUC increased during antineoplastic chemotherapy. Positive urine cultures were categorized into SB and UTI and multiple PUCs from the same dog and category were grouped together as 1 episode of PUC. Results: Urine culture was positive in 21/185 urine samples in 8/46 dogs. Antineoplastic chemotherapy did not influence the prevalence of PUC (P = 1.00), which was 11% (5/46 dogs; 95% confidence interval: 5-23%) before the start of and 13% (6/46 dogs; 95% confidence interval: 6-26%) during antineoplastic chemotherapy. Eight dogs had 10 episodes of PUC; 7/10 episodes were classified as SB, and in 3/10 episodes UTI (chronic prostatitis, prostatic abscess, and emphysematous cystitis) was diagnosed. Escherichia coli was the most common pathogen, isolated in 9/10 episodes. Conclusions and clinical importance: We did not find evidence that antineoplastic chemotherapy is a major predisposing factor for the development of PUC. Most dogs with PUC had SB.
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Aim This study aims to determine the etiology of urinary tract infection (UTI) in dogs and to develop an antibiogram of organisms isolated. Materials and Methods Urine samples were collected either through catheterization or cystocentesis from 35 dogs suspected of UTI admitted to VCC, LUVAS, Hisar. Bacteria were identified on the basis of cultural characteristics in 22 samples, and all the isolates were subjected to in vitro antimicrobial sensitivity testing. Results The urine samples found positive for bacteria yielded pure colony growth in 77.27% and mixed growth in 22.73% samples, respectively. Escherichia coli (29.62%) and Streptococcus spp. (29.62%) were the most prevalent microorganisms followed by Staphylococcus spp. (22.22%), Klebsiella spp. (11.11%), Pseudomonas spp. (3.7%), and Bacillus spp. (3.7%). Overall, maximum sensitivity of isolates was found toward ceftriaxone/tazobactam (88.88%) and least toward amoxicillin and cloxacillin (29.62%). Conclusion E. coli and Streptococcus spp. were the most predominant bacteria isolated from UTI affected dogs. In vitro sensitivity revealed a significant proportion of bacteria to be multidrug resistant.
Chapter
Changes in calculus management over the past decade have resulted in an increased percentage of uroliths that are difficult to manage medically. In both children and adults, open surgery for removal of lower urinary tract stones has been almost entirely replaced by minimally invasive techniques. In small animals, surgical removal of uroliths by cystotomy or urethrotomy has been the traditional method of choice, and these procedures are in common useage. Calcium oxalate and struvite uroliths are generally radiopaque; they are usually visible on survey radiographs. Abdominal ultrasonography is useful for the detection of both radiopaque and nonradiopaque calculi within the urinary bladder. Computed tomography is commonly used for detection of urinary tract stones in human urologic patients. Transurethral cystoscopic calculi removal in female dogs has been enhanced in some specialty hospitals by cystoscopic lithotripsy. Laparoscopic-assisted cystotomy facilitates shorter postoperative hospitalization compared to open cystotomy.
Chapter
The therapy of acute uncomplicated urinary tract infections (UTIs) is exclusively antimicrobial, whereas successful treatment of complicated UTIs also includes identification and correction of predisposing conditions. Microscopic examination of appropriately stained urine sediment can be a valuable screening tool to support the diagnosis of UTI in symptomatic patients. Treatment of acute uncomplicated UTIs is often successful without results of bacterial culture and susceptibility testing. Fluoroquinolones and third‐generation cephalosporins should not be routinely used for initial therapy of UTIs in small animals. Repeated treatment of animals without culture and susceptibility testing may lead to incorrect antimicrobial choices, unnecessary adverse effects of treatment, and possible selection of resistant bacterial populations. This chapter reviews the clinical presentation, diagnostic assessment and current recommendations for treating UTIs, including acute uncomplicated UTI, complicated UTIs, pyelonephritis, and prostatitis.
Article
Background: The IDEXX SediVue Dx (SediVue) is an automated, in-clinic urine sediment analyzer for veterinary patients. The bias between the results from manual microscopy and the SediVue is currently unknown. Objectives: To assess the diagnostic accuracy of the SediVue, we aimed to determine the bias between the SediVue (index test) and manual microscopy (reference standard) for the quantification of RBCs and WBCs in urine. Methods: Urine remnant samples were collected from cats and dogs that contained RBCs (n = 462) and WBCs (n = 510). Retrospective analysis of results from urine sediment examinations using both manual microscopy (using a KOVA and DeciSlide system) and the SediVue (1.0.1.3) was performed. Bias was determined with Bland-Altman plots. SediVue-captured images from high-bias samples were reviewed, and biases were compared. Results: The median bias for semi-quantitative RBC and WBC counts was determined for RBC and WBC counts. The cutoffs were RBC ≤ 5/HPF, 0.3; RBC 5.1-10/HPF, 10.1; RBC 10.1-20/HPF, 10.6; and RBC > 20/HPF, 28.93; WBC ≤ 5/HPF, 0.1; WBC 5.1-10/HPF, 2.2; WBC 10.1-20/HPF, 9.4; and WBC > 20/HPF, 26.6. High bias between the methods was identified in 98 samples (21.0%) with RBCs and 77 samples (15.7%) with WBCs. Reviewer-based enumeration of the SediVue-captured images decreased the percentage of samples with high bias to 17.3% for RBCs and to 11.4% for WBCs. Conclusions: Bias in the RBC and WBC counts between manual microscopy and the SediVue was unlikely to impact clinical interpretations in a majority of cases. Although reviewer enumeration of SediVue-captured images reduced observed bias, inherent differences between methodologies appeared to have a larger impact on the bias.
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Lower urinary tract disease is common in dogs with approximately 14% developing a bacterial lower urinary tract infection (UTI) during their lifetime. Empirical antimicrobials are often prescribed while waiting urine culture and susceptibility results. Regional knowledge of bacterial prevalence and antimicrobial resistance patterns aids veterinarians in antimicrobial choice. This study aimed to identify the prevalence of uropathogens in canine urine tract isolates and to assess for changes in antimicrobial resistance of Escherichia coli ( E . coli) over a 5-year study period at a large multidisciplinary private referral hospital in Australia (January 2013–December 2017). The proportion of resistant isolates was compared across 5 years (Fisher’s exact test and Cochran Armitage test for trend) for select antimicrobials towards E. coli . A total of 246 positive urine cultures were included. E. coli was the most prevalent uropathogen at 64%, followed by Proteus sp., Staphylococcus sp. and Enterococcus sp., respectively (9%, 8% and 7%). E. coli was most commonly resistant to amoxicillin at 41%. There was no statistically significant difference, nor trend, in resistance of E. coli isolates towards the selected antimicrobials over the 5 years. Resistance towards trimethoprim–sulfonamide was lower at 15%. This information will aid local veterinarians in selecting empirical antimicrobials pending culture results for the treatment of UTIs in dogs.
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Antibiotic Use Guidelines for Companion Animals, Second Edition, 2018.
Article
Zusammenfassung Bakterielle Harnwegsinfektionen (HWI) treten bei Hunden häufig auf und stellen eine häufige Indikation für den Einsatz von Antibiotika in der tierärztlichen Praxis dar. Bei HWI kommt es zum Anhaften, zur Vermehrung und Persistenz von Infektionserregern im Harntrakt. Durch die Gewebsinvasion wird eine Entzündungsreaktion ausgelöst, die mit klinischen Symptomen einhergeht. Je nach Lokalisation der Infektion erfolgt eine Einteilung in bakterielle Zystitis, Prostatitis oder Pyelonephritis. Davon abzugrenzen ist die subklinische Bakteriurie (SB). Diese liegt vor, wenn aus einer adäquat gewonnenen Urinprobe eine signifikante Anzahl an Bakterien isoliert werden kann, das Tier jedoch keine klinischen Symptome einer Harnwegserkrankung zeigt. HWI entstehen in aller Regel durch aufsteigende Infektion mit Bakterien aus der wirtseigenen fäkalen oder distalen urogenitalen Flora. Escherichia coli ist dabei sowohl bei Hunden mit HWI als auch bei Hunden mit SB das häufigste Isolat. Die Diagnose basiert auf den klinischen Symptomen und den Befunden der Urinuntersuchung und -kultur. Ausführliche Therapieempfehlungen finden sich in den kürzlich überarbeiteten Richtlinien der International Society for Companion Animal Infectious Diseases, die im Folgenden zusammengefasst werden. Das Befolgen solcher Richtlinien steigert nicht nur den Therapieerfolg, sondern leistet auch einen Beitrag zur Eindämmung der Antibiotikaresistenzen.
Article
The stability of canine urine samples is essential when the samples cannot be analyzed immediately. The objective of this study was to investigate the stability of canine urine samples at room temperature and under refrigerated conditions. Samples from 20 dogs were collected, divided, and stored at 4°C and 20°C. The samples were examined up to 48 h after collection for specific gravity, pH, protein, bilirubin, glucose, ketones, and sediment and at 4 h and 24 h for bacterial growth. Specific gravity and all chemistry parameters were stable for a minimum of 48 h in 90% of samples. The sediment was stable, apart from crystals. The bacterial growth of 3 bacterial species tested in vitro, as well as the clinical samples, was mostly constant over 24 h at the refrigerated temperature. In urine samples stored at room temperature, the total number of aerobic growing bacteria was increasing. The results of our study showed that routinely measured parameters were stable in unpreserved urine for a minimum of 4 h and up to 48 h in most cases. If it is not possible to culture urine immediately, it is recommended that urine samples be stored at 4°C for a period of up to 24 h.
Chapter
Urinary tract infections (UTI) are among the most common infections diagnosed in companion animals and usually require antimicrobial use. The antimicrobials available nowadays for UTI treatment are limited and most of them are considered as critically important to humans by the World Health Organization (WHO). Therefore, awareness of the antimicrobial resistance trends and underlying resistance mechanisms in uropathogenic bacteria from dogs and cats is of importance in a one health perspective. This has long been one of the main research fields of the Antibiotic Resistance Laboratory Team. A recent and pivotal study from our team has given, for the first time, an European overview of the geographic distribution of antimicrobial resistance in uropathogenic bacteria from dogs and cats. The southern European countries, including Portugal, had significantly higher resistance frequencies than Northern countries, mirroring what happens in human invasive bacteria. Noteworthy, increasing antimicrobial resistance trends over 16 years were also detected in bacteria from companion animals with UTI. The detection of multidrug-resistant (MDR) extended spectrum beta- lactamases (ESBLs)/AmpC beta- lactamases - producing bacteria in companion animals with UTI is worrisome due to its clinical implications. Furthermore, companion animals UTI may frequently be caused by high-risk clonal lineages to humans like Escherichia coli ST131, ST648 and Klebsiella pneumoniae ST15 which underlines their public-health relevance.
Article
Bacterial urinary tract infection (UTI) is a common clinical concern in dogs. However, incidence of feline UTI is much lower than in dogs although an increasing prevalence has been registered. The main objective of the present study was to describe and characterize the prevalence of urinary tract pathogens in urine samples of dogs and cats with urinary clinical signs throughout different Spanish provinces. Secondary aims were to determine if there were differences in urine sample characterizations based on species (i.e. dog and cat) or season. Dogs were found to have a higher rate of positive urinary cultures than cats (39.3% and 24.7% of the cultures submitted, respectively). The bacterial genera most commonly isolated in dogs were Escherichia spp. (45.3%), Proteus spp. (13.2%), Staphylococcus spp. (11%) and Enterococcus spp. (8.6%). Whereas in the feline population, Escherichia spp. (42.7%), Enterococcus spp. (22.2%) and Staphyloccoccus spp. (15.2%) were the most frequently isolated bacteria. The highest rates of positive urine cultures were registered in Melilla (70%), Zamora (66.7%), Teruel (64.3%) and Guadalajara (60%). Moreover, the proportion of positive urine cultures was not homogeneously distributed across provinces. Finally, some seasonality was found among most isolated bacterias. Enterococcus spp. was significantly more prevalent in summer, whereas Escherichia spp. and Proteus spp. were more commonly isolated in spring and Pseudomonas spp. in autumn.
Article
Selected information was compiled from canine urinalyses and urine cultures conducted between January 1969 and December 1995. Eight thousand three hundred fifty-four microbial isolates (bacteria and fungi) included 4,873 isolates from females and 3,481 from males. Ten bacterial genera accounted for 96.3% of the urinary isolates, including Escherichia coli (44.1%), Staphylococcus spp. (11.6%), Proteus spp. (9.3%), Klebsiella spp. (9.1%), Enterococcus spp. (8.0%), and Streptococcus spp. (5.4%) as the 6 most common isolates in both genders of dogs. Among these 6 genera, female dogs were generally predisposed over males, although males had more urinary tract infections (UTIs) caused by Klebsiella spp. Distributions of ages at UTI diagnosis tended to be similar between genders. Infection with a single microbial species was responsible for >72% of UTIs in both genders. Among females, 40 breeds and a mixed-breed group represented 90.2% of all positive urine cultures, 88.4% of the individual dogs with UTIs, and 88.2% of the microbial isolations. Among males, these same 41 breed groups represented 87.9% of all positive urine cultures, 87.6% of the individual dogs, and 88.2% of the microbial isolations. Copyright © 2001 by the American College of Veterinary Internal Medicine.
Article
Perineal urethrostomies are associated with complications that may mimic primary causes of feline lower urinary tract disorders. Though postoperative urethral strictures may be minimized by proficiency with an effective surgical technique, removal of the distal urethra may result in bacterial urinary tract infections in 25% to 30% of patients after surgery. Urinary tract infections caused by urease-producing microbes may induce struvite urolith formation. Thus the prophylactic benefits of minimizing recurrent urethral obstruction by urethrostomy must be weighed against a long-term predisposition to recurrent bacterial urinary tract infection and urolith formation.
Article
What is a bacterial UTI? A urinary tract infection (UTI) refers usually to a bacterial infection of any or all parts of the urinary tract but most commonly the urinary bladder (called bacterial cystitis). A UTI is common in dogs, especially females. They are uncommon in cats less than 10 years of age. Cats more than 10 years of age, however, have a higher risk and a UTI is often associated with other diseases. Two things must happen for a bacterial UTI to occur: 1. A break, either temporary or permanent, in the animal's defenses 2. Bacteria must migrate into the urinary tract, catch hold, and multiply The UTI may or may not be associated with symptoms. What are the symptoms of a bacterial UTI? Symptoms of a bacterial UTI may or may not be present and are dependent on which part(s) of the urinary system is/are infected. The urinary bladder is most often infected, which then causes urgency and irritation. Other symptoms may include the following:  Blood in urine (hematuria)  Straining to urinate (stranguria)  Foul-smelling urine  Urination in inappropriate places  Inability to hold urine  Urinating small volumes or not passing any urine despite posturing to urinate Less commonly, a bacterial UTI may involve one or both kidneys. Again, obvious problems may not be present. When present, however, they may include the following: In reproductively intact dogs and cats, the infection may also involve parts of the genital system (uterus in females or prostate in males) and clinical signs may relate to the infection in these locations. These described symptoms do not always mean that a UTI is present. All of these problems may occur because of diseases other than a UTI. For example, many cats less than 10 years of age do not have a UTI but are more likely to have uninfected inflammation (cystitis) or urinary stones. The symptoms are the same as those observed with a UTI. The presence of blood in urine does not mean that a UTI is present.
Article
The gammaherpesvirus bovine herpesvirus-4 (BHV-4) has been isolated from a wide variety of animals, including lions and domestic cats. Although BHV-4 antibodies have been detected in normal cats and cats with urinary disorders, the epidemiology and pathogenic role of BHV-4 in cats is unknown. The purpose of this study was to determine the prevalence of BHV-4 antibodies and viral nucleic acid in a population of free-roaming cats. Plasma and peripheral blood leukocyte samples were collected from 52 male and 52 female free-roaming cats impounded at a regional animal control facility in Central Michigan. Plasma concentrations of BHV-4 antibodies were measured with an indirect fluorescent antibody test. Peripheral blood leukocyte DNA was isolated, and a 2-stage polymerase chain reaction with heminested primers delineating a conserved portion of the BHV-4 glycoprotein B gene homologue was used to amplify BHV-4-specific DNA sequences. BHV-4 antibodies were detected in 38 (73%) male and 23 (44%) female cats. Seropositive cats were significantly more likely to be male than female (odds ratio = 3.22; P= .007). Cell-associated viremia was detected in 17 (33%) male and 11 (21%) female cats. Of the 61 seropositive cats, 23 (38%) had a detectable viremia; only 5 (12%) seronegative cats had detectable viremia. Seropositive cats were significantly more likely to be viremic than sero-negative cats (OR = 4.30; P= .009). Our results suggest that BHV-4 infection may be more widespread in certain cat populations than previously reported. Furthermore, many cats seropositive for BHV-4 antibodies have a concurrent cell-associated viremia.
Article
Viruses have been implicated as causative agents in the etiopathogenesis ofsome forms of feline lower urinary tract disease (LUTD). This hypothesis was supported by isolation of feline calicivirus, bovine herpesvirus 4 (strain FeCAHV), and feline syncytia-forming virus from cats with naturally occurring LUTD, and by experimental studies of induced viral urinary tract infection. Results ofearly clinical studies yielded contradictory results concerning the role of viruses in feline LUTD. However, recent detection of bovine herpesvirus 4 antibodies in feline serum samples and discovery of calicivirus-iike particles in crystalline/matrix urethral plugs obtained from cats with naturally occurring LUTD, suggests the need to reexamine the etiopathologic role of viruses using contemporary methods of virus identification and localization.
Article
The degree of bacterial contamination of 75 urine samples collected by voluntary voiding, catheterization, and cystocentesis was studied in 25 clinically normal dogs (14 females and 11 males) to evaluate the suitability of quantitative urine culture for diagnosis or urinary tract infection. Significant bacteriuria (greater than 100,000/ml) was not observed. Insignificant bacteriuria presumably caused by urethrogenital contaminants was detected in 44% of the urine samples collected by voluntary voiding, in 20% of the samples collected by catheterization, and in 12% of the samples collected by cystocentesis. The urine was sterile in 40% of the samples collected by voluntary voiding, in 80% of the samples collected by catheterization, and in 84% of the samples collected by cystocentesis. A bacteria count suggestive of bacteriuria (10,000--100,000/ml) was obtained in 1 sample collected by cystocentesis but was attributed to inadvertent penetration of a loop of intestine. Low bacteria counts were obtained in 4 (16%) samples collected by voluntary voiding, presumably as a result of urethrogenital and integumentary bacterial contaminants. It was concluded that urine samples properly collected from dogs by voluntary voiding, catheterization, or cystocentesis are suitable for detection of significant bacteriuria.
Article
Renal cortical scintigraphy has been reported to be useful in children for confirmation of the diagnosis of acute pyelonephritis. Subsequent experimental studies have demonstrated that dimercaptosuccinic acid (DMSA) scintigraphy, when compared directly with histopathology, is highly reliable for the detection and localization of parenchymal inflammatory changes associated with acute pyelonephritis. Recent clinical studies of acute pyelonephritis using DMSA scintigraphy reveal that the majority (50 to 91%) of children with febrile urinary tract infections have abnormal DMSA renal scan findings and that the majority of these children do not have demonstrable vesicoureteral reflux. However, when vesicoureteral reflux is present, renal cortical abnormalities are demonstrated by DMSA scintigraphy in 79 to 86% of the kidneys. In children with febrile urinary tract infections routine clinical and laboratory parameters are not reliable in the differentiation of acute pyelonephritis, documented by DMSA renal scan findings, from urinary tract infections without parenchymal involvement. Furthermore, the presence of P-fimbriated Escherichia coli associated with febrile urinary tract infections does not reliably predict those kidneys that have acute parenchymal inflammation demonstrated by DMSA renal scans.
Article
Candida albicans urocystitis secondary to urethral stricture and administration of antibiotics was diagnosed in a cat by fungal culturing of urine and examination of specimens. Surgical repair of the stricture and administration of 5-fluorocytosine resulted in resolution of the cystitis. Related problems included anorexia and severe weight loss, which necessitated enteral nutritional support, dehydration, renal disease, and nosocomial Pseudomonas aeruginosa urocystitis.
Article
In a prospective study, 141 cats with hematuria, dysuria, urethral obstruction, or combinations of these signs were evaluated by contemporary diagnostic methods and compared with 26 clinically normal cats (controls). Specific diagnosis was established in 45% (64/141) of cats affected with lower urinary tract disease (LUTD). Crystalline matrix plug-induced urethral obstruction was diagnosed in 21% (30/141) of affected cats, uroliths were identified in 21% (30/141) of affected cats, uroliths with concomitant bacterial urinary tract infection (UTI) were identified in less than 2% (2/141) of affected cats, and bacterial UTI alone was identified in less than 2% (2/141) of cats with LUTD. Viruses, mycoplasmas, and ureaplasmas were not isolated from urine samples collected from affected or control cats. Bovine herpesvirus 4 (BHV-4)-neutralizing antibodies were not detected in any serum sample obtained from cats with LUTD or from control cats. In contrast, BHV-4 antibodies were detected by an indirect immunofluorescent antibody (IFA) test in sera obtained from 31% (44/141) of cats with LUTD and 23% (6/26) of control cats. The prevalence of positive BHV-4 IFA test results in affected cats was not significantly different from that observed in control cats. Significant association was not apparent between positive BHV-4 IFA test results and clinical diagnosis, abnormal laboratory findings, or cat age. However, the number of male cats with BHV-4 IFA titer was significantly (P less than 0.02, chi 2 test) greater than that of female cats. Detection of BHV-4 antibodies in approximately 30% of affected and control cats indicates prior virus exposure. Further investigations are warranted to clarify the specific role of BHV-4 in cats with naturally acquired LUTD.
Article
The clinicopathologic manifestations of bovid herpesvirus-4 (BHV-4; FCAHV strain)-induced infection of the lower portion of the urinary tract were characterized in 12 adult neutered male and 6 female specific-pathogen-free cats, and were compared with those in 12 neutered male control cats. Six neutered male and 6 female cats were given immunosuppressive doses of methylprednisolone acetate prior to inoculation of their urinary bladders with BHV-4. Six neutered male control cats were given immunosuppressive doses of methylprednisolone acetate prior to inoculation of their urinary bladders with uninfected tissue culture control inoculum. Six additional neutered male control cats were exposed only to uninfected tissue culture control inoculum. All cats were observed for 90 days following inoculation. Dysuria and gross hematuria were observed in only 1 BHV-4-exposed cat. Radiographic abnormalities of the lower portion of the urinary tract were not observed. Microscopic hematuria, crystalluria, and lipiduria were identified with similar frequency in BHV-4-exposed and control cats. Results of urine culturing for bacteria, mycoplasma, ureaplasma, and viruses were negative. Viruses were not isolated from blood leukocytes collected from exposed or control cats. Three to 6 weeks after inoculation, high concentrations of BHV-4 serum antibodies were detected in all exposed cats by an indirect fluorescent antibody test. Light microscopic examination of the urinary tract revealed multifocal lymphoid cystitis in 2 BHV-4-exposed cats. Except for suppurative bronchitis in 1 BHV-4-exposed cat given glucocorticoids, morphologic differences in urinary and extraurinary tissues were not observed. In urinary bladder tissue collected 90 days after inoculation, BHV-4 was reisolated from urinary bladder explants of all but 1 exposed cat. Virus was also isolated from a kidney explant of 1 exposed male cat, and spleen cell co-cultures of 1 exposed female cat given glucocorticoids.(ABSTRACT TRUNCATED AT 250 WORDS)
Article
Clinicopathologic manifestations of induced infection of the feline lower urinary tract with bovid herpesvirus-4 (BHV-4, strain FCAHV) were characterized in 6 conventionally reared adult cats (2 sexually intact males, 2 castrated males, and 2 females). Two additional control cats were exposed with noninfected cell culture control inoculum. Clinical and radiographic signs of lower urinary tract disease were not observed in exposed or control cats. Microscopic hematuria was detected in urine samples collected by cystocentesis from 4 to 6 exposed cats and 1 of 2 control cats. Results of culture of urine for bacteria, mycoplasmas, ureaplasmas, and viruses were consistently negative. Low titer of serum BHV-4 (strain FCAHV)-neutralizing antibodies was detected in 4 of 6 exposed cats, but not in controls. Gross abnormalities of the urinary tract were not observed in any cat. Light microscopic examination of serial sections of the lower urinary tract revealed mild focal lymphoid cystitis in 2 of 6 exposed cats, one of which also had increased amounts of connective tissue and proliferation of blood vessels in the urinary bladder lamina propria. Ninety days after initial exposure, BHV-4 (strain FCAHV) was reisolated from explanted urinary bladder tissues of 5 of 6 exposed cats. Virus was not isolated from tissues of control cats. It was concluded that BHV-4 (strain FCAHV) establishes persistent urinary tract infection in conventionally reared adult male and female cats. However, persistent BHV-4 infection in cats may remain clinically inapparent.
Article
Urine specimens were obtained from 115 dogs. Each specimen was divided into 2 aliquots; one aliquot was placed into a sterile container (non-preserved), and the other was preserved in a boric acid-glycerol-sodium formate at 4 C. Both aliquots were then transported to a laboratory, and specimens of each aliquot were bacteriologically cultured immediately upon arrival at the laboratory. Specimens of the preserved aliquot also were cultured after 24, 48, and 72 hours of preservation. In 47 specimens containing greater than or equal to 1 X 10(4) colony-forming units (CFU)/ml, the results of quantitative bacteriologic culturing of preserved urine at 0, 24, 48, and 72 hours were the same as the result of the immediate quantitative bacteriologic culture of non-preserved urine. In 2 of 5 specimens containing greater than or equal to 1 X 10(3) CFU/ml but less than 1 X 10(4) CFU/ml, the results of quantitative bacteriologic culture of preserved urine differed from the corresponding immediate culture of nonpreserved urine. Bacteria were not isolated from 63 specimens (less than 1 X 10(3) CFU/ml). Bacteriologic cultures of preserved urine were also negative for bacterial growth at 0, 24, 48, and 72 hours. Bacteriuria was detected by direct microscopic examination of gram-stained smears of uncentrifuged urine in 50 of 52 urine specimens from dogs with urinary tract infection. Bacteria were observed in 1 of 63 specimens that did not have bacterial growth when cultured.
Article
Bacterial urinary tract infection is a common disease complex in the dog. Numerous factors predispose to the condition which, once arisen, predisposes the dog to pyelonephritis. Thus, subclinical infections, detected by the presence of significant bacteriuria, become important to diagnose. This study is a survey on urinary bacterial counts performed on urine obtained by catheterization and midstream-sampling. In cases revealing bacteriuria, further analysis is undertaken in order to initiate individually adjusted, rational therapy.
Article
A commercially available leukocyte esterase assay was evaluated for application in analyzing canine urine for the detection of pyuria. In 229 urine samples, the leukocyte esterase activity was compared with leukocyte concentrations, as assessed by microscopic sediment analysis and chamber cell counts. The leukocyte esterase assay was specific (93.2%) for canine pyuria, but was poorly sensitive (46.0%) and did not appear to be applicable to analysis of canine urine samples.
Article
Contrast radiography enabled identification of 17 dogs with pelvic location of the caudal portion of the urinary bladder. The caudal pole of each bladder consistently was more blunted than expected. The range of craniocaudal dimension within the pelvic canal was 6% to 26% of the distended bladder. Ten dogs were females with urinary incontinence. Seven dogs did not have incontinence; 4 were males and 3 were intact females. Six dogs had associated anatomic abnormalities: urachal diverticulum (3), bladder adhesions (1), rectovaginal fistula (1), and inverted vulva (1). Eleven dogs had urinary tract infection. In addition, urinary incontinence and pelvic bladder without urinary tract infection or other anatomic abnormalities was identified in 4 large-breed spayed females. These dogs responded poorly to diethylstilbestrol therapy. Three of the 4 subsequently were treated with ephedrine, and all had their incontinence effectively controlled by its continued use. Four of the 10 incontinent dogs in this series were Doberman Pinschers, suggesting breed predisposition. These data indicated an association between pelvic bladder and urinary incontinence in the spayed female dog, but also indicated that pelvic bladder can be found in both sexes and that it is associated with urologic abnormalities other than incontinence.
Article
Results of quantitative culture of 25 canine urine samples stored at different temperatures for varying periods (2, 4, 6, 12, and 24 hours) following collection were compared. Samples stored at room temperature (21 to 25 C) were unreliable for diagnostic quantitative culture after 24 hours. False-positive results were obtained in 13 (50%) of the samples, and false-negative results were obtained in 1 (4%) sample. Likewise, samples sent via the US mail were unreliable for diagnostic quantitative culture since false-positive results were obtained in 9 (35%) of the samples. Samples stored at refrigeration temperature (3 to 8 C) provided more satisfactory data. Culture of urine samples refrigerated for 2 hours resulted in quantitative results that were similar and interpretations that were identical to those obtained for samples cultured without having been refrigerated. Refrigeration for periods up to 6 hours resulted in qualitative counts that differed from those obtained after initial culture of the nonrefrigerated samples, but interpretations of results were identical. After 24 hours of refrigeration there were no false-positive results; however, false-negative results were observed in 1 (4%) of the samples. These observations indicated that optimal results of quantitative culture of urine can be consistently obtained only if samples are immediately processed following collection. If immediate culture is not possible, the specimens may be stored for at least 6 hours at refrigeration temperature without compromising the validity of results.
Article
Ocular and systemic candidiasis was diagnosed in an immunosuppressed and diabetic 12-year-old cat that initially was examined because of polyuria, polydipsia, and urinary tract disease. Bilateral recurrent corneal erosions and chorioretinitis, urinary tract infections attributable to bacteria or Candida sp, and renal dysfunction developed during the next 2 months. Examination of corneal scrapings revealed spherical to oval, budding, yeast-like cells. The cat's condition progressively deteriorated, and it was euthanatized. Toxoplasmosis was diagnosed by fecal flotation and from serum titers, and pituitary-dependent hyperadrenocorticism was detected at postmortem histologic evaluation. Candida budding yeasts and pseudohyphae with blastospores were detected in the corneas, vitreous bodies, retinas, CNS, pharynx, trachea, esophagus, kidneys, and urinary bladder at postmortem examination.
Article
Many forms of therapy currently used for empiric treatment of feline lower urinary tract diseases represent significant predisposing factors for fungal infection (i.e., prolonged antibiotic and/or glucocorticoid therapy, aciduria, and indwelling transurethral catheters). Therapy of fungal urinary tract infection should be based on the cat's clinical history, physical examination, and laboratory findings. Amelioration of risk factors has been associated with spontaneous resolution of funguria. For other patients, alkalinization and administration of antifungal chemotherapy are needed to control disease.
Article
Bacterial urinary tract infection rarely is the initial cause of lower urinary tract disease in cats; however, a substantial number of cats with various lower urinary tract disorders develop urinary infections as a complication of the underlying disease or its treatment. Examination of urine sediment for pyuria is a good screening test for urinary tract infection, but results of urine cultures are needed to diagnose such infections reliably, as well as to guide therapeutic decisions. Appropriate antimicrobial drug therapy is the cornerstone of treatment for urinary tract infection. Treatment of the underlying urinary disorder also is important, and follow-up urine cultures should be performed to determine therapeutic outcome.
Article
The exact cause of hematuria, dysuria, and urethral obstruction remains unknown in a large percentage of naturally occurring cases of feline lower urinary tract disease (FLUTD). One attractive hypothesis implicates viruses as the cause of some idiopathic forms of FLUTD; supporting this hypothesis is the fact that a gamma herpesvirus, a calicivirus, and a retrovirus have been isolated from urine and tissues obtained from cats with this type of disease. Although the clinical course and laboratory findings of cats with idiopathic FLUTD are suggestive of an infectious cause, the question of whether viruses have a pathologic role in some forms of naturally acquired FLUTDs has not been completely answered.
Article
A group of 41 cats with signs of lower urinary tract disease was compared to a group of 41 cats without any history of disease for prevalence of seropositivity for feline immunodeficiency virus (FIV). The group of healthy cats was similar in age and gender to the group of cats with signs of lower urinary tract disease. Three of the cats with lower urinary tract disease and one control cat were seropositive for FIV. This difference was not statistically significant. The most common cause of lower urinary tract signs was idiopathic. Only 7 cats had urinary tract infection, most associated with perineal urethrostomy or catheterization. Six of the cats with bacterial urinary tract infections were FIV negative. J Vet Intern Med 1996;10:34–38. Copyright © 1996 by the American College of Veterinary Internal Medicine.
Article
To identify the underlying cause of clinical signs in cats with nonobstructive diseases of the bladder and urethra. Prospective case series. 109 cats examined by the urology service of The Ohio State University's veterinary teaching hospital because of stranguria, hematuria, pollakiuria, or urination in inappropriate locations. History was obtained and a CBC, serum biochemical analyses, serologic tests for FeLV and feline immunodeficiency virus, urinalysis, bacterial culture of urine, and contrast radiography or urethrocystoscopy (females only) were performed. 16 cats had cystic calculi: 8 had struvite uroliths, 7 had calcium oxalate uroliths, and 1 had a urolith of unknown composition in conjunction with an anatomic defect. Anatomic defects, including diverticulae, urethral strictures, and a malpositioned urethra, were identified in 12 cats. A urinary tract infection was identified in 1 cat, and neoplasia was diagnosed in 2. One of the cats with neoplasia also had a struvite urolith. The remaining 80 cats did not have an anatomic defect, urolith, or tumor. Ten of these cats also did not have radiographic or cystoscopic abnormalities and were presumed to have a behavioral disorder. The remaining 70 cats had radiographic or cystoscopic abnormalities, and idiopathic cystitis was diagnosed. In 14 of the cats with idiopathic cystitis, results of a urinalysis were normal. Cats with idiopathic cystitis were significantly more likely to eat dry food exclusively (59%) than were cats in the general population (19%). Results suggest that idiopathic cystitis occurs commonly in cats with stranguria, hematuria, pollakiuria, or inappropriate elimination and is associated with consumption of dry foods. Contrast radiography or cystoscopy is necessary for differentiating idiopathic cystitis from behavioral disorders in some cats.
Article
Accurate diagnosis of pyelonephritis using clinical and laboratory parameters is often difficult, especially in children. The main aims of this prospective study were to compare the value of different imaging techniques [renal sonography, cortical scintigraphy with technetium-99m dimercaptosuccinic acid (99mTc DMSA) and computed tomography (CT)] in detecting renal involvement in acute urinary tract infections and to determine the sensitivity of DMSA scans for permanent renal scars 6 months later. Between February 1992 and January 1993, 55 children admitted to our pediatric unit with febrile symptomatic urinary tract infections were eligible for analysis. Ultrasonography (US), DMSA scanning and micturating cystourethrography were performed in every case. Only 18 children underwent CT. A second DMSA scan was performed in 48 children a mean of 7.5 months after the first. US abnormalities were found in 25 children (45 %). The first DMSA scan showed a parenchymal aspect suggestive of pyelonephritis in 51 patients (93 %). Among the 18 patients studied by CT, 14 had abnormalities. Normal US findings did not rule out renal parenchymal involvement. Scintigraphy appeared to be more sensitive than CT for renal involvement. The frequency and degree of initial renal parenchymal damage seemed to correlate with vesicoureteral reflux, but the most severe initial parenchymal defects were not associated with marked clinical or laboratory manifestations. Repeat DMSA scans, performed on 45 kidneys with abnormalities at the first examination, showed resolution in 19, improvement in 16, persistence in 8 and deterioration in 2. The prevalence of vesicoureteral reflux was not higher in patients with renal scarring on the second DMSA scan than in patients whose scans showed an improvement. DMSA scans should be considered as a reference in the detection and follow-up of renal scarring associated with acute urinary tract infection as this technique is more sensitive than US and CT, the latter being unsuitable because it entails radiation exposure and sedation of patients.
Article
Perineal urethrostomies are associated with complications that may mimic primary causes of feline lower urinary tract disorders. Though postoperative urethral strictures may be minimized by proficiency with an effective surgical technique, removal of the distal urethra may result in bacterial urinary tract infections in 25% to 30% of patients after surgery. Urinary tract infections caused by urease-producing microbes may induce struvite urolith formation. Thus the prophylactic benefits of minimizing recurrent urethral obstruction by urethrostomy must be weighed against a long-term predisposition to recurrent bacterial urinary tract infection and urolith formation.
Article
A retrospective study was performed to determine the proportion of dogs with hyperadrenocorticism or diabetes mellitus or both that had urinary tract infection (UTI) and to describe clinical and laboratory findings. Dogs with these endocrine disorders were included if results of quantitative urine culture were available and dogs were not receiving antimicrobials. Dogs with positive urine cultures were considered to have UTI and dogs with negative urine cultures were used as controls. Information including history, clinical signs, physical examination findings, and results of laboratory tests and urine culture was extracted from all records. Findings in dogs with UTI were compared with control dogs. There were 101 dogs with hyperadrenocorticism or diabetes mellitus or both that met inclusion criteria; 42 (41.6%) had UTI and 59 (58.4%) did not. UTI was present in 46% of dogs with hyperadrenocorticism, 37% of dogs with diabetes mellitus, and 50% of dogs with both endocrine disorders. There was no association between endocrine group and occurrence of UTI. Escherichia coli was the most common bacteria isolated, and cultures from 29 dogs (69%) showed growth of this organism. Of dogs with UTI, <5% had stranguria, pollakiuria, or discolored urine, whereas 60% had pyuria and 69% had bacteriuria. We conclude that UTIs are common in dogs with hyperadrenocorticism, diabetes mellitus, or both diseases. Clinical signs of UTI, however, are uncommon and results of urinalysis may be normal. Therefore, it is appropriate to recommend urine culture as part of the evaluation of dogs with these endocrine disorders.
Article
The gammaherpesvirus bovine herpesvirus-4 (BHV-4) has been isolated from a wide variety of animals, including lions and domestic cats. Although BHV-4 antibodies have been detected in normal cats and cats with urinary disorders, the epidemiology and pathogenic role of BHV-4 in cats is unknown. The purpose of this study was to determine the prevalence of BHV-4 antibodies and viral nucleic acid in a population of free-roaming cats. Plasma and peripheral blood leukocyte samples were collected from 52 male and 52 female free-roaming cats impounded at a regional animal control facility in Central Michigan. Plasma concentrations of BHV-4 antibodies were measured with an indirect fluorescent antibody test. Peripheral blood leukocyte DNA was isolated, and a 2-stage polymerase chain reaction with heminested primers delineating a conserved portion of the BHV-4 glycoprotein B gene homologue was used to amplify BHV-4-specific DNA sequences. BHV-4 antibodies were detected in 38 (73%) male and 23 (44%) female cats. Seropositive cats were significantly more likely to be male than female (odds ratio = 3.22; P = .007). Cell-associated viremia was detected in 17 (33%) male and 11 (21%) female cats. Of the 61 seropositive cats, 23 (38%) had a detectable viremia; only 5 (12%) seronegative cats had detectable viremia. Seropositive cats were significantly more likely to be viremic than seronegative cats (OR = 4.30: P = .009). Our results suggest that BHV-4 infection may be more widespread in certain cat populations than previously reported. Furthermore, many cats seropositive for BHV-4 antibodies have a concurrent cell-associated viremia.
Article
To determine proportional morbidity rates (PMR) and risk factors for lower urinary tract diseases (LUTD) in cats. Case-control study. Records of 22,908 cats with LUTD and 263,168 cats without LUTD. Data were retrieved from the Purdue Veterinary Medical Data Base. Descriptive statistics and univariate logistic regression analyses were performed to assess whether breed, age, sex, and neutering status were associated with different causes of LUTD. Mean PMR for LUTD irrespective of cause was 8/100 cats (range, 2 to 13/100 cats). Increased risk for urocystolithiasis (Russian Blue, Himalayan, and Persian cats), bacterial urinary tract infections (UTI; Abyssinian cats), congenital urinary tract defects (Manx and Persian cats), and urinary incontinence (Manx cats) was detected. Cats between 2 and < 7 years of age had increased risk for urethral plugs, neurogenic disorders, congenital defects, and iatrogenic injuries. Cats between 4 and < 10 years of age had increased risk for urocystolithiasis, urethral obstructions, and idiopathic LUTD. Cats > or = 10 years of age had increased risk for UTI and neoplasia. Castrated males had increased risk for each cause of LUTD except UTI and incontinence. Spayed females had increased risk for urocystolithiasis, UTI, and neoplasia. Sexually intact females had decreased risk for each cause of LUTD except neurogenic disorders and iatrogenic injuries. Specific breed, age, sex, and neutering status may be associated with specific types of feline LUTD. Knowledge of patient risk factors for LUTD may facilitate development of surveillance strategies that enhance earlier detection.
Article
Selected information was compiled from canine urinalyses and urine cultures conducted between January 1969 and December 1995. Eight thousand three hundred fifty-four microbial isolates (bacteria and fungi) included 4,873 isolates from females and 3,481 from males. Ten bacterial genera accounted for 96.3% of the urinary isolates, including Escherichia coli (44.1%), Staphylococcus spp. (11.6%), Proteus spp. (9.3%), Klebsiella spp. (9.1%), Enterococcus spp. (8.0%), and Streptococcus spp. (5.4%) as the 6 most common isolates in both genders of dogs. Among these 6 genera, female dogs were generally predisposed over males, although males had more urinary tract infections (UTIs) caused by Klebsiella spp. Distributions of ages at UTI diagnosis tended to be similar between genders. Infection with a single microbial species was responsible for >72% of UTIs in both genders. Among females, 40 breeds and a mixed-breed group represented 90.2% of all positive urine cultures, 88.4% of the individual dogs with UTIs. and 88.2% of the microbial isolations. Among males, these same 41 breed groups represented 87.9% of all positive urine cultures, 87.6% of the individual dogs, and 88.2% of the microbial isolations.
Article
To determine influence of vestibulovaginal stenosis, pelvic bladder, and recessed vulva on response to treatment for clinical signs of lower urinary tract disease in dogs. Retrospective study. 38 spayed female dogs. Medical records and client follow-up were reviewed for dogs evaluated via excretory urography because of clinical signs of lower urinary tract disease. Clinical signs, results of radiography, and response to surgical or medical treatment were analyzed. Clinical signs included urinary tract infection (n = 24), urinary incontinence (20), vaginitis (11), pollakiuria or stranguria (10), and perivulvar dermatitis (4). Vaginocystourethrographic findings included vestibulovaginal stenosis (n = 28), pelvic bladder (17), and ureteritis or pyelonephritis (4). Ten dogs had a vestibulovaginal ratio of < 0.20 (severe stenosis), 9 dogs had a ratio of 0.20 to 0.25 (moderate stenosis), 9 dogs had a ratio of 0.26 to 0.35 (mild stenosis), and 10 dogs had a ratio of > 0.35 (anatomically normal). Lower urinary tract infection, incontinence, and pelvic bladder were not associated with response to treatment for recessed vulva. Vestibulovaginal stenosis with a ratio < 0.20 was significantly associated negatively with response to treatment. Dogs without severe vestibulovaginal stenosis that received vulvoplasty for a recessed vulva responded well to treatment. Vestibulovaginal stenosis is likely an important factor in dogs with vestibulovaginal ratio < 0.20. Vaginectomy or resection and anastomosis should be considered in dogs with severe vestibulovaginal stenosis and signs of lower urinary tract disease.
Article
Records from 20 animals (13 dogs, seven cats) with Candida spp. urinary tract infections were reviewed. Six Candida spp. were isolated; Candida albicans was the most common isolate. Concurrent diseases or nonantifungal drugs administered within 1 month of isolation included antibiotics (n=16), corticosteroids (n=6), diabetes mellitus (n=4), nonurogenital neoplasia (n=3), and noncandidal urogenital disease (n=14). All animals had sources of local or systemic immune compromise that likely predisposed to infection. Of five animals with resolution of infection, three did not receive specific antifungal treatment. The authors conclude that correction of predisposing conditions is likely critical for management of Candida spp. urinary tract infection.
Evaluation of blood agar plates as a transport medium for aerobic bacterial urine cultures [abstract]
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  • Bemis J Da New
  • Bryant Mj Duckett
Blanco LJ, Bartges JW, New J, Bemis DA, Bryant MJ, Duckett R. Evaluation of blood agar plates as a transport medium for aerobic bacterial urine cultures [abstract]. J Vet Intern Med 2001;15:303.
Bacterial urinary tract infections Textbook of veterinary internal medicine
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Lulich JP, Osborne CA. Bacterial urinary tract infections. In: Ettinger SJ, Feldman EC, editors. Textbook of veterinary internal medicine. 4th edition. Philadelphia: WB Saunders; 1999. p. 1775–88.
Canine lower urinary tract disorders
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Lulich JP, Osborne CA, Bartges JW, Lekcharoensuk C. Canine lower urinary tract disorders. In: Ettinger SJ, Feldman EC, editors. Textbook of veterinary internal medicine, vol. 2. 5th edition. Philadelphia: WB Saunders; 1999. p. 1747–83.
Genitourinary infections Infectious diseases of the dog and cat. 2nd edition. Philadelphia: WB Saunders
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Barsanti JA, Johnson CA. Genitourinary infections. In: Greene CE, editor. Infectious diseases of the dog and cat. 2nd edition. Philadelphia: WB Saunders; 1990. p. 157–83.
Retrospective evaluation of urinary tract infection in 42 dogs with hyperadrenocorticism or diabetes mellitus or both
  • Forrester
Genitourinary infections
  • Barsanti
Evaluation of blood agar plates and incandescent lighting for aerobic bacterial urine cultures
  • Saunders
Evaluation of blood agar plates as a transport medium for aerobic bacterial urine cultures
  • Blanco