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Diagnosis of urinary tract infections
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.
... They occur when the natural defence mechanisms of the urinary tract and pathogenic microbes are out of balance (Amphaiphan et al., 2021). Infection can be localized to a single site or located in two or more of the urinary organs (Bartges, 2004). The typical clinical symptoms of UTI include pollakiuria, stranguria, and haematuria. ...
... LUT infections usually cause changes in the typical urine pattern (Dunning and Stonehewer, 2002). Lower UTIs can cause pollakiuria, stranguria, dysuria, and abnormal urination (Bartges, 2004). ...
... Cystocentesis is preferred for the evaluation of UTIs. Infectious prostatitis and vaginitis need separate therapy (Bartges, 2004). The USG of UTIs depends on whether they are in the upper urinary tract or concurrent. ...
Bacterial urinary tract infections (UTIs) are among the most common diseases in dogs and cats. The infections occur when the natural defence systems of the urinary tract and pathogenic bacteria are out of balance. Diagnosis of UTIs requires a simultaneous evaluation of clinical signs and urine culture, which is necessary before initiating appropriate antibiotic therapy. Several variables, such as subclinical bacteriuria or pre-analytical errors, can make the interpretation of urine cultures problematic. The aim of this review was to provide an up-to-date overview of UTIs in dogs and cats and to improve the current understanding of the epidemiology, pathogenic aspects of uropathogens, and innovative therapeutic modalities.
... Diagnosis of a UTI includes findings from the history, physical examination, complete urinalysis, and urine culture (Smee et al., 2013) [3] . 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., 2019;Smee et al., 2013) [4,1,5] . Studies regarding the canine urinary tract infections are very scanty in India when compared to other countries. ...
... Diagnosis of a UTI includes findings from the history, physical examination, complete urinalysis, and urine culture (Smee et al., 2013) [3] . 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., 2019;Smee et al., 2013) [4,1,5] . Studies regarding the canine urinary tract infections are very scanty in India when compared to other countries. ...
... Major clinical symptoms observed in the present study can be due to lower UTIs and which were in concurrence with the studies of Bartges (2004) [4] . ...
This study was conducted to diagnose urinary tract infection from the dogs presented to the Veterinary College Hospital during the period of 6 months by urinalysis, ultrasonography and cultural examination and to determine the antimicrobial resistance profile of the urine samples. 72 dogs were presented to Veterinary College Hospital, Bengaluru with clinical sign suggestive of UTI among that 65 urine samples having more than 10 3 cfu/ml on quantitative urine culture were considered for study. Urinalysis and sonographic changes were evaluated. Urine culture was carried out to isolate bacteria from urine samples and to know quantitative bacterial count in the sample. Increased frequency of urination, straining while passing urine, hematuria and oliguria were the common signs observed in dogs. Change in the colour, turbidity, proteinuria, pyuria, haematuria and bacteriuria were noticed on urine analysis. Thickening of the bladder (> 3 mm), hyperechoic calculi in lumen and sludge in the lumen were noticed in ultrasonography.
... Age and sex are contributing factors to the incidence of UTIs. In general, bacterial UTIs are more common in dogs than in cats, older animals and females [1,4,5]. Approximately 14% of dogs will develop a bacterial UTI in their lifetime [3,4]. ...
... In general, bacterial UTIs are more common in dogs than in cats, older animals and females [1,4,5]. Approximately 14% of dogs will develop a bacterial UTI in their lifetime [3,4]. In contrast, UTIs account for approximately 1-3% of all cases of feline lower urinary tract disorders. ...
... In veterinary practice, inadequate empirical choices, antibiotic treatment of nonbacterial conditions, failure in the administration by the owners, and extensive periods of treatment are the main factors associated with reduced patient outcomes and one of the great contributors to the selection of bacterial resistance [4,11,17]. In this study, the authors analysed the bacterial isolates and their antimicrobial susceptibility patterns from UTIs in dog and cat samples that were admitted to a veterinary laboratory (Inno-Veterinary Laboratory, Braga) during the period from 2017 to 2021. ...
There are growing concerns regarding the rise of antimicrobial-resistant bacteria in companion animals. This study aimed to bring new insights into the current scenario of Portugal's anti-microbial resistance bacteria isolated from companion animals with urinary tract infections and is the first to be performed during a long period on a large scale. Of a total of 17472 urine samples analyzed, 12,166 (69.6%) (CI 12,200-12,200) were negative for bacterial growth, and 5306 (30.4%) (95% CI 5310-5310) had bacterial growth. Of the culture-positive samples, 5224 (96.6%) (95% CI 5220-5220) were pure cultures and 82 (3.2%) (95% CI 81.9-82.1) had mixed growth. Escherichia coli was the most frequently isolated bacteria (n = 2360, 44.5%) (95% CI 2360-2360), followed by Proteus mirabilis (n = 585, 11%) (95% CI 583-583), Enterococcus faecium (n = 277, 5.2%) (95% CI 277-277) and Staphylococcus pseudintermedius (n = 226, 4.3%) (95% CI 226-226). The overall susceptibility rates were low for erythromycin (45.3%) and clindamycin (51.3%), and high for aminoglycosides (96.3%), carbapenems (92.4%), trimethoprim-sulfamethoxazole (81.2%), and quinolones (79.9%). E. coli also showed considerable resistance to amoxicillin-clavulanic acid. The rates of multidrug-resistant bacteria are still high compared to the northern countries of Europe. This study's findings show the emergence of antibiotic resistance in the antibiotic agents commonly used in the treatment of UTIs in dogs and cats in Portugal.
... 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). ...
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.
... 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. ...
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.
... Urinalysis is a simple, rapid, and low-cost test that detects possible infections and provides substantial assessment of the urinary system. This includes physical, biochemical, and microscopic (sedimentoscopy) examination of urine (Bartges, 2004;Weese et al., 2019). (O'Neil et al., 2013) reported that leukocytes, red blood cells, nitrite, and bacteria are reliable indicators of bacterial UTIs. ...
... However, there may be a discordance between the results of cytology and urine culture as pseudobacteria may erroneously be identified as bacteria (Peterson et al., 2012, McGhie et al., 2014. Therefore, the assessment of urinary sediment in suspected UTI is an essential part of urinalysis; however, it must be analyzed in context with other diagnostic data (Bartges, 2004). In addition, although urinalysis may indicate UTI, few studies have demonstrated an association between urine culture and urinalysis results (Weese et al., 2019). ...
... Qualitative methods were used to determine the etiological agents, wherein the bacteria present in the urine samples were isolated and identified. Samples were sent to the Laboratory of Routine Bacteriology and plated on blood agar supplemented with 5% equine blood (Difco TM ) and MacConkey agar media (Difco TM ) (Bartges, 2004), and incubated for 24-48 h at 37 °C. The isolates were characterized both microscopically (for gram staining) and biochemically (catalase and oxidase tests). ...
Bacterial urinary tract infections (UTI) are among the most frequent infectious diseases of small animals. Although antimicrobial therapy is recommended for treating bacterial UTIs, the current consensus is that treatment may not be necessary for asymptomatic animals. The aim of this study was to evaluate the diagnostic ability of urinalysis to detect bacteriuria and to compare it with urine culture (gold standard method) to assess the risk of false-positive results. A retrospective study was conducted from January 2016 to July 2019 and urine samples of 119 dogs were analyzed. Diagnostic validation was performed for urinalysis, based on the morphological classification and intensity of bacteriuria. Agreement between the results was assessed using the kappa (k) index. When the presence of cocci was used as a diagnostic criterion to suggest bacteriuria, it was observed that the agreement (k = -0.006) was lower than that expected by chance. However, a poor agreement (k = 0.22) was also found for bacilli during urinalysis (k = 0.23). A significant degree of agreement was observed in cases with high intensity of bacteriuria. Therefore, urine culture must be performed for conclusive evidence of bacteriuria to avoid false-positive results during urinalysis.
... 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. ...
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.
... 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: ...
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). ...
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.
... UTIs in canines can be caused by a single pathogen, resulting in a simple infection, or by multiple pathogens, leading to a mixed infection (Thompson et al., 2011) [22] . Optimal practices for diagnosing and managing UTIs in companion animals include performing bacterial culture and sensitivity testing on urine-isolated pathogens before initiating treatment (Bartges et al., 2004) [2] . Despite this, antimicrobial treatment is frequently started empirically to alleviate clinical symptoms, bypassing these diagnostic steps (Guardabassi et al., 2004) [7] . ...
... UTIs in canines can be caused by a single pathogen, resulting in a simple infection, or by multiple pathogens, leading to a mixed infection (Thompson et al., 2011) [22] . Optimal practices for diagnosing and managing UTIs in companion animals include performing bacterial culture and sensitivity testing on urine-isolated pathogens before initiating treatment (Bartges et al., 2004) [2] . Despite this, antimicrobial treatment is frequently started empirically to alleviate clinical symptoms, bypassing these diagnostic steps (Guardabassi et al., 2004) [7] . ...
... (Dowling, 1996). The clinical signs associated with UTIs are haematuria stranguria, pollakiuria, urinary incontinence, fever, emesis and many more (Bartges, 2004). These signs are useful in identifying a UTI patient. ...
... According to Bartges (2004) clinical signs associated with UTIs may or may not be present and if present they are variable in every case and they depend on number of factors such as predisposing causes, host immune response, site of the infection, duration of infection and virulence of the pathogen. The signs therefore vary and may include haematuria, stranguria, pollakiuria, inappropriate urination, dysuria, kidney failure and even septicemia. ...
The study entitled was carried out on dogs suspected for urinary tract infection at Mumbai Veterinary College, Parel. The Mean ± SE of hemoglobin, PCV, and TEC, of dogs with E. coli associated UTI was 2.23±0.62 gm%, 35.96±1.82%, and 5.45±0.28×106/cmm respectively. These parameters were found to be within normal range. Mean ± SE of Neutrophils was 77.89±1.42 %, for Eosinophils 1±0.31%, for Lymphocytes 19.53±1.25%, for Monocytes 1.42±0.18% and for Basophils was 0.16±0.12%. Marked leukocytosis with neutrophilia associated with UTIs was observed. Mean ± SE of ALP, AST and ALT was 108.84±9.77 U/L, 47.33±4.44 U/L and 50.24±9.85 U/L respectively. These values were almost normal. Mean ± SE of total protein, albumin and globulin were 6.42±0.2 g/dl, 2.52±0.1 g/dl and 3.86±0.24 g/dl respectively. There was mild hypoalbuminemia with hyperglobulinemia. Mean ± SE of BUN was 30.41±5.85mg/dl and mean ± SE of creatinine was 1.72±0.21. This elevation may be due to decrease renal filtration due to the renal injury caused by inflammation and infection.
... Серед собак частіше хворіють самки, а серед котів -самці (White et al., 2016;Vázquez-Martínez et al., 2018;Thompson, 2021). За частотою виникнення розрізняють спорадичні та рецидивуючі бактеріальні уроцистити (Bartges, 2004;Dorsch et al., 2014). В категорію "спорадичних" відносять інфекційні уроцистити, які виникають не частіше 1-2 рази в рік. ...
... Патогенез вторинних інфекцій нижнього відділу сечовивідних шляхів вказує на використання антибіотиків як єдиного ефективного методу лікування бак-теріальних уроциститів у собак та котів. Незалежно від етіології бактерійного агента важливо визначати його чутливість до протимікробних засобів (Bartges, 2004;Marques et al., 2016;Weese et al., 2022). Прогнозоване повторення інфекції дає підставу лікарю ветеринарної медицини первинно призначати антибіотики із списку у антибіотикограмі, до яких найбільш чутливий визначений збудник. ...
Diseases of the urinary system are a common problem for small animals. Most often, pathological changes in the urinary bladder and urethra are registered in dogs and cats. In particular, urocystitis ranks first in the list of diseases of the lower urinary tract. The etiology of urocystitis can have a different genesis - infectious and non-infectious. Infectious urocystitis is divided into primary and secondary, which depends on the way of penetration of the uropathogen into the body. They have the same characteristics (bacterial pathogen, pathogenesis, clinical signs) as other infectious diseases, but no clear nosological classification exists. Most often, the causative agents of infectious urocystitis are bacteria that live on the body of animals as conditionally pathogenic microflora. These include escherichia, enterococci, corynebacteria, staphylococci, streptococci, proteus, and pseudomonads. Under favorable conditions, such as urolithiasis, immunosuppression, neoplasia, or congenital or acquired anatomical and functional defects of the urethra and bladder, these bacteria penetrate the urinary canal and begin to multiply uncontrollably there, which leads to the emergence of an infectious inflammatory process. Secondary bacterial urocystitis is more dangerous than primary ones, as constant relapses of the disease characterize their course. The final process of this disease is usually urosepsis. Therefore, according to various authors, the only effective therapy method for secondary infectious urocystitis is using antibiotics to which the pathogen is sensitive. This leads to antibiotic resistance of the bacterial microflora in the patient's body. The emergence of resistance of pathogens to antimicrobial agents makes further treatment of this pathology impossible. Preventive measures, proposed in various publications, ensure only the continuation of the remission of the disease. These measures cannot stop the recurrence of bacterial urocystitis and its irreversible consequences. Due to the cyclic nature of the pathogenetic process, dogs and cats suffering from secondary infectious urocystitis are classified as terminal patients. Alternative solutions to this problem have not yet been proposed. Analysis of literature data indicates that infectious urocystitis occurs more often as a complication of primary pathology. Still, after eliminating the initial cause, they play a vital role in the body of sick animals. Therefore, scientists' research should be directed to developing and implementing therapeutic measures and means that would neutralize bacterial agents without causing them to become resistant to antibiotics. The article describes the mechanisms of infection by uropathogens through the distal part of the urinary system and possible favorable factors that are the key to this process. The frequency of the disease occurrence in cats and dogs is given according to species, age, and sex. Issues of approach and treatment of bacterial urocystitis and related complications are highlighted. Based on the obtained data, an analysis was carried out, and a perspective vector was formed for further scientific research, which would eliminate the problem of this disease in small animals.
... Penyakit saluran kemih bagian bawah lebih sering terjadi pada kucing (7,3%) dibandingkan pada anjing (3%), dan pada anjing penyakit saluran kemih bagian bawah yang paling umum adalah infeksi saluran kemih atau cystitis (14%) dan urolitiasis (3%). Tidak seperti kucing yang sebagian besar kasus cystitis bersifat idiopatik, infeksi bakteri adalah penyebab cystitis paling umum pada anjing (Bartges, 2004). Kultur urin positif diamati pada 15-65% anjing dan sekitar 12% pada kucing dengan gejala klinis penyakit saluran kemih (Windahl et al., 2014). ...
... Umur rata-rata anjing saat diagnosis cystitis terlepas dari jenis kelamin adalah sekitar 7-8 tahun (Cohn et al., 2003). Tanda klinis paling umum yang terkait dengan penyakit cystitis pada anjing adalah hematuria, disuria, stranguria, polakiuria dan inkontinensia urin (Bartges, 2004). Polakiuria adalah tanda klinis paling umum yang dilaporkan oleh Westropp et al. (2012). ...
Penyakit saluran kemih bagian bawah adalah penyakit umum pada anjing yang dapat terjadi pada anjing jantan dan betina. Penyakit ini dapat mengancam nyawa, terutama jika muncul sebagai penyakit obstruktif. Diagnosis dan pengobatan dini diperlukan, jika tidak maka dapat menyebabkan kematian. Seekor anjing Pitbull jantan berumur lima tahun dengan bobot 26 kg memiliki riwayat mengalami stranguria disertai hematuria selama tiga hari serta kelemahan pada kaki belakang. Pemeriksaan fisik menunjukkan vesika urinaria mengalami pembesaran dan nyeri saat dipalpasi. Pemeriksaan hematologi rutin menunjukkan anemia mikrositik hipokromik. Hasil pemeriksaan biokimia darah menunjukkan peningkatan kadar glukosa (381.86 mg/dL). Urinalisis menunjukkan darah (+), protein 100 mg/dL, leukosit (+), pH 8 dan berat jenis 1,005. Sedimentasi urin menunjukkan adanya eritrosit pada endapan urin. Pemeriksaan radiografi menunjukkan distensi pada vesika urinaria. Pemeriksaan ultrasonografi menunjukkan peradangan pada medula ginjal kanan dan dinding vesika urinaria. Berdasarkan hasil temuan ini, anjing kasus didiagnosis mengalami pyelonefritis dan cystitis. Penanganan pertama dilakukan dengan pemasangan kateter. Urin yang berhasil dikeluarkan sebanyak 750 mL berwarna merah kecoklatan dan berbau amonia yang samar serta anyir. Terapi cairan Ringer Laktat diberikan untuk mengembalikan hidrasi anjing kasus. Terapi untuk penanganan pyelonefiritis dan cystitis diberikan amoxicillin 15 mg/kg BB selama tiga hari dan dexametasone 0,5 mg/kg BB selama 3 hari. Karena belum menunjukkan tanda-tanda kesembuhan, pada hari ketujuh penggunaan amoxicillin diganti dengan cefotaxime 12 mg/kg BB selama tujuh hari. Terapi simtomatik diberikan kejibeling (1 kapsul/hari, p.o) selama 14 hari, Hematodin dan calcium glukonate 10% selama tujuh hari. Setelah menjalani terapi selama 14 hari anjing kasus menunjukkan kondisi yang semakin membaik ditandai dengan tidak terjadinya hematuria dan stranguria.
... 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. ...
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.
... 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. ...
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.
... 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. ...
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.
... On the other hand, this technique is not reliable for the detection of CFU <10 4 per million litter (Gatermann et al., 2005). Additionally, the culture method requires special care during the collection, preservation, and transportation of urine samples to avoid the death and proliferation of bacteria and contamination (Bartges, 2004). Recent studies showed that the above-mentioned culture media are not sufficient to differentiate ExPEC from non-pathogenic E. coli and other uropathogens bacteria (Perry, 2017). ...
... In small animal medicine, various pathologic conditions can affect the urinary tract and cause clinical signs such as hematuria, pollakiuria, and stranguria [1]. However, in some patients, urinary tract disorders may show no remarkable clinical signs. ...
Background
Despite the prevalence of echogenic foci floating in the urinary bladder seen in ultrasonography in dogs, surprisingly little has been written on its significance, including its potential association with urinalysis. The objective of the study was to determine the diagnostic value of the echogenic foci floating in urinary bladders in dogs.
Results
- Cystosonography was performed on 45 dogs. Bladder contents were examined and divided into positive (containing echogenic particles) and negative (absent echogenic particles) groups according to the presence and absence of floating echogenic particles. Five mL of urine was collected via cystocentesis. Urine analysis and culture were done and the relationship between ultrasound evaluation and urinalysis results was investigated. In dogs with bladder echogenic particles in ultrasonography, the prevalence of hematuria, pyuria, bacteriuria, and lipiduria were 88.9%, 92.6%, 29.6%, and 70.3%, respectively. However, in dogs in which echogenic particles were not observed in their bladders, the prevalence of hematuria, pyuria, bacteriuria, and lipiduria was 77%, 50%, 5.5%, and 77%, respectively. There was a significant association between bladder debris and positive urine culture, with an odds ratio of 7.15 (95% confidence interval: 0.81–63.28) compared with matched controls. Furthermore, there was a significant relationship between the presence of floating echogenic particles with pyuria, and urine color ( p ≤ 0.05).
Conclusion
In conclusion, the present results showed the detection of bladder debris on ultrasound can be a predictor for pyuria and positive urine culture in dogs.
... are often associated with canine UTI (Marques et al. 2016;Roberts et al. 2019;Hernando et al. 2021). Confirmation of aetiology by urine culture followed by antimicrobial susceptibility test (ABST) is considered as gold standard for diagnosis and treatment (Bartges 2004). In fact, most of the UTI cases have been treated empirically and culture with antimicrobial sensitivity was performed as last resort if there is no response to treatment. ...
Urinary tract infection (UTI) caused by antimicrobial resistant bacteria is common in dogs leading to serious health impact in pet animal as well as on human health. Understanding the prevalent uropathogens and their drug susceptibility is essential for limiting the antimicrobial resistance through implementation of stewardship policies. In view of this, present study was envisaged to determine the prevalent bacterial uropathogens and their antibiogram from clinical cases of canine UTI. Urine samples were collected from 35 dogs presented with clinical signs of UTI and a total of 27 bacterial isolates were recovered. Among that Escherichia coli was the most predominant isolate followed by Klebsiella aerogenes, Staphylococcus aureus, Proteus mirabilis, Enterococcus sp. and Citrobacter freundii. All isolates were found resistant to one or more 1st line antibiotics recommended by consensus guidelines and 70% of total isolates showed multidrug resistance. Additionally, this study evaluated the weightage of empirical therapy as per the consensus guidelines over antimicrobial susceptibility test guided treatment. Dogs with uncomplicated UTI were selected and categorized into three different groups (n = 6). Group 1 was treated with common empirical choice amoxycillin-clavulanic acid and dogs showed susceptible to ciprofloxacin were kept in Group 2 and treated with ciprofloxacin along with urinary alkalizer disodium hydrogen citrate. Nitrofurantoin susceptible cases were kept in Group 3 and treated with a combination of nitrofurantoin and urinary acidifier ammonium chloride. Therapeutic outcome was evaluated and success rate was higher in Group 2 and 3 than Group 1 suggested that selection of antibiotics with the use of local or institutional antibiogram data is more considerate than acknowledged international guidelines in the existing situation.
... In small animal medicine, various pathologic conditions can affect the urinary tract and cause clinical signs such as hematuria, pollakuria, and stranguria [1]. However, in some patients, urinary tract disorders may show no remarkable clinical signs. ...
Background: Despite the prevalence of echogenic foci floating in the urinary bladder seen in ultrasonography in dogs, surprisingly little has been written on its significance, including its potential association with urinalysis. The objective of the study was to determine the diagnostic value of the echogenic foci floating in urinary bladders in dogs.
Results- Cystosonography was performed on 45 dogs. Bladder contents were examined and divided into positive (containing echogenic particles) and negative (absent echogenic particles) groups according to the presence and absence of floating echogenic particles. Five mL of urine was collected via cystocentesis . Urine analysis and culture were done and the relationship between ultrasound evaluation and urinalysis results was investigated. In dogs with bladder echogenic particles in ultrasonography, the prevalence of hematuria, pyuria, bacteriuria, and lipiduria were 88.9%, 92.6%, 29.6%, and 70.3%, respectively. However, in dogs in which echogenic particles were not observed in their bladders, the prevalence of hematuria, pyuria, bacteriuria, and lipidauria was 77%, 50%, 5.5 %, and 77%, respectively. There was a significant association between bladder debris and positive urine culture, with an odds ratio of 7.15 (95% confidence interval: 0.81-63.28) compared with matched controls. Furthermore, there was a significant relationship between the presence of floating echogenic particles with pyuria, and urine color ( p ≤ 0.05).
Conclusion: In conclusion, the present results showed the detection of bladder debris on ultrasound can be a predictor for pyuria and positive urine culture in dogs.
... Complete diagnosis of bacterial UTI includes urinalysis with sediment examination and culture. Urine collection by cystocentesis is highly recommended to prevent sample contamination [2,11]. Escherichia coli is the most common Gram-negative bacteria isolated from urine samples of canines (39)(40)(41)(42)(43)(44)(45)(46)(47)(48)(49)(50)(51)(52)(53)(54)(55)(56)(57)(58).8%) and felines (38.8-59.5%) ...
... This bacterial concentration in midstream free-catch urine (10 5 CFU/mL) has been considered suggestive of UTI, but the bacteria we observed at these concentrations were generally skin commensals (S. pseudintermedias, S. canis). 60 Additionally, all of these dogs remained healthy, asymptomatic, and never exhibited pyuria during and after the study (Table S11). These results demonstrate the potential for high-level contamination in free-catch urine from healthy dogs, as noted previously. ...
Background
Urine is routinely evaluated in dogs to assess health. Reference ranges for many urine properties are well established, but the scope of variation in these properties over time within healthy dogs is not well characterized.
Objectives
Longitudinally characterize urine properties in healthy dogs over 3 months.
Animals
Fourteen healthy client‐owned dogs.
Methods
In this prospective study, dogs were evaluated for health; then, mid‐stream free‐catch urine was collected from each dog at 12 timepoints over 3 months. Urine pH, urine specific gravity (USG), protein, cultures, and antimicrobial resistance profiles were assessed at each timepoint.
Results
Urine pH varied within and between dogs over time (Friedman's test: within P = .03; between P < .005). However, USG, protein, and bacterial diversity of urine were consistent within dogs over time, and only varied between dogs (Kruskal‐Wallis: between all P < .005). Antimicrobial resistant isolates were identified in 12 out of 14 dogs with 34 of 48 of the isolates demonstrating resistance to amoxicillin.
Conclusions and Clinical Importance
Urine pH should be assessed at multiple timepoints via pH meter before making clinical decisions. Mid‐stream free‐catch urine with high concentrations of bacteria (>10⁵ CFU/mL) should not be considered the only indicator of urinary tract infection. Bacterial isolates from dogs in this study had widespread resistance to amoxicillin/oxacillin underscoring the need for antimicrobial stewardship.
... We have developed a multiplex PCR-based diagnostic test for bacterial vaginosis involving the detection of multiple anaerobes in vaginal The urine culture is still the "gold standard" for diagnosis of UTI (Bartges, 2004). It is simple and inexpensive. ...
nucleic acid segments present in small or complex samples to sufficiently high levels to allow their detection by optical, physical and other methods. It is a rapid and simple way of copying specific DNA fragments from minute quantities of source DNA material using a heat-stable polymerase and suitable primers to direct the amplification of the desired region of DNA. Objective: The objective is to review multiplex PCR and its application in diagnosis of disease. Method: The method adopted in this review is broad search of both electronic data bases, hard copies by studying and comparing the information obtained from available current published scientific researchers in peer reviewed journals, books, and conferences etc. Results: it was found that Diagnostic microbiology is in the midst of a new era. Rapid nucleic acid amplification and detection technologies are quickly displacing the traditional assays based on pathogen phenotype rather than genotype. Conclusion: The review concludes that PCR technology is gradually changing the world of rapid laboratory diagnosis.
... A bacterium was considered uropathogenic if (a) it was detected in pure culture or (b) in high numbers and (c) if the animal showed clinical symptoms of UTI or (d) if the animal was previously treated with antibiotics due to UTI [19,26,95]. Growth was estimated semi-quantitatively: isolated bacterial growth, 1-5 colonies, (+); bacterial growth, 6-50 colonies, +; moderate bacterial growth, 51-200 colonies, ++; strong bacterial growth, >200 colonies, +++. ...
Bacterial urinary tract infection (UTI) is a common diagnosis in companion animal practice and is one of the leading reasons for antimicrobial prescriptions. We analysed 1862 samples from the urinary tract of dogs and cats, submitted to a veterinary microbiological diagnostic laboratory in 2019 and 2020 in Germany. Susceptibility of 962 uropathogenic isolates to 15 antimicrobials, suggested as first- and second-line treatment options for UTI, was determined according to CLSI recommendations. Bacterial growth of uropathogens was detected in 43.9% of dog and in 38.5% of cat samples. Escherichia (E.) coli was the most frequently isolated pathogen (48.4%), followed by Enterococcus spp. (11.9%) and coagulase-positive staphylococci (CoPS; 11.5%). Females were more likely to exhibit a positive microbiological culture. Regarding first-line antibiotics, 93.4% of the most commonly isolated uropathogenic species were susceptible to the first-line antibiotics amoxicillin/clavulanic acid (AMC) and 87.6% to trimethoprim-sulfamethoxazole (SXT), while 76.1% showed decreased susceptibility to ampicillin (AMP). Multidrug resistance (MDR) was detected in 11.9% of E. coli, 50.4% of enterococci, and 42.7% of CoPS; 90.6% of these isolates were susceptible to nitrofurantoin (NIT). Our data indicate that empiric treatment of UTI with AMC or SXT could be recommended and is preferable to treatment with AMX. NIT should be considered for the treatment of MDR uropathogens.
... According to the literature, to consider that bacteriuria is consistent with cystitis, a bacterial count of > 10,000 CFU/mL is needed for samples obtained by catheterization; any value < 1000 CFU/mL should be considered as contamination. 21 Therefore, we achieved the resolution of the clinical condition with the isolated use of bladder irrigation with O 3 SS. ...
Bacterial cystitis is a common clinical problem among cats and dogs and is one of the main reasons for the administration of antimicrobials. This can cause serious damage to public and animal health, as this practice facilitates the selection of bacteria that are multidrug-resistant to antibiotics. In this context, it is urgent to understand and validate therapeutic modalities that complement antimicrobial treatment in cystitis cases. Ozone therapy has been proposed by scientists owing to the various mechanisms of action in a range of pathologies, both in human and animal medicine. This paper describes the bactericidal action of two different protocols of bladder irrigation with ozonized saline solution (59 μg/mL) in a paraplegic canine with recurrent bacterial cystitis caused by Proteus spp. In the first protocol, the bladder instillations were applied once a day for three consecutive days while in the second, successive lavages were performed throughout the day until a significant reduction in the presence of bacteria in the urine sediment. In this study, we were able to demonstrate that repeated bladder instillation within 24 hours was the most effective treatment for Proteus compared to a single instillation on successive days.
... 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]. ...
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.
... 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. ...
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.
... 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). ...
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.
... (1) pyuria (defined as >5 WBCs per high power field) 23 ; (2) positive urine culture; (3) resolution of clinical signs with antibiotic treatment. ...
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.
... 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. ...
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.
... 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. ...
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.
In this study, we aimed to isolate microorganisms from urine samples taken from dogs with urinary system infection and to determine an antibiotic susceptibility. For this purpose, urine samples taken from 30 dogs by cystocentesis were inoculated on Blood Agar, MacConkey Agar and Sabourraud’s Dextrose Agar. The isolated microorganisms were identified by conventional microbiological methods. In this study, while 19 bacteria were isolated from 15 dogs (63.33%), no isolation was detected within the mycological culture. The most isolated bacteria were Escherichia coli (26.32%) and coagulase negative Staphylococci (26.32%). The isolates were susceptible 84.2% to ceftriaxone, 78.9% to enrofloxacine, 73.7% to ciprofloxacin, gentamicin and trimethoprim + sulfamethoxazole, 73.7% to amoxicillin-clavulanic acid and cefixime, 57.9% to cephalexin, 52.6% to oxytetracycline and 47.4% to ceftiofur. We concluded that Escherichia coli and coagulase negative Staphylococci were the most common reason for urinary tract infections in dogs and due to the differences to antibiotic of the bacterial isolates that antibiotic susceptibility tests is necessary for treatment.
Diagnosis of bacteriuria in veterinary medicine is commonly based on unstained urinary sediment evaluation. Nonetheless, amorphous particles can be confused with bacteria. This study aims to investigate whether the stained sediment increases the sensitivity and specificity of bacteriuria detection. One hundred urine samples were collected, with 60 obtained through voided specimens and 40 through catheterization, from dogs of various breeds, genders, and ages. Additionally, a 1 ml aliquot from each sample was subjected to quantitative bacteriological culture, serving as the gold standard test for comparison with the sediment analysis. Comparing to the bacteriology culture, the stained sediment of urine collected by catheterization exhibited a relative sensitivity of 60% and specificity of 70%, while to voided specimens showed a sensitivity of 93.3% and specificity of 57.8%. Unstained sediment presented a sensitivity of 100% and specificity of 10% to urine collected by catheterization, and 93.3% and 4.4% to voided samples, respectively. Both stained and unstained methods demonstrated negative predictive values > 60%, but the positive predictive value of unstained sediment ranged to 24.6% (voided samples) to 27% (catheterization) indicating a lower probability of true positives. Both techniques showed a low correlation coefficient (kappa) indicating that they cannot replace the gold standard method for confirming bacteriuria. However, Gram staining of urinary sediment improved the differentiation between amorphous substances and bacteriuria in canine urine samples, suggesting its potential applicability in laboratory routines.
Objective:
The aim of this study was to investigate the bacterial population and antimicrobial resistance of bacteria isolated from feline urine from 2012 to 2018 in the Canadian provinces of Alberta and British Columbia.
Animals and procedure:
IDEXX Reference Laboratories provided data from urine samples submitted from Alberta and British Columbia for aerobic culture and susceptibility testing from January 1, 2012 to December 31, 2018. The analysis included 8084 bacterial isolates from 7522 cystocentesis samples, with at least 1000 colony-forming units per mL.
Results:
Escherichia coli, Enterococcus species, and Staphylococcus species were the most commonly isolated bacteria, at 60.0%, 22.7%, and 11.8%, respectively. The proportions did not vary significantly throughout the study period or between British Columbia and Alberta. Apart from an increase in the resistance of Staphylococcus species to clindamycin, there was minimal change in the antimicrobial susceptibility of the 3 most commonly isolated bacteria over the study period. More than 85% of Gram-positive organisms were susceptible to amoxicillin with or without clavulanic acid, and > 85% of Gram-negative organisms were susceptible to amoxicillin with clavulanic acid and trimethoprim with sulfamethoxazole.
Conclusion and clinical relevance:
Treatment with amoxicillin, with or without clavulanic acid, may be considered for bacterial feline lower urinary tract disease in Alberta and British Columbia while awaiting culture results.
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.
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.
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.
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.
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.
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.
Objective:
To identify a method for developing antibiograms for use in companion animal private practices (PPs).
Samples:
Reports (n = 532) of aerobic bacterial culture and antimicrobial susceptibility testing performed between January 1, 2018, and December 31, 2018, at 11 PPs and 1 academic primary care practice (APCP).
Procedures:
Data extracted from reports included patient identification number, laboratory accession number, patient signalment, collection method, body site, and results of bacterial culture and antimicrobial susceptibility testing. A custom antibiogram was then constructed with the help of commonly available software by adapting methods used by human hospitals. Susceptibility patterns of bacteria isolated by PPs and the APCP were compared to identify challenges associated with collating data from multiple laboratories.
Results:
4 bacterial species (Escherichia coli, Proteus mirabilis, Pseudomonas aeruginosa, and Staphylococcus pseudintermedius) and 3 bacterial groups (Enterobacteriaceae, Enterococcus spp, and coagulase-positive Staphylococcus spp) met the minimum requirement of ≥ 15 isolates for construction of an antibiogram. For urine samples, 3 bacterial species and 2 bacterial groups met the minimum requirement of ≥ 10 isolates. For samples from skin, 2 bacterial species and 2 bacterial groups met the minimum requirement of ≥ 10 isolates. Patient signalment, sample source, and distribution of bacterial isolates were similar between PP and APCP patients.
Conclusions and clinical relevance:
Results demonstrated that it was feasible to adapt existing guidelines for developing antibiograms in human medicine to the veterinary outpatient setting. Use of antibiograms could aid in empirical antimicrobial drug selection in a manner that supports antimicrobial stewardship principles.
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.
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.
Antibiotic Use Guidelines for Companion Animals, Second Edition, 2018.
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.
Danish antibiotic use guidelines 2nd edition
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.
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.
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.
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.
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.
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.
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.
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.
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 < 2% (2/141) of affected cats, and bacterial uti alone was identified in < 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 < 0.02, χ 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 .
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 cocultures of 1 exposed female cat given glucocorticoids.
Bovid herpesvirus-4 (FCAHV strain) caused persistent urinary tract infections in male and female specific-pathogen-free cats. Detection of occult bhv -4 infection required isolation of virus from tissues by explantation, or demonstration of specific bhv -4 antibodies by immunofluorescent techniques. Administration of glucocorticoids prior to inoculation did not enhance morbidity associated with bhv -4 urinary tract infection. Further investigations are needed to determine the pathogenic role of bhv -4 in noninduced feline lower urinary tract disease.
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 of 6 exposed cats and 1 of 2 control cats. Results of culture of urine for bacteria, maycoplasmas, 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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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]
- Blanco Lj
- Jw
- 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
- Lulich
- Jp
- Osborne
- Ca
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
- Lulich
- Jp
- Ca Osborne
- Jw
- Lekcharoensuk
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
- Ja Barsanti
- Johnson
- Ca
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
Canine lower urinary tract disorders
- Lulich
Bacterial urinary tract infections
- Lulich