A rarer pathway for bacteria to ascend:
- From neighboring sites from inflammatory process
- Leptospirosis in dogs
- Infectious peritonitis in cats
- Anaplasma, causing glomerulonefrit in dogs
They are not parasitic in the kidneys. In this case, the kidneys are the catalyst for the process that occurs in the body.
Do not forget that cats urinary tract infection common rarely. And pyelonephritis is not common. And if we diagnosed it, we need to understand why it happened? Often this is due to castration. The surgery took the infection by ascending bodies.
Infection can develop if the protective function of the body is impaired. This can occur in dogs without any factors once even in a young animal. If this infection is treated, relapses no longer occur.
However, for the most part, infections in animals develop when the body's defense function is disabled. In this case, the cause may be:
Provoking factors urinary tract infections
Structural and anatomical
Urolithiasis is a mechanical damage to the mucous membrane. Bacteria are able to adhere to the walls and develop, causing infection. Urolithiasis may not always be the cause, it may be a consequence of the inflammatory process. In particular, Struvites in dogs. Up to 95% are dogs with urinary tract infections. If we see the animal Uralic(suspected struvite urolithiasis) are required to take bacteriological urine culture. If we find a urease-producing bacterium, it makes sense to try to cure the infection. If the treatment does not give a result, then urolithiasis should be removed and sent for spectral analysis.
In cats, struvite urolithiasis may occur as a result of idiopathic cystitis. They are sterile and well soluble by diets such as "High Delusion".
Urinary incontinence may occur when:
- high risk of infection
- injury to the bladder wall due to stretching
- the lack of leaching bacteria
- pyoderma vulvar folds
The perineal urethrostomy:
If we perform a cat urethrostomy, nothing unusual happens. We're passing a very large area. To this we can add that cats have very concentrated urine – it is a very significant factor in protection against infection. Plus, the urethra is very long and narrow. This all creates a very big barrier between the interior and the environment.
Dogs are different. We're bypassing about 50% of the main defense mechanism. The result is a dog that is very likely infection. Therefore, the main task is to eliminate obstruction, identify the causes of urinary obstruction. And only after that you can make urethrostomy dogs.
At the moment, our scientists have begun to carry out cauterization operations according to a certain technique. We reserve preputii that have cancer. These glands secrete a certain secret. We leave the resident microflora, which covers the areas of parasitism. As a result, the development of pathogenic bacteria is suspended. In addition, the possibility of getting feces on the stoma area is prevented.
Acquired or congenital abnormalities. These include urachus, polypoidy cystitis, cysts of the urinary tract walls and others. This can all be a consequence of the inflammatory process. They may interfere with further studies in the treatment of cystitis. It is required to remove the above structures or partial cystotomy.
Urethral catheterization. It is impossible to ignore, a lot of cases. When catheterization of the urethra begins the development of infection. With a single catheterization bitch will develop an infection in 20% of cases. Even if the operation is completely sterile.
The closed system prevents bacteria from climbing the lumen of the catheter, but not between the catheter and the urethral wall. Moreover, in dogs the risk of infection increases with each day of the presence of the catheter in the urethra by 27%, and with the use of antibiotics at 454%. With prolonged joint use of a catheter and an antibiotic, the infection develops very strongly. As a result, you can get resistant to any drug strongly flowing infection.
- Exogenous corticosteroids
- The hypercortisolism
- Chronic kidney disease in cats
If we have a patient with a recurrent infection and can not understand what is the source-it is necessary to diagnose the above comorbidities.Cats is an immune deficiency, leukemia and others. In dogs usually a systemic disease occurring with certain symptoms and they are difficult to miss.
Occurrence of uti in cats and dogs:
Most often, the disease occurs in females. Because of their short and wide urethra. In males the urethra is already long. Protective property of non-castrated males have the prostate. The secret of the prostate has bactericidal properties. But if the patient becomes infected, the effect of the prostate begins to work in the opposite direction. As a result, the prostate as a sponge begins to accumulate an infection. Not all antibiotics can penetrate the prostate. If the patient is an intact male who has a chronic urinary tract infection and it is not treatable with antibiotics, it is necessary to castrate the patient. This will increase the chances of remission.
About 14% of dogs have at least one urinary tract infection throughout life, whereas in cats, this percentage is lower and equal to 0.1% - 1% of cases.
Diagnostics uti in cats and dogs.
- Fence urine for culture. Method Of Cystocentesis.
- Contraindications - coagulopathy
- Antibiotic therapy should be stopped 3-5 days before urine sampling for sowing.
This must be done because if the microflora in vivo is not sensitive to antibiotics in vitro – it can reduce the rate of growth or inhibit it permanently.
Microscopy of urine (sediment). If microscopy is carried out by drops and in this analysis we see the presence of any bacteria (sticks, cocci) – this point can not be taken into account. The urine of cats and dogs contains a lot of components similar to the bacteria we are looking for. But with such similarities, they are not.
If you want to look at the presence of bacteria, which is quite a highly sensitive method of diagnosing urine, you must: take urine Cystocentesis; dry smear; paint it. As a result, the analysis will provide reliable data for decision-making on further therapy.
As for additional diagnostics. Most infections are accompanied by abundant bacterial secretions. If you have sown bacteria in an amount less than 104 (less enrichment medium) - the probability of contamination is high.
In order for us to differentiate infection and contamination it is necessary to observe the clinical signs. Such as the active precipitate in the urine or the number of bacteria secreted at a level of more than 103 .
Not always signs of infection may be absent. However, the latest recommendation is that asymptomatic infections should not be treated. If a patient with chronic kidney disease in a control study found an infection and it does not occur progression of kidney disease, there is no need to treat such an infection. The same applies to any animal and the above features.
There are certain factors that contribute to the adhesion of bacteria on the walls, for example, urolithiasis, polypoid cystitis. In addition, there are strains of E. coli, which can be found inside the cells of the urothelium. They can show false-negative crops and lead to a relapse of the infection.
If you strongly suspect an infection, but the culture of cystocentesis came sterile-try to take the mucous membrane for sowing. In 25% of cases with negative seeding, you will have an infection when seeding the wall.
Antibiotics for the treatment urinary tract infections
It's antibiotic therapy. For this kind of infectious disease, it makes sense to divide antibiotics into rows. One, Two, Three. How are they different?
Second-line antibiotics - are drugs with an updated formula with a wider spectrum of action and higher toxicity, which have a fairly high risk of developing addiction. Usually used in humane medicine. These include fluoroquinolones.
Third-line antibiotics or reserve drugs - drugs used to treat multi-resistant strains. They are highly toxic. These include gentamicin, Meropenem, vancomycin. Used only in the case when after sowing using the drugs first two groups will not give result.
The most common first-line antibiotics are β-lactam antibiotics:
- Reach high concentrations in urine
- Poorly penetrate the tissues of the prostate and kidneys
- Side effects: gastrointestinal disorders, hypersensitivity...
Due to the secretion of urine through the kidneys while not reaching sufficient concentrations in the prostate and kidneys. Therefore, it is not recommended for the treatment of associated infections such as pyelonephritis, prostatitis. In the group of these drugs Amoxicillin, Cefovecin, Cefalexin.
Next group potentiated sulfonamides - are often used. Along with them, there is a sensitivity to amoxiclave. It has wider side effects:
- The crystalluria
Very common and good antibiotic. It is used in many cases with urinary tract infections especially if there is a sensitivity to antibacterial culture. Penetrates the prostate. To a greater extent, it is secreted mainly with bile. Up to 50% unchanged is excretion in the urine. In this case, the patient should be stable and fruitful kidney function. If renal function is impaired the drug will not give the necessary effectiveness. The drug ceases to enter the urine. In patients with reduced glomerular velocity, this drug is not used. In this case, it will be difficult to achieve a therapeutic effect. And the moment at which resistance of bacteria to a preparation will be developed is possible.
The rest of the drug shows the effectiveness of such infections: Escherichia coli(E. coli), Klebsiella spp(pathogenic bacteria), Proteus spp(pathogenic bacteria), Pseudomonas spp (gram-negative mobile rod-shaped bacteria), Enterococcus spp.
Dosage of doxycycline. It is calculated from the patient's body weight. One kilogram will require five milligrams of the drug in 12 hours. Or 10mg/kilogram per 24 hours (day). In addition, there are not only antibiotics based on Doxycycline, but also antibacterial drugs such as Vibramycin. Which can show its usefulness not only for the treatment of UTI.
Preparations of the second group. Drugs are not the first choice, they are-antibiotics reserve. Not recommended as first-line drugs. They have a broad spectrum of action, however they have a very high risk of developing resistance in the parasites to which they are sensitive. In cats, side effects may be retinotoxicity (damage to the retina of the drug toxins). However, there is some potential for retinotoxicity. And enrofloxacin comes first. If you plan cats use of drugs with greater dosage, it is better to use marbofloxacin.
Representatives of this group are Ciprofloxin. Very variable absorption in dogs. In 2 times may vary the concentration achieved in the blood after oral administration. This antibiotic used in dogs is not recommended in oral form. May cause bacterial resistance.
Antibiotic uroseptic. Microflora is sensitive to it, especially Escherichia coli (it is resistant to other types of antibiotics). With all this, it must be said that it penetrates only into the urine. For the treatment of pyelonephritis, cystitis - it is secreted only in the urine. The drug is used frequently, namely every 8 hours. And it's not very convenient. Because the correct reception depends on the success of therapy.
It should be remembered that the drug is used only by those individuals who have no problems with kidney function, because the only method of illuminating the drug. Otherwise, there is a risk of toxicity.
He is also an uroseptic. This drug is not very common in use. In this regard, the data on it is not much. Known drug regimen: a bag containing 3G of the drug is divided into 3 equal parts (1 g). These shares are taken every day. Still note that this drug is not used for mild diseases. These are mainly patients with highly resistant and chronic infection. Apply this drug in a complex patient for 3 times in 72 hours-the effectiveness is questionable. If we lead to a change of pathogen, it can bear fruit. The new pathogen will be more sensitive to antibacterial drugs. There is another dosing scheme 75-150 mg / kg every 12 hours. But there is no mention of how long we can use this antibiotic. Toxicity have him for dogs very low. But for cats this drug can not be used in connection with high nephrotoxicity.
It is in the list of sensitivity, along with amikacin and vancomycin, with antibiotics from the third(toxic) group. Not all patients tolerate it well. The list of side effects is very decent. Especially true for cats and myelosuppression. There is evidence that the use of this drug for more than 14 days will lead to myelosuppression. Dosages for use by cats and dogs vary. For dogs: 40-50 mg / kg every 8 hours. For cats: 12.5-20 mg / kg every 12 hours. However, it is the antibiotic of choice for a variety of strains.
These are drugs of the third group. And they are used as a last resort. Mostly looking for workarounds. Most patients have kidney disease-associated urinary tract infection, with aminoglycosides having very high nephrotoxicity. This figure varies greatly in this class. For example, gentomycin will be more nephrotoxic than amikacin.
There are data in humans and their extrapolation to animals is a real practice. They relate to the ratio of glomerular filtration rate and multiplicity of aminoglycosides. This is an article that has questionable data to practice. On the one hand, we reduce the concentration of the antibiotic in the blood, on the other hand, we can lead to insufficient secretion into the urine. As a result, the infection develops resistance. Antibiotic resistance, as a result of improper use, is very common in therapy.
You can reduce the frequency of receptions up to 48 hours. This is once in two days. If a patient with reduced glomerular filtration. But it is better to refrain from taking this drug in patients with impaired renal function.
A very good analogue of the above drug. These drugs have cross-sensitivity. This antibiotic is also a reserve. But it can be used in patients with kidney disease quite successfully. In this case, it will not cause side effects from the kidneys. Despite the fact that the instructions for use noted side effects on this side - in practice are rare.
Applies vaccinated 15 mg/kg 3 times in clock 3 weeks. This is a very inconvenient method of reception. As a rule, this method requires hospitalization.
How long to continue antibiotic therapy in UTI
The duration of therapy for acute uncomplicated urocystitis is 7-10 days. With complicated urocystitis in intact males 4-6 weeks. In chronic urocystitis and pyelonephritis from 4 weeks.
There are no certain studies that say that all patients ' recovery will take place within the specified time frame. These indicators are average and cannot be applied to every therapeutic case.
At the moment, they are beginning to conduct research using short courses of antibiotics, because in humane medicine this is how cystitis is treated. In women, cystitis is treated for a maximum of 3.5 7 days. While there is no reliable data on the use of antibiotics in small courses.
How to properly monitor therapy?
If the patient with acute uncomplicated cystitis single (the first episode of life) - control is performed by seeding after 7-14 days and after the course of antibiotics.
If a patient with a recurrent infection (chronic, recurrent, complicated) urocystitis, the meaning of control is as follows:
- Sowing 3-5 days after the start of antibiotic therapy
- Sowing 7-10 days after the end of antibiotic therapy
- Sowing every 3 months up to 3 sterile crops
- Sowing every 6 months up to 3 sterile crops