# Urinary Tract Infections...



## Andres Martin (May 19, 2006)

Due to the hmmmm...not so great...vet services available here, I need some advice from you guys in the know...

My dog (high performance, 22 mo. old, male Dutchie) has had three urinary tract infections in a row. The first one was treated with Amoxicilina (in Spanish), the second with Cefalexina, and the third with a product called Baytril. The infections cede, the ganglions in the neck area at the base of the jaw (which become inflamed, for some reason) reduce in size, the dog stops looking at his "netherlands", and everything is fine. After a few days, though, the symptoms begin again. I have some bloodwork from fifteen days ago, and I'll get new bloodwork today from a different lab. I'll post both sets later. Ditto with urine analysis results. My dog does not drink much water...I don't know why.

He eats raw, 10 chicken necks at night, two of them with the fat left on; and in the morning, two cups of a 60% by weight somewhat leanish chicken burger, 40% fruit, yogurt and veggie mix, with some chicken liver, and supplemented with two salmon oil caps per day, 400 mg Vit E every other day, and 1000 mg Vit C every other day.

Any advice will be e-appreciated!!!


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## Greg Long (Mar 27, 2006)

He may need to be on the antibiotics longer than prescribed.The Baytril should be the strongest for that type of infection.Amoxicilan is just Pennicilan(I probably spelled it wrong) and in my experience you have to keep them on it longer,up to 14 days I think, but it should also do the job.


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## Connie Sutherland (Mar 27, 2006)

Total aside about the feeding plan mentioned: salmon oil caps come in many sizes. A good rule of thumb (rather than a certain number of capsules) might be around 1/2 gram per ten pounds, up to 1 gram per ten pounds of dog weight (which is what I give).

Greg's point about the med regimen is well-said. 

I would do a second urinalysis after the protocol, when all appears well, to make sure the antibiotic is not just killing off one bacteria and leaving another one free range to multiply and re-infect.

BTW, more water to dilute the urine is a very good thing. I'd add water to the food dish, or give meat-poaching water, or whatever it took to increase fluids for that dog. He gets water in his good fresh diet, I know, but more is better with recurring UTIs.

JMO.

I'll look up saved UTI files and see if there's more I can post tonight. I remember reading about a chemotherapeutic agent for urinary tract infections caused by multiresistant E. coli. I'll dig that out.


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## Connie Sutherland (Mar 27, 2006)

OK, here are a couple of links. The first one 
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=3515744&dopt=Abstract
briefly discusses pipemidic acid, which is used against antibiotic-resistant recurring UTIs. Since this article was published, I see that the use of pipemidic acid has become generally accepted.

But preferred choices are clearly listed:

QUOTE: Antibiotics for treating urinary tract infection due to Escherichia coli, Klebsiella species, Staphylococcus aureus and Proteus species should include Cephradine, Ofloxacin, Cefaclor, Cephalothin and Pipemidic acid.

However, for treating UTI due to Pseudomonas species, the drug of choice must be a member of fluoroquinoline group (norfloxacin, ofloxacin and ciprofloxacin). END

At this site,
http://www.vin.com/VINDBPub/SearchPB/Proceedings/PR05000/PR00440.htm
there is a very good explanation of what underlying conditions can trigger recurring UTIs, as well as the antibiotic treatments that are preferred (in order of escalation and noting what ones should be reserved for certain conditions). It's from 2001, but it's the clearest and best I found and I didn't see anything later that contradicted anything here.

If you scroll down to "Therapeutic Failures," you'll find a couple of paragraphs that I would print out and carry with me to the vet when you go next.

Above that part are kidney warnings that will give you the language to ask the vet whether s/he's also looking for Pyelonephritis in the urinalysis.

I wish I knew more. All I really feel secure about saying after a couple of evenings' reading is that it's vital to hydrate the dog, encouraging water intake in whatever way is most effective (which I imagine is meat-poaching water and water added to the food dish), that the cleanest possible catch for the urinalysis is of utmost importance for diagnosis of recurring UTIs, and that you probably have to be a big part in the management of the antibiotic choices.

You couldn't get him to a teaching vet hospital at the first sign of a new infection, could you?

I'm still reading, though!

This quote from the second link is probably something to bring up with the vet, but maybe I would be worried that s/he might resort to it without ruling out underlying causes first:
QUOTE: If infections respond to therapy but reoccur frequently, and no predisposing cause can be found, they may sometimes be prevented (after cure) with prophylactic low-dose antibiotics. Typically 1/3 of the usual daily dose of a broad-spectrum antibiotic is given at bedtime. END


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## Connie Sutherland (Mar 27, 2006)

I forgot to mention that (1) enrofloxacin (Baytril) isn't on the preferred lists of some multinational orgs apparently because it's not available in all countries and because the recommended dosages in the countries where it IS available vary. So its exclusion on the sample list above may be related to that.

(2) In every article where diet is mentioned, the stress is on fresh foods with water content intact to support hydration. Kidney function and the dilution of the urine both rely on good hydration. IMO, the diet you're giving is excellent. I hope you can encourage more water intake.


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## Anne Jones (Mar 27, 2006)

My male had a UTI & in addition to natural treatment (holistic vet) which consisted of a couple of supplements, he told me to give him additional Vitamin C. I was giving 500 mg a day & he told me to increase it (I did gradually over a couple of days) to 1500 mg in the am & 1000mg in the evening due to elevated levels in his urine. I also was told to get him to drink as much as possible to flush the delute the urine. The vitamin C needed to be the non buffered only C type. He never had another problem after this. This might help your dog also. BTW I eventually decreased the Vit C to 1000 mg daily with no adverse effects.


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## Don Turnipseed (Oct 8, 2006)

I am just going through checking out different topics that have gone by since I am new but, I have a question. Do you crate your dog for lengthy periods? I have had a couple of young pups that the vet could not know the infection down in. The result was stronger and stronger antibiotics being administered along with the vet telling the people it could possibly have to do with the breeding. After having the people give me a step by step breakdown of what they were doing for a 24 hour period, I realized they were still keeping the pups crated all night and they didn't cry so they didn't take them out. Many dogs will almost die before peeing in their crate. Peeing is what flushes the system and keeps it clean. They fixed an enclosures on the patio and the infections cleared right up. Some dogs cannot handle extended, consistent periods in a crate and it is extremely difficult to clear these infections up while they are being crated. I only mention this because no one asked why the dog may be having a persistent problem. Meds is one reason but this may have something to do with it also. To clear up infections the dog has to pee whenever it gets the urge.


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## Connie Sutherland (Mar 27, 2006)

Yes, lots of free drinking water and free peeing is vital both to dilute the urine and then to flush it, flushing bacteria away with it.

That's a really good point, Don.


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## Connie Sutherland (Mar 27, 2006)

Hi, Andres,

Recurring UTIs came up this week in a canine nutrition class. I want to post a few recommendations that were given by the DVM teaching the class:

1. Bladder stones can trigger recurring UTIs, so it's a pretty good idea to mention to the treating vet how many UTIs there have been and to ask whether s/he recommends (1) x-rays (2) ultrasonography.

2. Urine cultures can determine which bacteria is growing. (Some are resistant to Baytril, even though it'e now generally considered one of the better UTI choices.)

3. 4-6 weeks of antibiotic therapy is recommended in cases of persistent UTIs. To ensure that the antibiotic is working, a culture should be done mid-treatment and then again when off the antibiotics. (This is often not done; the patient is sent off with the RX and that's it.)

4. Cranberry does keep bacteria from adhering to the bladder wall, just like the old recommendations claim, in dogs as well as humans, and it makes the urine slightly more acidic, which also helps. Some also recommend Vitamin C at 10 mg per pound of dog weight to further reduce the urine's pH.

Apparently dogs don't usually drink cranberry juice readily, but you can get extract in capsules.

Anne and Greg already mentioned the Vitamin C and the extended antibiotic protocol, of course; this just affirms what they each said.


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## Bob Scott (Mar 30, 2006)

I just read something on the web (so it must be true  ) about taking Alka Seltzer for UTIs. (for people)
Alka Seltzer goes great with Oreo cookies.


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