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Canine Bladder Infections: Part II

In the first article of this series you were introduced to the causes of canine bladder infections and their associated symptoms. This article will help you understand how canine bladder infections are accurately diagnosed. The process always begins with testing a urine sample.

Collection of urine samples for testing

If a bladder infection is suspected, testing the urine will be one of the first steps your veterinarian takes. There are a few different ways to collect urine from a dog.

A “free catch” sample involves catching some urine in a container as the dog urinates. The presence of bacteria in a free catch sample is nonspecific, meaning the bacteria might have originated anywhere en route to the collection container, including the bladder, urethra, vulva, prostate gland, and even the hair around the opening of the penis or vulva. In other words, bacteria found in a free catch sample may not be all that meaningful. Other possible downsides to collecting free catch urine samples are a wet hand and suspicious looks from the neighbors.

Urine can also be collected via catheterization. A plastic or rubber catheter is inserted into the end of the urethra and advanced forward into the urinary bladder. Once in the bladder, urine is withdrawn through the catheter. There are a few drawbacks to this sampling method. Most dogs experience some discomfort with the process. Additionally, it is tricky business finding the opening to the urethra in female dogs. And because the catheter comes in contact with the urethra and reproductive structures (vagina, penis, prostate gland) before reaching the bladder, one cannot be certain as to the origin of bacteria found in the urine sample.

The preferred method of urine collection is a technique called cystocentesis. This involves introducing a small needle directly into the urinary bladder. Urine is collected into a syringe attached to the needle. Other than the stress associated with restraint, there is typically no more discomfort for the dog than would be associated with a vaccination. The beauty of a cystocentesis sample is that, if bacteria are detected, one can be certain they were living in the bladder.

Diagnosis of infection

A bladder infection is definitively diagnosed when bacteria are identified within a urine sample that has been collected via cystocentesis. Supporting evidence of infection includes the presence of red blood cells and excessive white blood cells and/or protein within the urine. Keep in mind, these ancillary abnormalities can occur with a variety of urinary tract diseases other than infection.

Bacteria in the urine can be documented by two tests: urinalysis and urine culture. The combination of the two is always ideal. A urinalysis measures urine concentration and pH, screens for red blood cells, white blood cells and protein, and involves viewing the urine sample under the microscope. While this test is relatively reliable, it can produce false negative results particularly if the urine sample sits for several hours prior to testing (certainly the case when samples are sent to a commercial laboratory rather than tested in house). Over time, the bacteria have a way of disappearing from view. Additionally, if the urine sample is dilute (more water than sludge), small numbers of bacteria can readily be missed during the microscopic evaluation.

The gold standard method for documentation of bacterial infection is a urine culture. Urine is inoculated onto agar and incubated for 48 to 72 hours. This way, the growth of bacteria can be documented, and identification and sensitivity testing can be performed. These tests clarify the species of bacteria growing as well as which antibiotics the bugs are sensitive to. This is super important information, particularly when treating dogs with recurrent bladder infections.

Part III of this series will discuss the treatment of bladder infections with special attention given to those dogs who are “repeat offenders”. Please stay tuned!

Nancy Kay D.V.M.
Diplomate, American College of Veterinary Internal Medicine
Author of Speaking for Spot: Be the Advocate Your Dog Needs to Live a Happy, Healthy, Longer Life
Author of Your Dog’s Best Health: A Dozen Reasonable Things to Expect From Your Vet
Website: http://www.speakingforspot.com
Spot’s Blog: http://www.speakingforspot.com/blog
Email: dr.kay@speakingforspot.com
Facebook:http://www.facebook.com/speakingforspot

Written by

Dr. Nancy Kay wanted to become a veterinarian for just about as long as she can remember. Her veterinary degree is from Cornell College of Veterinary Medicine, and she completed her residency training in small animal internal medicine at the University of California-Davis Veterinary School. Dr. Kay is a board certified specialist in the American College of Veterinary Internal Medicine and published in several professional journals and textbooks. She lectures professionally to regional and national audiences, and one of her favorite lecture topics is communication between veterinarians and their clients. Since the release of her book, Speaking for Spot: Be the Advocate Your Dog Needs to Live a Happy, Healthy, Longer Life, Dr. Kay has lectured extensively and written numerous magazine articles on the topic of medical advocacy and veterinarian/client communication. She was a featured guest on the popular National Public Radio show, Fresh Air with Terry Gross. Dr. Kay's newest book is called, Your Dog's Best Health: A Dozen Reasonable Things to Expect From Your Vet. Her award winning blog, "Spot Speaks" is posted weekly (www.speakingforspot.com/blog). Dr. Kay was selected by the American Animal Hospital Association to receive the 2009 Hill’s Animal Welfare and Humane Ethics Award. This award is given annually to a veterinarian or nonveterinarian who has advanced animal welfare through extraordinary service or by furthering humane principles, education, and understanding. Dr. Kay was selected as the 2011 Leo K. Bustad Companion Animal Veterinarian of the Year, an award presented every year by the American Veterinary Medical Association to a veterinarian whose work exemplifies and promotes the human animal bond. Dr. Kay has received several awards from the Dog Writer’s Association of America. Dr. Kay's personal life revolves around her husband (also a veterinarian), her three children (none of whom aspire to be veterinarians) and their menagerie of four-legged family members. When she's not writing, she spends her spare moments in the garden or riding atop her favorite horse. Dr. Kay and her husband reside in Hendersonville, North Carolina.
Comments
  • Joanna de Assis August 19, 2014 at 9:17 AM

    Thank you again for the valuable reading! ;-)

  • Christine August 19, 2014 at 11:09 AM

    I am only familiar with the ‘free catch’ method. Inserting a needle into the bladder seems over the top to me UNLESS that would determine a more specific treatment. If a broad spectrum antibiotic is used in all cases, UTI or bladder, my question would be, what difference does the collection make? Sometimes it seems impossible to collect a urine specimen by free catch but I never had that happen yet so it would still be my choice unless there is a VERY good reason not to go that route.

  • Penny Haynes August 19, 2014 at 12:38 PM

    As a non-conformation person – rather someone involved in companion events – I find your articles some of the most useful in Best of Show.

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