UTI in pets

New Urinary Tract Infection Test Yields Results in Minutes

Diane Weinmann Animal Health, animal hospice , , ,

 

New Urinary Tract Infection Test Yields Results in Minutes

By Dr. Karen Becker

If you’re a regular visitor here and read my Healthy Pets newsletters, you’re probably aware that I have a major issue with the overuse of antibiotics in veterinary medicine. One reason is because like people, pets can develop allergies to medications that are overprescribed. In addition, antibiotics have side effects, many of which are long-term.

Another reason is antibiotic resistance, a rapidly expanding and deadly menace, which is the result of too frequent and unnecessary use of these drugs. In addition, antibiotic residues are passed up the food chain, so even if your veterinarian hasn’t over-prescribed them for your pet, there’s a good chance your animal companion is exposed to them regularly through the food he eats.

Dogs and cats ingest antibiotics when they eat food containing the meat of animals that were factory farmed, which includes about 99% of pet foods on the market today. The exception would be if you’re buying free-range, organic meats and making your own pet food, or if you’re purchasing one of a very small handful of pet foods that contain free-range, organic meats.

The Test You Should Insist on Before Giving Your Pet an Antibiotic

It’s important to understand that viral and fungal infections do not respond to antibiotics. Administering these drugs to treat a non-bacterial infection is a classic example of indiscriminate overuse, and I see it happen entirely too often in veterinary medicine. Veterinarians don’t know exactly what to do with a sneezing or coughing or itchy pet, so they send the owner home with an antibiotic.

That’s why I always urge every pet parent to insist on a bacterial culture and sensitivity test when your dog or cat is suspected of having or is diagnosed with an infection. Before you agree to a course of treatment, if your veterinarian doesn’t suggest it, insist on that test.

A culture is simply a sample from the affected area. It could be a sterile swab dipped in urine, or a swab of infected tissue, skin, or ear discharge. The sample is incubated and monitored for organism growth, which typically starts the following day. When colonies of organisms form, each one is tested to determine what type of bacteria is present.

The sensitivity portion of the test involves placing tiny amounts of different antibiotics on the organisms to see which ones the bacteria are the most sensitive (susceptible) to. The minimum inhibitory concentration, or MIC, is the lowest concentration of antibiotic that prevents visible growth of bacteria, allowing the veterinarian to choose the correct antibiotic and dose to successfully treat your pet’s infection.

The decision-making process must also involve choosing an antibiotic that can be administered by injection, orally or topically for optimum results in the specific area of the body where the infection is located.

If your veterinarian prescribes an antibiotic without a culture and sensitivity test, he or she is making a guess at what type of organism is present and the best antibiotic to treat it — a practice known as empirical prescribing. Although lots of vets are very good guessers, given the growing danger of antibiotic-resistant strains of disease-causing bacteria, in my opinion, there’s no longer any room for error.

Each time an unnecessary or inappropriate antibiotic is prescribed, the potential for resistance increases. A bacterial culture and sensitivity test gives your veterinarian two very important pieces of information: the precise organism causing the infection and the best antibiotic to treat it.

Only in an emergency situation should your veterinarian prescribe an antibiotic before the bacterial culture and sensitivity test can be performed. He or she can then switch medications if necessary when the test results arrive.

A culture and sensitivity test takes a little extra time, usually a minimum of 72 hours, so you should be prepared to leave your veterinarian’s office without a definitive diagnosis of exactly what type of bacteria is growing, and without a prescription. Rest assured the additional time it takes to identify the type of bacteria present and the medication needed will allow precise treatment of your pet’s infection rather than a risky hit-or-miss approach.

A New In-House Culture and Sensitivity Test for Urinary Tract Infections

With all the above said, I was very encouraged to learn recently of a new urine test developed by a company called Test&Treat.1 It’s an in-house test (meaning it can be performed right in your veterinarian’s office) that identifies urinary tract infections (UTIs) in pets and the best antibiotics to treat them. Signs your dog or cat may have a urinary tract infection include:

Suddenly urinating in the house or outside the litterbox Constant licking of urinary openings
Visible blood in the urine or litterbox; dark or cloudy urine Loss of bladder control; urine dribbling
Frequent trips to the litterbox; inability to pass urine or passing very little Vomiting, lethargy, lack of appetite
Straining to urinate; hunched posture; crying out in pain Drinking more water than usual

The “U-treat” test results are produced in minutes, which means veterinarians don’t need to play a medication guessing game while they wait for the results of urine samples that had to be sent to an outside laboratory. It also means your pet can begin receiving the correct therapy right away. According to VetSurgeon.org:2

“In addition, the company says that the test will help support the responsible use of antibiotics, which is particularly important given that Enterococci strains identified in canine urinary infections have been found to be resistant to three or more antimicrobials.”3

The U-treat test has two steps. The first step detects the presence (or absence) of a bacterial urinary infection and takes 5 minutes. The second step tests antibiotic susceptibility, and the results show the best choice of antibiotic as well as those that won’t work due to antimicrobial resistance. Step two takes 45 minutes.

U-treat was evaluated in cats and dogs at the University of Tennessee. According to VetSurgeon.org, the test demonstrated high levels of sensitivity (97.1%) and specificity (92%), compared to lab tests. U-treat is currently validated for use in dogs and cats and is being looked at for use in horses as well. It may also at some point cross over for use in human medicine.

Be Sure to Give Your Pet Antibiotics Exactly as Prescribed

A bacterial culture and sensitivity test will ensure your dog or cat heals more quickly and thoroughly. In addition, giving the proper dose of the antibiotic at the proper intervals and using up the entire prescription is important, even if your pet seems to be fully recovered before the medication has run out.

This will ensure the infection is fully resolved and prevent your pet from having to take another full course of antibiotics because the first one wasn’t finished, and the infection wasn’t effectively cleared.

Also Be Sure to Replenish the Healthy Bacteria in Your Pet’s Gut

It’s important to recognize that antibiotics literally mean “anti-life.” They indiscriminately kill off all bacteria, both the good guys and the bad guys. If your dog or cat has been treated with antibiotics, the trillions of healthy bacteria in her digestive tract have also been destroyed, which can set the stage for additional health problems, such as digestive upsets, intermittent diarrhea, poor food absorption, and dysbiosis (leaky gut syndrome).

It’s important to reseed your pet’s gastrointestinal (GI) system with friendly microorganisms — probiotics — during and after antibiotic therapy to reestablish a healthy balance of gut bacteria. This will also help keep your dog or cat’s digestive system working optimally and her immune system strong.

 

Urinary tract infections

Diane Weinmann Animal Health, animal hospice, healing your pet

Urinary tract infections

By Integrative Vet Care

Urinary tract infections (UTI) are frequently seen in small animal practice. They are estimated to affect up to 5% of all dogs, but are far more common in female and older dogs with diabetes.

Signs of a UTI include difficulty urinating, bloody or cloudy urine, increased urinary frequency along with decreased volume, accidents in the home, strong odor, vomiting, lethargy and increased water consumption. UTIs are caused by bacteria, with Escherichia coli (E.coli) being the most common. Other bacteria implicated in UTIs include Enterococcus, Klebsiella, Staphylococcus pseudintermedius and Pseudomonas.

Antibiotics are commonly prescribed for UTIs, and include cephalosporins, aminoglycosides, tetracyclines, fluoroquinolones and chloramphenicols. This has unfortunately resulted in increased antibiotic resistance among a variety of canine isolates, including E.coli.

Complicating the issue is that many UTI bacteria are present as a biofilm. A biofilm is a community of bacteria surrounded by a protective extracellular polymeric matrix consisting of a variety of compounds, including polysaccharides and glycoproteins. The biofilm matrix provides a physical barrier that protects the bacteria from the effects of antibiotics as well as the host immune system. The matrix is also porous enough to allow for the exchange of fluids and nutrients, resulting in an ideal environment for bacteria to thrive. Several studies have shown that the antibiotic-sensitivity profile of biofilm bacteria is very different than that of non-biofilm (planktonic) bacteria. In fact, biofilm bacteria may be more than 1,000 times more resistant to antibiotics than planktonic bacteria.

Traditional antibiotic culture and sensitivity testing of UTIs involves culturing a urine sample and exposing the resulting bacteria to a variety of antibiotics. A problem with this approach is that these bacteria are not grown as a biofilm. As a result, the test population does not accurately reflect the form of bacteria in the patient, and incorrect antibiotic sensitivity profiles are often obtained. In addition to being ineffective, continued use of the incorrect antibiotic promotes widespread antibiotic-resistance in bacteria.

The BecSCREEN assay has been developed to determine antibiotic-sensitivity profiles specifically for biofilm bacteria. In this assay, the bacteria are first grown as a biofilm and then exposed to a variety of antibiotics and concentrations. The end result is a test that determines the antibiotic sensitivity of the bacteria as it would naturally exist in the UTI. This approach may allow for a more accurate antibiotic sensitivity profile and more effective treatment. Additionally, by treating the infection with the proper antibiotics, the possibility of antibiotic-resistant strains emerging is reduced.

As we learn more about UTIs and the dangers of acquired antibiotic resistance, the need for assays that more accurately test the effectiveness of antibiotics on bacteria as they naturally appear becomes obvious, and provides us with better treatment and improved quality of life for our patients.

 

Extract Rivals Antibiotics in Preventing Urinary Tract Infections

Diane Weinmann Animal Health , , ,

By Dr. Becker and comments by Diane Weinmanndog-peeing

Bacterial urinary tract infections (UTIs) are fairly common in dogs, and similar to humans, females are more often affected. E. coli bacteria is responsible for about half of all canine UTIs.

The development of a urinary tract infection is the result of a change in a dog’s immune defenses that allows pathogenic bacteria to proliferate. This can be the result of a disease process, the dog’s individual anatomy, the use of catheters, and certain drugs.

For example, dogs with diabetes or Cushing’s disease (hyperadrenocorticism), dogs who are treated repeatedly with steroids (e.g., prednisone), and hospitalized dogs who are catheterized have more E. coli-related bacterial UTIs than other dogs.

Unfortunately, adding antibiotics to the mix can further increase the risk, as does the increasing age of the dog.

Risks Associated With Chronic Urinary Tract Infections

Urinary tract infections are treated with antibiotics. For treatment to be successful, it’s important that the appropriate drug is selected (which requires a culture and sensitivity test), and the length of therapy is adequate.

There are many side effects of antibiotic use, including gastrointestinal (GI) symptoms that can lead to the dog’s owner not giving the drug as prescribed, the dog refusing the drug, and/or decreased absorption leading to inadequate levels of antibiotic in the blood or urine.

These issues can interfere with the elimination of the bacteria that is causing the UTI, and can also contribute to antibiotic resistance. When a dog has recurring UTIs, it can be the result of a too-short course of antibiotic therapy, or the inability of the drug to reach the location of the bacteria.

Sometimes, relapses occur very quickly after a course of antibiotics is finished; other times, the infection reappears after some time has passed, in which case it can be mistaken for a new infection.

Antibiotic resistance is a growing problem in both human and veterinary medicine. A 2008 study revealed that bacterial resistance is highest in dogs with recurrent E. coli-related urinary tract infections.1

An earlier study identified E. coli bacteria in two dogs that proved resistant to 12 different antibiotics over the span of two weeks.2

Study Shows Cranberry Extract May Prevent UTIs

Recently, a team of researchers from the College of Veterinary Medicine at National Chung Hsing University in Taiwan conducted a study to determine the effects of cranberry extract on the development of urinary tract infections in dogs.3

They also wanted to measure the adherence of E. coli bacteria to canine kidney cells.

The team studied 12 pet dogs in one experiment, and six additional dogs in a second experiment. In the first experiment, the 12 dogs all had a history of recurrent UTIs (at least three infections in the previous year).

Six of the 12 received an antibiotic for two weeks, while the remaining dogs received cranberry extract for six months. Over the course of the six-month study, none of the 12 dogs developed a UTI.

In the second experiment, six dogs received cranberry extract for 60 days. In urine samples taken at 30 and 60 days, E. coli adhesion to kidney cells was significantly reduced compared to samples taken before the dogs began the extract. The researchers concluded that:

“Oral administration of cranberry extract prevented development of a UTI and prevented E. coli adherence to MDCK [canine kidney] cells, which may indicate it has benefit for preventing UTIs in dogs.”4

Translation: Cranberry extract appears to be as or more effective in preventing E. coli-related urinary tract infections in dogs as short-term antimicrobial treatment — without the side effects. In addition, cranberry extract can help fight multi-drug resistant bacteria in dogs with recurrent E. coli UTIs.

I recommend choosing an organic cranberry extract with D-mannose, which is a simple sugar closely related to glucose that occurs naturally in cranberries, peaches, apples, other berries and some plants.

D-mannose is fully absorbed (but does not prompt an insulin release or rock blood glucose levels, so there’s no negative systemic side effects) and quickly travels to the kidneys, then the bladder, and is excreted in urine.

D-mannose goes to work in your dog’s bladder, where it adheres to E. coli lectins. Almost all the D-mannose winds up in urine, which in turn coats the E. coli bacteria so it can’t stick to the walls of the bladder, and is rinsed out of the body when your dog urinates.

Symptoms of a Urinary Tract Infectiondog-with-urinals

Some signs your dog may have a urinary tract infection include:

✓ Suddenly urinating in the house ✓ Constant licking of urinary openings
✓ Visible blood in the urine; dark or cloudy urine ✓ Loss of bladder control; urine dribbling
✓ Inability to pass urine; passing very little urine ✓ Vomiting, lethargy and lack of appetite
✓ Straining to urinate; crying out in pain ✓ Drinking more water than usual

These are all signals that may indicate a potentially serious issue with your dog’s urinary tract or bladder. It’s important to get your canine companion, along with a urine sample, to your veterinarian as soon as possible. As an animal communicator, I received many calls from clients that desmonstrate these symptoms and behavioral issues that indicate you must take your pet to the vet!

A urinalysis will provide valuable information about why your dog is having urinary problems. In addition to providing information about the presence of blood, protein, glucose, ketones and bilirubin, a urinalysis will also determine how well your dog can concentrate his urine, which is an indicator of kidney health.

The urinalysis will also detect white blood cells, which means there is inflammation or infection, and a urine culture and sensitivity can determine if bacteria is present, and what type, to help devise a treatment plan. If an infection is present, medication will be needed to treat the problem.

However, sometimes pets experience inflammation or crystals without any infection present. In this latter case, a different set of medications may initially be needed, but ultimately, in both situations, this is often a sign that it may be time to change your dog’s diet (more about that shortly).

The Importance of Urine pH in Urinary Tract Health

Dogs are carnivores and should have a slightly acidic urine pH of between 6 and 6.5. (The higher the urine pH, the more alkaline it is.) Vegetarian mammals like rabbits and horses naturally have a very alkaline urine pH (above 8.0). Human urine is slightly more alkaline (between 6.5 and 7), and many pet owners wrongly assume their dog’s body functions in the same manner as their own.

It’s important to keep your healthy dog’s urine pH slightly acidic (below 7), because urine maintains its natural defenses when kept in the appropriate 6 to 6.5 range. When the pH creeps up toward the alkaline side, the urine loses its natural defenses and creates a more hospitable environment for bacterial growth and the development of struvite crystals.

The flip side of the coin is a urine pH below 6, which can cause your dog to develop a different type of problem — calcium oxalate stones. If your dog has had one or more infections or other problems with the urinary tract, I recommend buying pH strips from your veterinarian or at the local drug store, to check her urine pH at home so you know when it’s in or outside the desired range.

You should collect urine samples in the morning before you feed your dog. You can either hold the pH tape in the stream of urine while your dog is voiding, or you can catch a urine sample in a container and dip the tape into the sample to check the pH. This should be done immediately with a fresh sample to insure accuracy.

The Right Diet for a Healthy Urinary Tract

In my experience, poor or improper diet is the culprit in the vast majority of cases of dogs with chronic urinary tract problems. A prescription diet, which many conventional veterinarians recommend, typically combines high-carb foods with medications to lower your dog’s urine pH. This is never my approach. Instead, I transition dogs to a diet that does not contain pro-inflammatory alkalizing carbohydrates.

When we feed carnivores a cereal-based diet, their urine becomes alkaline as a result. Meat-based diets are naturally acidic, whereas alkalizing starch-based diets are frequently the cause of chronic UTIs, because lack of acidity removes the antimicrobial activity in urine.

Alkaline urine can also create cystitis (irritation of the lining of the bladder), crystals, and even uroliths, or stones, that require surgery.

Often, a dog’s urine pH can be maintained naturally between 6 and 6.5 by feeding a species-appropriate diet. To reduce urine pH, you must feed a low-carb, starch-free, potato/tapioca/lentil-free (so no “grain free” dry foods), and preferably fresh or at least canned food diet for the increased moisture content.

There are products on the market to reduce urine pH that contain the acidifying amino acid DL-methionine. This is a safe addition to your dog’s diet, but a more logical approach is to simply stop feeding grains and alkalizing foods.

dog-on-toliet