Inflammation of the genitourinary system in dogs treatment. Problems of the reproductive system of males
Bacterial urinary tract infection - colonization of sterile parts of the urinary tract (kidneys, ureters, bladder, proximal urethra) by bacteria. The term urinary tract infection most often refers to a bacterial infection, due to the fact that infection with fungal organisms and chlamydia is extremely rare, and a viral infection has not been definitively identified as the cause of urinary tract damage.
Bacterial cystitis is a term to describe a bacterial infection of the lower urinary tract, since the bladder is primarily involved in this disorder. Cystourethritis may be a better term due to the likelihood of urethral involvement.
Etiology and pathogenesis.
In healthy animals, the urinary tract is sterile from the proximal urethra. Urinary tract infection occurs through four main mechanisms: ascending infection, hematogenous and iatrogenic moles, and local infection secondary to pyometra. In the vast majority of cases, the disease develops when the pathogen ascends in violation of one or another link of natural protection. Below is a brief description of the main natural defense mechanisms of cats and dogs.
Table. Normal defense mechanism of the urinary tract
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Normal flora of the distal urethra, vagina and prepuce - occupies epithelial receptors, absorbs micronutrients preventing the colonization of pathogenic bacteria. |
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Composition of urine |
The bactericidal or bacteriostatic effect is exerted by factors such as high urea and ammonia content, high osmolarity and high acidity. |
|
Urination |
Timely and complete emptying of the bladder leads to hydrokinetic flushing of bacteria. |
|
Bladder |
The glycosaminoglycan layer of the uroepithelium inhibits bacterial adhesion (anti-adhesive properties). |
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Ureters |
The flow of urine from the kidneys prevents the infection from ascending, but bacteria can ascend through Brownian motion against the flow of urine. |
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The inherent protective properties of the epithelium of the renal pelvis reduce the likelihood of colonization. |
Anatomical and functional abnormalities predisposing or supporting urinary tract infection:
Bladder atony (high residual volume of urine).
Congenital anomalies of the bladder (eg duplication and location of the bladder in the pelvic cavity, persistent urinary duct, diverticulum and urachus cysts, periurachal microabscesses).
Urethral sphincter insufficiency with urinary incontinence.
Stricture and fistula of the urethra.
Deep cystitis with chronic changes in the bladder wall (polypoid, emphysematous and encrusting cystitis).
Anomalies of the ureters (eg ectopia, urethrocele).
Metritis or pyometra.
Neoplasia of the bladder or urethra.
Urachus anomalies.
Anomalies in the structure of the vulva and vagina.
Prostatitis.
Urolithiasis as well as small urinary stones left after surgery.
Hyperplasia of the clitoris.
Possible initiating or maintaining iatrogenic factors:
Catheterization and prolonged stay of the catheter.
Perineal urethrostomy.
Inappropriate suture material for bladder surgery.
Various conditions predisposing to urinary tract infection:
Endocrine diseases (, hyperthyroidism)
Immunosuppression of various origins, including when prescribing corticosteroids and chemotherapy drugs.
Chronic renal failure (in cats, infection develops in about 30% of cases)
Mucosal defense anomalies.
In urinary tract infections, the following pathogens are more often identified:
Escherichia coli:(40%–50%)
Staphylococcus spp.
Proteus spp.
Streptococcus spp.
Enterobacter spp.
Bacterial infection causes secondary inflammation of the bladder mucosa, but more often the course of the disease remains asymptomatic. Possible complications of the disease include the following:
Chronic kidney disease.
(especially canine struvite urolithiasis secondary to urease-positive bacteria)
Prostatitis.
Discospondylitis.
Sepsis (especially after immunosuppressive therapy).
Orchitis.
Infertility (both sexes).
Recurrent immune-mediated uveitis (dogs).
Immune-mediated polyarthritis
Clinical signs
Incidence
In dogs, this is the most common infection, with about 10% of hospitalized animals for various reasons having an asymptomatic urinary tract infection. A significant sexual predisposition to the disease is observed in bitches. The median age of disease onset is 7 years, but infection can occur at any age.
In cats, the incidence is much less common, with an age predisposition in middle-aged and older animals. In most cases, the disease develops as a consequence of a change in the specific gravity of urine in chronic kidney disease, or after perineal urethrostomy or catheterization.
Medical history
In most cases, there is an asymptomatic course and the disease is identified in the study of urine. Signs such as dysuria, hematuria, pollakiuria, and stranguria may serve as a likely reason for referral. The development of systemic manifestations is likely only with infection of the upper urinary tract.
Physical examination data
Probable signs include pain on palpation of the bladder and thickening of its walls and changes in the prostate during rectal examination. But most often there are no physical abnormalities.
Diagnosis
The presumptive diagnosis is clinical signs of dysuria and hematuria, the final diagnosis is the identification of bacteria in a urine smear and culture.
Urine sampling for analysis is carried out exclusively by cystocentesis. A urinalysis is not very informative, and likely changes include hematuria, pyuria, proteinuria, and bacteriuria. With pyelonephritis, the identification of erythrocyte and granular casts is likely. Microscopy of urine sediment to identify bacteria produces both false positive and false negative results. The test strips for counting leukocytes in cats and dogs are not informative. Changes in urine pH are also of little diagnostic value; persistently alkaline urine may support infection with urease-positive bacteria (ex. Staphylococcus aureus and Proteus spp.).
Urine culture is the "gold standard" for diagnosing lower urinary tract infections, using this method to determine both the type of microorganism and its sensitivity to antibiotics.
Cytological examination of urine correlates well with the results of a cultural study. For research, a drop of fresh urine is applied to the slide without forming a smear with drying and subsequent Gram staining. The assessment is carried out under magnification x 1000 (immersion), visualization of 2 or more bacteria in one field of view is typical for urinary tract infection. The method has significant sensitivity and specificity.
The use of a modified coloration of the urine sediment with Wright's dye is also likely. To do this, a drop of urinary sediment is applied to a glass slide and dried without forming a smear and then stained. The study is carried out at a magnification of 1000 (immersion), 20 fields of view are evaluated and are divided into the following categories: absent, rare (1-4), little (5-9), pronounced (10-20), many (> 20).
Diagnostic imaging is performed to identify various initiating and maintaining diseases. Probably the use of ultrasound, cystoscopy, plain and contrast radiography.
Differential Diagnosis
Urinary incontinence.
Other causes of cystitis (eg, neoplasms,).
Neurological lesions of the bladder.
behavioral problems.
Treatment
The basis of treatment is antibiotic therapy in conjunction with the correction of predisposing and supporting factors (if possible).
Therapeutic approach
The first step is to distinguish between complicated and uncomplicated infections.
Uncomplicated infection:
History of one or two episodes per year or initial treatment.
No immunosuppression.
Absence of underlying anatomical, metabolic, or functional abnormalities (predisposing or supporting).
Lack of antibiotic therapy for the last 1-2 months.
Complicated infection:
Defects in the body's natural defense system, including anatomical ones.
Mucosal injury due to urolithiasis or neoplasia.
Violation of the volume or composition of urine.
Systemic diseases (eg, hyperadrenocorticism, neoplasia).
Long-term treatment with corticosteroids.
Functional defect with incomplete emptying of the bladder.
Then, a distinction should be made between relapse and re-infection based on the results of a urinalysis. Relapse develops within a short period of time after the end of therapy, usually indicating a remaining deep-seated infection (eg, kidney, prostate, or urinary wall thickening) or complication by other factors (eg, uroliths, polypoid cystitis, remnants of the urachus).
Antibacterial therapy
Ideally, antibiotic selection is based on culture, but the fact that most animals respond adequately to routine therapy in uncomplicated cases should be taken into account. The concentration of an antibacterial drug in the urine is the most important factor in eliminating the infection, with significantly diluted urine, the concentration of the antibiotic may decrease.
First choice antibiotics are given in uncomplicated cases or while waiting for culture results. Second-choice antibiotics for resistant infection and based on culture results.
In most cases, infection is adequately treated with oral penicillins (preferably in combination with clavulonic acid), trimethoprim-sulfonamides, or first-generation cephalosporins (cephalexin or cefadroxil). Fluoroquinolones and others are more commonly used in cases of resistance.
In uncomplicated cases, the duration of antibiotic therapy is 14-21 days, 3-7 days after the end, a culture study is performed to confirm the success of the treatment. If the culture is positive, an appropriate antibiotic is used for a longer period of time.
In complicated or recurrent cases, the duration of antibiotic therapy is about 3-4 weeks, a culture study is carried out after 5-7 days from the start of therapy for identification. in vivo sensitivity to the selected antibiotic. Repeat culture 7 days after stopping antibiotic therapy to confirm the effectiveness of the treatment. If the culture is positive, different antibiotics are used based on subtitration or the same antibiotics over a longer period of time.
With frequent re-infection, the use of long-term low-dose therapy is likely - 33%-50% of the recommended dose of antibiotic, 1 time per day at night (increased contact with the urinary tract).
Table. Antibiotics used to treat urinary tract infections.
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A drug |
Dose |
Path |
multiplicity |
Average concentration |
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First choice antibiotics |
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Ampicillin |
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Amoxicillin |
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trimethoprim-sulfonamide |
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Cefalexin |
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Second choice antibiotics |
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Chloramphenicol |
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Nitrofurantoin |
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Gentamicin |
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Amikacin |
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Enrofloxacin |
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Tetracycline |
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Diet
With persistently alkaline urine, an acidifying diet is likely to be beneficial. Increasing water intake (ex. canned food) increases urine production and hydrokinetic flushing.
Monitoring
In animals with predisposing factors, a urine culture is performed every 3-4 months, regardless of clinical manifestations. In case of recurrent infection, periodic monitoring is carried out for the formation of cystoliths and pyelonephritis (radiography, ultrasound, urinalysis).
AT Alery Shubin, veterinarian, Balakovo.
Problems with the genitourinary system are a fairly common occurrence in pets. As a rule, they develop under the influence of two negative factors: these are either bacterial infections or bladder stones. If the animal has at least one of these pathologies, urocystitis is possible - in dogs it is severe and often leads to serious consequences.
So called combined inflammation of the bladder and urethra. The latter is the duct through which urine passes from the bladder to the urethra, located at the end of the penis in males and on the eve of the vagina in females. It happens (according to the nature of the inflammatory process) of the following types:
- catarrhal urocystitis. With this type of pathological process, abundant desquamation of the epithelial layer occurs, followed by the formation of a thick, viscous and translucent secret (catarrh).
- Purulent urocystitis. Everything is clear here - the process of inflammation is provoked by the penetration of pyogenic microflora into the organs of the genitourinary system. It proceeds hard, the disease is accompanied by a significant deterioration in the general well-being of the animal.
- Diphtheritic urocystitis. Even more severe pathology. It is accompanied by the appearance of fibrinous films on the mucous membrane of the bladder and urethra. This type of inflammation develops only in the case of particularly severe bacterial and viral infections. May lead to death.
- Phlegmonous urocystitis. Accompanied by purulent inflammation in the thickness of the bladder wall. As in the previous case, this variant of inflammation is possible only with a severe course of bacterial and viral infections. Again, the process is also extremely dangerous, can lead to death from sepsis and severe intoxication.
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In addition, according to the nature of the flow The disease is divided into two main types: acute and chronic urocystitis. As a rule, the pathology proceeds according to the acute type, the chronic course is much less common.
Major predisposing factors
In more than 90% of cases, the root cause is the same - the penetration of pathogenic microflora into the organs of the urinary system. This can happen in two scenarios. Either the bacteria ascend from the urethra (ascending type) or descend directly from the kidneys (descending type). Often, the disease is the result of careless catheterization of the bladder, when, due to the negligence of a specialist, the delicate mucous membrane of the urethra is damaged. But the causes of this disease are much more diverse.
Very often, urocystitis (especially in older animals) is due to the development of urolithiasis in them. Uroliths (that is, stones that appeared due to the deposition of salts) are not too similar to billiard balls: their sharp edges severely damage the mucous membranes of the organs of the urinary system, against which an inflammatory reaction develops. Often, an inflammatory reaction is a natural response of the body to the excretion of some toxic substances by the kidneys. In particular, urocystitis may well develop against the background of poisoning dogs with salts of heavy metals or some drugs that the animal can eat due to an oversight of its owners.
Extremely dangerous injuries, including postoperative. In particular, unsuccessful fusion of the bladder after surgery can lead to cicatricial contraction of the entire organ. This will cause stasis of urine, which in turn will lead to inflammation of both the bladder itself and the urethra. Very predisposes to inflammation of the organs of the genitourinary system, local or general. In particular, urocystitis is an “occupational” disease of service and hunting dogs, which are often forced to bathe in any weather, spending a long time outdoors.
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What microorganisms most often lead to inflammation of the bladder and urethra? The main "heroes of the occasion" are: staphylococci, streptococci, as well as Pseudomonas aeruginosa. The latter is one of the most dangerous pathogens of purulent processes, since this microorganism is extremely resistant to the action of many antibacterial drugs of the latest generation.
Fortunately, inflammation of the bladder and urethra is rarely generalized. More often, only relatively small areas of the mucous membrane are affected, which greatly facilitates therapy. The easiest way to determine the presence of urocystitis is by urinalysis, since blood appears in the latter, epithelial cells in inadequate quantities, microorganisms. As a rule, in 90% of cases of inflammation of the bladder, the frequency of urination increases dramatically (due to constant irritation of the mucous membrane of this organ), and the volume of urine excreted decreases. In severe cases, the general well-being of the sick animal noticeably worsens, and intermittent fever may develop.
Clinical picture of the disease and diagnosis
Symptoms depend on the type of disease. When the disease proceeds according to an acute scenario, the dog becomes lethargic, it is depressed, a feverish state may develop, the act of urination becomes painful, blood often appears in the urine. An experienced specialist with palpation can feel an increase in the bladder, as well as a thickening of the walls of the urethra, which is due to the infiltration of lymphocytes into the thickness of their tissues. It is useful to collect all the urine excreted by the animal per day: if its amount is reduced, this indicates serious damage to the kidneys. In all cases, a general urine test is performed. If inflammation is present, under a microscope one can easily see a huge number of "fallen off" epithelial cells, as well as the smallest crystals of uroliths, "casts" of the renal tubules.
Diseases of the genitourinary system stones of the bladder and urethral canal (Calculi vesicourinarius et urethrales) are observed mainly in old obese dogs (mainly in males, less often in bitches). In the bladder, several stones of various sizes are usually recorded, but sand is more common. In the urethral canal, stones, as a rule, are localized behind the bone of the penis, since, due to the impossibility of expanding the urethral canal, stones of significant size do not pass in this area.
Etiology. The main reasons for the formation of stones are considered to be metabolic disorders, which lead to an increase in the concentration of salts in the urine. Contribute to their formation catarrh of the bladder, limited movement, arteriosclerosis.
Clinical signs are manifested by difficulty urinating, excretion of urine in drops, the appearance of blood at the end of urination. Palpation of the bladder through the abdominal wall reveals its overflow with urine. When a stone gets stuck in the urethral canal, it can be detected by palpation after the penis has been brought out. The location of the stone is also determined by catheterization. The catheter can only be advanced to the stone.
If urine is retained for more than four days, the bladder ruptures and the animal dies from uremia. The most accurate diagnosis is established by x-ray examination, which establishes the localization, size and shape of the stones.
The prognosis can be favorable with timely medical care.
Dog treatment. Operative removal of stones. If they are present in the bladder, the latter is opened (cystotomy). This operation is performed with the animal in the dorsal position after preliminary neuroleptanalgesia. In males, prompt access to the bladder is carried out in front of the pubic fusion on the side of the prepuce at a distance of 1 cm, bypassing the rectus abdominis muscle.
The skin and deeper tissues up to 8-10 cm long are dissected in layers. In females, the dissection of tissues is carried out parallel to the white line, departing from it 0.5-1 cm. After opening the pelvic cavity with a finger brought under the bladder, lift it above the level of the wound, isolate from the latter with gauze pads and aspirate urine with a syringe.
Then, the bladder is fixed in front and behind the proposed incision with the help of ligatures-holders, without calcining the mucous membrane. Its wall is opened with a scalpel with a cut length that allows you to remove stones with a finger or forceps. The sand is removed with a special spoon. To establish the patency of the urogenital canal in males, a catheter is inserted into its end part and a 0.25% solution of novocaine is passed through it.
The bladder wound is sutured with a two-story serous-muscular suture. The wound of the abdominal wall with a three-story serous-muscular suture. The wound of the abdominal wall - with a three-story suture in layers: first with continuous sutures of the peritoneum from the inside of the sheath of the rectus abdominis muscle, then its outer plate (with the capture of the rectus abdominis muscle) and then with an interrupted interrupted suture of the skin.
When the stone is localized in the urethral canal, it is opened - urethrotomy. The urethral canal is opened along the white line behind the bone of the penis, focusing on the position of the previously inserted metal probe. The length of the incision is 2-3 cm. The stone is removed using anatomical tweezers or a blunt spoon, after which a significant amount of bloody urine is released from the canal. The operation is completed by lubricating the edges of the wound with antiseptic ointment; the wound is usually not sewn up, its healing occurs in 12-15 days.
Inflammation of the prepuce in dogs
Inflammation of the prepuce (Posthitis) is a consequence of irritation of the inner leaf of the prepuce during coitus, accumulated in the preputial sac of smegma, which decomposes under the action of urine, and microflora. The disease proceeds chronically and is accompanied by discharge from the prepuce of a liquid, gray, greenish-yellow purulent fluid of a mucous consistency. There is an increase in temperature and swelling of the prepuce, soreness, difficulty urinating.
The incidence of urinary tract infection (UTI) in dogs with diabetes mellitus (DM) and hyperadrenocorticism (HAK) is much higher than in other dogs. Only 15% of dogs without endocrine disorders develop UTI compared to 40-50% of dogs with DM and HAC. The morbidity rate in dogs chronically prescribed glucocorticoids is also 50%.
The pathogenesis of urinary tract infection
It is very difficult for healthy animals to get UTI due to the normal functioning of the urinary tract defense mechanisms. With the exception of the distal urethra, the urinary tract of healthy dogs remains sterile. Microorganisms that inhabit the lower genital tract and distal urethra prevent UTIs by inhibiting the attachment and growth of pathogenic bacteria. Frequent and complete urination physically removes bacteria from the urinary tract. Anatomical factors that cause one-way urine flow and prevent UTI penetration are ureteral motility, vesicoureteral valves, prostate secretions, urothelial surface properties, urethral length, urethral peristalsis, and urethral sphincter contraction. The properties of the mucous membrane, which produces antibodies and has its own antibacterial properties, and the surface layer of glycosaminoglycans also prevent the proliferation of bacteria in the urinary tract. Urine has its own antibacterial properties - very acidic or alkaline urine pH, hyperosmolality and high concentration of urea. Finally, systemic humoral and cellular immunity also protect healthy animals from UTIs.
Most UTIs are the result of bacteria entering the distal genitourinary tract and establishing themselves in the urethra or bladder, and possibly also in the ureters and kidneys. The bacteria that cause UTIs are the same bacteria that colonize the distal urogenital tract and perineum in healthy dogs. Any disorder that interferes with normal defense mechanisms and causes urinary tract dysfunction (low-density urine production or the presence of stones) predisposes the animal to UTI. Bitches are more likely to get UTIs, possibly because their urethra is shorter and they don't have prostate secretions.
Several mechanisms appear to predispose dogs with DM and HAC to UTIs. Both endocrine disorders cause polyuria and decreased urinary osmolality, which may increase the likelihood of UTIs. Excessive cortisol production in dogs with HAC may cause immunosuppression or a decrease in the normal inflammatory response to infection. Also, dogs with spontaneous OAC that have been treated with prednisone for a long time often develop UTIs. Glucosuria in diabetes can cause neutrophil dysfunction, which in fact predisposes to infections, including those of the urinary tract.
UTIs in dogs with DM and HAC are caused by the same organisms as in healthy dogs. Escherichia coli isolated in 65% of dogs, other isolated microorganisms are species Klebsiella(15%), kinds Streptococcus(7%), kinds Enterobacter(7%), kinds Staphylococcus(7%), kinds Enterococcus(7%) and types Proteus(7%). Approximately 80% of dogs with UTI, DM, and HAC are infected with one microorganism, and 20% with two or more organisms.
Clinical symptoms
Most dogs with UTIs, DM, or HAC are older dogs with an average age of 9 years. Miniature Schnauzers, Cocker Spaniels, and Poodles are predisposed to UTIs, while Golden Retrievers, Labrador Retrievers, and Métis are less prone to UTIs.
The clinical symptoms of UTIs are stranguria, dysuria, hematuria, and pollakiuria and are seen in less than 10% of dogs with DM and HAC. This may be due to the anti-inflammatory effects of excess cortisol in dogs with HAC. This is also due to the fact that owners are more likely to notice polyuria, which is common in dogs with DM and HAC. The absence of stranguria, dysuria, and pollakiuria in dogs with DM and HAC is indicative of kidney and ureteral infection, which may or may not be symptomatic of a urinary tract infection. General examination findings are typical of dogs with DM and HAC—cataract, skin lesions (pyoderma, skin thinning, alopecia, skin calcification), hepatomegaly, and abdominal enlargement.
Diagnostic assessment
The results of routine laboratory tests are characteristic of DM and HAC - stress leukogram, hyperglycemia, elevated liver enzymes, hypercholesterolemia and glycosuria. The specific gravity of urine varies, but most dogs have less than 1.020. The pH of urine is normal - 6-7. Proteinuria occurs in two-thirds of dogs with DM and HAC, whether they have a UTI or not. Urinary sediment analysis reveals hematuria in 45%, pyuria in 60%, and bacteriuria in 65% of dogs with UTI, DM, and HAC. Therefore, even with good urine sediment results, a UTI cannot be ruled out.
Because of the incidence of UTIs in dogs with DM and HAC and their lack of symptoms, urine cultures should be done in any case. Urine collected by cystocentesis should be sent for bacterial culture per mL of urine because low bacterial counts (less than 100 CFU/mL) may show contamination during specimen collection and transport. However, if an animal with a UTI received antibiotics 3-7 days prior to urinalysis, the number of bacteria may be less than expected. Urine culture results should be interpreted according to clinical symptoms and urinary sediment findings. Animals with stranguria, pollakiuria, pyuria, bacteriuria, or hematuria and few bacteria on culture are likely to have a UTI.
Treatment
If a significant growth of bacteria is detected during sowing, treatment with antibiotics is indicated. Since in animals with DM and HAC UTI will be complicated and may interfere with the treatment of endocrine disorders, the choice of antibiotics should be based on the results of urine culture and antibiotic susceptibility testing. Antibiotics that are most effective against bacteria that cause UTIs can be given while waiting for culture results (Table 1).
| Table 1. Antibiotics for the treatment of urinary tract infection in dogs with hyperadrenocorticism and flaccid dyspnea, or both. Information based on minimum inhibitory concentration | ||
|---|---|---|
| Microorganism | Recommended drugs | Alternative drugs |
| Escherichia coli | trimethoprim sulfa Amoxicillin-clavulanic acid |
Nitrofurantoin Chloramphenicol |
| species of Klebsiella | Enrofloxacin or norfloxacin trimethoprim sulfa Cephalexin or cefadroxil |
Amoxicillin-clavulanic acid |
| Streptococcus species | Ampicillin or amoxicillin Amoxicillin-clavulanic acid Erythromycin | Cephalexin or Cefadroxil Chloramphenicol |
| Staphylococcus species | Ampicillin or amoxicillin Cephalexin or cefadroxil Erythromycin |
trimethoprim sulfa Chloramphenicol |
| Enterobacter species | Enrofloxacin or norfloxacin | trimethoprim sulfa |
| Enterococcus species | Enrofloxacin or norfloxacin trimethoprim sulfa |
Chloramphenicol Tetracycline |
| Proteus species | Ampicillin or amoxicillin Enrofloxacin or norfloxacin |
Amoxicillin-clavulanic acid Cephalexin or cefadroxil |
If the animal has not received antibiotics, the susceptibility of most bacteria that cause UTIs will be predictable. However, variations are possible with long-term treatment of UTIs in animals with DM and HAC.
For each animal, the choice of the appropriate antibiotic should be based on several factors. First, at the minimum inhibitory concentration (MIC) of the pathogenic organism by the drug in the urine. The effective antibiotic will be the one whose concentration in the urine will be four times the MIC (table 2).
| Table 2. Rules for antibiotic treatment of urinary tract infections in dogs | ||
|---|---|---|
| A drug | MIC | Dosage |
| Ampicillin Amoxicillin Amoxicillin-clavulanic acid Cefadroxil Cefalexin Chloramphenicol Enrofloxacin Nitrofurantoin Tetracycline trimethoprim sulfa |
Not less than 64 mcg/ml Not less than 32 mcg/ml Not less than 32 mcg/ml Not less than 32 mcg/ml Not less than 32 mcg/ml Not less than 16 mcg/ml Not less than 8 mcg/ml Not less than 16 mcg/ml Not less than 32 mcg/ml At least 2 mcg/ml (at least 16 mcg/ml |
25 mg/kg po every 8 hours 11 mg/kg po every 8 hours 16.5 mg/kg po every 8 hours 10-20 mg/kg po every 8 hours 30-40 mg/kg po every 8 hours 33 mg/kg po every 8 hours 2.5 mg/kg po every 12 hours 5 mg/kg po every 8 hours 18 mg/kg po every 8 hours 15 mg/kg po every 12 hours |
Although quinolones, including enrofloxacin (Baytril, Haver) and norfloxacin (Noroxin, Merck), are effective for most UTIs, they should not be given empirically because they can selectively grow resistant organisms for which there are no antibiotics. In the case of a polybacterial infection, an antibiotic that is effective against all bacteria should be chosen. If this is not possible, each type of bacteria should be dealt with sequentially rather than a combination of antibiotics. Despite the fact that bacteriostatic drugs (chloramphenicol, nitrofurantoin, erythromycin, tetracycline) are effective against UTIs, bactericidal drugs are recommended in animals with DM and HAC due to the violation of protective mechanisms. Uncastrated males are prone to prostate infection, so they should be given antibiotics that reach the required concentration inside the prostate (chloramphenicol, trimethoprim-sulfa, erythromycin, tetracycline, and quinolones).
With the exception of quinolones and trimethoprim sulph, which are effective when given twice daily, other UTI antibiotics should be given three times daily. To maintain the optimal concentration of the antibiotic in the urine, the owner should give the drug immediately after urination. The ideal duration of treatment for UTIs in animals with DM and HAC is not known, but it makes sense to prescribe antibiotics until the underlying endocrine disorder has been resolved. The recommended duration of treatment is 4-6 weeks, although some animals may require longer therapy.
It is very important to monitor the effectiveness of treatment, as well as possible relapses. Because most animals with UTIs, DM, and HAC are asymptomatic and most have normal urinary sediment results, a quantitative and qualitative urine culture should be performed 3-5 days after the start of treatment and again 7 days after antibiotics have been discontinued. . If bacterial growth is detected at culture, then therapy is adjusted according to the results of the antibiotic susceptibility test and culture is repeated to ensure that the new antibiotic is effective. Since the duration of treatment for UTI remains unknown, it is recommended that a urine culture be performed every month until negative results are obtained. Animals with DM and HAC are characterized by recurrence of UTIs throughout their lives, so for these patients it is necessary to constantly (every 3-6 months) perform a urine culture.
The genitourinary system is represented by the kidneys, bladder, urinary canals, prostate gland (males), ovaries (females), uterus and genitals.
With changes in the normal state of the body, inflammation begins. Bacteria that inhabit the genitourinary organs, leading a peaceful lifestyle, begin to multiply intensively and cause diseases. This can occur with stress, a sharp change in living conditions, nutrition, hypothermia.
There are many pathologies of the genitourinary system. All of them require treatment by a veterinarian. An important point in diagnosing this group of diseases is the correct diagnosis. Periodic examination of particularly predisposed dog breeds.
Kidney disease (nephritis, pyelonephritis, glomerulonephritis)
In dogs, inflammation of the kidneys is recorded more often than in other animals. This is primarily due to improper feeding. The dog is a carnivore, it must receive meat in sufficient quantities. If the animal is fed cereals and vegetables, the urine will be alkaline.
Whereas with proper feeding - sour. In such an environment, microbes do not survive. And in alkaline, they begin to feel great and multiply. This is where inflammation comes from.
In addition, the causes of kidney disease can be chemical and physical long-term exposure, infection from the urinary tract, hypothermia. Exposure to allergens, pathological processes.
Signs of kidney disease:
- pain when urinating;
- pain in the lumbar spine or abdomen;
- frequent urination;
- urine with blood;
- swelling;
- back arching;
- convulsions;
- the smell of urine from the mouth.
Treatment is carried out with antibiotics, homeopathic remedies, corticosteroids, novocaine blockade, antispasmodics, diuretics. Medicinal herbs, medicinal dog food, diet food are prescribed.
It is necessary to provide the pet with a dry place, clean water at room temperature.
For the purpose of prevention, keep animals in a warm and dry room, without drafts, avoid hypothermia, and feed them properly.
Bladder diseases (cystitis, spasms)
A spasm is a strong contraction of the smooth muscles of the bladder. The muscles have contracted and cannot relax, which causes pain. Spasms of the bladder occur with urolithiasis, against the background of cystitis. The dog is anxious, the bladder is tense and full. Urine is poorly excreted or completely absent.
Pathology is removed with antispasmodics, homeopathic preparations. They are administered both subcutaneously or intramuscularly, and into the bladder using a catheter.
Cystitis is an inflammation of the lining of the bladder. Occurs when an infection, hypothermia. Since the bladder is sufficiently resistant to bacteria, a certain provoking factor is needed for the onset of the disease. For example, violation of urination, blood circulation, weakened immunity.
Main symptoms:
- urine with blood;
- frequent urination with pain;
- constant ineffectual urges;
- heat;
- an admixture of pus in the urine, mucus.
The doctor conducts treatment with antibiotics, sulfonamides, herbal preparations. In order to prevent the dog to keep in a dry room, to avoid drafts, hypothermia. You need to follow the right diet, which will help to avoid urolithiasis.
Balanoposthitis
Balanoposthitis - inflammation of the prepuce and glans penis at the same time. It is characterized by pain and redness, discharge of pus, less often blood. Occurs when urine and semen accumulate in the preputial sac. It is also possible to develop the disease if phimosis is present - a narrowing of the foreskin.
Treatment is reduced to washing the prepuce with potassium permanganate (weak solution) or chlorhexidine. Then the introduction of synthomycin or ointment levomekol. In severe cases, antibiotics are prescribed. Treatment lasts 2-3 weeks.
Prevention - regular examination at the veterinarian, preventive washing of the prepuce.
Urolithiasis disease
Urolithiasis - the formation of stones or sand in the kidneys, bladder, which prevents the normal separation of urine.
It is more common in cats than in dogs. However, some breeds of dogs are more prone to this disease. This is associated with a genetic disorder of phosphorus-calcium metabolism. In addition, a urinary tract infection can be the cause of urolithiasis.
Improper feeding - the predominance of proteins over carbohydrates, an excess of fish and dairy products.
Pathology is characterized by the accumulation of calculi or stones in the bladder, renal pelvis. In fact, stones are calcium or phosphorus salts that accumulate and prevent urine from being excreted normally. If they form too much, blockage of the urinary tract can occur. This results in the death of the animal.
Symptomatically, the disease manifests itself:
- pain when urinating;
- lethargy;
- refusal to eat;
- frequent or difficult urination.
The dog needs to be seen by the veterinarian as soon as possible. He will prescribe antispasmodics, a special diet that excludes a large amount of calcium and phosphorus salts. Diet is an important part of therapy. Therapeutic nutrition is able to dissolve stones and sand in the kidneys and bladder.
For prevention, you need to make the right diet for feeding the dog, corresponding to its breed. Also avoid infections of the genitourinary system.
Orchitis
Inflammation of the testicles, or orchitis, most often occurs due to injuries, bites and frostbite. It is possible to transfer infection from the urinary tract through the spermatic cord.
The dog is in pain, the testicles become reddened, hot, hard to the touch. The dog moves with difficulty, spreading its hind legs, tightening its stomach. With purulent orchitis, the formation of multiple abscesses is possible. If the process is delayed, the testicle may atrophy (it shrinks and loses its function). In this case, only castration is shown.
The vet usually prescribes antibiotics, sulfonamides orally. Apply topical antibiotic ointments. Novocain for pain relief. Antihistamines and corticosteroids to relieve swelling.
For prevention, you should try to avoid injuries to the testicles, treat all urinary infections in time.
Diseases of the prostate
Males of all ages often suffer from prostatitis. This is an inflammation of the prostate gland, in which it enlarges, prevents urination and fecal excretion.
Pathology occurs after an untreated infectious disease. Also a provoking factor is stress, hypothermia, urolithiasis. Castrated males rarely develop prostatitis. The main cause of the disease is an imbalance of hormones.
The dog is hunched over. Whine when touched on abdomen. Experiencing frequent urge to urinate. The act of defecation becomes difficult because the enlarged gland compresses the rectum.
Treatment is reduced to antibiotic therapy. Plus, homeopathy and herbal medicine are prescribed.
In addition to this disease, there are still prostatic hyperplasia, cysts, adenoma and abscesses. Since all these pathologies are difficult to conservative and surgical treatment, they are considered severe. Prevention is given special attention.
The most predisposed breeds are the German Shepherd and its mestizos. The rest are much less likely to get sick.
For the purpose of prevention, you need to protect the dog from hypothermia, from urinary tract infections. Since the chronic course of prostatitis is very difficult to treat, it is necessary to treat acute inflammation in time. Be sure to periodically examine the dog for this particular group of diseases.
Vaginitis
In bitches, a pathology such as vaginitis may occur. This is an inflammation of the mucous membrane of the vagina. Caused by fungi or bacteria.
The causes of inflammation are mainly considered to be a decrease in the body's resistance, trauma to the vagina.
The disease is characterized by increased discharge from the vulva. The dog often licks it. The discharge may be colorless or yellowish.
Treatment is mostly local. These are ointments and antimicrobial liniments, solutions. Washing the vagina with an antiseptic.
Prevention is reduced to the exclusion of injuries, stress, good nutrition and maintenance.
phimosis
This pathology occurs in males of any age. It is characterized by narrowing of the foreskin, when the penis cannot be removed from the preputial sac. This is due to congenital malformations, neglected or untreated balanoposthitis.
Symptoms appear only when trying to mate a dog with a bitch. This causes pain in the male.
Surgical treatment - removal of the foreskin. If this is not done on time, balanoposthitis may occur. The constant stagnation of urine and sperm in the preputial sac and the inability to wash it provokes this disease again and again.
Prevention comes down to timely diagnosis of diseases of the penis and therapy.
Most urinary tract infections are treatable. However, some of them are very difficult, even surgical methods do not save. These include cancer, prostate adenoma, kidney failure.
Therefore, you need to protect your pet, properly feed, exercise. Be sure to check with your veterinarian periodically. This will reveal hidden diseases and possibly even save your pet.
