Persistent UTI in puppy with struvite & pH9..

Re: Persistent UTI in puppy with struvite & pH9..

Anthony Todd — Sat, 13 Apr 2013 00:05:16 GMT

Why not acidify the urine with, say, methionine, or NH4Cl, and concurrently try to work out why the pH is 9?

The infection surely will return if the pH and and resulting struvite crystalluria remain?

As the infection responds to ABs I can't see the point of identifying the bug and it adds to the cost but not the solution.

Must be something on the web in humans or animals about persistent alkaline urine??

Yes, there's this:

http://jat.oxfordjournals.org/content/31/8/486.full.pdf

Which talks about urine stored at high temperature (or in the post?) [I'm not trying to be insulting; I'm sure this isn't the reason]

Lots of folk worried about their dogs' with urine pH of, coincidentally, 9.0 too which is odd in itself; dogs apparently normal apart from that????

Does patent urachus or any congenital fault give alkaline urine always??

I suppose the pup isn't on some weird diet from the breeder or a well-meaning "expert"??

Re: Persistent UTI in puppy with struvite & pH9..

Holly Lee — Fri, 12 Apr 2013 15:33:56 GMT

Thanks, was wondering how easy persistent urachus would be to see! Do have good scanner.

Is completely continent when on Abx, and seems to be conscious urination in house when off them so hopefully not ectopic ureter although I know some present late.

At the moment on RCW Junior GI food and maybe slightly improved but have primed for ultrasound + cysto for C&S when (if..) signs recur.

Thanks for all suggestions, greatly appreciated.

Re: Persistent UTI in puppy with struvite & pH9..

james herriot lied — Fri, 12 Apr 2013 14:51:40 GMT

[quote user="Utlendigur"]

Could there be some sort of congenital abnormality eg fistula or patent urachus?

[/quote]

+1 for this - and if you have access to a scanner, even a large animal linear probe, diverticulae relating to a proximal persistent urachus are easy enough to spot. A nice, big stone would also show up well.

At this age, anatomical anomalies would be in the mix. Is the puppy entirely continent yet? A USMI / ectopic ureters would be in there too, allowing ascending infection.

These can be really satisfying patients, once you find that primary cause.

Re: Persistent UTI in puppy with struvite & pH9..

Rob Loxley — Thu, 11 Apr 2013 12:59:27 GMT

I'd look to run cultures pre-abs and towards the end of abs to answer the UTI question, also persistent struvite some radiographs to look for calculi would be nice

Re: Persistent UTI in puppy with struvite & pH9..

Holly Lee — Thu, 11 Apr 2013 11:11:12 GMT

[quote user="Utlendigur"]If the assumed bacterial infection raised the pH, the struvite might be secondary to alkaline urine.[/quote]

That was the initial assumption but I felt that if the high pH was simply due to infection then it should have come back to normal after a month on antibiotics which has resolved clinical signs but not altered pH or presence of struvite.

Re: Persistent UTI in puppy with struvite & pH9..

Holly Lee — Thu, 11 Apr 2013 11:09:31 GMT

Thanks for those posts of help. To clarify, the puppy was thought to be approximately 12 weeks old when I first saw it immediately after import. It is now obviously older than that! I was trying to give an indication of the age when it appeared to start showing signs which was shortly after it was in the owners possession. I appreciate all concerns, and appreciate the opinions on the underlying urinary problems.

Re: Persistent UTI in puppy with struvite & pH9..

Rob Loxley — Thu, 11 Apr 2013 08:35:18 GMT

[quote user="Holly Lee"]Any suggestions[/quote]

I think some urine cultures and imaging would be my next step

Re: Persistent UTI in puppy with struvite & pH9..

Utlendigur — Wed, 10 Apr 2013 23:38:48 GMT

[quote user="emma_j"]If the puppy 12 weeks old now, and you've been treating it in the UK for a month - it cannot have been imported legally[/quote]

My thoughts too...

Could there be some sort of congenital abnormality eg fistula or patent urachus? If the assumed bacterial infection raised the pH, the struvite might be secondary to alkaline urine.

Re: Persistent UTI in puppy with struvite & pH9..

emma_j — Wed, 10 Apr 2013 22:43:34 GMT

If the puppy 12 weeks old now, and you've been treating it in the UK for a month - it cannot have been imported legally - they must be at least 15 weeks old at import (12 weeks old to receive rabies vacc, and 3 weeks post vacc for import). If that is the case, aside from the UTI, this dog is a rabies risk and DEFRA would probably like to know.....

Re: Persistent UTI in puppy with struvite & pH9..

emma_j — Wed, 10 Apr 2013 22:43:33 GMT

Re: Persistent UTI in puppy with struvite & pH9..

CatherineThomas — Wed, 10 Apr 2013 21:56:25 GMT

When I had a case with persistently high pH and recurrent infections I spoke to Hills and they recommended the puppy was fed on the hills vet essentials for puppies, because although not as good as the cd or SD it should also help to normalise the urine pH. It worked with my puppy eventually, although she didn't have significant crystals.

Re: Persistent UTI in puppy with struvite & pH9..

Lynn Broom — Wed, 10 Apr 2013 21:06:50 GMT

I'd be looking for possible underlying uroliths which may be acting as a nidus for infection. I've seen quite large oxalate uroliths in 2 young puppies (one GSD, one cocker) - both required surgical removal.