Treating urinary tract infection in dog with transitional cell carcinoma

RE: Treating urinary tract infection in dog with transitional cell carcinoma

Stephen Courtney — Sat, 12 Dec 2015 01:28:29 GMT

When I give pulse therapy antibiotics to prevent otherwise recurring bacterial cystitis, I give once daily doseage, at night - so the animal spends the night time with a bladder full of antibiotics. Bear in mind, these are cases which are either on antibiotics or have bacterial cystitis - most of them are geriatric CKD cats

It seems to work well, I would worry that in the three weeks off, a bug could easily get established.

RE: Treating urinary tract infection in dog with transitional cell carcinoma

David Mills — Thu, 10 Dec 2015 05:41:56 GMT

Granny and eggs, but interpret C/S with care as many abx reach very high levels in urine which can overcome 'standard' resistance. Cysto is the way to go, free catch culture is notoriously unreliable.

Personally I would treat with prolonged course (4w min) then pulse therapy rather than continuous abx- 3 weeks off, 1 week on.

RE: Treating urinary tract infection in dog with transitional cell carcinoma

Stephen Courtney — Wed, 09 Dec 2015 23:21:12 GMT

If the current infection is sensitive to potentiated amoxycillin then i would treat it with that, and frankly would just leave the dog on antibiotics. If you get a relapse very time she comes off, then don't come off. My recurring bacterial UTIs usually get minimum 6 weeks solid treatment, and if there is an underlying cause such as this tumour, likely causing stagnant areas within the bladder and incomplete voiding, even 6 weeks won't be long enough.

Of course you need to keep an eye on things and do regular cultures and sediment examinations.

i'm not at all sure i'd be sticking needles into this bladder though. even with ultrasound guidance.

RE: Treating urinary tract infection in dog with transitional cell carcinoma

Kara Gibson — Wed, 09 Dec 2015 01:59:13 GMT

Some valid points, other than haematuria she has not had other clinical symptoms. Initially we were using free catch samples but I had concerns that what we were growing may not be from the bladder so we discussed getting samples by cystocentesis (avoiding the thickened area of the bladder but accepting the risk of seeding the tumour) vs sedating her and placing a catheter to collect the sample. The owners opted for cystocentesis and the most recent sample shows a significant growth of MRSA which actually is sensitive to amoxyclav.

As far as the owners are concerned the dog is happy, bright, eating well and other than occasionally having haematuria off antibiotics urinating normally, they are not anywhere near considering PTS.

RE: Treating urinary tract infection in dog with transitional cell carcinoma

Michael Woodhouse — Tue, 08 Dec 2015 18:10:49 GMT

Is it time to PTS the dog if it is potentially full of multiple resistant bacteria that cannot be controlled without antibiotics? We have to do right by the dog.

RE: Treating urinary tract infection in dog with transitional cell carcinoma

Andrew Kent — Tue, 08 Dec 2015 17:03:42 GMT

[quote user="Kara Gibson"]

Whenever we have stopped abs for longer than a couple of weeks she starts with haematuria again.

[/quote]

Does the dog have signs other than haematuria? and is this gross / severe or on analysis?

Haematuria is common with TCC even in the absence of infection so, like others, I might look at other methods of management.

And were these cultures free catch or something else? And heavy growths? I often worry about contamination when we grow so many different bugs if on free catch samples.

Andy

RE: Treating urinary tract infection in dog with transitional cell carcinoma

Martin Atkinson — Tue, 08 Dec 2015 16:30:53 GMT

[quote user="Kara Gibson"] We have repeatedly checked with the owner to make sure they are giving the antibiotics correctly which they assure us they are. [/quote]Have you seen the trial where it has been shown where vets were 90% confident that the client was complying and the evidence showed it was in reality 10%?!

Have you tried Cystease/Urinaid or equivalent? May at least alleviate the symptoms. I would be inclined to tell the clients that this is the future if they won't have surgery.

RE: Treating urinary tract infection in dog with transitional cell carcinoma

Kara Gibson — Tue, 08 Dec 2015 07:01:15 GMT

Whenever we have stopped abs for longer than a couple of weeks she starts with haematuria again.

RE: Treating urinary tract infection in dog with transitional cell carcinoma

Braden Collins — Tue, 08 Dec 2015 06:44:36 GMT

If the dog is asymptomatic, do you really need to treat? I wouldn't be throwing AB's at a dog which is urinating normally when antimicrobial resistance is an issue already.