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Mikey T · 08-24-2010, 03:01 AM

the follow articles may be of interest

Antimicrobial drug use and resistance in dogs

Chronic Bladder infection in Rottweiller

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When bladder infections keep coming back over and over again, there is usually a problem that is interfering with the bladder's ability to fight off infection. The most common contributing problems are bladder stones, anatomic defects allowing urine pooling, hyperadrenocorticism, diabetes mellitus, kidney infection and bladder cancer. In some cases, antibiotics are not used long enough to eliminate the infection and it never really goes away but this is probably not an especially common cause of bladder infections that appear to be recurring over and over. We think that obesity is a factor in some cases of recurrent bladder infections

TREATMENT OF ROUTINE & RECURRENT URINARY TRACT INFECTIONS

Dennis J. Chew, DVM, DACVIM (Internal Medicine)

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Urinary antibacterials remain the hallmark for treatment of UTI, though correction of predisposing factors is also

important. The concentration of antimicrobial that is achieved in the urine (micrograms/mL) is the most important factor in predicting eradication of UTI. Tissue levels of the antimicrobial will be important in those with renal and prostatic infections, as well as those with markedly thickened bladder walls from chronic infection. Antibacterial treatment for UTI is usually given for 10 to 14 days in those with uncomplicated UTI, at least 30 to 60 days for those with upper UTI, and for at least one month to sexually intact males. Antibacterials should be selected after confirmation of UTI by quantitative urinary culture. UTI can be treated on the basis of susceptibility testing, or on the basis of predicted biologic behavior in those with uncomplicated UTI.

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Those that fail to get better (reduction in signs, pyuria, and quantitative urine culture results) or have multiple new positive cultures (with or without clinical signs) are by definition “difficult.” Animals that have received antibacterial treatment within the past two months are at increased risk that the organisms causing their UTI will be more resistant than are those who have not recently been exposed to antibiotics. Complicated cases have identifiable
defects in host defense mechanisms, including anatomical, functional, or metabolic defects. They may have mucosal damage due to urolithiasis or neoplasia, alteration in urine volume or composition, be affected by a concurrent systemic disorder (diabetes mellitus, hyperadrenocorticism, neoplasia), or have received long-term exogenous steroids.

Recurrent infections are repeated episodes of bacterial urinary infection (positive quantitative urine culture often associated with clinical signs) usually following therapy. Recurrent infections are reinfections, relapsing infections, or persistent infections. Since treatment is so different, it is important to distinguish between recurrent infection that is due to reinfection, relapsing, or persistent infection. The only reliable way to do this is with quantitative urine
cultures that are taken before treatment, while on antibacterials and at various time intervals after treatment has been discontinued. Imaging studies are important in the evaluation of recurrent UTI (radiographs, contrast urography, ultrasonography, cystoscopy).