Testing For A Uti

[Guest SusanP]

Ok, so we had a fiasco this week with Dr.Doug--urine showed protein, but botched bloodwork showed creatinine of greater than 40. Vet wanted to treat for kidney disease for a month before re-testing. A quickly arranged second test eventually showed normal blood values, and this was confirmed by a protein ratio something urine test, though. The upshot as of today is that his kidneys are just fine and he has a UTI.

 

So now the vet wanted to take a sterile urine sample via needle to send out for a culture before treating him.

 

Because Doug has been through a lot this week with them, and because I've had it with them, and because the last time I went this route with a hound, the culture was negative and they ended up treating her anyway, leaving me wondering why I put her and my pocketbook through the needle sampling, and because in years past with vets I trusted more, UTIs were treated without the urine culture, I put my foot down. The result is that I'm going in soon to pick up a course of antibiotics, and he'll have a urine test in a week to see if the UTI cleared up.

 

 

But who is right here?

 

You can probably tell I'm not real enchanted with this vet's office. Looking into alternatives...

Edited October 17, 2009 by SusanP

[CaliforniaGreys]

The reason for the culture is it tells them what antibiotic to use.

UTI's can be painful, and with my pups I would prefer the urine sample and a culture to be sure we were treating with the right antibiotic to knock it out.

 

After what you've been through with this office I sure can understand your frustration. And if you don't want to have to bring your pup in again, I don't see any reason why you can't get a urine sample first thing in the morning and catch it mid stream. Then bring it in

[Guest Energy11]

The reason for the culture is it tells them what antibiotic to use.

UTI's can be painful, and with my pups I would prefer the urine sample and a culture to be sure we were treating with the right antibiotic to knock it out.

 

After what you've been through with this office I sure can understand your frustration. And if you don't want to have to bring your pup in again, I don't see any reason why you can't get a urine sample first thing in the morning and catch it mid stream. Then bring it in

DITTO!

[Guest multigrey]

The reason for the culture is it tells them what antibiotic to use.

UTI's can be painful, and with my pups I would prefer the urine sample and a culture to be sure we were treating with the right antibiotic to knock it out.

 

After what you've been through with this office I sure can understand your frustration. And if you don't want to have to bring your pup in again, I don't see any reason why you can't get a urine sample first thing in the morning and catch it mid stream. Then bring it in

 

 

Amen to this advice.

When I take a dog in for a U/A, I ask that if there is any bacteria present, I want the sample cultured. I don't want to waste time putting the dogs on a course of antibiotics and have the dog get worse because it was the wrong drug. Not all UTI's respond to the same drugs...it all depends what sort of bacteria you are dealing with.

 

It's your dog, you know him best and you are entitled to ask that treatment and testing be done the way you are comfortable. Don't settle for second best for your dog.

[joejoesmom]

As many have said, the reason for the culture is to determine what bacteria is present. Different bacteria require different antibiotics. If the vet guesses wrong and gives the wrong antibiotic, your dog will continue to suffer and there is a long term risk (not necessarily for your dog but for the world as a whole) of creating antibiotic resistant bacteria. If the vet treats with a broad spectrum antibiotic, beneficial bacteria may be killed along with the problem bacteria. This can lead to digestive issues (which generally clear up on their own after the antibiotic is stopped) in your dog along with the previously mentioned problem of creating antibiotic resistant bacteria.

 

You mentioned that years ago your vets treated without a culture. Things have changed -- we have more and more bacteria that are resistant to one or more antibiotics. Once upon a time, docs treated almost everything with one of just a few different antibiotics. As more and more resistent bacteria were created, new antibiotics had to be created. So today, it is good practice to do a culture.

 

The problem with taking a urine sample yourself (from the dog's urine stream) is the potential introduction of other bacteria. This could result in a culture of bacterial that are not present in your dogs urinary tract. If your dog really can't handle the drawing of urine directly from the bladder, I would suggest obtaining a sterile specimin cup. Then thoroughly cleanse your dogs private parts just before you take him/her outside. Allow the dog to start peeing, then collect the urine from the middle of the stream. Immediately cover the specimin cup and take it to your vet right away. This gives the best chance of not introducing foreign bacteria.

 

It does sound like you need to find a different vet. Perhaps your local rescue group could recommend one?

 

I haven't read all of your posts so I apologize if you have already covered this. If your dog is older, or if she has eaten something that could cause kidney damage, it is a good idea to do a urinalysis after the UTI is cleared up. A UTI causes there to be protein in the urine. Apparently this is what happened initially. If there is protein in the urine (and no suspected UTI), the next step is to do a protein/creatinine ratio. This helps determine if there is kidney damage. Once again, a UTI will affect this. If the UTI caused the proteinurea, a simple inexpensive urinalysis after the UTI is gone will show a low protein content.

 

Hope this info helps

 

[Batmom]

Well, I'm going to be the dissenter.

 

I usually don't culture before treating for a UTI. It's expensive, it takes time, and most UTI's just don't warrant it. Repeat UTIs in a short time? Sure. UTIs that don't seem to clear up? You bet. Garden variety UTIs? There's no need to cysto and culture.

 

IMHO cystocentesis is useful in the same circumstances as culture is, *and* when owner cannot get a reasonably clean catch at the vet's office. (If you're going to spend the $ on a culture, fresh sample is best.)

 

I *am* sensitive to the notion of suiting the antibiotic to the ailment, but I've literally never had a culture show anything remotely useful. Here, we start with the first-line antibiotics just as they do for people UTI's, which don't commonly require cysto or culture either prior to treatment.

[MaryJane]

I always get a urine the "old-fashioned" way. Just make sure that you get an first morning specimen and catch it mid-stream.

 

Doing the "culture and sensitivity" confirms that the antibiotic being used is the right one.

[Guest SusanP]

Ok, he's on Clavamox for 5 days with a recheck of urine for protein after that. Certainly if there were special issues I would not balk at more advanced tests, and it is good to get an idea of the standard of care for this situation that is out there. Thanks for the input, everyone.

 

They gave me 7 days' worth of Clavamox for him (though they told me 5 days on the phone). Retest is supposed to be in 5 days too, though I'm guessing they meant 7 as well...

 

And I got a refund for the thyroid panel they tried to send to Michigan for him when it was actually my *other* hound who had a "questionable" T4 of .5--wrote the order for a test in the wrong dog's record and everything. :huh

 

But the receptionist couldn't find a vet to ask about a refund for the extra kidney/liver tests --she said it may not have been their fault that the test didn't run well, so she didn't think they would do the retest for free. I asked her to have someone call me...

[Guest TeddysMom]

Well, I'm going to be the dissenter.

 

I usually don't culture before treating for a UTI. It's expensive, it takes time, and most UTI's just don't warrant it. Repeat UTIs in a short time? Sure. UTIs that don't seem to clear up? You bet. Garden variety UTIs? There's no need to cysto and culture.

 

 

I agree. I never have a culture done unless the first round of antibiotics doesn't clear it up. Vet's almost always give you what they are accustomed to using anyway. I think it is great it you can catch a urine sample but I figure everytime they invade the body, there is a chance of introducing another bacteria plus it is not easy on the dog.

[CaliforniaGreys]

The only thing that concerns me about not growing a culture is that sometimes the UA comes back negative for bacteria and then if a culture is done, there it is.

[Batmom]

The only thing that concerns me about not growing a culture is that sometimes the UA comes back negative for bacteria and then if a culture is done, there it is.

 

Which is a valid concern. But, if owner brings in a sample, tests negative for bacteria, dog doesn't have evident symptoms of UTI or there is concern, ... , a cysto and culture could still be done at that point. I realize some vets aren't as flexible, either about treating presumed UTI or about doing cysto/culture without making an appointment days later.

 

Guess I am unreasonably sour about cultures partly because ours have not been helpful, whereas antibiotics have been.

[GreyPoopon]

I'm with Batmom on this. We've had a lot of UTIs here, especially with one dog. The only test that wasn't negative was a sterile-container catch done by a vet asst (ETA: IIRC, the culture was negative). Cysto/UA/culture stuff has invariably been negative, and yet the selected antibiotic has worked. The one exception to this pattern is the most recent incident, which is starting to look more complex--but if it is a UTI, the culture was unhelpful.

Edited October 18, 2009 by GreyPoopon

[krissn333]

Well, I'm going to be the dissenter.

 

I usually don't culture before treating for a UTI. It's expensive, it takes time, and most UTI's just don't warrant it. Repeat UTIs in a short time? Sure. UTIs that don't seem to clear up? You bet. Garden variety UTIs? There's no need to cysto and culture.

 

IMHO cystocentesis is useful in the same circumstances as culture is, *and* when owner cannot get a reasonably clean catch at the vet's office. (If you're going to spend the $ on a culture, fresh sample is best.)

 

I *am* sensitive to the notion of suiting the antibiotic to the ailment, but I've literally never had a culture show anything remotely useful. Here, we start with the first-line antibiotics just as they do for people UTI's, which don't commonly require cysto or culture either prior to treatment.

 

 

The only thing that concerns me about not growing a culture is that sometimes the UA comes back negative for bacteria and then if a culture is done, there it is.

 

Which is a valid concern. But, if owner brings in a sample, tests negative for bacteria, dog doesn't have evident symptoms of UTI or there is concern, ... , a cysto and culture could still be done at that point. I realize some vets aren't as flexible, either about treating presumed UTI or about doing cysto/culture without making an appointment days later.

 

Guess I am unreasonably sour about cultures partly because ours have not been helpful, whereas antibiotics have been.

 

Agree, and agree. The culture was only helpful when Ace had recurrent symptoms. They did a cysto and culture.

 

Susan, I'd do the Clavamox for the 7 days. 5 seems a little too short IMO. Some antibiotics are fine for 5 days (zithromax being one of those). Make sure you keep the pills in their foil wrappers until you're ready to give them too. They can lose potency otherwise.

[joejoesmom]

I guess my dogs have been unusual. Three UTIs in the last 6 years. All negative cytology. First one started on Clavamox (or just plain amoxicillin - can't remember), no improvement. Did culture, different antibiotic to target the bug -- worked like a charm. Second, same story. Third, did culture first, now on Cipro (another non-typical bacteria). All different dogs, all different bacteria, no overlap in UTIs.

 

So I guess my view is different based on my experiences.

 

 

[Guest HersheysMom]

The only thing that concerns me about not growing a culture is that sometimes the UA comes back negative for bacteria and then if a culture is done, there it is.

 

This definitely happens! When Sonie had that awful ecoli infection they weren't seeing bacteria, yet a culture grew and told us a lot about the type of infection. So, when we did our follow-up after treatment, I specifically told the lab to culture even if no bacteria is seen. At that time they saw no bacteria and could not get a culture to grow, which meant the treatment worked. It also tells me you can get a clean sample to be cultured as long as you are careful about it. With our first dog we did have cultures done via a needle to the bladder, however with Sonie we've been culturing them from a free catch.