How Long Should This Take?!

[greyhead]

How long should it take for a lab to figure out if there's a germ growing in a urine culture? I realize the sensitivity part adds time, but they wouldn't be doing that unless the culture was positive for something, right? I took the sample in two days ago.

 

Edited August 23, 2014 by greyhead

[Batmom]

They usually let it grow for 2-3 days. Say 3 days until final. Maybe add a day depending on when the lab picks stuff up from your vet? If it's started growing something on day 1, your vet will get a preliminary report at that time.....

[greyhead]

Thank you!

 

However, that means I have to drag Shane 40 miles up the road in rush hour to take him to the closest good ER place. If it's not a UTI, it's his kidneys that are making him drink a lot, pee a lot, and eat very little. ETA: For the last four days.

Edited August 20, 2014 by greyhead

[JohnF]

It could also be Diabetes.. doesn't have to be Kidneys...

 

Urine cultures are often annoyingly non-specific. Maybe best to treat with Baytril if there are significant symptoms?

[tbhounds]

Did you have recent blood work done or I guess that's the plan??

[greyhead]

The blood work is running now, and so far no word on the culture. The e.r. is trying to find out if a urinalysis was done.

[greyhead]

It seems the culture was sent to a lab in Kansas! WTH?! They are analyzing a free catch here now. He was lost 5 lbs since last weighed 10 days ago. :-(

[Batmom]

Hope you can get to the bottom of things and get your boy back on track.

[greyhead]

We haven't got the discharge report yet -- they'll email it to me tonight -- since they wanted him to be able to go home. They ran blood work while we were still there, and his kidney values are high -- creatinine at 3.6 IIRC 3.2 and BUN at 40, both being significant increases for him. He was dehydrated, so they gave him sub-q fluids; we didn't think he'd do well being kept overnight for IV fluids. We'll give him more sub-q at home tomorrow. They were still processing the urinalysis, which she'll send me the results of tonight too, but we decided to treat him empirically for now with Baytril. The culture results will be available eventually, and then we'll see if anything needs adjusting.

 

There's some hope that the kidney values have been elevated by the infection and could come back down with treatment. Natch, I hope it's mostly the infection, but he has had long-standing but slow elevation of his kidney values for years.

 

Thanks *very much* for the information and for letting me vent earlier! (I'll post again if anything interesting comes with the discharge info later tonight.)

 

ETA: I drove in the HOV lane with my sick *passenger* and I make no apologies! I was full prepared to hand any interested police the phone number of the e-vet to confirm that we were expected, and to pay whatever ticket might ensue. It really does feel like that, doing the "wrong" thing for the right reason.

Edited August 21, 2014 by greyhead

[tbhounds]

Well, this does sound like you may be dealing with renal insufficiency. The fact that he's been pu/pd (polyuria/polydipsia) and he's been dehydrated leads to chronic kidney disease., however, he may have a kidney infection (pyelonephritis. Usually if that's the case) they are acting really sick--perhaps this is the case??

Edited August 21, 2014 by tbhounds

[galgrey]

Sending good thoughts.

[greyhead]

She did mention pyelonephritis in the report as a possibility, and it's not the first time that has come up. So how does a UTI get distinguished from a kidney infection?

Diagnostic tests and/or treatments performed:

CBC: WBC 6.9k, hct 65% (historically normal for this patient), plt 175k
Chem: BUN 40, creat 3,2, K 3.8, AlkP 129, rest wnl
UA: slightly green in color, usg 1.015, pH 5.0, trace protein, RBC 4-8/hpf, WBC 0-3/hpf, no
bacteria noted.
Urine culture not started (pending at rDVM)

Edited August 21, 2014 by greyhead

[KF_in_Georgia]

Mary, I think they distinguish one from the other by considering where the urine is taken from. If urine drawn by needle from the bladder is infection-free, but urine exiting the dog in the normal manner shows infection, then it's in the urinary tract rather than the bladder.

[tbhounds]

Sorry for not responding sooner--usually with pyelonephritis your acting really sick. Pain, vomiting and fever can be present but not all dogs will present that way. With some dogs they just drink and urinate more frequently. Often radiographs, ultrasound and contract dye may be needed to definitively diagnose PN.

[greyhead]

Thanks, Kathy and Tracy. The culture came back negative, so they do think it's a kidney infection. (We have an internist appointment Wednesday and may ultrasound at that time.) He was doing better with the fluids he got Wednesday and the Baytril, but he declined again yesterday (not eating, return of pu/pd). So I called around to find a vet who had Lactated Ringers in stock. Couldn't find my vet, though, to authorize the sale. So we had to go 40 miles back to the e-vet. (There's a closer one, but I don't trust them, and the farther one has been evaluating/treating him these last 8 months.)

They reran the blood work and there had been some improvement -- creatinine moved from 3.2 to 3.1, and BUN from 40 to 33. So we feel we're on the right track with the treatment, at least. But it took 4 hours and $400+ when all I really needed was some more bags of fluids! <sigh> It took so long because some actual emergencies arrived right after we did, and two of them did die. But Shane wouldn't lie down the whole time and can't stand in one area for too long because of his LSS, so we walked around inside the building the whole time. Fortunately, that took his mind off his troubles and reduced his panting some, and everyone found him charming. But after all that, he couldn't jump back into the car, so a tech and I each took and end and lifted him.

It was $98 for three fluid kits! I'm told there's a supply problem? I don't know how long we'll have to continue fluids or if the infection will get beaten back and he won't continue to need them. We used to buy them by the case from East Coast suppliers (that's where they all were) for our CRF cat, but I think there are some distribution points in the West now. What's up with all these "supply problems" in vet products that drive prices sky high and/or make things entirely unavailable?

[tbhounds]

Fwiw--fluids are in limited supply right now--ridiculous but true. We are counting our bags at the the clinic.

[greyhead]

Oh, btw, our Seattle-area vets are sending stuff, including Shane's sample, to a lab in Kansas. So this added lots of time to the process. If it had been a local lab, our sample delivered Monday morning would have been sufficiently cultured by Wednesday afternoon to have informed his treatment at the e-vet, and we would have gone ahead with the ultrasound. As it is, we're not stopping the Baytril, and the ultrasound may be less informative.

[SarahsBlackPack]

I had Angel's urine cultured because she has kidney diease. And every few months she seems to have a flare up. where she doesn't want to eat., she has a fever. And drinks a ton of water. So my vets suggested having her urine cultured to make sure it wasn't some sort of infection going in her kidney's. And I took a urine sample to my vet 2 weeks ago today and I finally heard back from my vet last week wensday.

[greyhead]

Wow, Sarah, that was quite a wait. What did the culture show, and how is Angel?

 

It's interesting to me that there apparently can be a kidney infection that doesn't show up on a culture. So we're staying on the Baytril for now, despite the negative culture, because it and the sub-q fluids seem to help him.

[SarahsBlackPack]

Wow, Sarah, that was quite a wait. What did the culture show, and how is Angel?

 

It's interesting to me that there apparently can be a kidney infection that doesn't show up on a culture. So we're staying on the Baytril for now, despite the negative culture, because it and the sub-q fluids seem to help him.

 

That's what I thought too! The culture came back negative for infection. Both of my vets seem to think her flare up is due to her kidney diease. We normally do 2 weeks of Cipro when she has a flare up and then she's fine for a few months. We've gotten to the point we always have her Cipro on hand for when she has a flare up. But over all she is doing greyt for being 11 and half years old.

[greyhead]

We saw the internist yesterday and had an ultrasound, which showed a brightening of the kidneys and, as before, one kidney smaller than the other. So in addition to mild (as yet) kidney disease, the vet thinks it's a kidney infection, despite the negative urine culture. So 6 weeks of Baytril. He has been on sub-q fluids this week, but the vet thinks we can discontinue them.

We also reran blood work and will have the results today.

[EllenEveBaz]

How is Shane doing?