Urinary Tract Infections (UTI)
To determine if your dog's urinary tract has a urinary tract infection or another problem, the veterinarian will start with a physical examination and urinalysis. The urinalysis will reveal three possible outcomes:
- Your dog is experiencing symptoms of a UTI and has the presence of bacteria in the urine
- Your dog has asymptomatic bacteriuria which means that there are no visible symptoms, but a standard urinalysis shows the presence of bacteria.
- A condition called symptomatic abacteuria, where there are symptoms of a urinary disorder, but there is no bacteria in the urine. This is also called urethral syndrome. Related symptoms include pain while urinating, abdominal pain, and frequent urination.
Depending on how the urine was collected (through urination via. free catch, catheter, or Cystocentesis which is when urine if collected through the abdominal wall), your veterinarian will make a determination based on the amount of bacteria collected.
When an antibiotic is prescribed after finding bacteria in the urine, a veterinarian will monitor your dog to track when the infection is eliminated. If the infection is persistent, meaning a positive urine culture occurs during treatment with an antibiotic, the veterinarian will determine if there are other issues at work such as reduced kidney function or why the medication is not reaching the infection site.
If the urine infection is persistent, your dog will be tested on a schedule of about 3 to 5 days while on the antibiotic. Afterward, testing may continue at the 1 month, 3 months, and 6-month intervals to test for a relapsing infection.
In a few less common cases, UTI symptoms are a sign of hyperadrenocorticism (Cushing's Disease). Approximately 50% of dogs with Cushing's disease have a urinary tract infection.(1) Clinical signs for Cushing's disease are similar to UTI and include other symptoms in addition to those associated with UTI such as:(2)
- Endocrine alopecia (hair loss due to hormone issues)
- Extreme hunger (polyphagia)
- Great thirst (polydipsia)
- Excessive urine production (polyuria)
Dogs with diabetes (diabetes mellitus) are more prone to urinary tract infections due to having more dilute urine than healthy dogs. Normal dogs have higher levels of chemicals in the urine that kill harmful bacteria. If the urine is dilute, there is less of this chemical available to eliminate bacteria.
Dogs with diabetes also have more sugar in the urine, which enables bacteria to grow. Another reason is that diabetic dogs may have a distended bladder problem, enabling the colonization of bacteria to form in the urine, since it is in the bladder for longer periods of time than in dogs without the condition.
Lower Urinary Tract Issues
Lower urinary tract disease in dogs is usually caused by:
- Stones (urolithiasis)
Signs of lower urinary tract problems include the following. If you observe any of these bring a urine sample to the veterinarian for urinalysis. This in addition to a physical examination will help your veterinarian reach a diagnosis.
- Blood in the urine
- Dark urine
- Cloudy urine
- Urine that has a bad smell
- Urination in the home or urination accidents
- Licking the vulva
- Licking the penis
- Pain during urination (dysuria)
- Frequent urination
- A small amount of urine during urination (pollakiuria)
- Straining during urination (stranguria)
Treatment of Lower Urinary Tract Issues
If urinalysis indicates the presence of infection, a veterinarian will prescribe an antibiotic. If the veterinarian believes that stones are the cause, an abdominal x-ray is needed. Note that an x-ray may not show a stone when one is in fact the cause of the problem.
If your dog has bladder stones, they may be able to be dissolved with prescription dietary modifications. These diets are lower in magnesium, protein, and phosphorous. You will also be advised to increase the amount of water your dog drinks. If you cannot remove bladder stones with diet, there are other methods of removal that can be used such as urohydropropulsion (using a catheter to flush the stones out) or surgical removal.
Once the bladder stones are eliminated, a prescription diet can help to keep them from coming back. If only crystals are found without the presence of tones, then the prescription diet can also help to avoid any future problems.
Urinary Sphincter Incompetence
Urinary sphincter incompetence is a problem that is common in older female dogs that have been spayed. Signs are incontinence when relaxing or sleeping. Treatment often starts with medications. A veterinarian will also check for any underlying cause.
Behavioral Causes of Urination in the Home
Dogs that are exhibiting behavioral issues could urinate in the home or be experiencing submissive wetting. If your veterinarian cannot find a medical cause, then it may be helpful to consult with a behavior specialist.
Upper Urinary Tract Issues
Symptoms related to upper urinary tract issues are often related to kidney disease (CKD). These symptoms are excessive urination and thirst. As the kidney disease advances a dog will exhibit symptoms such as:
- Weight loss
- Appetite loss
Some diseases have no outward signs and are diagnosed with urinalysis. These diseases are protein-losing nephropathies and Pyelonephritis.
Protein-losing nephropathy is a specific kind of kidney problem that leads to seepage of blood serum and protein in the urine. This disease often goes undiagnosed and can lead to fatal end-stage kidney failure if not caught and treated promptly. This disorder usually is found in large-breed dogs.
Pyelonephritis (PLN) is a sudden and severe kidney infection. This condition causes the kidneys to swell and can cause permanent damage.
Treatment of Upper Urinary Tract Issues
If your dog has CKD (kidney disease) therapies include a prescription diet to reduce the work the kidney's need to do and supportive care such as:
- Subcutaneous fluid therapy (for diuresis which is too much urine production)
- Phosphate binders (sucralfate)
- Appetite stimulants
The prognosis for dogs with managed CKD is good with many dogs living for years with the condition.
A veterinarian will write a prescription for the appropriate antibiotic. Antibiotics are used to treat PLN for between 6 to 12 weeks. Treatment will continue until the dog has a negative urine culture. Treatment also can include:
- Low-dose aspirin therapy
- Fish-oil supplements
- Blood pressure medication
- Prescription kidney diet
If treated and well-managed, a dog can live a long life with this condition.
(1) Clinicians Brief - UTI & Hyperadrenocorticism; October 2003,
(2) Today's Veterinary Practice; Canine Hyperadrenocorticism: Challenges Establishing the Diagnosis; Ann Della Maggiore, DVM, Diplomate ACVIM, & Richard Nelson, DVM, Diplomate ACVIM; University of California–Davis