June 24, 2022

Antibiotics for UTIs in Dogs and Cats? : When to say “no”


A bacterial culture, the gold standard for detecting urinary tract infections, can take days to produce noticeable results, forcing doctors to prescribe antibiotics in the interim to relieve symptoms in pets. Antech’s new FIRSTract delivers results in just hours, helping reduce antibiotic overuse.

Imagine a client comes into your clinic and says their dog just peed inside the house or their cat is urinating outside the litter box and says their pet “Needs an antibiotic. The reflex hypothesis is urinary tract infection (UTI). “Sometimes, even though we know better, we give in and offer the antibiotic,” says Jen Ogeer, DVM, MSc, MBA, MA, vice president of medical affairs at Antech Diagnostics.

What the data show

Studies have found that 10-14% of dogs have a UTI at some point in their life, and more than 4% of dogs with UTIs continue to have recurrent or persistent UTIs throughout their life. throughout their life.1 Healthy cats are traditionally considered to be more resistant to UTIs than dogs, in part because of their high urinary concentration and high urinary osmolality.2 Most studies have assessed the prevalence of bacterial UTIs in cats with clinical signs of idiopathic feline lower urinary tract disease (MFLUT).3-4 The estimated frequency ranges from 1% to 4.9% to 8% to 33%.5-9

Simply put, vets know that FLUTD probably doesn’t equate to a UTI, as UTIs are typically rare in healthy, middle-aged cats and rare in dogs. Veterinarians also better understand the role stress plays in UTI-like symptoms, which allows us to correctly identify signs like Pandora syndrome,ten in which stress and a deprived environment play an important role.

“We also know that we are arguably dispensing too many antibiotics unnecessarily and that we are contributing to the single health problem of antimicrobial resistance,” Ogeer adds.

Antech rapid urine culture

According to Michelle Frye, DVM, SM, owner of the Echo Lane Animal Clinic in Houston, TX, vets should collect a detailed history report from pet owners. She recommends asking questions about the duration, frequency and location of accidents and the color of urine.

If it’s a suspected UTI, the next step begins with Antech’s FIRSTract test, the first automated benchmark laboratory test for rapid urine culture, providing accurate and reliable results within hours. .11

FIRSTract uses 500 µL of urine inoculated into a proprietary culture broth optimized for the growth of aerobic bacterial pathogens and incubated in a controlled and fully automated environment. During the incubation process, samples are temperature-controlled and continuously mixed, thereby minimizing sedimentation, flotation and growth anomalies typical of many microorganisms. Interference from erythrocytes, leukocytes and dead cells is minimized by obtaining an initial baseline reading of turbidity. Light scattering is measured and evaluated from the turbidity of the inoculated broth sample. Measurements are taken every 5 minutes and continuously monitored for an exponential increase in turbidity which is consistent with the presence of any viable bacteria replicating in the patient’s urine sample.

Refine the urine sample

Urine samples can be difficult to obtain, especially in aggressive cats or non-adherent dogs. A sterile sample obtained by cystocentesis is the sample of choice for urine culture. If the animal has recently voided or if cystocentesis is not possible, a urine catheter sample in males or a sample purged midway is allowed.

“Traditional urine culture takes days to develop on an agar plate,” says Frye. “It takes a long time for a pet to suffer. Now I get the result in hours instead of days. I can figure out what the problem is much faster.

In addition to this, Frye recommends using an ultrasound to collect the urine sample by cystocentesis in order to visualize the bladder. Additionally, she advises using a sterile urine sample to check for bacteria, crystals, general health, kidney disease, and endocrine disorders. Obtain a specific urine density to potentially find cancer cells. There is also an added benefit of using ultrasound to quickly assess the bladder wall and look for stones or urinary masses.

And, of course, simultaneously perform a routine physical examination on the animal and blood tests if necessary.

“If the animal urinates more frequently, I need to understand why,” says Frye. “I sometimes see concomitant illnesses, for example UTIs with other conditions such as diabetes or kidney disease.”

At the end of the line

For customers who want the instant antibiotic, Frye says it’s imperative that you educate them about the growing problem of antibiotic resistance and how “the inappropriate use of antibiotics can contribute to the creation of ‘superbugs’ or multidrug-resistant bacteria that may require hospitalization and a very expensive treatment plan.

“I think these conversations with the pet owner are essential and part of our job as vets,” Frye adds. “I am so grateful that urine culture has evolved to deliver the needed results in a timely manner, which makes this discussion with the client much easier. And homeowners appreciate that infectious diseases are no longer commonplace. Particularly with the pandemic, everyone knows that infectious diseases have not just gone away. “

Steve Dale, CABC, writes for veterinary professionals and pet owners, hosts 2 national radio shows and has appeared on TV shows including Good Morning America and The Oprah Winfrey Show. He sits on the editorial advisory board of dvm360® as well as the boards of directors of the Human-Animal Bond Association and the EveryCat Foundation. He appears in conferences around the world. For more information, visit stevedale.tv.

The references

  1. Ling GV. Therapeutic strategies involving antimicrobial treatment of the canine urinary tract. J Am Vet Med Assoc. 1984; 185 (10): 1162-1164.
  2. Litster A, Thompson M, Moss S, Trott D. Bacterial infections of the feline urinary tract: an update on an evolving clinical problem. Veterinarian J. 2011; 187 (1): 18-22. doi: 10.1016 / j.tvjl.2009.12.006
  3. Kruger JM, Osborne CA, Goyal SM, et al. Clinical evaluation of cats with lower urinary tract disease. J Am Vet Med Assoc. 1991; 199 (2): 211-216.
  4. Lekcharoensuk C, Osborne CA, Lulich JP. Epidemiological study of risk factors for diseases of the lower urinary tract in cats. J Am Vet Med Assoc. 2001; 218 (9): 1429-1435. doi: 10.2460 / javma.2001.218.1429
  5. Bailiff NL, Nelson RW, Feldman EC, et al. Frequency and risk factors for urinary tract infection in cats with diabetes mellitus. J Vet Intern Med. 2006; 20 (4): 850-855.doi: 10.1892 / 0891-6640 (2006) 20[850:farffu]2.0.co; 2
  6. Gerber B, Boretti FS, Kley S, et al. Assessment of clinical signs and causes of lower urinary tract disease in European cats. J Small Anim Pract. 2005; 46 (12): 571-577.doi: 10.1111 / j.1748-5827.2005.tb00288.x
  7. Kraijer M, Fink-Gremmels J, Nickel R. The short-term clinical efficacy of amitriptyline in the management of idiopathic feline lower urinary tract disease: a controlled clinical study. J Feline Med Surg. 2003; 5 (3): 191-196.doi: 10.1016 / S1098-612X (03) 00004-4
  8. Eggertsdóttir AV, Lund HS, Krontveit R, Sørum H. Bacteriuria in cats with feline lower urinary tract disease: a clinical study of 134 cases from Norway. J Feline Med Surg. 2007; 9 (6): 458-465.doi: 10.1016 / j.jfms.2007.06.003
  9. Sævik, Bente K, Trangerud C, Ottesen N, Sørum H, Eggertsdóttir AV. Causes of lower urinary tract disease in Norwegian cats. J Feline Med Surg. 2011; 13 (6): 410-417.doi: 10.1016 / j.jfms.2010.12.012
  10. Westropp J, Delgado M, Buffington T, Chronic lower urinary tract signs in cats; Veterinary clinics Small animal practice. 2019; 49 (2): 187-209.doi: 10.1016 / j.cvsm.2018.11.001
  11. Ogeer J, Andrews J, Hanel R. Antech’s FIRSTtract rapid urine culture demonstrates excellent performance and high sensitivity and specificity compared to standard urine culture results, Antech Diagnostics. 2020. Accessed May 6, 2021. https://www.antechdiagnostics.com/assets/site/downloads/FIRSTRACT-White-Paper.pdf