Cystitis

Question 1

define cystitis

Answer 1

nonspecific inflammation of the bladder

Question 2

Primary cause of cystitis in dogs

Answer 2

bacterial invasion and multiplication within urine and potentially bladder wall

Question 3

Risk factors for development of bacterial cystitis

Answer 3

• females b/c urethra is shorter
• inability to maintain functional urethral sphincter (incontinence)
• Anatomic abnormalities that alter the urethra or urethral sphincter (ectopic ureters)
• compromised mucasa (neoplasia of bladder, cystic calculi damage)
• compromised immune system (diabetes mellitus & hyperadrenocorticism)

Question 4

Where does bacteria originate from?

Answer 4

fecal matter

Question 5

How do bacteria often gain entry to lower UT?

Answer 5

contamination of prepuce or vagina –> urethra

Question 6

Special characteristics some bacteria may have to help them colonize lower UT

Answer 6

• Specialized adherence structures that allow bacteria to attach to urinary epithelial cells
• Secretion of hemolysin which damages urinary epithelial cells, promotes inflammation, and decreases effectiveness of local immunity
• Prevention of phagocytism by immune system via production of a substance by the bacteria’s capsule

Question 7

List clinical signs associated with bacterial cystitis

Answer 7

pollakiuria
stranguria
dysuria
hematuria

Question 8

What pathologic effect does bacteria infection have on the bladder?

Answer 8

Bacteria stimulate inflammatory reaction within urinary bladder walls –> vasodilation of local blood vessels –> edema and swelling –> pain receptors stimulates +/- mild to moderate hemorrhage into urine

Question 9

Why does pollakiuria occur?

Answer 9

any accumulation of urine within bladder stimulates inflammatory response which in turn stimulates the bladder to contract

Question 10

Why does stranguira occur?

Answer 10

continued inflammation causes spasms of bladder muscle resulting in straining to urinate

Question 11

Why doe dysuria occcur?

Answer 11

Pain associated with inflam. response causes difficult and abnormal urination patterns and vocalization during urination

Question 12

Why does hematuria occur?

Answer 12

blood vessel damage in bladder wall

Question 13

Alterations to CBC/Chem and why

Answer 13

normal

b/c rxn usually is local (not systemic)

Question 14

alterations to UA

Answer 14

WBC present

Bacteria present

Question 15

Cystocentesis

Answer 15

• preferred method of collection
• urine from bladder is sterile
• don’t need to surgical prep, but good idea to change needle before putting sample into tube due to possible skin contamination

Question 16

Urinary catheter problems with sample collection

Answer 16

• may get contamination with bacteria not causing infection b/c tip must pass from outside body to distal urethral into bladder
• may introduce bacteria to the bladder that wasn’t there before

Question 17

Why is free catch urine really not ideal for culture and sensitivity?

Answer 17

urine must pass thru distal urethral and repro region where it WILL pick up bacteria; environmental opportunities for contamination also present due to long fur/being outside

Question 18

Approach for first time infections

Answer 18

• Culture & sens not always done b/c not likely to have resistant organisms
• Antibiotic based off of ability of antibiotic to be excreted by kidneys and concentrated in urine (penicillins or cephalosporins)
• Tx for 10-12 days

Question 19

Approach for recurrent/persistent infections

Answer 19

• culture and sens required
• Tx for 21-28 days
• ideally retest culture 7-10 days into Tx an 5-7 days after Tx has ended to make sure no growth

Question 20

How treatment approach differs in intact male dogs

Answer 20

• assumed prostate is involved
• pick antibiotics via culture and sens
• antibiotics given for 21-28 days
• recommend neuter b/c difficult to eliminate bacterial prostatitis with high lvls of testosterone present