Bladder Stones / Urinary Tract Infections

Bladder Stone / Urinary Tract Infections

One of the more common conditions seen in dogs and cats is urinary tract disease/infection. In dogs, true infections occur more commonly than inflammatory conditions. Research shows that younger cats rarely have true infections but typically have inflammatory conditions. Older cats tend to have true infections as dogs do. The most common clinical signs of a UTI is increased frequency or attempts to urinate but with a minimal production of urine. The urine may appear normal in color or may show discoloration that could represent blood. Diagnosis is through obtaining urine and testing it along a reagent strip.

Urinary tract infections are treated with 1-2 weeks of antibiotics to clear the infection. A two week injectable antibiotic is now available for convenience. Increasing fluid intake will help flush the bladder and relieve discomfort. 

Bladder stones develop as the body inefficiently processes minerals. The composition of the two most common stones are calcium oxylate and magnesium/ammonium/phosphate (struvite). Both stones occur with the same frequency. Struvite stones occur in the face of infections and an alkaline urine environment. Calcium oxylate stones form in a more acidic urine. Struvite stones can be dissolved by removing the bacteria as well as acidifying the urine. Calcium oxylate stones, however, must be surgically removed. Dietary management is the cornerstone preventative therapy. The goal is to reduce the minerals that comprise these stones. 

Bladder stones can possibly be diagnosed through physical examination if the stones are large enough. In all cases, though, radiographs (x-rays) are necessary to determine size and amount as well as to rule out other intrabdominal issues. Although struvite stones can be dissolved, the length of time needed for dissolution may be too excessive. Radiographs alone cannot distinguish struvite from calcium oxylate stones. Once removed, the stones should be submitted to a laboratory to identify the mineral composition of the stones so that an appropriate diet can be instituted. 

Demodectic Mange

Demodectic mange, or "Red Mange" is a dermatologic skin disorder in which the normal demodectic mites are uninhibited and create multifocal skin lesions. This specific mite normally resides on/in the skin of healthy dogs, cats, and even humans! It is proposed that puppies who develop Demodectic mange have a genetic predisposition to developing the mange. If an adult dog develops this mange, it is speculated that either it is a reoccurrence of mange (if they had it as a puppy) or a condition in which the immune system is weakened which normal keeps these mites in check. Those possible conditions are hypothyroidism, stress, Cushing's disease, kidney or liver dysfunction, or other conditions. As this is considered a heritable trait, pets with this condition should be spayed or neutered. 

The clinical signs of Demodectic mange are hair loss, crusting and scaling (particularly around the eyes and ears), potential itching, and a skin odor. Demodex should always be considered as a possible differential for any puppy with hair loss. 

Diagnosis involves a thorough history and physical examination along with a skin scraping. Unfortunately the skin scrape is not highly sensitive meaning that the mites can be difficult to locate. However once mites are positively identified, therapy can be instituted. 

Therapy involves providing a medicine, commonly ivermectin, to the dog once a day for at least 1-2 months. Collie breeds and collie crosses should use a product such as milbemycin as some collies have a predisposition to ivermectin toxicity. Secondary bacterial skin infections are very common and should be treated with appropriate antibiotics. Patients should be skin scraped monthly until negative results occur. Medicine should continue one month beyond a negative skin scraping. The length of therapy can vary greatly from pet to pet. Some animals only require 1 month of therapy and others may require several months to a year. 

This condition cannot be cured in every case, but it can be successfully managed. It is possible and even likely that this condition will manifest itself years later, especially if another illness or stressful event occurs.