|
Annabelle
is a 7-year-old Queensland heeler who lives in Goleta,
Calif. She used to tend 100-or-so head of sheep, but
since George sold his ranch, Annabelle spends most of
her time herding the birds in her back yard.
About six
months ago, Annabelle started to urinate more
frequently.
According
to George, she was asking to go outside sometimes up to
seven or eight times a day. Each time, she would urinate
small amounts. George took Annabelle to the
veterinarian. A urinalysis determined a urinary tract
infection. A short course of antibiotics later,
Annabelle seemed fine. But about a month later, the
symptoms had returned. Another course of antibiotics was
prescribed and Annabelle again improved. This occurred
two more times. George said everything else seems to be
fine, except he has noted Annabelle’s bad breath when
she is sitting next to him in his truck.
A course
of antibiotics should cure the infection, but when it
doesn’t, further investigation is in order.
There are
underlying issues that can lead to recurrent urinary
tract infections. Among them is a condition leading to
stones in the kidney(s) or bladder. These stones can
harbor bacteria so that when the antibiotics are
stopped, the bacteria can come out of the stones and
reinfect. Usually, a radiograph of the abdomen will
demonstrate the stones and, depending on location —
kidney(s) or bladder — surgery should cure the
problem.
There is
also the possibility that the bacteria may be resistant
to the drugs. I do not think this is the case, but this
can be ruled out by growing the offending bacteria and
testing available antibiotics against them. In this way,
we can determine what antibiotics are likely to kill the
bacteria in the urinary tract.
The
presence of one or more tumors in the bladder can lead
to urinary tract infections. These can sometimes be seen
on radiographs, but, usually, an ultrasound of the
bladder is much more reliable. These tumors can be
benign, and removal usually will cure these patients.
Malignant bladder tumors are a different story and can
be fatal if not addressed early in their course.
There are
many other possibilities, and I am sure I could not list
them all. I do want to mention one other possibility
because of Annabelle’s bad breath. Bad breath usually
means some degree of dental disease. With dental disease
comes bacterial growth, producing tartar around the
teeth and gum line. These bacteria can be constantly
shed into the bloodstream through the gums and gain
access to other parts of the body. Because the kidneys
accept about 25 percent of the blood flow from the
heart, bacteria from the mouth can get into the kidneys
and from there into the bladder, setting up a urinary
tract infection. Antibiotics will treat the infection in
the bladder, but once they are stopped, bacteria from
the dental disease can lead to reinfection. Once the
dental disease is cleared up, the urinary tract
infection would be gone as well.
Obviously,
it is time or even past time for Annabelle to have some
more diagnostic testing. There is an underlying reason
she is constantly having her urinary tract reinfected
with bacteria. Until that reason is discovered,
antibiotics are not the cure.
|
