As Genny got older, she got bladder infections or urinary tract
infections more and more often. They were treated with antibiotics at
first, steroids, later. The veterinarian explained that her kidneys
were failing slowly, doing an incomplete job, and creating an
environment that made the infections possible. He made the diagnosis
from the fact that Genny was leaving puddles on the floor. I think he
may have done some lab work from a urine sample.


Cubbe is now finishing a round of antibiotics from her 2nd urinary
infection in 2 years. She's energetic and healthy so I'm not too
worried about her. She's 10 years old.


My question is about expense and lab work. To the best of my
recollection, the inexpensive veterinarian in Miami for Genny only ever
did lab work on the urine sample I collected from Genny when she was
outside and squatting. I don't think he even did much of that. He
based his diagnosis on the fact that she was leaving puddles.


The veterinarian up here wants to get a sterile sample from Cubbe
straight from her bladder. With Cubbe, that's going to mean a sedative
that knocks her out completely, plus the reversal. That's going to be
expensive. I'm not against spending money for the health of my dog, but
can anyone explain why any of that is necessary? *I've* had bladder
infections before, and the urine sample obtained in the usual manner
(pee in a jar; wash your hands) was always good enough, nothing invasive
or uncomfortable required.


We decided on this vet for a combination of reasons: convenience, how
terrific they are when she boards, good medicine. I've wondered in the
past if they do unnecessary and expensive tests in the name of being
more cautious than I think warrants the discomfort and expense.


What do y'all think? What could the sterile sample tell them that a
regular sample (or no sample at all) couldn't?


--Lia

What do y'all think? What could the sterile sample tell them that a
regular sample (or no sample at all) couldn't?


--Lia



Cultures mostly. You can get outside contminates, and when cultured, show
positives and you might be treating things that might not even be in Cubbe.
There is no way to determine what is Cubbe, and what is contaminated, so they
do sterile cultures to be sure.


Tuck had an infection a couple months ago. The vet gave him a generic
antibiotic, and While i was gone, they finally got his culture back. The
antibiotics I was giving him had no effect on his strain of infection. I had
to take him back and they gave him the BIG guns of antibiotics. At that point
we were really grateful that we had done the culture.

In article ,
Julia Altshuler wrote:
The veterinarian up here wants to get a sterile sample from Cubbe
straight from her bladder. With Cubbe, that's going to mean a sedative
that knocks her out completely, plus the reversal. That's going to be
expensive. I'm not against spending money for the health of my dog, but
can anyone explain why any of that is necessary?

The vet wants to culture her urine and probably try to
figure out which antibiotic will be most effective against
whatever bacteria are causing the problem. I guess I'd want
to find out why he thinks that the current round of
antibiotics didn't do the job. Other than that I think that
if the vet needs a clean sample, the vet needs a clean
sample.

Greta had a UTI that Cornell never was able to knock out
(she ended up on Clavamox for life) and so she'd have a
cystocentesis a few times/year. At Cornell they didn't
knock her out, but she was an older, highly tractible dog.
They used an ultrasound to guide the needle.
--
Melinda Shore - Software longa, hardware brevis -

Prouder than ever to be a member of the reality-based community

On Tue, 14 Aug 2007 11:30:18 -0400, Julia Altshuler
wrote:

As Genny got older, she got bladder infections or urinary tract
infections more and more often. They were treated with antibiotics at
first, steroids, later. The veterinarian explained that her kidneys
were failing slowly, doing an incomplete job, and creating an
environment that made the infections possible. He made the diagnosis
from the fact that Genny was leaving puddles on the floor. I think he
may have done some lab work from a urine sample.


Cubbe is now finishing a round of antibiotics from her 2nd urinary
infection in 2 years. She's energetic and healthy so I'm not too
worried about her. She's 10 years old.


My question is about expense and lab work. To the best of my
recollection, the inexpensive veterinarian in Miami for Genny only ever
did lab work on the urine sample I collected from Genny when she was
outside and squatting. I don't think he even did much of that. He
based his diagnosis on the fact that she was leaving puddles.


The veterinarian up here wants to get a sterile sample from Cubbe
straight from her bladder. With Cubbe, that's going to mean a sedative
that knocks her out completely, plus the reversal. That's going to be
expensive. I'm not against spending money for the health of my dog, but
can anyone explain why any of that is necessary? *I've* had bladder
infections before, and the urine sample obtained in the usual manner
(pee in a jar; wash your hands) was always good enough, nothing invasive
or uncomfortable required.


We decided on this vet for a combination of reasons: convenience, how
terrific they are when she boards, good medicine. I've wondered in the
past if they do unnecessary and expensive tests in the name of being
more cautious than I think warrants the discomfort and expense.


What do y'all think? What could the sterile sample tell them that a
regular sample (or no sample at all) couldn't?

Really, antibiotics shouldn't be prescribed on the basis of a puddle,
unless the dog has a history of UTIs. A urine sample is necessary to
confirm the presence (or absence) of bacteria, blood, WBCs, etc. in
the urine, or to detect other possible cuases of incontinence through
specific gravity, color, etc. A sterile sample isn't absolutely
necessary unless the dog completes a course of antibiotics and still
shows signs and symptoms of infection. Then a culture of 'sterile'
urine is necessary to determine what bacteria is involved and what
antibiotics will be effective on that bacteria. Cystocentesis is the
way a sterile urine sample is obtained from a dog.

Music recently had a $380 UTI. Because his urine showed low specific
gravity, we did a CBC and chemistry to check kidney function. A round
of broad-spectrum but extremely expensive antibiotics failed to knock
out the infection so cysto and culture were necessary. They revealed
e. coli, for which another course of fortunately less expensive
antibiotics was prescribed. Them's the breaks, sometimes. I was so
relieved he wasn't in kidney failure that I hardly cared about the
cost. Hardly.

Mustang Sally

"diddy" none wrote in message:

Cultures mostly. You can get outside contminates, and when cultured, show
positives and you might be treating things that might not even be in
Cubbe.

This is something that I've spoken with the vet about, considering that we
were doing urine cultures on Khan just about every week for a few months (at
least it seemed that way). She said that she does not normally find Cyto to
be necessary, as a good microbiologist can tell the difference between
contaminants and an honest to goodness infection. Having done a good bit of
micro, I tend to agree.

As for Genny's UTIs, I'm not sure why the vet never did any tests; I can
understand if he did a couple and it always came back as one, but making a
diagnosis on the basis of puddle-leaving seems rather cavalier. Khan is
incontinent and likely to leave puddles, but we sure as heck aren't treating
him for UTIs on the basis of that. For one thing, he doesn't have a UTI
(which was confirmed through culture). For another, we wouldn't have caught
other stuff that is going on with him (low specific gravity of urine
indicating possible kidney issues, and until ruled out, something like
diabetes, Cushing's, etc.).

In your shoes, I would express my discomfort to the vet about doing the
procedure, and see if they'd be amenable to having a urine culture done from
a mid-stream catch, first thing in the morning. Depending on what that
turns up and the analysis of that, there may be no need for a cyto.

Suja

More information: Genny died in 1990 so I don't remember if the
veterinarian diagnosed entirely on the basis of puddles. I'm sure he
didn't do the cyto, sterile sample thing, but he might have had me bring
in a urine sample. There's no reason why I would remember that.


When Cubbe got an infection 2 years ago, the symptom was waking us at
night to go outside to squat, then visible blood in her urine 2 days
later. At that time, I was worried that Cubbe was going the way Genny
did, but the veterinarian reassured me that sometimes dogs get
infections and that it doesn't necessarily mean anything. She also
assured me that there wasn't anything in her diet or anything that
happened to cause the infection. Her symptoms disappeared after the she
started on the antibiotic.


Knowing how uncomfortable a UTI can be, I was feeling seriously guilty
for not getting her to the doctor after the first night she woke us up.


This time, we had a urine sample to the doctor first thing in the
morning when she woke us to go outside at night. Again, her symptoms
disappeared almost immediately when she started on the medicine. Now,
she's seems fine. Since I wrap the enormous pill in cream cheese, she's
better than fine. She looooves cream cheese.


The doctor wants to do the cyto 2 weeks after the end of the course of
antibiotics. I was thinking that if there were no return of symptoms a
regular urine sample caught in the morning should be sufficient.


--Lia

In article ,
Julia Altshuler wrote:
The doctor wants to do the cyto 2 weeks after the end of the course of
^^^^
"cysto"
[for cystocentesis - look it up]

antibiotics. I was thinking that if there were no return of symptoms a
regular urine sample caught in the morning should be sufficient.

I would think. I've never had a vet request a cystocentesis
without a caught sample showing a problem first. The reason
for a clean sample is to do a culture and sensitivity test,
and if there's no need to do a sensitivity test then you
should be quizzing your vet pretty closely about why he
wants the cysto, especially since he's talking about
knocking her out. Even the Cornell vet school (which treats
every pet like a science experiment) doesn't use that degree
of overkill.
--
Melinda Shore - Software longa, hardware brevis -

Prouder than ever to be a member of the reality-based community

On Tue, 14 Aug 2007 12:29:51 -0400, "Suja" wrote:


"diddy" none wrote in message:

Cultures mostly. You can get outside contminates, and when cultured, show
positives and you might be treating things that might not even be in
Cubbe.

This is something that I've spoken with the vet about, considering that we
were doing urine cultures on Khan just about every week for a few months (at
least it seemed that way). She said that she does not normally find Cyto to
be necessary, as a good microbiologist can tell the difference between
contaminants and an honest to goodness infection. Having done a good bit of
micro, I tend to agree.

As for Genny's UTIs, I'm not sure why the vet never did any tests; I can
understand if he did a couple and it always came back as one, but making a
diagnosis on the basis of puddle-leaving seems rather cavalier. Khan is
incontinent and likely to leave puddles, but we sure as heck aren't treating
him for UTIs on the basis of that. For one thing, he doesn't have a UTI
(which was confirmed through culture). For another, we wouldn't have caught
other stuff that is going on with him (low specific gravity of urine
indicating possible kidney issues, and until ruled out, something like
diabetes, Cushing's, etc.).

In your shoes, I would express my discomfort to the vet about doing the
procedure, and see if they'd be amenable to having a urine culture done from
a mid-stream catch, first thing in the morning. Depending on what that
turns up and the analysis of that, there may be no need for a cyto.

By cyto I assume you're referring to cystocentesis and not cytology?
Cystocentesis is done to obtain a sterile sample for culture. It
shouldn't be necessary to determine whether or not there is bacteria
(though there are times when it is, maybe depends on who's looking
though the microscope), but if an infection doesn't respond to a
particular antibiotic it's necessary do culture and sensitivity to
identify the bacteria and determine what antibiotic it'll respond to.
We've had plenty of UTIs over the years, only had to do cystocentesis
a couple of times. Mid-stream catch for plain old urinalysis is
definitely the first step, and may be all that's necessary. As you
say, prescribing antibiotics on the basis of a puddle isn't the best
approach; incontinence can be caused by things other than UTI.

Mustang Sally

On Tue, 14 Aug 2007 12:49:19 -0400, Julia Altshuler
wrote:


The doctor wants to do the cyto 2 weeks after the end of the course of
antibiotics. I was thinking that if there were no return of symptoms a
regular urine sample caught in the morning should be sufficient.

Yes, wait to see if there is a return of symptoms after the
antibiotics are finished. If yes, cystocentesis for culture &
sensitivity may be needed; if not, no reason to do a cysto.

Mustang Sally

Jim was the one who actually spoke to the veterinarian. At first I
thought he said that she said she wanted a sterile sample 2 weeks after
the round of antibiotic was complete. When I checked with him and gave
him the information from this thread, he said he wasn't sure, and maybe
she said that if there were no symptoms, only the ordinary urine test
was needed. So I thank everyone for the information. I'll keep y'all
informed on how Cubbe fares.


--Lia