SUMMARY: Integrative veterinarian and founder of ToeGrips® for Dogs, Dr. Julie Buzby believes that you can never have TMI on UTIs in dogs. Urinary tract infections in dogs can be SERIOUS business, especially when they go undetected. In this post, she shares an overview of urinary tract infections in dogs, the spectrum of symptoms, and some practical steps you can take to ensure your dog’s urinary health.
Did you know that urinary tract infections in dogs (UTIs) can be occult? Not “occult” as in wizardry or voodoo. “Occult” disease in medicine means that the condition occurs without obvious signs or symptoms. I suspect that there are many dogs, especially females, running around the world with undiagnosed UTIs.
Most of us are familiar with UTIs in humans, which (like dogs) are much more common in females. But do you know the symptoms of urinary tract infection in dogs? I’d like to introduce you to three of my patients, who illustrate the gamut of ways canine urinary tract infections can present.
Beyond the bladder: The worst-case scenario
Every veterinary hospital has a few “frequent flyer” patients who seem to be at the office constantly. Penny, a 4-year-old Westie, was one of ours. She was usually on the appointment schedule for her chronic skin issues. But one Friday morning Penny presented for blood in her urine. She had a low-grade fever but no other obvious symptoms. After running some tests, she was diagnosed with a urinary tract infection (UTI) and sent home with oral antibiotics.
But here’s the horrible part that plagues me to this day: Penny died that weekend. Her death was a shock to everyone on our staff—the doctor who saw her, certainly me, and most of all, her family. It was heartbreaking on so many levels.
Because of this unexpected outcome, I asked Penny’s mom if she would consent to a necropsy (an animal autopsy). She agreed, and I drove the deceased dog to a specialist to have the autopsy performed. Penny’s parents wanted closure and I wanted answers, but the final report broke my heart.
Penny had died from an infection in the kidneys called pyelonephritis, which is literally translated as “pus in the kidneys.” Most likely, bacteria from her UTI had ascended from the bladder through her ureters—the little tubes that connect the bladder to the kidneys.
To this day, I don’t know how she got so sick so fast without her conscientious owners seeking emergency veterinary care. I suspect her family thought that she was on appropriate medication and just needed time. I’m haunted to this day by the thought that we could have done more for Penny.
Urinary tract infections are more than just painful and annoying. In “the perfect storm”, they can become life-threatening. I hope that Penny’s story will help others avoid this devastating outcome.
When there’s more to the story: Predisposing factors
My second story, about a sweet senior dog named Bailey, is an example of the importance of keeping a vigilant eye on dogs who are predisposed to UTIs.
Bailey, a massive black Newfy, was scheduled with me for acupuncture. She had recently become acutely paralyzed, most likely due to a fibrocartilaginous embolism. I will never forget meeting her because Bailey’s owner pushed her into the office on a luggage cart like they have in the Marriott lobby. Unusual but brilliant.
Fortunately, with time and treatment, Bailey regained mobility and the Marriott got their luggage cart back. But her problems were not limited to her limbs. She also had bladder involvement. The nerves that innervate the hind legs come from the same general area in the spine as the nerves that run to the colon and the bladder, so it’s not uncommon to see bladder involvement with hind limb nerve damage.
Caution flag #1: Bailey was not emptying her bladder normally
In Bailey’s case, she had an issue urinating normally. When her bladder was full, her owner had to express it. He did this by putting some pressure on the bladder to initiate the flow of urine. Bailey definitely wasn’t emptying fully nor emptying normally. Since urinating helps “flush” the system, Bailey had an automatic red flag for developing a UTI (remember the ascending bacteria concept?).
Why emptying the bladder helps prevent a UTI in dogs
Interestingly enough, the bladder should be sterile (bacteria-free) and the urine should be sterile too. However, a dog’s hind end is not sterile by any means. So bacteria can enter the opening of the urethra and climb up the urinary tract heading toward the bladder and then continue to climb even higher toward the kidneys if left unchecked and with enough time.
As I mentioned, the process of urinating helps flush pathogens out. (Think of water at full speed traveling through a garden hose and flushing dirt out as a result of the flow.) The very act of urinating acts as a mechanism to prevent urinary tract infections. But because Bailey was urinating so infrequently and not emptying fully when she did, she was much more prone to getting a urinary tract infection.
Caution flag #2: Prednisone increased Bailey’s likelihood for developing a UTI
Second, Bailey had been prescribed prednisone, which decreased her ability to fight infection. This was another red flag in her predisposition to develop a urinary tract infection.
One of the side effects of prednisone is that it decreases the body’s immune system. So while the prednisone and acupuncture significantly improved Bailey’s mobility, her chances of developing an infection were higher than that of the average dog.
Why UTI screening may be necessary before a dog shows symptoms
While Bailey wasn’t yet showing any symptoms of a urinary tract infection, she did have two red flags that were not in her favor. I suggested to my client that he take a urine sample to his regular vet just as a preemptive measure—to make sure that a UTI wasn’t brewing.
Two weeks passed and Bailey’s dad hadn’t noticed any obvious UTI symptoms. Without physical changes, it was hard for the client to have the motivation or a sense of urgency to have Bailey checked. He didn’t.
Urinating in the house: a classic sign of a UTI
However, several weeks later, Bailey started urinating in the house. She was both leaking urine and having accidents. The client saw the physical evidence and took it seriously. He drove Bailey to his regular vet for testing and she was diagnosed with a urinary tract infection. With antibiotics for her UTI, Bailey was feeling better quickly and my client’s carpets were dry once more.
In sharing Bailey’s story, my hope is that if your dog has predisposing factors that increase the likelihood of a UTI, you will speak with your vet and consider periodic urinalysis checks for good measure. Your veterinarian is an excellent resource and will appreciate that you’re looking out for your dog’s best interests by making early detection a priority.
Chance’s UTI story:
The Vigilant Owner = The Happy Ending
My last example of how a UTI manifests in dogs focuses on a sweet senior male dog named Chance. While boarding, he got very sick near the end of his stay. His mom rushed home to pick him up and poor Chance had a fever of 104 degrees. (For details about determining your dog’s normal body temperature, please check out my podcast: Learn Your Dog’s Vital Signs.)
His mom rushed him to the emergency vet hospital where he was diagnosed with pyelonephritis, like Penny. Fortunately, Chance recovered fully, but not after an expensive and extensive stay at the veterinary referral center.
Why do I share these stories with you? It’s not to worry you, as I never want to cause anyone to worry. Instead, I hope to help spread awareness of the importance of knowing all the signs of a UTI so that we can best care for our dogs.
In cases like these, the early signs of urinary tract infection were quite hard for the dog owners to detect. But a UTI was sneaking up on the dogs, none the less. By the time the more obvious signs cropped up, it was critical that the dogs receive veterinary care.
Signs and symptoms of a UTI in dogs
Educate yourself on the signs of urinary tract infections in dogs. The list below includes a wide range of symptoms that may be present when a dog has a urinary tract infection. As the UTI progresses, the signs generally move from hidden/subtle to obvious.
Know the signs of a UTI and always be observant of your dog’s behavior. Signs may include:
- Licking of the external genitalia
- Dark staining around the vulva (females)
- Frequent urination
- Urinating just a few drops at a time
- Urine leaking
- Urinating in the house; accidents
- Blood in the urine
These signs are classically associated with a UTI, although they may be associated with other medical conditions too. I can’t stress enough the importance of consulting your vet when you first notice anything of concern.
Here is one more thing that you can do to help your dog:
Take your dog to your veterinarian for yearly physical exams. And if your dog is a senior (seven OR MORE years of age), your dog may benefit from more frequent visits—at least biannual. Sometimes a UTI is found through a routine screening test or based upon little clues that, as veterinarians, we find on a physical exam.
What happens if your dog’s urinary tract infection goes untreated
In addition to infection and pyelonephritis mentioned earlier, if a UTI goes undiagnosed, there’s a type of bladder stone, called struvite stones, which form in the face of infection. If a urinary tract infection goes untreated, a dog can develop bladder stones. Not all bladder stones are related to infection. However, this specific type—which is quite common in dogs—is directly correlated to an infection in the bladder.
Why a UTI is more common in female dogs
You may be wondering why urinary tract infections are more common in female dogs. It’s really a simple matter of location, location, location. The way the plumbing lays out on a female dog—the distance from the bladder to the external world and the location of the bladder opening—makes the chances for a UTI more likely. Basically, the end of the urethra—which is the tube that runs from the bladder externally—ends in a completely different place than on a male dog.
If you think about the anatomy of a female and male dog, the male dog’s plumbing has a lot longer path to travel through the penis to end under the abdomen. In the female, the vulva sits right under the anus, so we see more fecal contamination. This is especially true for senior dogs who may have more difficulty squatting to urinate (more difficulty posturing) and are prone to incontinence, or are overweight with folds of skin around the hind end.
Related post: Is Incontinence Normal in Senior Dogs?
Feces is full of bacteria
Fecal contamination is one cause of urinary tract infections. We know that the feces are full of bacteria. For example, E. coli is one of the more common bacteria that we see causing UTIs and is a fecal contaminant. If your dog has any sort of issue urinating or defecating in a tidy manner, I’m an advocate for using unscented, sensitive skin baby wipes to help keep your dog “wiped” clean.
Does cranberry juice help a UTI in dogs?
The question of cranberry supplements for UTIs in dogs comes up frequently. In fact, you may have heard about cranberry for your dog’s urinary tract health. There’s a half-truth here. Cranberry only works if the dog has an E. coli infection. In other words, it’s not going to work for every single type of UTI in dogs. Don’t think of it as a panacea. But if you know that your dog is specifically prone to E. coli UTIs, a cranberry supplement such as CranMate® is a great option.
If you suspect that your dog has a UTI
If you think your dog may have a urinary tract infection, please don’t wait. Speak with your veterinarian. More than likely, your vet will ask you to bring a urine sample from home to the vet’s office. (For more about how to collect a urine sample, watch for my upcoming companion blog post on how to improve your dog’s lab tests.)
In some cases, your dog’s veterinarian may need to collect a sterile sample from the dog’s bladder by cystocentesis—drawing the urine directly from the bladder using a needle. (It sounds awful, but it is a very common, safe procedure.) The urine will be sent to a lab for testing to determine if bacteria are present, the type, its concentration, severity of the infection, and more. Finally, the lab will determine which antibiotic will most effectively treat the infection.
I believe in you and your dog
In conclusion, I believe in you. You know your dog better than anyone else. And with this information on the sneaky ways of UTIs, you’re prepped to help your dog live the happiest, healthiest life possible.
If you sense any abnormality in your dog, and certainly anything related to the urinary tract, please call your veterinarian. Like all medical issues, the sooner it is diagnosed, the easier, cheaper, safer, and faster it can be resolved. And ultimately, that is the very best thing for our dogs.
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