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Recurrent Urinary Tract Infections - Prevention Strategies

  • May 11, 2016 12:03 PM EDT

    Urinary tract infections (UTI) are generally classified as uncomplicated or they can be recurrent due to relapse or reinfection by virulent uropathogens. Other complicating factors that can contribute to recurrent UTI include poor hygiene, immunosuppression, and anatomic abnormalities.

    In his discussion on Recurrent UTI and Prevention Strategies for Re-Infection, Dennis Chew, DVM, DACVIM provided this check list to reference when dealing with a patient with a recurrent urinary tract infection:

    • Confirm the disease is bacterial, the organism's susceptibility to antibiotics, and MIC

    • Exclude ANATOMICAL abnormalities
      • Urolithiasis (upper and lower)
      • Ectopic ureters
      • Neoplasia (bladder, urethra, prostate)
      • Urachal diverticulum
      • Polypoid cystitis
      • Recessed vulva
      • Vestibulovaginal stenosis
      • Chronic bladder thickening
      • Pyelonephritis
      • Prostatitis

    • Exclude METABOLIC conditions
      • Dilute urine
      • Diabetes mellitus
      • Hyperadrenocorticism / exogenous corticosteroid Rx
      • Renal failure
      • Hyperthyroidism
      • Immunosuppression / chemotherapy

    • Exclude FUNCTIONAL abnormalities
      • Complete voiding
      • Urine retention
      • Urinary incontinence and wicking effects

    Learn more about Recurrent UTI, the causes, appropriate work up, and therapeutic considerations.

    Management of patients with recurrent UTI can be frustrating - particularly when an underlying or complicating factor cannot be identified and/or treated. Patients are often prescribed long term antimicrobial therapy which can contribute to the development of antimicrobial resistance. In humans, cranberry extract has been shown to prevent recurrent UTI in women. Cranberries have a number of constituents (phytochemicals) and general heath benefits. Until recently, the effects of cranberry in veterinary patients was unknown.

    In this week's Evidence Based Update we discuss a recently published study that examined the effects of cranberry in dogs with a history of recurrent UTI. Discussion includes:

    • Normal host defenses that prevent UTI
    • Why UTI develops
    • Effects of cranberries on bacterial growth and adherence to cells
    • Efficacy of cranberries compared to antibiotics on uropathogens
    • Considerations for use of cranberry in the management of patients with UTI
    • The Specialist's Spin and takeaway on the findings of this study

    View this Evidence Based Update (Running time: 18 mins)

     

    Reference: Effects of cranberry extract on prevention of urinary tract infection in dogs and on adhesion of Escherichia coli to Madin-Darby canine kidney cells - Am J Vet Res. 2016 Apr;77(4):421-7.

     

    • 300 posts
    May 12, 2016 10:13 AM EDT

     

    Here's a preview of this week's EBU