Significance of scattered small echogenic foci floating in urinary bladder as ultrasonography finding in dogs.

BACKGROUND: Despite the prevalence of echogenic foci floating in the urinary bladder seen in ultrasonography in dogs, surprisingly little has been written on its significance, including its potential association with urinalysis. The objective of the study was to determine the diagnostic value of the echogenic foci floating in urinary bladders in dogs. RESULTS: - Cystosonography was performed on 45 dogs. Bladder contents were examined and divided into positive (containing echogenic particles) and negative (absent echogenic particles) groups according to the presence and absence of floating echogenic particles. Five mL of urine was collected via cystocentesis. Urine analysis and culture were done and the relationship between ultrasound evaluation and urinalysis results was investigated. In dogs with bladder echogenic particles in ultrasonography, the prevalence of hematuria, pyuria, bacteriuria, and lipiduria were 88.9%, 92.6%, 29.6%, and 70.3%, respectively. However, in dogs in which echogenic particles were not observed in their bladders, the prevalence of hematuria, pyuria, bacteriuria, and lipiduria was 77%, 50%, 5.5%, and 77%, respectively. There was a significant association between bladder debris and positive urine culture, with an odds ratio of 7.15 (95% confidence interval: 0.81-63.28) compared with matched controls. Furthermore, there was a significant relationship between the presence of floating echogenic particles with pyuria, and urine color ( p ≤ 0.05). CONCLUSION: In conclusion, the present results showed the detection of bladder debris on ultrasound can be a predictor for pyuria and positive urine culture in dogs.

Clinical Differences in Dogs with Enterococcal Bacteriuria Compared with Other Bacteriuria: A Retrospective, Case-Control Study.

A retrospective case-control study was performed to determine the clinical differences between dogs with enterococcal bacteriuria (n = 96 cases) and control dogs with any other bacteriuria (n = 288). More dogs with nonenterococcal bacteriuria demonstrated lower urinary tract clinical signs such as hematuria, pollakiuria, and stranguria (40% versus 27%, P = .02). Recessed vulva (odds ratio [OR] 2.5, 95% confidence interval [CI] 1.4-4.2, P < .001), hyperadrenocorticism (OR 0.149, 95% CI 0.004-0.066, P = .03), chronic kidney disease (OR 2.29, 95% CI 1.14-4.51, P = .01), and myelopathy (OR 5.77, 95% CI 3.07-10.82, P < .001) were more common in dogs with enterococcal bacteriuria. Enterococcus spp. cases were more likely to have polymicrobial growth than controls (OR 28.52; 95% CI 12.63-69.62, P ≤ .001). Pugs (OR 7.4, 95% CI 2.6-19.9, P < .001), bearded collies (OR 24.3, 95% CI 2.9-205.5, P = .003), and Saint Bernards (OR 17.3, CI 1.9-154.4, P = .01) had increased odds of enterococcal growth compared with mixed-breed dogs. In the control (but not the case) population, there was an association between resolution of clinical signs and administration of antimicrobials (P = .01). The signalment, clinical signs, comorbidities, and response to therapy in dogs with enterococcal bacteriuria are different from dogs with other bacteriuria.

A double-blinded randomized placebo-controlled non-inferiority trial protocol for postoperative infections associated with canine pyometra.

BACKGROUND: Pyometra is a common infectious condition, especially in elderly bitches. In addition to an infected uterus, dogs may have concurrent urinary tract infection (UTI). The preferred treatment is surgical removal of the ovaries and uterus, whereupon the general prognosis is excellent. In addition, antimicrobial therapy is frequently prescribed for postoperative treatment. However, no research exists on the benefit of postoperative antimicrobial treatment in uncomplicated canine pyometra. Antimicrobial resistance has become a major challenge in treatment of bacterial infections. Diminishing overuse of antimicrobial agents is essential for controlling the development of antimicrobial resistance in both animals and humans. METHODS: This double-blinded, randomized, placebo-controlled two-arm clinical trial is designed to compare the incidence of postoperative infections associated with surgical treatment of uncomplicated pyometra followed by two different treatment protocols. For the study, 150 dogs presenting with an uncomplicated pyometra and that are to undergo surgical treatment will be recruited. Dogs with body weight < 3 or > 93 kg, complicated pyometra, primary disease increasing the risk of infection, or immunosuppressive medication will be excluded. All dogs will receive one dose of sulfadoxine-trimethoprim intravenously as an antimicrobial prophylaxis. Postoperatively, dogs will be randomized to receive either a five-day course of placebo or an active drug, sulfadiazine-trimethoprim orally. During the surgery microbiological samples will be taken from urine and uterine content. The follow-up includes a control visit in 12 days and an interview of the owner 30 days after surgery. If bacteriuria is detected at the time of surgery, a urinary sample will be cultured for bacterial growth at the control visit. The primary outcome is the incidence of a postoperative surgical site infection (SSI), and the secondary outcome is the occurrence of clinical UTI with bacteriuria. Intention-to-treat and per-protocol analyses will be performed to compare outcome incidences between the treatment groups. DISCUSSION: Research-based evidence is necessary to create treatment guidelines for judicious use of antimicrobials. The goals of this study are to provide evidence for reducing the use of antimicrobials and targeting the treatment to patients proven to benefit from it. Publishing the trial protocol will increase transparency and promote open science practices.

Risk factors of enterococcal bacteriuria in cats: A retrospective study.

Objective: To determine if factors associated with urothelial damage and inflammation, including urinary catheterization, urinary obstruction, and urolithiasis are associated with the presence of enterococcal bacteriuria in cats. Animals: Thirty-one cats with Enterococcus spp. bacteriuria and 31 cats with Escherichia coli bacteriuria. Procedure: A retrospective case-control study with cases and controls identified by records search for Enterococcus spp. (case) and E. coli (control) bacteriuria from August 1, 2014 to July 31, 2019. Cases and controls were balanced with respect to average age. Binary logistic regression was used to estimate and test whether the odds of having Enterococcus spp. bacteriuria (instead of E. coli) were associated with the presence of any characteristic. Results: Urinary catheterization, urinary obstruction, and urolithiasis were not observed more often in Enterococcus cases versus E. coli controls (19% versus 25%, P = 0.543; 19% versus 32%, P = 0.244; and 16% versus 16%, P = 1, respectively). Signs of lower urinary tract disease were significantly less common in Enterococcus cases than in E. coli controls (OR: 0.30; 95% CI: 0.10 to 0.83, P = 0.02). Hematuria was significantly less common in cases than controls (P = 0.048). Conclusion: No association was identified between urinary catheterization, urolithiasis, or any other comorbidities (hyperthyroidism, chronic kidney disease) and enterococcal bacteriuria in cats. Clinical relevance: Unlike in humans and dogs, urothelial damage and inflammation caused by factors such as urinary catheterization and urolithiasis may not be the mechanism for enterococcal bacteriuria in cats.

Facteurs de risque de bactériurie à entérocoque chez le chat : une étude rétrospective. Objectif: Déterminer si les facteurs associés aux lésions et à l'inflammation urothéliales, y compris le cathétérisme urinaire, l'obstruction urinaire et les lithiases urinaires, sont associés à la présence de bactériurie à entérocoque chez le chat. Animaux: Trente et un chats avec bactériurie à Enterococcus spp. et 31 chats atteints de bactériurie à Escherichia coli. Procédure: Une étude cas-témoins rétrospective avec des cas et des témoins identifiés par la recherche de dossiers pour bactériurie à Enterococcus spp. (cas) et à E. coli (témoin) du 1er août 2014 au 31 juillet 2019. Les cas et les témoins étaient équilibrés par rapport à l'âge moyen. La régression logistique binaire a été utilisée pour estimer et tester si la probabilité d'avoir une bactériurie à Enterococcus spp. (au lieu d'E. coli) était associée à la présence de n'importe quelle caractéristique. Résultats: Le cathétérisme urinaire, l'obstruction urinaire et la lithiase urinaire n'ont pas été observés plus souvent chez les cas avec Enterococcus spp. par rapport aux témoins avec E. coli (19 % vs 25 %, P = 0,543; 19 % vs 32 %, P = 0,244; et 16 % vs 16 %, P = 1, respectivement). Les signes de maladie des voies urinaires inférieures étaient significativement moins fréquents chez les cas à Enterococcus que chez les témoins à E. coli (OR : 0,30; IC à 95 % : 0,10 à 0,83, P = 0,02). L'hématurie était significativement moins fréquente chez les cas que chez les témoins (P = 0,048). Conclusion: Aucune association n'a été identifiée entre le cathétérisme urinaire, la lithiase urinaire ou toute autre comorbidité (hyperthyroïdie, maladie rénale chronique) et la bactériurie à entérocoque chez le chat. Pertinence clinique: Contrairement aux humains et aux chiens, les lésions urothéliales et l'inflammation causées par des facteurs tels que le cathétérisme urinaire et la lithiase urinaire peuvent ne pas être le mécanisme pour la bactériurie à entérocoque chez les chats.(Traduit par Dr Serge Messier).

Leukocyte Esterase and Nitrite Urine Reagent Strip Utility Under Altered Assay Conditions in Dogs.

The study evaluated leukocyte esterase (LE) and nitrite reagent pad usefulness in canine urine using multiple time endpoints and decision thresholds. Whole and sedimented urine samples from 116 client-owned dogs were analyzed with reagent strips from four manufacturers. Results for LE and nitrite were recorded every 30 s up to 150 s using "trace" and "+" positive thresholds and compared to microscopic urine sediment analysis and culture results. Sedimented urine assessed at 150 s with a "trace" positive threshold for LE had significantly or trending higher sensitivity (brand dependent) for pyuria detection compared with manufacturer recommendations. Using these parameters, LE sensitivity and negative likelihood ratio were 66.67-89.47%, and 0.13-0.37, respectively. Following manufacturer recommendations, LE specificity and positive likelihood ratio were 96.91-100% and 17.02-30.63, respectively. Nitrite performance for pyuria and bacteriuria detection was poor for all conditions. LE reagent pads are a useful screening test for pyuria detection using sedimented urine and a "trace" positive threshold at 150 s, whereas LE use with traditional manufacturer recommendations is a good confirmatory test for pyuria detection. Nitrite reagent pads are not useful for pyuria or bacteriuria detection.

Effect of intermittent bladder flushing on recurrence rate in feline urethral obstruction: 72 cases.

Objective: To evaluate the effect of intermittent bladder flushing on recurrent urethral obstruction (rUO) at 7 d and 30 d after discharge and the risk of bacteriuria as a result of indwelling urethral catheterization. Animals: There were 72 cats with suspected obstructive feline idiopathic cystitis admitted to the hospital. Procedures: Cats were randomly assigned to either intermittent bladder flushing (n = 34) or no-flush (control) groups (n = 38). Bladder flushing was performed with 5 mL/kg of sterile 0.9% saline, q8h during indwelling urinary catheterization. Urine was tested for bacteriuria by a point-of-care test at the time of urinary catheterization and via cystocentesis following catheter removal before discharge. Risk of rUO by groups and its association with other variables were evaluated. Results: The age (median: 3.0 years) in the flush group was younger (P = 0.01), and the length of hospitalization (> 24 hours) was longer (P < 0.01) than that of the control group. Overall rUO was 6.6% on Day 7 and 21.8% on Day 30 after discharge, but there was no significant difference between groups. A shorter duration of catheterization (< 24 hours) was associated with higher risk of rUO (odds ratio: 6.0). The incidence of catheter-related bacteriuria was 14.5% and was not significantly different between groups (13.8% and 15.2% in the flush and control, respectively). Conclusion and clinical relevance: Intermittent bladder flushing during hospitalization appears safe but did not decrease the incidence of rUO. The incidence of bacteriuria following catheterization was not affected by intermittent bladder flushing.

Effet des rinçages intermittents de la vessie sur le taux de récidive de l'obstruction urétrale féline: 72 cas. Objectif: Évaluer l'effet du rinçage intermittent de la vessie sur l'obstruction urétrale récurrente (rUO) à 7 jours et 30 jours après le congé et le risque de bactériurie résultant d'un cathétérisme urétral à demeure. Animaux: Il y avait 72 chats suspects de cystite idiopathique féline obstructive admis à l'hôpital. Procédures: Les chats ont été assignés au hasard à des groupes avec rinçage intermittent de la vessie (n = 34) ou sans rinçage (témoin) (n = 38). Le rinçage de la vessie a été effectué avec 5 mL/kg de solution saline stérile à 0,9 %, toutes les 8 heures pendant le cathétérisme urinaire à demeure. L'urine a été testée pour la bactériurie par un test au point de service au moment du cathétérisme urinaire et par cystocentèse après le retrait du cathéter avant le congé. Le risque de rUO par groupes et son association avec d'autres variables ont été évalués. Résultats: L'âge (médiane: 3,0 ans) dans le groupe rinçage était plus jeune (P = 0,01) et la durée d'hospitalisation (> 24 heures) était plus longue (P < 0,01) que celle du groupe témoin. La rUO globale était de 6,6 % au jour 7 et de 21,8 % au jour 30 après le congé, mais il n'y avait pas de différence significative entre les groupes. Une durée de cathétérisme plus courte (< 24 heures) était associée à un risque plus élevé de rUO (rapport de cotes: 6,0). L'incidence de la bactériurie liée au cathéter était de 14,5 % et n'était pas significativement différente entre les groupes (13,8 % et 15,2 % dans le rinçage et le témoin, respectivement). Conclusion et pertinence clinique: Le rinçage intermittent de la vessie pendant l'hospitalisation semble sans danger mais n'a pas diminué l'incidence de rUO. L'incidence de la bactériurie après cathétérisme n'a pas été affectée par le rinçage intermittent de la vessie.(Traduit par Dr Serge Messier).

Salmonella enterica subspecies houtenae as an opportunistic pathogen in a case of meningoencephalomyelitis and bacteriuria in a dog.

BACKGROUND: We report the first case of canine Salmonella meningoencephalomyelitis and second case of canine Salmonella bacteriuria, as well as the first reported case of Salmonella enterica subspecies houtenae in a dog. CASE PRESENTATION: Immunosuppressive treatment in a dog for a relapse of steroid-responsive meningitis and arteritis (SRMA) allowed for the opportunistic establishment of a bacteremia with Salmonella enterica subsp. houtenae, ultimately causing meningoencephalomyelitis and subclinical bacteriuria. The bacterial infections were treated with a four-month course of amoxicillin; clinical treatment success was determined by serial negative urine cultures and lack of clinical signs correlated to the meningoencephalomyelitis. CONCLUSIONS: Both the bacteriuria and meningoencephalomyelitis represented opportunistic infections in a dog immunosuppressed for SRMA. The clinical course of this infectious meningoencephalitis emphasizes the importance of differentiating relapse of initial disease from opportunistic infection occurring in a compromised central nervous system. The novel Salmonella species identified in this case acts as a reminder that infectious disease diagnostics should not be curbed by anecdotal prediction of routine pathogenic suspects.

Subclinical bacteriuria and surgical site infections in dogs with cranial cruciate ligament disease.

OBJECTIVE: To determine the prevalence of subclinical bacteriuria (SBU) in dogs with cranial cruciate ligament (CCL) disease, the clinical variables and clinicopathologic data associated with SBU, and the incidence of surgical site infections (SSI) in dogs with and without SBU. STUDY DESIGN: Prospective, clinical cohort study. ANIMALS: One hundred fifty-five dogs with CCL disease. METHODS: Dogs had a urinalysis, sediment examination, and aerobic urine culture performed. Age, breed, sex, body weight, body condition score, clinical history, and physical examination findings were recorded. Dogs with SBU were not treated for bacteriuria or with postoperative antibiotics. Standard perioperative antimicrobials were provided for all dogs. Dogs that received nonsteroidal anti-inflammatory drugs were not excluded. Dogs that underwent an osteotomy were followed for at least 1 year to determine incidence of SSI. Outcomes and variables associated with SBU were assessed. RESULTS: In 155 dogs with CCL disease, the prevalence of SBU was 6.5%, and SBU occurred exclusively in female dogs (11.4%). The incidence of SSI was 22.3% (25/112). Two of six dogs with SBU and 23/106 dogs without SBU developed SSI. Organisms isolated from SSI were different from those isolated from urine. CONCLUSION: The prevalence of SBU in dogs with CCL disease was similar to that in other studies in which SBU was evaluated in various populations of dogs. CLINICAL SIGNIFICANCE: Screening for and treatment of SBU may not be beneficial prior to tibial osteotomy for CCL disease. Additional studies are required to determine whether dogs with SBU have a greater risk of SSI.

A clinical approach to multidrug-resistant urinary tract infection and subclinical bacteriuria in dogs and cats.

Multidrug-resistant bacteria are increasingly isolated from the urinary tract of pets, particularly those that suffer from concurrent conditions, have been hospitalised, or were treated with antimicrobials in the recent past. Many of the multidrug-resistant bacteria encountered are resistant to all commonly used oral antibiotics. This poses both a therapeutic dilemma in the individual pet and a threat to public health. This article begins with an overview of multidrug resistance in organisms that are commonly isolated from the urinary tract of pets. This is followed by a proposed clinical approach to managing multidrug-resistant urinary bacteria, which summarises current knowledge regarding appropriate sampling and analysis, reviews the current guidelines regarding appropriate antimicrobial use and discusses treatment options that might be considered. The article highlights several shortcomings of the current knowledge to be considered when planning future clinical research and developing policies.

Investigation of subclinical bacteriuria in cats with dermatological disease receiving long-term glucocorticoids and/or ciclosporin.

BACKGROUND: Dogs receiving long-term glucocorticoids or ciclosporin have an increased frequency of bacteriuria. No studies have investigated the frequency of bacteriuria in cats receiving long-term glucocorticoids and/or ciclosporin. HYPOTHESES/OBJECTIVES: To document whether subclinical bacteriuria occurs in cats receiving long-term glucocorticoid and/or ciclosporin for management of chronic disease. ANIMALS: Thirty two cats treated with parenteral glucocorticoids and/or oral glucocorticoids and/or ciclosporin were included. METHODS: Thirty two cats receiving oral glucocorticoids and/or ciclosporin for at least three months or at least two injections of long-acting glucocorticoids within the preceding six months were evaluated. Thirty four healthy cats were used as a control group. Urinalysis and urine culture was performed on urine samples collected by cystocentesis from each cat. RESULTS: In the glucocorticoid/ciclosporin group, none of 32 cats had a positive urine culture. In the control group, one of 34 cats had a positive urine culture. There were no statistically significant differences between the urinalyses from either group. CONCLUSIONS AND CLINICAL IMPORTANCE: There was no evidence to suggest that administration of long-term glucocorticoids and/or ciclosporin is associated with bacteriuria in cats.

The frequency of urinary tract infection and subclinical bacteriuria in dogs with allergic dermatitis treated with oclacitinib: a prospective study.

BACKGROUND: Oclacitinib is a selective Janus kinase inhibitor for the treatment of canine allergic pruritus and atopic dermatitis in dogs. Glucocorticoids and ciclosporin increase urinary tract infection (UTI) frequency in dogs with inflammatory skin disease. OBJECTIVE: Prospective study to evaluate the frequency of UTI and subclinical bacteriuria in dogs with allergic dermatitis receiving oclacitinib. METHODS: Client-owned dogs ≥2 years of age with a history of allergic dermatitis without apparent history of urinary tract disease or predisposition to UTI were included. Prior to enrolment, urinalysis and quantitative urine culture were performed after a washout period of at least 14 days from systemic antimicrobial drugs and 28 days for ciclosporin and systemic glucocorticoids. Dogs received oclacitinib at labelled dosing for an intended period of 180-230 days with a follow-up urinalysis and urine culture performed regardless of urinary tract signs. Systemic antimicrobial and immune-modulating drugs were not administered during the study. RESULTS: None of the 55 dogs in this study developed UTI while receiving oclacitinib based on follow-up urinalysis and urine culture performed during a range of 58-280 days (mean 195 days). Two dogs developed self-limiting abnormal urinary tract signs without urine culture or urinalysis findings consistent with UTI. CONCLUSIONS AND CLINICAL IMPORTANCE: These findings indicate that bacteriuria is not an expected adverse effect in dogs treated with oclacitinib without a prior history of UTI or predisposing condition during this treatment period. Therefore, routine urine culture is not indicated for such dogs in the absence of abnormal urinalysis or clinical signs of urinary tract disease.

ASSOCIATIONS BETWEEN ULTRASOUND AND CLINICAL FINDINGS IN 87 CATS WITH URETHRAL OBSTRUCTION.

Urethral obstruction is a life-threatening form of feline lower urinary tract disease. Ultrasonographic risk factors for reobstruction have not been previously reported. Purposes of this retrospective cross-sectional study were to describe urinary tract ultrasound findings in cats following acute urethral obstruction and determine whether ultrasound findings were associated with reobstruction. Inclusion criteria were a physical examination and history consistent with urethral obstruction, an abdominal ultrasound including a full evaluation of the urinary system within 24 h of hospitalization, and no cystocentesis prior to ultrasound examination. Medical records for included cats were reviewed and presence of azotemia, hyperkalemia, positive urine culture, and duration of hospitalization were recorded. For medically treated cats with available outcome data, presence of reobstruction was also recorded. Ultrasound images were reviewed and urinary tract characteristics were recorded. A total of 87 cats met inclusion criteria. Common ultrasound findings for the bladder included echogenic urine sediment, bladder wall thickening, pericystic effusion, hyperechoic pericystic fat, and increased urinary echoes; and for the kidneys/ureters included pyelectasia, renomegaly, perirenal effusion, hyperechoic perirenal fat, and ureteral dilation. Six-month postdischarge outcomes were available for 61 medically treated cats and 21 of these cats had reobstruction. No findings were associated with an increased risk of reobstruction. Ultrasonographic perirenal effusion was associated with severe hyperkalemia (P = 0.009, relative risk 5.75, 95% confidence interval [1.54-21.51]). Findings supported the use of ultrasound as an adjunct for treatment planning in cats presented with urethral obstruction but not as a method for predicting risk of reobstruction.

Multicenter molecular investigation of recurrent Escherichia coli bacteriuria in dogs.

Escherichia coli is the most common cause of recurrent urinary tract infection (UTI) in dogs. UTI recurrence comprises of persistent, unresolved E. coli infection or reinfection with a different strain of E. coli. Differentiating between these processes is clinically important but is often impossible with routine diagnostics. We tested the hypothesis that most recurrent canine E. coli bacteriuria is due to recurrence of the same E. coli strain involved in the initial infection. Molecular typing was performed on 98 urinary E. coli isolated from dogs with recurrent bacteriuria from five veterinary diagnostic laboratories in the United States. Of the 42 dogs in this study with multiple E. coli bacteriuria observations, a single strain of E. coli caused recurrent bacteriuria in 26 (62 %) dogs, in some cases on multiple occasions for prolonged periods of time (up to eight months). A single E. coli strain was detected during both subclinical bacteriuria and clinically-apparent UTI in three dogs. Isolates with the P-fimbrial adhesin genes papA and papC were associated with recurrence by the same strain of E. coli. Multiple isolations of a single strain of E. coli associated with recurrent bacteriuria suggests that E. coli may be maintained within the urinary tract of some dogs for prolonged periods of time. In some patients, the same strain can cause both clinical UTI and subclinical bacteriuria. This indicates that in dogs, the urinary bladder may serve as a subclinical, long-term reservoir of E. coli that may cause clinical UTI in the future.

Point-of-care rapid immunoassay performed on voided urine, refrigerated up to 24 hours, accurately detects bacteriuria.

OBJECTIVE: To collect voided urine from dogs with clinical signs of lower UTI and determine the diagnostic performance of a commercially available rapid immunoassay (RIA) immediately after urine collection and after refrigeration at 4 and 24 hours. ANIMALS: 40 client-owned dogs. METHODS: Aerobic urine culture was performed on urine collected by cystocentesis. Urine samples were collected by voiding, and the RIA performed in triplicate within 30 minutes (time 0) and again in triplicate after 4 and 24 hours of refrigeration. Test precision and agreement between culture results and RIA results at each time point were determined, and factors possibly associated with false results investigated. RESULTS: 14 of 40 dogs (35%) had UTI verified by aerobic urine culture, and all had positive RIA. Three dogs had false positive RIA results. Sensitivity, specificity, positive predictive value, and negative predictive value of the RIA were 100, 88%, 82%, and 100%, respectively, and results were not different after 4 and 24 hours of refrigeration. Precision was excellent. CLINICAL RELEVANCE: This point-of-care RIA, performed on voided urine refrigerated up to 24 hours, rapidly and accurately identifies bacteriuria in dogs with lower urinary tract clinical signs, inexpensively.

Urinalysis and culture results of free-catch urine samples in dogs: a randomised controlled trial.

OBJECTIVES: To evaluate the prevalence of bacterial presence in free-catch urine samples preceded by either a standardised prepped ("clean-catch") protocol versus unprepped (non-cleaned) voiding. MATERIALS AND METHODS: The study was a single-centre prospective single-blinded randomised controlled trial. Urine samples were obtained from 100 client-owned dogs presenting for routine evaluation. Dogs were randomly assigned to either the prepped group (preputial or peri-vulvar area cleaned with sterile saline before collection) or the unprepped group (no preliminary cleansing) stratified by sex. Urinalysis and urine culture (blood and MacConkey agar) were performed on all samples. Significant bacterial presence on urine culture was defined as >104 colony forming units (CFU)/mL. RESULTS: There were no statistically significant associations between prepped versus unprepped collection method or sex with a urinalysis positive for bacteriuria. However, on culture, significant bacterial growth was almost five times more likely to be associated with males relative to females (odds ratio 4.59, 95% confidence interval 1.61 to 13.10). The probability of finding a positive culture was not statistically associated with prep method (odds ratio 1.43, 95% confidence interval 0.50 to 4.08). CLINICAL SIGNIFICANCE: For the majority of dogs without clinical signs of urinary tract infection, free-catch urine collection does not result in significant bacteriuria found on analysis or culture. The presence of bacteria found in free-catch samples may be secondary to sample contamination or subclinical bacteriuria. Sample contamination or subclinical bacteriuria may be more prevalent in male dogs.

Occurrence of bacteremia, bacteriuria and bacteriuria-related bacteremia in dogs and cats with chronic kidney disease. A pilot study.

In human medicine, major infections are the most significant and critical non-cardiovascular complications in patients affected by chronic kidney disease (CKD), with bacteriuria being the primary source of bloodstream infections and its evolution toward sepsis. The availability of data on prevalence of bacteremia and its association with bacteriuria in dogs and cats with CKD is limited. The aim of this observational cross-sectional study was to determine the occurrence of bacteremia, bacteriuria, and bacteriuria-related bacteremia in dogs and cats affected by CKD. Client-owned dogs and cats with a documented history of CKD undergoing disease follow-up were enrolled. Each included animal underwent a comprehensive physical examination, clinico-pathological and microbiological analyses of blood and urine, along with molecular detection of the 16S rRNA bacterial gene in blood. Aseptically collected blood and urine were obtained through jugular venipuncture and cystocentesis, respectively. After collection, blood and urine samples underwent bacteriological culture within one hour. In the population enrolled, 2/47 dogs and 1/41 cats presented bacteriemia. Moreover, 8/47 dogs and 6/41 cats presented a positive urine culture. Additionally, in one out of the 47 dogs, the same pathogen was identified from blood and urine samples, with a final diagnosis of urosepsis. No instances of bacteriuria-related bacteriemia were observed in the cat population. In conclusion, this study shows a low prevalence of bacteremia and confirms a high prevalence of bacteriuria in companion animals affected by CKD. Moreover, a low prevalence of bacteriuria-related bacteremia was also found.

Evaluation of the efficacy of a live Escherichia coli biotherapeutic product (asymptomatic bacteriuria E. coli 212).

BACKGROUND: Recurrent bacterial cystitis, often referred to as recurrent urinary tract infection (UTI), can be difficult to manage and alternative treatments are needed. HYPOTHESIS/OBJECTIVE: Intravesicular administration of asymptomatic bacteriuria (ASB) E. coli 212 will not be inferior to antimicrobial treatment for the management of recurrent UTI in dogs. ANIMALS: Thirty-four dogs with >1 UTI in the 12 months before presentation. METHODS: All dogs were deemed normal otherwise based on absence of abnormalities on physical examination, CBC, serum biochemical panel, and abdominal ultrasonography. Dogs were randomized to 1 of 2 treatment groups: Group 1 antimicrobials for 7 days or group 2 intravesicular administration of ASB E. coli 212. Owners were provided a voiding questionnaire regarding their dogs' clinical signs, which was completed daily for 14 days to assess clinical cure. Dogs were examined on days 7 and 14 to assess clinical cure, and urine specimens were submitted for urinalysis and bacterial culture. RESULTS: Clinical cure rates for ASB E. coli 212-treated dogs were not inferior to 7 days of antimicrobial treatment with a 12% margin of difference to determine non-inferiority. No significant difference was found between the treatment groups on days 7 and 14 in the proportion of dogs achieving ≥50% or ≥75% reduction in their clinical score compared with baseline. CONCLUSIONS AND CLINICAL IMPORTANCE: These data suggest that intravesicular administration of ASB E. coli 212 is not inferior to antimicrobials for the treatment of recurrent UTI in dogs. This biotherapeutic agent could help alleviate the need for antimicrobials for some dogs with recurrent UTI, improving antimicrobial stewardship.

UTIs in small animal patients: part 1: etiology and pathogenesis.

Understanding how urinary tract infections (UTIs) can occur and how to classify them can help the practitioner to make a plan for treatment. This review summarizes the etiology, pathogenesis, and host defense mechanisms associated with bacterial UTIs in dogs and cats. UTIs in Small Animal Patients: Part 2: Diagnosis, Treatment, and Complications will appear in the March/April 2013 issue of the Journal of the American Animal Hospital Association.

Comparison of wet-mount, Wright-Giemsa and Gram-stained urine sediment for predicting bacteriuria in dogs and cats.

This study assessed the standard urinalysis technique and sediment stain techniques as predictors of bacterial culture results for canine and feline urine. Canine (n = 111) and feline (n = 79) urine samples were evaluated using unstained wet-mount and air-dried Gram and Wright-Giemsa stained sediment; results were compared to aerobic bacterial culture. Eleven canine and 7 feline urine samples were culture positive. Unstained wet-mount and stained sediment had sensitivities of 89% and 83% and specificities of 91% and 99%, respectively. The specificity of using either stain was higher (P < 0.01) than wet-mount examination for detecting bacteriuria. There were significant differences among 3 technologists in detecting true positives (P < 0.01). Association of sediment and culture results used 112 canine and 81 feline samples. There was a negative association (P < 0.01) between lipid detection and wet-mount identification of bacteria.

Comparaison de sédiments d'urine à l'état frais, avec la coloration Wright-Giemsa et la coloration de Gram pour la prédiction de la bactériurie chez les chiens et les chats. Cette étude a évalué la technique d'analyse urinaire standard et des techniques de coloration du sédiment d'urine comme prédicteurs des résultats de la culture bactérienne. Les échantillons d'urine canine (n = 111) et féline (n = 79) ont été évalués en utilisant des sédiments à l'état frais et des sédiments séchés à l'air avec coloration de Gram et de Wright-Giemsa; les résultats ont été comparés à une culture bactérienne aérobie. Onze échantillons d'urine canine et 7 échantillons d'urine féline ont obtenu des résultats positifs pour la culture. Le sédiment à l'état frais non coloré et le sédiment coloré présentaient des sensibilités de 89 % et de 83 % et des spécificités de 91 % et de 99 %, respectivement. La spécificité de l'utilisation de l'une ou l'autre de la coloration était supérieure (P < 0,01) à celle de l'examen à l'état frais pour la détection de la bactériurie. Il y avait une différence significative entre les technologues pour la détection des vrais positifs (P < 0,01). L'association des résultats des sédiments et des cultures a utilisé 112 échantillons canins et 81 échantillons félins. Il y avait une association négative (P < 0,01) entre la présence de lipide et l'examen à l'état frais des bactéries.(Traduit par Isabelle Vallières).

Evaluation of haem dipstick pad, urine protein, urine pH and urine protein:creatinine ratio results as a marker of bacteriuria in dogs and cats with inactive urine sediment.

OBJECTIVES: Evaluation of haem dipstick pad, urine protein, urine pH and urine protein:creatinine ratio results as a marker of bacteriuria in dogs and cats with inactive urine sediment. MATERIALS AND METHODS: Cats and dogs with contemporaneous urine dipstick, microscopic sediment analysis and microbiological culture and sensitivity results over a four-year period (2016 to 2020) were retrospectively identified. Dogs and cats with active urine sediments (at least five erythrocytes and/or five leukocytes per high-power field) and/or spermaturia were excluded. Association between urine pH, haem dipstick result, protein dipstick result and urine protein:creatinine ratio with bacteriuria were evaluated using binary logistic regression analysis. Likelihood ratios for bacteriuria were calculated at different diagnostic thresholds. RESULTS: A total of 668 and 169 dog and cat urine samples were included. Of these, 166 dogs (25%) had a positive urine culture, whilst only 29 cats (17%) had a positive urine culture. In dogs and cats, any positive haem dipstick result was significantly associated with bacteriuria, although only a ≥4+ haem positive result in dogs was associated with a small increase in the likelihood of a positive urine culture, and positive likelihood ratios did not support the use of haem dipstick results as a screening test for bacteriuria in cats. pH, urine protein:creatinine ratio and protein dipstick results were not associated with bacteriuria. CLINICAL SIGNIFICANCE: Our findings provide proof of concept that haem dipstick pad results in dogs with inactive sediment and without spermaturia might be useful as a screening test for bacteriuria, although further studies are required to confirm these findings.