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Old 02-15-2015, 06:31 PM   #1 (permalink)
 
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cystocentesis vs clean catch urine sample

Thoughts on the pros/cons and when each would be recommended?

V. has a UTI (no actual sx of a UTI but we caught it due to a stinky smell coming from her back end (which actually is coming from an irritated spot under her tail and her anus). She was on antibiotics for 2 weeks starting 1/9 for a vulva bacterial infection.

Anyway - had the derm look at her when we brought her in for her allergy shot - and she thought she had a UTI as V. dribbled a few drops of urine when they examined her. Said to get a urine sample over to our regular vet. I hadn't noticed any signs of a UTI but after she said that I inspected her vulva area and noted it was very faintly irritated a touch in the folds.

So - dropped off a urine sample and they called me back and wanted to do a cystocentesis which frankly I wasn't comfortable with - but I have a strong preference to avoid invasive procedures unless absolutely necessary. We went in for her appointment and the tech kept pushing the procedure and I kept saying I wasn't comfortable with it (and quite honestly I like my vets and I do think they're competent...to a point - but I think the surgeon who operated on V. from the specialty hospital is more competent - and if we're doing an invasive procedure I would want a second opinion and I would want him to do it).

So the vet came in and she didn't push it - she said the free catch sample showed a UTI and that she was asking for the sterile collection b/c she "heard" we were coming in for sx of a UTI and she was concerned about antibiotic resistant bacteria and wanting to know if the bacteria/infection had traveled up her urethra to her bladder. However after examining V. and hearing her sx (stinky and irritated anus, stinky and irritated spot above her anus and very slightly irritated vulva w/ no outward signs of a UTI - we never noticed any dribbling) she said she felt comfortable assuming at this point it was localized and putting her on a 3 week antibiotics course (she also gave me mal-a-ket solution for cleansing the whole area saying the smell was from an overgrowth of bacteria).

If this doesn't clear it up then obviously we will have to go further - my question is - what's the deal with the cystocentesis? I had never heard of it before - is it being done routinely now? Seems to me to be a little bit of over kill unless there is a potentially serious problem. I didn't think we were there yet, and I'm still not 100% clear how it would have changed the course of treatment other than to prescribe a different antibiotic. Since V. was on an antibiotic early January with seemingly good results - it kind of seemed to me that she had a positive response but maybe was stopped too soon? Any thoughts?
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Old 02-16-2015, 06:06 AM   #2 (permalink)
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cystocentesis vs clean catch urine sample

I know when my friends had a pup who had a UTI and she would struggle to pee. She was literally peeing itty bitty drops only and the vet was worried about build up. Other than that I am with you about waiting it out before doing an invasive procedure. Is V having nothing come out? Or just the smells etc that brought it to your attention so I would think she was still peeing why the need for a cystocentesis. But I'm no vet lol can you call and get a second opinion somewhere?

Sorry you guys are going through this. no fun for sure. Whatever way you decide keep us in the loop. Good luck!
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Old 02-16-2015, 01:04 PM   #3 (permalink)
 
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As far as I can tell...she has no noticeable signs of a UTI at all - which sort of threw me because I was complaining about her slightly irritated and somewhat tender anus, with the small red, irritated spot above the tail that STUNK TO HOLY HELL...

they did do several slides and said there was an overgrowth of bacteria - and I'm assuming that caused the stink.

I think I'm going to call the vet to clarify...I would have asked more questions If I didn't get so thrown off my game by the cysto recommendation.
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Old 02-17-2015, 08:53 PM   #4 (permalink)
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the smell symptoms make it sound more like a canine vaginitis. an external infection of bacteria or yeast that enters the urethra and the secondary complication that results is the UTI.
in addition to the meds, i would include a mild anti microbial soap. and keep the area dry as possible. wipe with anti microbial wipes after each urination.
maybe some dietary changes too.
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Old 02-18-2015, 11:15 AM   #5 (permalink)
 
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We have a mal-a-ket solution from the vet to cleanse the area - and she gets a bath once a week w/ a chlorhexiderm 4% shampoo from her dermatologist.

When you say change her diet are you thinking food allergies? She has allot of environmental allergies and gets and allergy injection every 3 weeks. The elimination diet didn't turn up any food allergies - but we did that @ 7 years ago - so things certainly could have changed...

The smell isn't coming from the vulva it's coming from the anus. Does seem less intense/strong since we started treatment - but the overgrowth of bacteria is on the anus and tail as well.

The vet said that given the sx she really didn't think it was a bladder infection and felt it was a more localized infection.

FWIW - a couple of members on a different forum - who I believe are experienced breeders - told me the cysto was a routine procedure - and from what I have since read - the best/only way to accurately diagnose a UTI/bladder infection. So I learned something. I still don't like it - only because I don't trust people to be competent and any time you perform an invasive procedure you open the opportunity to introduce human error - but that's just me and my paranoia.
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Old 02-18-2015, 07:22 PM   #6 (permalink)
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oh i see.
the wash is good. maybe try an enema cleanse if you think the infection is also inside the rectal cavity.
as far as dietary strategy, i was referring to lowering her pH levels so her excretory system is more hostile for bacteria. the more acidic the better.
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Old 02-19-2015, 12:24 AM   #7 (permalink)
 
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Thank you. I looked into the PH levels...soooo everything with this dog is a challenge - to lower the ph a diet low in fruits, grains and vegetables is recommended. Veronica gets cooked vegetables twice a day (per her vet) instead of more caloric treats b/c we are trying to manage her weight.

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Old 02-19-2015, 04:41 AM   #8 (permalink)
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Hello! My girl had an on going uti. She was given three diffrent kinds of antibiotics because after she finished one it would come back within a week or so. From advice on here I stared to wipe her more often (she had a leaky anal glad) and I started to add a tablespoon of apple cider vinegar to her food once a day to help with her PH levels. After her last round of atibiotics and the apple cider vinegar she hasn't gotten it again. I'm hoping it remains that way and I'm always wiping her down. My vet never asked to do that procedure. He seemed confident that her free urine sample was enough. Hope that helps and I hope V gets well soon!
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Old 02-20-2015, 12:58 AM   #9 (permalink)
 
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Thank you Kai! That's very helpful info!!
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