Cystitis

From Dog
Ultrasonographic appearance of the urinary bladder of a dog with bacterial cystitis, showing a markedly thickened wall[1]
Polypoid cystitis in a 10-year-old female spayed Boxer with chronic pyelonephritis[2]
Emphysematous cystitis in a dog[3]

Cystitis is an umbrella term for any inflammatory or infectious disease of the canine urinary bladder.

Bacterial cystitis is the most frequently observed inflammatory disease affecting the urinary bladder of dogs and humans[4]. Unlike cats with feline lower urinary tract infections, where bacteria are rarely present, canine cystitis frequently involves secondary or primary bacterial components.

Causes of bacterial cystitis in the dog include:

  • Genetic
- Hyperuricosuria
- Ectopic ureter
- Hypospadias[5]
- Transitional cell carcinoma
- prostatitis, epididymitis
- nephrotic syndrome[7]
- pyelonephritis
- renal amyloidosis[8]
- Leptospira spp

In ascending bacterial infections, urethral sphincter mechanism incompetence plays an important role in introduction of bacteria into the bladder[9]. However, descending infections from the kidneys also occurs, such as is observed with Leptospira spp.

Unresolved, long-standing infections associated with cystitis often lead to polypoid cystitis, a nonspecific mucosal reaction secondary to chronically inflamed bladder, where there is gross polypoid lesions (with edema) or papillary lesions[10]. This is commonly seen in young dogs with ectopic ureter.

Juvenile vaginitis/cystitis is commonly observed in prepubertal dogs and bitches and is usually nonpathogenic once diagnosed and treated. Urinary incontinence in old dogs is often associated with a low-grade cystitis.

Bacteria are normally found in the dog lower urinary system, especially associated with cystitis. In order of importance, they include:

A diagnosis of cystitis in dogs is based on urine bacterial culturing, urinalysis including sedimentation assessment and clinical symptoms such as dysuria, hematuria, and pollakiuria[13].

Although the presence of WBCs greater than five cells per high power field (HPF) (×400) and detection of bacteria in urine are indicative of infection, urine culturing is the gold standard for confirming cases of bacterial cystitis. However, failure to detect bacteria in urine sediment does not rule out urinary tract infection[14]. The results of urine culturing can be negative when antibiotic therapy has been initiated prior to urine collection or if handling of the urine sample during collection, preservation, or transportation is inadequate[15].

For treating bacterial cystitis in veterinary medicine, assessment of the medical history, clinical signs, serial urinalysis, and urine culturing are the best methods for monitoring the infection and determining whether to continue treatment[16].

Broad-spectrum antimicrobials are usually indicated, with antimicrobials that have a high urianry excretion such as amoxycillin/clavulanate and cephalexins.

References

  1. Seo KW et al (2012) C-reactive protein as an indicator of inflammatory responses to experimentally induced cystitis in dogs. J Vet Sci 13(2):179-185
  2. Vetpath
  3. Matsuo S et al (2009) Emphysematous cystitis in a chemically-induced diabetic dog. J Toxicol Pathol 22(4):289-292
  4. Barsanti JA (1998) Genitourinary infections. In: Green CE, editor. Infectious Disease of the Dogs and Cat. 2nd ed. Philadelphia: Saunders. pp:626–645
  5. Pavletic MM et al(2007) Reconstruction of the urethra by use of an inverse tubed bipedicled flap in a dog with hypospadias. J Am Vet Med Assoc 231(1):71-73
  6. Zotti A et al (2007) Chronic cystitis with ossification of the bladder wall in a 6-month-old German shepherd dog. Can Vet J 48(9):935-938
  7. Klosterman ES, Pressler BM (2011) Nephrotic syndrome in dogs: clinical features and evidence-based treatment considerations. Top Companion Anim Med 26(3):135-142
  8. Segev G et al (2012) Renal amyloidosis in dogs: a retrospective study of 91 cases with comparison of the disease between Shar-Pei and non-Shar-Pei dogs. J Vet Intern Med 26(2):259-268
  9. Delisser PJ et al (2012) Static hydraulic urethral sphincter for treatment of urethral sphincter mechanism incompetence in 11 dogs. J Small Anim Pract 53(6):338-343
  10. Berent AC et al (2012) Evaluation of cystoscopic-guided laser ablation of intramural ectopic ureters in female dogs. J Am Vet Med Assoc 240(6):716-725
  11. Johnson, JR et al (2003) Identification of urovirulence traits in Escherichia coli by comparison of urinary and rectal E. coli isolates from dogs with urinary tract infection. 'J Clin Microbiol 41:337-345
  12. Gatoria IS et al (2006) Comparison of three techniques for the diagnosis of urinary tract infections in dogs with urolithiasis. J Small Anim Pract 47(12):727-732
  13. Lees GE (1996) Bacterial urinary tract infections. 'Vet Clin North Am Small Anim Pract 26:297–304
  14. Bartges JW (2005) Urinary tract infections. In: Ettinger SJ, Feldman EC, editors. Textbook of Veterinary Internal Medicine: Diseases of the Dog and Cat. 6th ed. St. Louis: Elsvier Saunders. pp:1800–1808
  15. Padilla J et al (1981) Effects of storage time and temperature on quantitative culture of canine urine. J Am Vet Med Assoc 178:1077–1081
  16. Osborne CA & Lees GE (1995) Bacterial infections of the canine and feline urinary tract. In: Osborne CA, Finco DR, editors. Canine and Feline Nephrology and Urology. 1st ed. Baltimore: Williams & Wilkins. pp:759–797