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. 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:
- Primary bacterial (see below)
- Geriatric cystitis associated with urinary incontinence
- Benign inflammatory fibrous polyp (eosinophilic polypoid cystitis)
- Emphysematous cystitis associated with diabetes mellitus
- Secondary disease
- - prostatitis, epididymitis
- - nephrotic syndrome
- - pyelonephritis
- - renal amyloidosis
- - Leptospira spp
In ascending bacterial infections, urethral sphincter mechanism incompetence plays an important role in introduction of bacteria into the bladder. 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. 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:
- Escherichia coli
- Klebsiella spp
- Proteus mirabilis
- Pseudomonas aeruginosa
- Haemophilus spp
- Streptococcus spp - α-haemolytic
- Corynebacterium urealyticum
- Alcaligenes faecalis
- Bacteroides spp
- Pasteurella spp
- Citrobacter spp
- Enterococcus spp
- Providencia stuartii
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.
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. 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.
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.
Broad-spectrum antimicrobials are usually indicated, with antimicrobials that have a high urianry excretion such as amoxycillin/clavulanate and cephalexins.
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