Urinary Tract infections

• These defenses are necessary to prevent infections in the urinary tract.

• If any of these defenses are abnormal or absent infection can result.

• Chronic urinary tract infections have an underlying cause.

Urinary Tract Defenses

• Normal Micturition

• Anatomy

• Mucosal Defense Barriers

• Antimicrobials properties of urine

• Systemic Immune System

The Microbes

• Gram negatives

• Gram positive

Clinical Signs

• Upper Urinary Tract

• Lower Urinary Tract

• Prostatic Infection

Diagnostics (chronic infections)

• Rectal Exam!

• Urinalysis (of course)

• Culture & MIC (of course)

• Abdominal radiographs

• Abdominal ultrasound

• Cystoscopy

Urinalysis

• Things that make you suspicious for infection

Urine Culture

• When to ALWAYS culture

• Be careful of contaminants

Therapy

• Uncomplicated UTI

• Enrofloxacin resistance

• Resistance has increased since 1994

• Multi-drug resistance can occur with resistance to enrofloxacin

• Complicated urinary tract infections

Owner Compliance

• Antimicrobial usage compliance

Chronic UTI

• Relapse

• Re-infection

Chronic Infection

• Superinfection

• Always culture after finishing antibiotics

• Tend to have more resistant MIC patterns

• Reinfections seen in paraplegics, chemo patients and/or steroids, anatomic defects or urolithiasis

Prophylactic Therapy

• Low dose antimicrobial therapy

Ancillary Therapy

• Methenamine mandelate