Blood In Dog's Urine

Hey guys. Dr. Lara here today. I'm here with Pepper. Pepper is a four year old female, intact, that means not spayed English bulldog. And she's coming in today because she has blood in her urine. All right, so blood in the urine in an English bulldog. So in general, blood in the urine is not the end of the world. It's not an emergency, but it is something that is typically uncomfortable. If you know anyone who's ever had a urinary tract infection or anything like that, it's pretty uncomfortable. And so it is something that I do think needs to be addressed sooner rather than later. So. So let's talk about some of the different things that can cause that. One, could be a urinary tract infection. Two, could be some sort of bladder stones. Three, could be some sort of what we call a sterile cystitis. So what that is is just inflammation of the bladder wall without any sort of infection or tumor or anything like that. Four, is a, is a tumor. And so those are the most common causes of urinary tract infections or blood in the urine. That being said, English bulldogs have a higher propensity to urinary tract infections or lower urinary tract disease because they have of their anatomy. So what ends up happening is, especially if the bulldogs are spayed, female bulldogs are spayed before a heat cycle, it doesn't allow the vulva to drop, and when it drops, it does drop permanently. So that's something that actually helps to prevent English bulldogs and dogs in general from getting urinary tract infections in the future. The other thing is English bulldogs, male English bulldogs are prone to what are called cysteine stones. Cysteine. There are four kinds of bladder stones. Cysteine is one of the more uncommon bladder stones. And that typically results when the body doesn't properly eliminate a particular mineral and then that ends up getting leaked into the bladder, which ends up forming stones. Okay. Now when we have a dog that is having urinary tract or lower urinary tract disease. So that's either blood in the urine, that's frequent urination, that's loss of control of urination, that's blood in the urine, that's licking around the perigenital area more frequently, the ways that we go about that is first we would or finding out what the cause is, we would do a urinalysis. And so in an ideal world, we would catch what's called a cystocentesis. Cystocentesis is where we stick a needle directly into the bladder. Sounds a lot more gruesome than it really is. Most dogs are actually freaking out more about being held than they are about. About the actual procedure in and of itself. The reason we would ideally collect that particular sample is, is because if there is blood in that urine or if there's bacteria in that urine, we know that the blood and the urine are coming from within the bladder versus if we go ahead and collect it from what's called a free catch. So when she pees it out and it slides it right out of the vulva into our cup or our collections specimen, we can't tell if that's from the urinary tract, from contamination of the vulva, or if it's truly coming from the urinary bladder. So we do the urinalysis, we look under the microscope, and that gives us an idea of a. How much blood there is, is. If there's any. If there's bacteria and also white blood cells. We can't really get any indications of what's going on in terms of bladder stones. The next thing that typically we would do in terms of testing would be to do some blood work. We'd want to see if there's any sort of metabolic diseases that are potentially going on that could be making her more prone to urinary tract infections, like diabetes, like kidney disease, like Cushing's. Those are just some of the potential diseases that could make them more prone to urinary tract disease. After that, we would do what's called a culture. Insensitivity culture and sensitivity is a test where we collect, like I said, ideally, a sterile urine sample, which would be via the cystosynthesis. And we would send that off to the lab to have them try and grow whatever is in the bladder. Once we actually. If the lab is actually able to grow something, what they will do is they will go ahead and try and figure out which bacteria or antibiotic will actually kill the bacteria. And then that way, when we make our recommendations for further treatment, it's based off that particular test instead of trying to guess which bacteria is there and which antibiotics it will respond to. Most recently, I think it was a meeting of the internal medicine specialist. They were saying that we need to be more conscious of the antibiotics that we're using because we are potentially starting to see more resistance in the bacterial organisms. And to try and prevent that, what we're looking at doing is we are looking at going ahead and doing culture and sensitivities more often. It is not, you know, that test is a more expensive test than a urinalysis. So there is a method to the madness. And it's not just to run up the bill. So that's just something to keep in mind. If your veterinarian is talking to you about that now, the step after that would be going ahead and doing X rays. There are four kinds of bladder stones. There's struvite stones, there's calcium oxalate stones, there's cysteine stones, which we had talked about that the bulldogs, the male bulldogs, are more prone to specifically. And the urate stones. Of those four, only two will show up on X rays. All four of them will show up on abdominal ultrasound. Okay. Once we've figured out whether or not there's evidence of bladder stones, then we kind of go from there. And then in terms of treatment, in this particular case, we haven't seen any evidence of bladder stones yet. So what we are going to do is I will particularly put patients on one week's worth of antibiotics for a couple of reasons. One, to go ahead and make sure that it sits well with their stomach, because once your veterinarian or I have dispensed antibiotics to you and those drugs leave the hospital, we cannot take them back. So if I sell you three weeks worth of antibiotics, or your veterinarian sends you home with three weeks worth of antibiotics and it doesn't sit well with their stomach, you can't return it. Clients have been upset in the past, and understandably so. The other thing that I will do typically is I will give a short acting steroid injection to reduce the inflammation in the urinary tract. That's typically what gives them the sensation of having to go all the time and the discomfort. And so that is there while we're waiting to see if the antibiotics are going to work, and also potentially while we're waiting for our culture results. Okay. The last thing that I will typically do is I will usually go ahead and send my patients home with probiotics. The probiotics obviously are there to go ahead and help replace some of the good bacteria that we are potentially killing with the antibiotics that we are trying to use to kill the bad bacteria in her urinary tract. It is a custom that I have started or a practice that I have started within the last probably six to 12 months. And there's no typically, there's no disadvantage to going ahead and putting the patients on antibiotics. Some places will use a cold laser to help with the urinary tract. And we do have that technology here to do that. And I do advise my clients to do that as well. Just because it does help with getting the patients comfortable faster. 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