Your dog is urinating in the house and you’re sure that it’s a urinary tract infection. You go to the vet, gets some antibiotics, and everything gets better for a while. Then a few weeks or few months later you’re back in the same vet office with the same problem. What’s going on?
Why Does Your Dog Keep Getting Urinary Tract Infections? The most common reasons why treatment fails for a UTI are because the owner didn’t finish the medication as directed, the course of therapy was too short, the antibiotics weren’t the right ones, or there’s an underlying issue that’s causing the infection to return.
What Are The Symptoms Of A Urinary Tract Infection In A Dog?
- Urinating where it shouldn’t (and knows it shouldn’t)
- Very strong-smelling urine
- Having to urinate frequently
- Getting into the urination position and staying there for a long time
- Seeing blood in the urine
- The dog is licking its genital area a lot
- Drinking excessive water
A dog can have one or all of these symptoms with a UTI. They can also have all of these symptoms and not have a UTI. It’s complicated at times. It’s medicine. Read further to find out why.
Why Do Dogs Get Urinary Tract Infections In The First Place?
The following are some of the most common ways in which bacteria can accumulate in the bladder of a dog:
- Ascending Infection – this fancy term just means that the bacteria originated outside of the dog and entered the urinary tract through the vulva and went up into the bladder. This is likely the most common reason why most female dogs get a UTI. Bacteria can hop onboard when a dog squats in a dirty area or soils itself and doesn’t get cleaned properly.
- Something Is There – bladder stones or a mass can disrupt the bladder’s natural defenses to infection
- Overstressing The Bladder – making your dog hold its urine for far too long can trigger an infection. How long is too long? Hard to know when your dog won’t tell you but anything over 8-10 hours is too long for most dogs. For some dogs, 5 hours can be too long.
- Diabetes – when the body has too much sugar in the bloodstream it spills some of that over into the urine; there is always a small amount of bacteria in the bladder just like everywhere else in the body. However, giving that tiny bit of bacteria a ton of fuel like glucose can cause them to multiply like crazy.
Most Common Reasons Why Treatment For A UTI Fails
There are 5 main causes:
- Didn’t treat the urinary tract infection long enough before stopping antibiotics
- Didn’t treat with the right antibiotics
- There’s an underlying source of infection such as stones or a mass causing repetitive infections
- It’s not a urinary tract infection in the first place
Not Treating The Infection Long Enough
It used to seem like the standard length of treatment for a urinary tract infection was a week, but now veterinarians know that many times the course of antibiotics is determined by a number of factors: how old the dog is, how bad the infection is, whether the infection is caused by a rod or a cocci-type bacteria, the overall health of the dog, etc.
The bottom line is that no two dogs are the same. Therefore I have many different treatments when it comes to UTIs. I might do 7 days of antibiotics in a mild case in a young dog. However, I could easily do 14 days of a very strong antibiotic in an older dog or one that has other health conditions (diabetes, dental disease).
How do you know if the infection wasn’t treated long enough? That likely happens when a culture is done and it turns out that the antibiotic your dog was on was the right one.
How do you prevent this from happening (not treating long enough)? The way I do it in my practice is to check a urine sample 3-4 days after the antibiotics are finished. Other veterinarians will likely vary this based on their experience and opinion.
Didn’t Treat With The Right Antibiotics
There are a handful of different types of bacteria that cause most infections in dogs. Some of these can be handled by a wide variety of drugs. Some need a very specific type of treatment. Of course, there’s always the wild card bacteria that shows up and is resistant to almost everything that’s stocked in the pharmacy.
When a veterinarian needs to get a culture and sensitivity (C&S) done, it’s mostly to identify the right antibiotics to use. It seems lately that I’m doing far more C&S’s than I used to because the same old infections now seem to be resistant to many of the common medications I used in the past.
Some veterinarians will jump to a C&S for any infection and that’s not wrong. It’s a lot more expensive for the client but it’s sometimes the fastest way (and it could be cheaper in the long run) to fix the problem.
In my clinic, a C&S costs roughly $200 and takes 3-5 days to get the results.
Underlying Health Condition Causing The Infection To Return
If there is a true infection (confirmed with a urinalysis) that’s been treated and has gone away (again, confirmed by urinalysis or culture), having it return yet again within a few months means that the UTI is a symptom in itself of another issue. The most common possibilities include:
- Bladder or Kidney Stones
- Bladder Mass
- Diabetes (although you’ll know that if you do a urinalysis – checking for diabetes is always done with this test;)
- Cushing’s Disease
- Other rare causes that we won’t delve into due to the likelihood of me panicking you about all the possibilities
If I am suspicious of an underlying cause, I start first with an x-ray of the abdomen to look for a bladder stone. Most bladder stones contain some sort of mineral that makes them fairly easy to see on an x-ray. It’s also a lot cheaper than an ultrasound so it makes a good first choice.
There are a few types of bladder stones, however, that don’t show up on an x-ray but would require an ultrasound to identify. I had a case earlier this year involving urate stones that were invisible until we did an ultrasound.
Bladder masses nowadays can sometimes be diagnosed with the urinalysis. Transitional Cell Carcinoma is one of the most common types of bladder cancer and the cell for which it’s named is sometimes shed into the urine and seen during testing.
If I see an unusual amount of transitional cells in a urine sample, my next recommendation is to do an ultrasound. While an x-ray could show the bladder mass, I want an ultrasound to really look inside and see just how bad things are.
If an xray and/or ultrasound doesn’t show any stones or masses, then I re-evaluate the body as a whole. First I go back to the bloodwork (or do some if it hasn’t been done yet to evaluate the entire system) and see where there are problems.
Is the dog already diabetic? Any diabetic can be more prone to UTIs (due to the elevated levels of sugar in their blood and urine that bacteria just love to feed on), but an un-regulated Diabetic is even more prone. If your diabetic dog keeps getting UTIs, talk to your veterinarian to make sure they they’re confident that his/her diabetes is being treated properly.
Cushing’s disease is a disorder where the adrenal glands overproduce the hormone cortisol which is a natural steroid. This can cause a decreased immune response and allow what seems to be a fully treated UTI to return.
It’s Actually Not A UTI
One of the most common puppy issues that pops up is a dog who develops symptoms that look just like a urinary tract infection. They pee frequently and struggle with house training because of it. They may even “strain” to urinate (get in the urination position without anything coming out) or lick their private areas.
If it’s a female puppy, it could be puppy vaginitis. This sometimes frustrating condition appears for no good reason and sometimes sticks around for a while. Affected puppies can have a thick mucoid vaginal discharge with a very reddened vulva. Antibiotics can seem to help but this problem can also fix itself if given enough time.
In male puppies, it’s common in some breeds to see that the hair growing over the end of the prepuce/penis area has matted together in a thick crust. When adult dogs urinate, usually the skin (prepuce) over the penis will retract a bit and the dog finishes peeing before they put their leg down and everything goes back to normal.
However, puppies tend to dribble a bit before/after they pee (just like kids) and that can cause urine to collect and gum up the hair in front of the prepuce. This can also happen with female puppies as well so if you note matted fur around their private parts, you may need to trim it – very carefully!
What about a behavioral cause? I’ve seen dogs break with house-training when something changes in the household and they start having accidents in the house. This can happen due to new people in the home, a major change in the daily schedule, or even something as simple as a male child maturing and the dog smelling hormones that weren’t there before.
Your veterinarian should be able to guide you along the steps needed to figure out why your dog keeps getting urinary tract infections. Hopefully this article was able to show you that the diagnosis isn’t always easy and that additional testing can be necessary to figure out a solution.