UTI, Proteus Mirabilis and Triple Phosphate crystals

donna's mum

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#1
Hello everyone,

I came across this forum when I was searching for information on UTI and struvite crystals. An old post (2011) brought me to this forum. I have a 6 month old Australian Shepherd-Lab mix female (unspayed - decided to wait until a couple of heat periods before we spay her) puppy who on December 21st suddenly started peeing frequently and everywhere, even at home. I took her to the vet the same morning and he suggested a blood test, urine test and culture. The blood sample was collected the same evening but I wasn't able to get a urine sample until the next day. It was supposed to be a "sterile" sample but I had to first collect it in a tray at first and then into the little bottle because she was peeing only small amounts all over the place, and by the time I would come near her, she was finished. I let the vet know it wasn't exactly sterile but he sent it to the lab anyway.

Dec 23rd I went to the vet again and he was just looking at the blood test and the urinalysis report. Blood report was OK with the ALP slightly elevated (I must mention the report read senior canine wellness report, even though she's just 6 months old, and after I googled around a little I found that ALP levels for puppies tend to be a little high). Anyway, the urinalysis suggested a very high PH of 9, and the presence of bacteria. The culture wasn't ready yet, but I was keen on starting antibiotics for fear of the infection spreading. Vet prescribed Clavaseptin and Hill's prescription diet. I wasn't keen on the prescription diet (I prefer home cooked food) but vet insisted that since the PH was so high, it might lead to the formation of crystals and stones, so I complied.

The Clavaseptin dose was one 200mg tablet twice a day. I started with Clavaspetin the same evening (DEc 23) and slowly transitioned to the Prescription diet. She had stopped drinking water almost completely (unusual for her), so I started adding a little chicken broth to make her drink, and it worked. She's had lots of fluids and the antibiotic, the prescription diet (albeit slow transition) and I was also giving her some organic plain kefir twice a day. The culture result came on Monday, Dec 28th and it mentioned Proteus Mirabilis bacterium and the presence of triple phosphate crystals.

Her course of antibiotics ended yesterday morning (2nd Jan) but I'm continuing the prescription diet. Will be going for another urinalysis and culture this week. Vet also suggests an X-Ray to check for stones but I'm not sure. Please suggest if it's absolutely essential to do the X-Ray? She's insured, so the cost isn't an issue but I'm wondering if it's a good idea to have X-rays done on a 6 month old pup. This evening hubby noticed two small puddles in the living room (not sure if it's her pee or some spilt water which is unlikely) but could the infection be coming back? I was thinking of going to the vet around mid week with her urine sample for the second round of culture, but looks like I might have to go tomorrow if we notice more puddles. Hubby didn't see her squat though. At the height of her UTI, she was squatting to pee, even inside the house.

Has anyone had their dog suffer UTI from this particular bacteria? Is it unusual for a puppy to get crystals? My vet seems to think it's highly unusual for a puppy to get UTI and crystals (he says older dogs are more prone to this). How long should I continue the prescription diet? I asked the vet if there's any other option to the prescription diet, and that I didn't like that the diet is primarily corn-based, but he said "These are big American companies, they know what they are doing.....". I didn't say anything but that's precisely my worry. I don't want big corporates to have anything to do with my little puppy's health if I can help it. I'm willing to keep up with the diet temporarily but definitely not long term.

Also, please do suggest if we should get her X-ray done.

Too many questions, I know.. but I'm seriously worried.

Thanks a lot for your help!
 

Flybynight

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#2
These kinds of decisions are always best made between yourself and your vet, but I'll respond based on my female prone to both UTI's and stones.

While more common in adults, any age dog can get a UTI. Mine started getting them annually around age 4, but I have heard of it happening as young as 8 weeks.

Struvite stones are formed largely through bacterial action - i.e. they require infection with urease-producing bacteria (such as Proteus). Prevent the infection, prevent the stones. Infection can lead to stone formation within 2 weeks if not treated, so it's important to catch it quickly. However, some level of struvite crystals will be seen in about half of all normal healthy dogs, so not all crystals are a sign of disease.

Some dogs (especially females) are more prone to UTIs overall. This can be for genetic reasons, but also anatomical issues such as an inverted vulva (did your vet check for this?). Inverted vulva may correct itself after a heat or two, or can be surgically fixed if it's bad enough. Thick haired dogs also tend to trap more bacteria around their vulva; it can help to trim this area short and/or use wipes to clean it after urination. We did this for my Chow mix, with good results (she is both very hairy, and has an inverted vulva).

With my dog, we always ran a urinalysis and treated the bacterial infection, then re-examined a urine sample after antibiotics. Typically crystal load had declined (or was not very high to begin with), and we moved on. We did not perform radiographs until she had UTIs within 6 months of each other, at which point we discovered stones. The trigger was the increase in frequency.

I'm not clear from your post whether your vet just found "some" crystals, or "lots" ? I would also be curious to know whether your follow up still shows unchanged high levels of crystal.

If a dog does indeed have stones, and if they are small enough, they can be dissolved with a prescription food like Hill's S/D. This is a temporary diet regimen not meant to last more than 3 months as it is extremely low protein. And it works very well for specifically dissolving confirmed struvite stones.

Hill's C/D is also low protein (but not as low), and is supposed to make urine more acidic as well as having low levels of "ash". However, it is actually bacterial infection itself that typically causes urine to become alkaline in the first place, and there is no clinical evidence of C/D preventing infection. For this reason, I did not follow one of my vet's recommendations to place my dog on this for life. I DID use S/D to dissolve a small stone (which was one that appeared a few years after surgery to remove larger stones). Once we confirmed the small stone was dissolved, she went back to regular food.

So overall we focus on preventing infection, monitoring her closely to catch a UTI as soon as it starts, and treating confirmed UTIs quickly.

We feed a high quality, low ash food, we ALWAYS feed it with water in the dish to increase H2O intake, and we feed Solid Gold Berry Balance to support bladder health.

But these are all steps to take for a dog with chronic UTIs, which your puppy is much too young to be diagnosed with. I would personally want to see if crystal levels change after the antibiotics have done their job, and then I would monitor closely for future infection. If crystals are still high and infection still present, I would then want to re-evaluate the antibiotic used (as they may not have worked), and maybe consider an x-ray.

But again - this is my perspective based on my dog. YMMV.
 
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