Canine Urinary Tract Infections: Are Those Expensive Tests Necessary?

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Darlene Norris is a long-time pet lover. She has worked as a vet assistant and draws on this experience when she writes her articles.

Behavior Problem or Canine Bladder Infection?

If you've ever had a bladder infection, you know all about the pain and burning when you urinate, besides having to run into the bathroom every five minutes! It's pretty much the same for your dog when she has a canine urinary tract infection. But it's not like she can tell you that something is bothering her, so it's up to you to notice if her behavior changes. What should you be looking for?

  • Restlessness, pacing around, whining.
  • Wanting to go outside again, right after you've just let her in.
  • Breaking housetraining and having accidents in the house (inappropriate urination).
  • Drinking a lot of water.

Because this type of infection is pretty much localized in her bladder, she won't usually have a fever or lose her appetite. As a result, a pet owner may think the dog is misbehaving and take her to the trainer, when she really needs to go to the
vet instead.

What Tests Should Your Vet Run?

If you bring your dog in for urinary issues, your vet may want to run a battery of tests, usually starting with a simple urinalysis.


Your vet will probably want to run a urinalysis. This is an important screening test, regardless of whether your vet thinks your dog has a canine bladder infection or not.

The urine sample is spun in a centrifuge to separate the solids and the liquids. The solid part is called sediment. Your vet will examine the sediment under a microscope, looking for crystals, cells, and bacteria. The vet will also chemically analyze the sample to learn its specific gravity (a measure of how concentrated the urine is), and also to see if protein or other substances are present.

Urine Culture

However, if your dog is showing signs of a urinary tract infection, your vet may skip the urinalysis, and just do a urine culture.

A urine culture may be recommended if:

  1. There are white blood cells present. These are a sign of infection, and they shouldn't be present in a normal urine sample.
  2. Your vet finds bacteria in the sediment when he or she looks at it under the microscope.
  3. There is excessive protein in the urine, which can be a result of inflammation in the bladder. Alternatively, the kidneys may be excreting protein. The vet needs to rule out a bladder infection before he or she looks at the kidneys.
  4. The urine is so diluted that bacteria and white blood cells can't be found. A dog who drinks too much water probably has a bladder infection.

A urine culture starts with spinning the urine sample in a centrifuge. The sediment is then used to innoculate an agar culture. If bacteria grow on the culture, this means an infection is present. It usually takes two or three days to run a urine culture, to give the bacteria time to grow.

The urine culture provides your vet with important information. It tells your vet what species of bacteria is causing the problem. This helps him or her determine whether the bacteria present actually cause disease. Some don't, so you don't need to use an antibiotic on bugs that aren't causing a problem.

The culture also indicates the number of bacteria present. A lower concentration of bacteria may indicate that the bacteria might be hanging out in the lower urinary tract, and aren't actually colonizing the bladder.

The urine culture should include a sensitivity test, or antibiotic profile. Skipping the sensitivity test can be a false economy, since you can waste a lot of time and money giving your pet an antibiotic that won't kill the specific bacteria causing the problem.

Antibiotic resistance is also an issue. More and more bacteria are becoming resistant to antibiotics that used to wipe them out. Often this is a result of using the wrong antibiotic to try to eradicate an infection.

Are These Tests Really Necessary? Yes.

Many times vets are hesitant to recommend these tests, as they are expensive. Some people just can't afford them, while others refuse to pay the added cost. And there are some clients who think that the only reason vets run these tests is to pad the bill. But this isn't true.

A urinalysis helps your vet to determine if your dog has a different health issue, while a urine culture is the only way your vet can confirm that your pup does indeed have a urinary tract infection.

If you skip having the sensitivity test done, your vet will be shooting in the dark as far as using the right antibiotic to clear up your dog's bladder infection. This means the infection could come right back as soon as the pills are gone.

If finances permit, it's a good idea to repeat the urine culture after the antibiotic treatment is finished. If your dog comes down with another urinary infection, at least this way your vet will know if the original infection came back, or if it's a new infection. This is important information because repeated bladder infections can be caused by cancer or Cushing's disease or another serious health problem.

How Is a Canine Urine Sample Collected?

Canine urine may be collected in one of four ways.

1. Table Top

This means the sample is collected from the exam table or floor where the dog dribbled urine. This is not the preferred way to collect a sample, since it's probably contaminated with bacteria, either from the surface where it was collected or from the dog's lower urinary tract.

2. Free Catch

The urine is collected mid-air as the pet urinates. The sample may be contaminated by bacteria in the lower urinary tract, but at least it won't have bacteria from the floor or wherever it was collected.

3. Catheter

Your pet won't enjoy this much, but it's over pretty quickly. Your vet will pass a small tube into your dog's bladder, and collect a sample. This sample is less likely to be contaminated, although bacteria can possibly be introduced into the bladder.

4. Cystocentesis

The vet inserts a needle through the abdominal wall directly into the bladder. A urine sample is withdrawn with a syringe. Although it's possible for a little blood to get into the urine sample, the sample should be uncontaminated by any bacteria other than what might be in the bladder.

© 2009 Darlene Norris

Bev on February 19, 2019:

You are so correct if lab cost were not so much more pets would be saved!

Pauline Robinson on October 25, 2017:

I just paid 175.00 for the lab work, and 195.00 for the culture. Not counting the medications...

Kristina Wesman on September 07, 2017:

I dropped off a urine spec for testing and I needed a ua/uc recheck because she just got done with a 2 week course of Keflex for a staph infection uti. The vet did the ua but didn't do the uc because she says it would need to be expressed sterilely. Is this true? I didn't do this before.

graystones on May 04, 2017:

$25-100 sounds reasonable. I'm being quoted $140 for the urinalysis/culture. I wish vets didn't markup lab tests so significantly. A lot more pets in need of life savings tests would get them if lab tests were not a big profit center for vets

Can UTIs be Prevented?

While not a cure for UTIs, providing more water for your dog can lessen the chance of this infection from starting. Be sure your dog always has plenty of fresh, clean water–change the bowl when you see globs of drool or food floating around. Let your dog outside more often if possible–don’t let him hold it for hours and hours. This can prevent an accident from happening in your home as well! You can also give your dog probiotic supplements to encourage the growth of healthy bacteria. Last, make sure the area around your dog’s urinary opening is clean of any debris, scratches, etc. Most pet stores sell antibacterial wipes, which can be used to clean this area.

  • A bacterial skin infection around the vulva that has ascended up the ureter into the bladder is a common cause of UTI.
  • A vulva (the external, visible female genitalia) with extra skin folds around it allows urine to pool and develop bacteria (may also be called a recessed vulva). This is common in overweight dogs or female dogs that were spayed at a very young age.
  • Excessive licking at the vulva for any reason (bacteria from the dog's mouth ascend into the bladder) may cause a UTI.
  • Incontinence (unconscious leaking of urine) can lead to UTI because urine is constantly on the skin around the vulva, growing bacteria that may ascend into the bladder.
  • Older, arthritic dogs may not fully empty their bladders due to joint pain because it is difficult for them to assume and hold the necessary urination position. This can lead to UTI.
  • An improper pH in the urine (this can occur because of improper diet or concurrent illness) may predispose a dog to UTI.
  • A weakened immune system from some other illness may allow UTI to develop more easily.
  • Dogs with diabetes mellitus are more prone to UTI than other dogs because the extra sugar present in these dogs' urine encourages bacterial growth.
  • Dogs with bladder stones or crystals are more likely to develop concurrent UTI.

Diagnosis of UTI in dogs is done through a veterinarian's examination and one or both of the following tests performed on a urine sample:

  • Urinalysis: a multi-faceted test of your dog's urine that will reveal signs of infection such as the presence of white blood cells, red blood cells, and bacteria.
  • Urine Culture: a test where any bacteria present in the urine are encouraged to multiply in a laboratory so they can be identified. Once they are classified, the laboratory often tests various antibiotics on the bacteria strain to determine which one will work well. In the case where a dog has never had a UTI before, a culture may not be done.

One big question that many dog owners have is "How do I collect urine from my dog"? Most of the time, you won't have to: your veterinarian can get the sample. There are four ways that urine may be collected to run the tests required to diagnose a UTI.

  • Surface Sample: urine from the floor, the exam table, or another surface that the dog has urinated on. This is the least desirable collection method for urine because the sample may contain bacterial contamination from the surface that isn't actually present in the dog's body.
  • Free Catch Sample: urine collected in a cup from the stream of urine coming from the dog's body when she urinates. This type of sample is less likely to be contaminated than one taken from a surface but it still may contain bacteria from the skin of the dog's external genitalia.
  • Catheter Sample: urine extracted directly from the dog's bladder via a thin tube placed through the urethra into the bladder. This usually produces an uncontaminated sample but can be a bit uncomfortable for the patient. It is possible to introduce bacteria from the outside into the dog's bladder with this method (though this is quite uncommon).
  • Cystocentesis Sample (Cysto): urine extracted directly from the dog's bladder via a needle placed into it through the dog's body wall. While many owners are shocked and concerned about this method, it is usually very comfortable for the patient and provides an uncontaminated sample for urinalysis and culture.

Kidney Infection (Pyelonephritis)

Pyelonephritis is inflammation of the kidneys. This is usually caused by bacteria in the urinary tract that have climbed upwards into the bladder and then continued into the kidneys. The risk factors for pyelonephritis and those for bacterial cystitis are very similar. Anything that interferes with normal urine flow through the urinary system, such as stones in the kidneys or ureters, can increase the risk for pyelonephritis. In young dogs, birth defects such as ectopic ureters can cause pyelonephritis. Dogs at risk for this condition are the very young, the very old, those that have weak immune systems, and those with kidneys that cannot properly balance the amount of water in the urine. In many cases, your veterinarian may not be able to identify what caused the pyelonephritis.

Signs of pyelonephritis include pain in the sides, especially in the area around the kidneys, fever, and a general sense of not feeling well. Other signs include vomiting, a reduced appetite, excessive thirst, or excessive urination. The kidneys might suddenly begin to fail. Dogs with longterm pyelonephritis may have few or no signs (other than excessive thirst and urination), and they are often not diagnosed until their kidneys begin to fail.

Your veterinarian may be able to diagnose pyelonephritis through urine and blood samples. In many cases, ultrasonography or contrast x-rays may be necessary for diagnosis.

Treatment includes longterm antibiotics (4 to 8 weeks), sometimes at high dosages. If your dog is very ill, your veterinarian may give intravenous fluids and injectable antibiotics. In extreme cases, the infected kidney must be removed in order to prevent the infection from spreading to the remaining, healthy kidney. Your veterinarian may take urine samples at regular intervals during and after treatment to make sure the infection does not come back. Dogs with pyelonephritis are at high risk for repeated infections. Because pyelonephritis can be a life-threatening disease, following your veterinarian’s recommendations is important.

Animals with short-term pyelonephritis may be able to recover full kidney function, depending on the amount of damage that occurred before treatment. If both of the kidneys have already failed, your veterinarian will prescribe treatments to slow further damage and manage the signs of kidney disease and failure.

YOUR WHOLE PET / Your dog's bladder infection: Don't guess when you can know

I was at the dog park the other day, chatting with a dog-obsessed friend who knows me really well, when another dog owner came over and mentioned that her dog had recently been diagnosed with a bladder infection.

I smiled at her and opened my mouth to ask a question, and noticed that my friend was shaking her head, scrunching up her eyes and basically indicating with every available bit of body language that something terrible was about to happen. I frowned, and asked, "What?"

"Please," she said. "Not the bladder infection lecture again."

The dog owner looked from me to my friend, and back again. "Bladder infection lecture?" she finally asked.

My friend sighed. "Don't say I didn't warn you," she said.

So now you're all wondering: What's the big deal with canine bladder infections? The dog has one, a couple of weeks of antibiotics, and the dog's fine. Right?

It should be that simple, but far too often, it's not. And that's not because canine urinary tract infections are that hard to diagnose or treat they usually aren't. And it's not because there is medical controversy over the best way to diagnose and treat canine bladder infections there isn't.

It's because a lot of the time you have no idea your dog has a bladder infection in the first place, and when you do, it can be surprisingly hard to get it properly diagnosed and treated.

The reason for that is because the main symptom is a painful burning sensation in the urinary tract, and our dogs, being unable to speak, can't tell us about it. Instead, they act restless, or pace around or whine. They beg for attention, try to get us to take them outside even though we've just gotten back from a walk, and sometimes start wetting the floor or the bed. Many owners interpret this as a behavior problem. I've seen dogs put on remedial housebreaking programs and have even known trainers to recommend withholding nighttime water despite the fact that a simple bladder infection hasn't been ruled out.

So if your dog starts exhibiting any of these behaviors, even if she doesn't have accidents in the house, don't call the trainer. Call your veterinarian.

Of course, some dogs will show more definite physical signs, such as increased thirst and urination, and some will even stop urinating altogether -- a medical emergency that requires an immediate trip to the veterinary emergency hospital. But as the Veterinary Information Network's Dr. Wendy Brooks says, "Because bladder infections are localized to the bladder, there are rarely signs of infection in other body systems: no fever, no appetite loss, and no change in the blood tests."

So, let's say you've observed behavior that makes you think your dog might have a UTI and you've taken her to the veterinarian. This is where it should get pretty straightforward. The next step should be a complete physical exam, collection of a urine sample, and a few simple tests, including a urine culture and, if bacteria are found when the urine is cultured, a sensitivity test to determine what antibiotics can kill the bacteria. A urinalysis should be done at the same time to test for other symptoms that might indicate that something else is going on. Then the proper antibiotics should be prescribed for the correct period of time. The symptoms should go away, the dog's urine should then be free of bacteria, and complications like drug-resistant kidney or prostate infections should be avoided.

Notice I used the word "should" in that last paragraph instead of "will." That's where the lecture comes in because unfortunately, a lot of dog owners won't let their veterinarians do those tests, and even more unfortunately, a lot of veterinarians have either given up suggesting them or never tried in the first place. This leads to dogs being diagnosed and treated based on guesswork and hope. And those dogs are indeed at risk of serious and painful -- and expensive -- complications.

So given the high stakes, why are owners and even some vets reluctant to do these tests?

For one, although costs vary, the urine culture and sensitivity testing will add from $25 to $100 to your bill, and for some pet owners that puts the testing out of reach, no matter how advisable it might be. And some owners are simply unwilling to spend their money on their pets' health problems, even though they can afford it.

But there are still a lot of owners who are willing and able to pay for the tests, or would be if their vets explained the value to them. I've asked a few of these vets why they don't at least try to offer the tests to these clients. Most of them told me that they got so tired of being turned down that they simply stopped trying. I can -- and do -- suggest that those vets try to do a better job of educating their clients, but as a pet writer I also know that there are people who firmly believe their veterinarians get up early every morning just to think of new ways to pad their pet's bill, and nothing I say to them ever changes their minds.

It's also possible that the vet is reluctant to do the testing. For example, my dog, Rebel, has a genetic kidney defect that leaves him prone to recurrent UTIs. When I moved to a small town in western Sonoma County years ago and started trying out the local vets, more than a few were very surprised that I wanted a urine culture done, and even actively discouraged me from doing it. Some of them continued to dismiss the idea, regardless of the fact that I was willing and able to pay for the tests -- and in fact was asking for them. Once I had to bluntly tell the veterinarian, "It's my money and it's my dog. I want the test," before she would order it. She had simply reached for the antibiotics the minute the words "bladder infection" were out of my mouth.

Fortunately, a friend who is a veterinarian suggested I try Dr. Nancy Walters, a general practitioner in Occidental, near the Russian River. Walters looked over Rebel's medical records, examined him, and asked me a few questions. She said we needed to do a urine culture and sensitivity test, and just as she was drawing a deep breath to explain to me why that was necessary, I cut her off. In the gushing tones usually reserved for a teenage girl discussing her favorite movie star, I told her that I was happy to finally find a vet I didn't have to beg to take my money to run a medically necessary test on my dog.

How did Walters, running a country-vet practice in a small town, come to consistently recommend urine culture and sensitivity testing to her clients whose dogs had suspected UTIs, when so many of her colleagues didn't? I've since moved back to San Francisco and she's not my veterinarian anymore, but I gave her a call and asked.

"We see a lot of UTIs in dogs. A lot," she answered. "And in the 22 years I've been doing this, so often we find that the organism is resistant to certain drugs. I found that without doing this testing, you just don't know where you are. You're just guessing, and then second-guessing. I prefer to do the culture right away. I don't like to backtrack. I like to get it right the first time."

Getting it right the first time can save you money, too -- and so can using a veterinarian who can culture your dog's urine right in the office. Some veterinary practices now routinely culture all urine samples in-house at the same time they do the less-expensive urinalysis, at little or no additional cost. Only if there are bacteria in the urine is the more expensive sensitivity test done at an outside lab. This can keep prices down while still protecting your dog.

Even if you do end up having to do the more expensive tests, they can actually save you money by helping your veterinarian prescribe the right drug from the start. Without that testing, your vet is only guessing when he prescribes an antibiotic, and while he might get lucky with his first guess, what happens if he doesn't? Usually at that point you've paid for two to three weeks of an antibiotic that didn't work. Depending on the antibiotic and the size of the dog, this could cost hundreds of dollars.

In addition to wasting money on the wrong drugs, when you use an antibiotic to which your dog's bacteria are resistant, you increase the likelihood that your dog will end up with a deeply entrenched, hard to treat, potentially life-threatening bacterial infection. Walters said that such infections might respond only to costly and inconvenient IV or injectable antibiotics -- or none at all. "That's where you don't want to be," she cautioned.

Far worse than the cost in dollars, however, is the growing problem of drug resistance. This problem doesn't just affect your dog, because it's not your dog who becomes resistant to a drug it's the bacteria inside his body. Every time your infected dog urinates, he is spreading those bacteria -- and their genes for drug resistance -- into the environment, where they can infect other animals and humans, too. It might not just be your dog who ends up with the impossible-to-treat drug resistant bladder or kidney infection it could be you.

Be alert for symptoms. Test. Treat based on the test results. Ideally, do a follow-up urine culture to confirm the infection is cleared, so that if the symptoms return, the veterinarian will know if it's a relapse of the original infection or a new infection. This can help identify serious underlying health problems, such as Cushing's disease or cancer, that can cause recurrent bladder infections.

Is it really this simple? Although there are a couple of extremely rare medical conditions that can muddy the waters, for almost all dogs, yes, it is. So many times, in both human and veterinary medicine, we have to make decisions without sufficient information or being able to fully evaluate the outcome of treatment. Your dog's bladder infection isn't one of them. So unless the additional testing costs are genuinely out of reach, don't settle for guesswork and hope.

Christie Keith is a contributing editor for Universal Press Syndicate's Pet Connection and past director of the Pet Care Forum on America Online. She lives in San Francisco.

Watch the video: Urinary Tract Infection in Dogs. Wag!


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