finished antibiotics & still blood in urine
 

My Oscar has finished his Cephalexin for what was thought to have been a UTI, but there is still blood in his urine. It seems to be at the end of his urination. He is playful and acting normally but I am concerned. The vet gave me the option to get a sterile urine sample or to do blood work. Any recommendations as to which I should do first? Oscar is 5 months old, 2.4 lbs, and on the skinny side.

Not much help here, I'd get both done and a Culture and Sensitivity on the urine, and then schedule him for a Bile Acid Test, as many dogs that tend to be small, thin, picky eaters, UTI could have Liver Shunt/MVD. All Yorkies and mixes should be BAT tested, as liver issues run in the breed, and the symptoms you described fit the profile. Best to find out early, anyway.

Urine culture with sterile urine and then you will probably need to do xray and/or ultrasound. Blood work never hurts and any persistent urinary issues in Yorkies is a sign to bile acids test.

How long was he on the ceph? usually they use clavamox for uti so not sure why ceph.

At this point i would do blood work and bats if this were mine as the antibiotic should have killed the infection so something else is going on.

If blood work comes back normal on those tests then i would do ultrasound to see if stones but dog is too young usually for stones i think

My guess is this little one might have liver issues since so young and blood in urine so stones may be present

what percentage of protein are you feeding as puppy foods have high protein

i am guessing crystals because the blood is at the end of the urination cycle so sounds like when bladder is emptied something in the tract is causing it to bleed. Those crystals can be very sharp

Did vet not do urinalysis first time around before doing antibiotics ? If not why not? Why treat for something you do not know is going on?

In future i recommend taking urine sample in if you see something like this and have them run urinalysis as they tried to treat my dd with an antibiotic before the urinalysis and culture came back and i said NO. I want to know if this is an infection before i treat with antibiotics so sometimes they treat with antibiotics before they know what is causing the prob. Turns out my dd did not have a uti she just had excessive rubbing and licking due to allergies so glad i did not do antibiotics as there was no reason to do so but vet wanted me to give it to her before results were back. My gut is that is what may have happened here.

Is your vet familiar with mvd/liver shunt in this breed? Please ask the vet

If the vet did not run urinalysis as i would think should have been done before antibiotics then that is the first step but not sure if he did it or not from post so please advise

He was on the antibiotics for 2 weeks. They did do a urinalysis with a sample I brought in. They want to get a sterile sample now. I feel like the sterile sample seems so invasive though (needle through his belly). I'm going in today @ 2:00 to do it. They said that the next step will be blood work.

That would be a cystocentesis. It does sound invasive, but most dogs do extremely well with it. It only takes a minute (or a bit longer if it is ultrasound guided) and is not nearly as bad as it sounds. My girl has them at least yearly. No big thing. :)

do what you think is best but i do not think it will be much difference personally as i always do my own samples first thing in am and they are fine as i feel the same as you do

so if they did the urinalysis were there any crystals in the urine ?

ask what they are looking for on cysto and make sure they do ultrasound guided one if you choose to go forward with it like c said

Should I not do the sterile urinalysis & just go straight to the blood work & BAT?
As far as food goes: I give him Blue Buffalo kibble for puppies & alternate with Stella & Chewy's freeze dried beef dinner. Those were the two that he seemed to like best. Should I change the food?

All they said was that bacteria was present.

can you post the protein percentage as protein is high on stella's i believe and stella's is dehydrated raw so i am not a big fan of mixing raw diets and kibble you need to do one or the other in my opinion

did they find any crystals on first urinalysis? Ask why the cysto and what will it give them that they do not already have as if they are looking for crystals then i would just do the blood work and bats as they are trying to rule out liver disease.

You should do what your vet is suggesting as long as they are moving ahead and trying to find an answer. If they want to send urine for culture, then yes, it should be a sterile sample. Not sure why they would rerun a u/a at this point.

A cysto does not need to be u/s guided if your vet is fine doing it another way. With Ellie, it usually is because her bladder is hard to find. There is a slight risk, but there is even a slight risk for drawing blood, esp. from the jugular, so just trust that your vet has done this many times before and will do fine. I've even watched the procedure before. The pups really do not care what is being done to them in most cases. :)

that much time on antibiotic should be ok to kill that infection and keflex is a strong antibiotic stronger than clavamox in my opinion.

It is skin infections usually that require 25 days on antibiotics as it has to go from inside body to outside so takes longer to kill infections i think is why they do for longer

The crystals would not be contaminated in a free catch only the bacteria as a free catch can have more bacteria from the back of a wee wee pad contamination but i do not think you will pick up crystals from the back of a wee wee pad so if they are trying to narrow down for that then cysto may be a waste of money and i would go straight to blood work.

was there crystals in urinalysis?

This is a young dog so stones I think would be unlikely

maybe ask some questions as to what they are looking for so you feel more comfortable

And I didn't see that this doggie was so young. I would definitely be doing some bloodwork in addition to more urine testing.

here is some info on the cysto to learn about what they are talking about doing

Cystocentesis in Dogs

I was told that they are using ultrasound for the sample.

also ask them was their protein in the urinalysis

always get copies of everything done and make a file at home and read through it so you understand what is going on and can make the best decisions fully understanding what is going on.

High protein diets can be a problem in this breed and that may be what is going on with your baby

that is good as that is the only way i would have it done on a toy breed as their bladders are very small and your baby is 5 mos so his bladder is really tiny and that is the safest way in my opinion.

Oh, I didn't know that -about mixing the raw with kibble.
The label on Stealla & Chewy's says: crude protein-42%

more info

Urinalysis in Dogs

The Importance of a Urinalysis in Dogs

here is a list of info for you to check out

Article Search Results - PetPlace.com

BINGO there is your problem

this breed should not be on high protein diets - since having issues i would not have him on more than 22% stick to blue buffalo - how much is in there?

so it sounds like liver is not processing the high protein diet real well so I would recommend getting blood work and bats done to see what is going on with liver as you will need to do this before neuter anyway so might as well get it out of the way now.

My personal opinion is to get bats done on 12 hr fast if your dog can handle a 12 hr fast so they can do blood work and pre bile acid test on empty stomach then introduce food then 2 hr on the dog they will pull blood again to see how liver is functioning prior to food and after food is introduced.

Does your dog act differently at all after eating the stellas at night ?

blue buffalo puppy kibble is 27% protein. Could food just be the problem? Can too much protein cause crystals in urine & maybe there is no liver issue?

He acts normal before and after eating. (both dog foods) He is more playful usually after eating.

yes too much protein can cause crystals to form and usually puppy food is high in protein so usually we see liver issues pop up in the first year because of this which is when you want to find out as the earlier the better

Many vets that are well versed on liver issues in maltese and yorkie breed will bat test all yorkies and maltese so they know if it is there or not. If it is there then how bad is it? You need to get the bloodwork and bats before going under anesthesia so the vet knows what to do when putting him under as dogs with liver disease need to be treated a certain way with meds and anesthesia.

My dog has mild mvd she has no issues really with it - she is on meds for allergies she has been under anesthesia etc. So sometimes it is very mild and no big deal which could be the case with yours but you need to know since he is a yorkie and at 5 mos having some symptoms with urine issues you want this ruled out now not later bc if it is a more severe case symptoms may not show up until 1 years old.

Better to be safe the test is not that big of a deal two blood draws and you have to do it before neuter anyway to be safe going under anesthesia.

ok that is good then it could just be too high and mild mvd so liver is not processing properly all that protein thus creating crystals

but you need to ask your vet these two questions and post

is there crystals in urine

is there protein in urine

as the urinalysis will state this information

here is more info on blood in urine to read

Hematuria in Dogs

stones

http://www.petplace.com/dogs/urolith...ogs/page1.aspx

I will definitely do the BAT and/or blood work. Just got back from the vet & they could not do the cysto. She said that he was too wiggly & small. She wants me to bring him in the morning and leave him so that they can wait until his bladder is full. She said if that didn't work, they would sedate him slightly. I hate to keep asking so many questions but should I be concerned about sedation?

A sterile urine sample (provided it really IS a sterile and done either via a catheter or a needle into the bladder) will give you the best results if it is a bladder infection. You'll get some results quickly, but a true urine culture takes about 3 days to grow out and then identify the particular bacteria.

But blood in the urine can also be from the kidneys. In that case a blood sample will give you the best idea if it's a kidney infection vs. something like kidney stones. You should be able to get the results back more quickly (the next day) vs. the culture.

Lesser possibilities are that some tick-borne diseases can cause bloody urine and medication reactions.

I'd do both if it were my puppy.