hopin 2nd time is the charm

Zoe finished up her 2nd round of anti-biotics yesterday. I made an appt for today with her vet so we can test and make sure it's all gone. I'm glad he doesn't think I'm a hypochondriac! I just see no point in continuing unless we know it's not gone yet and don't want to make the mistake after the first round of thinking it's gone when it wasn't. These UTI's are tricky!

Mel, if the vet is gonna take another sample for a C & S, I would DEFINITELY leave it a week after the meds are finished. Taking a sample now so soon after the meds will not give a definitive answer. Hope you've sent the bugs packing and it's all good!

I'm interested in having a vet appt. a week after antibiotics are done. My vet wants to see them just before they use the last pill and I really am not too thrilled about it. Is there anything I can read that would explain it? Jasmine's run out this Friday & we are up to our gills in activities. It would be so much nicer to drive the 50 miles the following week. Do you give probiotics after antibiotics? I use people probiotics and wonder if I could use them for Willow and Jasmine? I keep forgetting to ask my vet & she never has suggested them. Mel, sorry to hijack this post of yours. Good luck!

vet just called. it's all clear! I'll keep a look out for any symptoms as you guys suggest, but I'm happy to hear the good news for now.

Yea for good news!

YAY for Zoe!

Joanne:
The deal with testing urine for infection when they are still on an antibiotic or have just finished it is that the antibiotic can mask the signs of infection. Unless the infection is REALLY aggressive and resistant to the antibiotic being used, infection won't necessarily show up on a U/A while the dog is still on antibiotics or still has them in his or her system. I only re-test urine a week or more after antibiotics and I won't put a dog on antibiotics without a C and S being done.

That's good news to hear, Mel! Yay, for Zoe!!

northernwitch wrote:YAY for Zoe!

Joanne:
The deal with testing urine for infection when they are still on an antibiotic or have just finished it is that the antibiotic can mask the signs of infection. Unless the infection is REALLY aggressive and resistant to the antibiotic being used, infection won't necessarily show up on a U/A while the dog is still on antibiotics or still has them in his or her system. I only re-test urine a week or more after antibiotics and I won't put a dog on antibiotics without a C and S being done.

Blanche, even in the case of resistant organisms, there's usually enough antibiotic activity to prevent growth of the resistant organisms in the culture. The best way is, as you suggest, to wait until at LEAST a week after discontinuation of the antibiotic and then re-culture.

Zoe's UTI is back. *sigh*

It's not that I didn't want to listen to you guys, I just didn't want to insult my vet. She seemed fine and then I got home tonight after work and she had gone on her pee pad and a little drop of red. :( So, I will be contacting them for more anti-biotics and not retesting until a week after she's done with what will now be her 3rd round.

now the question is...why didn't my vet tell me to wait like you guys? I really like my vet. He owns the practice where SNPR takes all their pugs. I don't want to doubt or insult him, but now I'm a little weary.

suggestions?

Mel wrote:Zoe's UTI is back. *sigh*

It's not that I didn't want to listen to you guys, I just didn't want to insult my vet. She seemed fine and then I got home tonight after work and she had gone on her pee pad and a little drop of red. :( So, I will be contacting them for more anti-biotics and not retesting until a week after she's done with what will now be her 3rd round.

now the question is...why didn't my vet tell me to wait like you guys? I really like my vet. He owns the practice where SNPR takes all their pugs. I don't want to doubt or insult him, but now I'm a little weary.

Have you tested her for stones?

suggestions?

Switch to Dr. C, he sees pretty much all our pugs so he's seen it all with them by now. We've had quite a few with UTI's and he always waits to recheck. That's what we're doing with Mack-he's going in for a recheck tomorrow, actually.

Have you had her tested for stones by any chance?

Saira wrote:

Mel wrote:Zoe's UTI is back. *sigh*

It's not that I didn't want to listen to you guys, I just didn't want to insult my vet. She seemed fine and then I got home tonight after work and she had gone on her pee pad and a little drop of red. :( So, I will be contacting them for more anti-biotics and not retesting until a week after she's done with what will now be her 3rd round.

now the question is...why didn't my vet tell me to wait like you guys? I really like my vet. He owns the practice where SNPR takes all their pugs. I don't want to doubt or insult him, but now I'm a little weary.

Have you tested her for stones?

suggestions?

Switch to Dr. C, he sees pretty much all our pugs so he's seen it all with them by now. We've had quite a few with UTI's and he always waits to recheck. That's what we're doing with Mack-he's going in for a recheck tomorrow, actually.

Have you had her tested for stones by any chance?

well, the first time I took her in he did an xray and showed it to me. didn't see any stones.

so you're saying I should break up with my vet? lol

Mel wrote:

Saira wrote:

Mel wrote:Zoe's UTI is back. *sigh*

It's not that I didn't want to listen to you guys, I just didn't want to insult my vet. She seemed fine and then I got home tonight after work and she had gone on her pee pad and a little drop of red. :( So, I will be contacting them for more anti-biotics and not retesting until a week after she's done with what will now be her 3rd round.

now the question is...why didn't my vet tell me to wait like you guys? I really like my vet. He owns the practice where SNPR takes all their pugs. I don't want to doubt or insult him, but now I'm a little weary.

Have you tested her for stones?

suggestions?

Switch to Dr. C, he sees pretty much all our pugs so he's seen it all with them by now. We've had quite a few with UTI's and he always waits to recheck. That's what we're doing with Mack-he's going in for a recheck tomorrow, actually.

Have you had her tested for stones by any chance?

well, the first time I took her in he did an xray and showed it to me. didn't see any stones.

so you're saying I should break up with my vet? lol

I'm saying to see Dr. C on the side......

Hopefully it clears up, it's a pain. We went through a couple of rounds with Sophie and then had to clear up the crystals.

Saira wrote:

Mel wrote:

Saira wrote:

Mel wrote:Zoe's UTI is back. *sigh*

It's not that I didn't want to listen to you guys, I just didn't want to insult my vet. She seemed fine and then I got home tonight after work and she had gone on her pee pad and a little drop of red. :( So, I will be contacting them for more anti-biotics and not retesting until a week after she's done with what will now be her 3rd round.

now the question is...why didn't my vet tell me to wait like you guys? I really like my vet. He owns the practice where SNPR takes all their pugs. I don't want to doubt or insult him, but now I'm a little weary.

Have you tested her for stones?

suggestions?

Switch to Dr. C, he sees pretty much all our pugs so he's seen it all with them by now. We've had quite a few with UTI's and he always waits to recheck. That's what we're doing with Mack-he's going in for a recheck tomorrow, actually.

Have you had her tested for stones by any chance?

well, the first time I took her in he did an xray and showed it to me. didn't see any stones.

so you're saying I should break up with my vet? lol

I'm saying to see Dr. C on the side......

well, I emailed him about 20 min ago and it only took him a few minutes to reply. Does anyone else get that quick of a response from their vet?

Here's what he said when I asked for more meds:
" Of course - will have some waiting for you. It could be the antibiotics were in her system. The other thing that some times UTI don't show up on a urinalysis - they are looking for bacteria and white blood cells and that can be in a small amount or just not in that part of the urine sample. We will keep her on for an extended period to get it taken care of. "

Mel, PLEASE don't start the antibiotics again without having a pee sample sent off for a C & S. The fact that the bug is still there probably means that the bug is resistant to that particular med and starting another round of the same antibiotics could have you right back there with the same result in a couple of weeks. Sure, continue with the same meds after a sample is taken, but you should have an answer within 48 - 72 hours on exactly what you're dealing with and what meds work.

I honestly have lost count of the number of times I've gone through this process with firstly LouLou and Puck, and now Imi as they all went through loss of mobility and feeling in their back ends. It's like second nature to me now - see the signs of a UTI; off to the vet for a sample for C & S, as well as a UA while we wait; starting on a broad spectrum ABX and hoping the bug is sensitive to then; waiting a couple of days for the results; and changing meds if necessary. Probably done it at least a hundred times! I've even gone through the process of having them treated for very rare, exotic bugs and bugs that hid between a layer of crystals and the bladder wall! That required surgery. FUN FUN FUN. Not.

I know how uncomfortable it can be questioning your vet's methods, but at the end of the day, whose feelings are more important? Just say you want a C & S done a.s.a.p. before you start the meds. They won't get upset. And if they do, screw 'em.

Hugs to you and Miss Zoe.

honestly, I don't really understand most of what you said. what's C&S?

also, what's weird is she's better soon as she's on the meds. it's when she stops that it comes back. wouldn't logic say that she just needs more time on the meds? *shrug*

Sorry Mel, should explain things better! I'll get Alice to come back later tomorrow to explain things better than I can, but in the meantime I'll try.

A "C & S" is a "Culture and Sensitivity". They take a pee sample, send it off to the lab and put it in a petri dish with a "growing" medium. After 24 - 48 hours, if there are any bugs in the sample, they will start to grow. Once they grow bacteria the perform "sensitivity" tests to establish to which antibiotics the bugs are susceptible and put her on the right meds. I searched online for a good explanation and this is all I could find...

With a sufficient population of bacteria grown on the plate in the form of a "lawn", the technicians will perform two main operations:


1. IDENTIFY THE SPECIES OF BACTERIA.
This is done with various techniques, including examination of lawn characteristics (color, texture, growth pattern, etc.) gram-staining, microscopic examination, metabolic requirement "footprints" and even DNA sequencing.

2. DETERMINE THE BACTERIAL POPULATIONS SENSITIVITY TO A RANGE OF ANTIBIOTICS.

This can be done by placing small disks of filter paper or agar impregnated with various types of antibiotics onto the bacterial lawn. The bacteria are allowed to incubate for a day or two, and then the plate is examined to see whether the bacterial growth is inhibited (or not) by the antibiotics on each disk.

SENSITIVE: In this case, a clear, circular "halo" (technically known as a "plaque," or zone of inhibition) will appear around the antibiotic disk, indicating an absence of bacteria. The antibiotic has inhibited their growth and/or killed them, meaning that this particular antibiotic should be effective against the infection your dog has.

INTERMEDIATE: A somewhat cloudy plaque indicates that not all the bacteria in the area around the disk have been killed. This means that there are some members of the bacterial population that are sensitive to this particular antibiotic, but others that are genetically immune to its effects. If an antibiotic to which the bacteria show "intermediate" sensitivity is used, it is likely that the sensitive members of the bacterial population will be killed, and the resistant ones will survive, resulting in the selection of a population resistant to that particular antibiotic.

RESISTANT: In this case, the filter paper will have no discernible plaque around it, meaning that the bacteria are growing normally, even in the presence of the antibiotic. An antibiotic producing no plaque will most likely be ineffective against the bacteria causing your dog's infection.


A Petri dish with bacterial colonies on an agar-based growth medium

As to why she seems okay when you put her back on the antibiotics, once again Alice will explain it better, but my uneducated answer is probably that the meds are enough to suppress the bugs when they are being administered, but not enough to kill them off - just enough to make her appear symptom-free. As soon as the meds stop the bugs rapidly multiply and back they come, causing all the signs of a UTI - blood in the urine, discomfort and increased frequency in urination.

Hope this has explained it (until Alice comes and does a better job!) and helps you see the benefit of a C & S. And you can go through all this and find that she has a particularly resistant bug and you HAVE been giving her the right meds, but she just needs a longer course! The most important thing is though, you have removed any chance for getting it wrong. To me UTI = C & S. No ifs, ands or buts. Years of experience with them with my girls have proven it again and again.

viralmd wrote:

northernwitch wrote:YAY for Zoe!

Joanne:
The deal with testing urine for infection when they are still on an antibiotic or have just finished it is that the antibiotic can mask the signs of infection. Unless the infection is REALLY aggressive and resistant to the antibiotic being used, infection won't necessarily show up on a U/A while the dog is still on antibiotics or still has them in his or her system. I only re-test urine a week or more after antibiotics and I won't put a dog on antibiotics without a C and S being done.

Blanche, even in the case of resistant organisms, there's usually enough antibiotic activity to prevent growth of the resistant organisms in the culture. The best way is, as you suggest, to wait until at LEAST a week after discontinuation of the antibiotic and then re-culture.

Good to know, Alice. The only time I've had to deal with an antibiotic resistant bacteria in the rescue h as been an elderly dog with MRSI and it showed up every time on C and S even when he was on antibiotics for another issue.

Mel:
You're Zoe's advocate. It's up to you to tell the vet what you want done and if he gets insulted then he's not much of a vet. You can certainly explain politely what you would like to see happen. If you keep putting Zoe on antibiotics without the culture and sensitivity testing, then you run the risk of encouraging resistant bacterias. And why have her on antibiotics that aren't working? Until you do C and S, you have NO idea (and neither does your vet) if what she's taking is appropriate for her infection.

Vets throw around clavamox like candy and increasingly we see dogs that don't respond to it.

northernwitch wrote:Vets throw around clavamox like candy and increasingly we see dogs that don't respond to it.

not sure if it makes a difference, but she's on amoxicillin. I will ask about the C&S.

Mel wrote:

northernwitch wrote:Vets throw around clavamox like candy and increasingly we see dogs that don't respond to it.

not sure if it makes a difference, but she's on amoxicillin. I will ask about the C&S.

Essentially the same thing.

And I'd be insisting on C and S.

# Amoxicillin + clavulanate is commonly used in dogs and cats to treat a variety of infections and its most common brand name is "Clavamox".
# Amoxicillin + clavulanate is a combination of two drugs that act together (synergistically) to treat or prevent bacterial infections in animals. Amoxicillin is an antibiotic related to penicillin, except that it has a somewhat broader spectrum of antibacterial action.
# Clavulanate is an inhibitor of an enzyme produced by bacteria. This enzyme, beta-lactamase, would ordinarily render amoxicillin inactive. Clavulanate has no antibacterial effects; it simply acts as an inhibitor of an important resistance