Detection of Occult Urinary Tract Infections in Dogs With Diabetes Mellitus

McGuire, Nancy; Schulman, Rhonda L.; Ridgway, Marcella D.; Bollero, Germán A.

doi:10.5326/0380541

Cited by 46 publications

(45 citation statements)

References 5 publications

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“…11,12,[32][33][34] In our study, neither diabetes nor hyperthyroidism were associated with UTI. However, selection bias may be responsible, in part, for this finding.…”

Section: Discussioncontrasting

confidence: 64%

Clinical features and risk factors for development of urinary tract infections in cats

Martinez-Ruzafa

Kruger

Miller

et al. 2012

Journal of Feline Medicine and Surgery

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The clinical and diagnostic features of 155 cats with urinary tract infection (UTI) and 186 controls with negative urine culture/s were characterized retrospectively (signalment, clinical signs, urinalysis, urine culture, concurrent diseases, lower urinary tract diagnostic/therapeutic procedures). Multivariable logistic regression was used to identify risk factors associated with UTI. Cats of all ages were affected by UTI with no sex/breed predisposition. Lower urinary tract signs were absent in 35.5% of cats with UTI. Pyuria and bacteriuria had sensitivities of 52.9% and 72.9%, and specificities of 85.5% and 67.7% for detection of UTI, respectively. Risk factors significantly associated with increased odds of UTI were urinary incontinence [odds ratio (OR) = 10.78, P = 0.0331], transurethral procedures (OR = 8.37, P <0.0001), urogenital surgery (OR = 6.03, P = 0.0385), gastrointestinal disease (OR = 2.62, P = 0.0331), decreased body weight (OR = 0.81, P = 0.0259) and decreased urine specific gravity (OR = 0.78, P = 0.0055). Whilst not independently significant, renal disease and lower urinary tract anatomic abnormalities improved statistical model performance and contributed to UTI.

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“…11,12,[32][33][34] In our study, neither diabetes nor hyperthyroidism were associated with UTI. However, selection bias may be responsible, in part, for this finding.…”

Section: Discussioncontrasting

confidence: 64%

Clinical features and risk factors for development of urinary tract infections in cats

Martinez-Ruzafa

Kruger

Miller

et al. 2012

Journal of Feline Medicine and Surgery

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“…The prevalence of the latter in DK-DKA and in uncomplicated canine DM is reported to range from 20 to 37% (Forrester et al, 1999;Hume et al, 2006) and occult infections (absence of pyuria, bacteriuria and compatible clinical signs) is common due to decreased neutrophilic chemotaxis (McGuire et al, 2002). Aerobic bacterial urine cultures are warranted in all dogs with DK-DKA, regardless of their clinical signs and the results of urine sediment examination (Feldman and Nelson, 2004).…”

Section: Discussionmentioning

confidence: 99%

Canine Diabetic Ketosis-Ketoacidosis: A Retrospective Study of 23 Cases (1997-2013)

Kasabalis

Chouzouris

Timiou

et al. 2018

J Hellenic Vet Med Soc

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ABSTRACT. The purpose of this retrospective study was to describe the historical and clinical findings, the clinicopathological abnormalities, the occurrence and nature of concurrent diseases, the treatment and outcome of 23 dogs with diabetic ketosisketoacidosis (DK-DKA). Inclusion criteria consisted of the presence of clinical signs suggestive of diabetes mellitus (DM) along with persistent hyperglycemia, glycosuria and ketonuria during the first 24 hours of hospitalization. In nineteen dogs (83%) DM had not been previously diagnosed. Common presenting complaints were polyuria/polydipsia (100%), partial or complete loss of appetite (87%), depression (87%), vomiting (65 %) and weight loss (30 %). The most frequent physical examination findings included dehydration (61%), depression (61%), hypotrichosis-alopecia (39%), palpable cranial abdominal organomegaly (26%), pendulous abdomen (26%), lesions compatible with superficial pyoderma (17%), thin and hypotonic abdominal skin (17%), and hypothermia (17%). The most important clinicopathological abnormalities, apart from hyperglycemia, glucosuria, and ketonuria, included anemia (48%), leukocytosis (39%), increased activities of alkaline phosphatase (100%), lipase (56%) and alanine aminotransferase (52%), hypertriglyceridemia (90%) and hypercholesterolemia (84%). Also, 12 dogs demonstrated hypokalemia on admission or during hospitalization. A concurrent disease was identified in 74% of the cases while 26% had two or more comorbidities. The latter included pancreatitis (30%), urinary tract infections (17%), superficial pyoderma (17%), urolithiasis (13%) and hyperadrenocorticism (13%). Twenty two dogs were treated with short-acting insulin (regular or lispro) and one with intermediate-acting (lente) insulin, whereas intravenous fluid therapy was instituted in 78% of them with potassium and phosphorus supplementation in 65% and 9%, respectively. Seventeen (81%) dogs survived to be discharged, three (13%) died during hospitalization, one (4%) was euthanized and on two (9%) occasions owners declined hospitalization after the first 24 hours due to financial constrains or a poor prognosis. Mean duration of hospitalization for the survivors was 5.7 ± 2.4 days, mean time to resolution of ketonuria was 4.2 ± 1.9 days and median time of rapid-acting insulin administration was 4 days (range 2-8 days).

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“…At many practices and institutions, including the practice at which the authors work, QUC is routinely performed when evaluating a proteinuric dog, even in the absence of an active urine sediment or signs of lower urinary tract disease. Some diseases that cause renal proteinuria, such as diabetes mellitus or hyperadrenocorticism, also predispose dogs to bacterial growth in urine, which is frequently subclinical . Additionally, a lack of pyuria and cytologic detection of bacteria cannot rule out bacterial growth in urine in dogs with dilute urine samples, which is a reason urine cultures are still recommended despite an inactive sediment .…”

Section: Introductionmentioning

confidence: 99%

Characteristics associated with bacterial growth in urine in 451 proteinuric dogs (2008‐2018)

Grimes

Heseltine

Nabity

et al. 2020

Veterinary Internal Medicne

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Background Urine cultures are frequently recommended to rule out infection as a postrenal cause of proteinuria. Objective Identify characteristics associated with bacterial growth in urine in proteinuric dogs. Animals Four hundred and fifty‐one dogs admitted to a teaching hospital between January 2008 and January 2018 with urine protein‐to‐creatinine ratios (UPCs) >0.5. Methods Retrospective study included dogs with a UPC, urinalysis, and quantitative urine culture (QUC) performed within a 72‐hour period by searching electronic records. Dogs with recent antimicrobial therapy, urine collected by methods other than cystocentesis, or UPC ≤0.5 were excluded. Signalment, comorbidities, serum BUN and creatinine concentrations, urinalysis findings, and QUC results were recorded. The association between these characteristics and presence of bacterial growth in urine was assessed by univariable and multivariable analysis. Results Thirty of four hundred fifty‐one dogs (6.7%) had bacterial growth in urine. Of these, 18 (60.0%) had active urine sediment. Bacterial growth in urine was associated with pyuria (odd ratio [OR] 25.1, 95% confidence interval [CI] 7.9‐79.6, P < .001), bacteriuria (OR 11.1, 95% CI 3.2‐39.1, P < .001), and lower urinary tract disease (OR 6.7, 95% CI 1.9‐23.0; P = .0028). If QUC was prompted based on these criteria, 8/451 (1.8%) of proteinuric dogs would have had undetected bacterial growth. Conclusions and Clinical Importance The proportion of proteinuric dogs with both inactive urine sediment and bacterial growth in urine was low, suggesting that QUC might not be necessary in the evaluation of all proteinuric dogs. An active urine sediment or lower urinary tract disease should prompt QUC for proteinuric dogs.

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Detection of Occult Urinary Tract Infections in Dogs With Diabetes Mellitus

Cited by 46 publications

References 5 publications

Clinical features and risk factors for development of urinary tract infections in cats

Clinical features and risk factors for development of urinary tract infections in cats

Canine Diabetic Ketosis-Ketoacidosis: A Retrospective Study of 23 Cases (1997-2013)

Characteristics associated with bacterial growth in urine in 451 proteinuric dogs (2008‐2018)

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