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Urinary tract infection - Coggle Diagram

- - - - no/low risk for other comorbidities
      - not an entire male dog
      - no recent abs use
    - - NSAIDs
      - consider delaying ab tx until infection confirmed by culture provided results available in 24h
      - empirical ab choice acceptable - amoxicillin +/- clan or TMPS
      - 3-5 days abs based on antimicrobial sensitivity testing
  - - - urine c+s
      - USS, plain, contrast radiography, cystoscopy
      - review previous ab use
    - - approach as for sporadic cystitis
      - address underlying causal factors
      - duration of treatment dependent on circumstances and pathogen
      - follow up culture important
        
        during treatment may be appropriate to determine response and duration of therapy
        
        5-7 day post antibiotics to document clinical cure
    - - endocrinopathies
      - renal disease
      - obesity
      - abnormal valvular conformation
      - congenital abnormalities to urinary tract
      - urinary retention
      - urinary incontinence
      - prostatic disease
      - polypoid cystits
      - urolithiasis
      - immunosuppressive therapy
      - rectal fistula
  - - - may result from ascending infection or bacteraemia
      - incidence in dogs and cats not well defined
      - clinical signs can be vague and non specific
      - severe and rapid renal injury may occur
      - leptospirosis ddx
      - diagnosis
        
        hx and clinical signs
        
        clinical pathology
        
        urinalysis and culture
        
        diagnostic imaging
        
        consider
        
        pyelocentesis
        
        blood cultures
        
        serological testing/PCR
      - Treatment
        
        initiate empiric treatment pending c+s
        
        factors influencing ab choice
        
        previous hx
        
        ascending versus haematogenous infection
        
        oral versus iv
        
        Urine/blood culture results
        
        renal function
        
        duration depends on diagnosis and response to tx
  - - - lipid soluble, weakly alkaline with high pKa most likely to cross blood prostate barrier
      - good empiric choices
        
        fluroquinolones
        
        trimethoprim sulphonamide