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- 8 yr mn fel DLH dx with crf one year ago and placed on Rx renal diet. He also has a history of chronic UTI’s over the past two years which present with hematuria and pollakiuria and have been difficult to treat even when culturing the urine. Kal also has had a brown nasal discharge for 6 months.
- 9/21/20 – occ bacteria on UA
8/28/20 – marked rod bacteria on UA (tx w/ Enrofloxacin)
7/31/20 – rod bacteria on UA, cultured as E.coli (tx w/ Clavamox)
6/3/20 – BW has azotemia (Creat 2.9, BUN 43, Ca 11.4, SG 1.019)
3/25/19/ – urinary culture showed E. faecalis (tx w/ Amoxicillin)
2/25/19 – rod bacteria on UA, (Tx w/ zeniquin)
- The patiet presented to this primary vet for the first time on 12/17/20. Urinalysis showed a UTI and the culture grew E.coli.
- Abdominal US shows normal bladder. However, kidneys show hyperechoic outer medullar, uneven corticomedullary definition.
- What are your rule outs for these kidneys? Chronic interstitial nephritis? GN?
- My rule outs for the recurrent UTI’s include crf, pyelonephritis, resistant infection, and immunosuppression. Any other thoughts for patient management? Chronic or pulse AB tx? increased fluid intake, BP meas. etc.
2 responses to “Recurrent urinary tract infections in 13yr mn fel DLH”
Crhonci interstitial
Crhonci interstitial nephritis/osis and a touch of pyelectasia may be harboring the e coli. any time pyelectasia and uti run together you need 4-6 weeks of specific and to try to clear infection but may not even do it then owing to the chronci changes give bacteria places to hide. Pyelectasia can be from pelvic scarring as well so pyelectasia is not pyeleonephritis.
On urinalysis is there just
On urinalysis is there just bacteruria or evidence of active inflammation?, as cats with chronic kidney disease may have asymptomatic bacteruria without inflammation, which often is impossible to eradicate.