UTI (Urinary tract infection) in diabetic dogs

January 27, 2022

UTI, also known as, urinary tract infection, is one of the most common conditions that diabetic dogs are vulnerable to. In fact, about 21-37% of dogs with diabetes mellitus (DM) have been reported to show a positive urine culture. Affected dogs present with a wide range of symptoms, from being asymptomatic to expressing great pain upon urination.

What is a UTI?

Urinary tract infection is when a pathogen invades and multiples in the urinary tract, usually after entering through the urethra. The pathogenic bacteria may ascend along the urinary tract from the urethra to the bladder, ureter, and even up to the kidneys. Most cases of UTI involve infection by one bacteria species. However, some complicated cases may involve two to three species simultaneously colonizing the urinary tract. While E. coli is thought to be the dominant UTI-causing bacteria species, other common strains include Streptococcus spp., Staphylococcus spp., Corynebacterium spp., Pasteurella spp., Klebsiella spp., and Proteus spp.

Why is UTI common in diabetic dogs?

Glucosuria, or glucose in urine, may explain the increased vulnerability of dogs with DM to infections of the urinary tract. The excess glucose found in urine of diabetic dogs serves as a food source for bacteria, turning their urinary tracts a compatible environment for bacterial growth. Glucose in urine is also known to be associated with decreased immune response. It is thought to decrease the movement of neutrophils, a type of white blood cell, to the infection site. Obesity, which may be present in the diabetic dog, is also thought to promote bacterial growth. Increased skin folds surrounding the genitals may serve as breeding grounds for bacteria. Decreased frequency of urination, secondary to an inactive lifestyle of obese dogs, is also thought to promote bacterial growth in the urinary tract.

What are the symptoms of UTI? What can happen if UTI is left untreated?

Below are the common symptoms of UTI:

Dysuria: Discomfort, pain, or burning during urination
Polyuria: Abnormally frequent urination
Stranguria: Slow discharge of small volumes of urine, having to strain to pee
Polydipsia: Increased thirst, shown by increased drinking
Gross hematuria (blood in urine, visible to the eye)
Cloudy urine (presence of pus)
Abnormally frequent licking of the genitals
Fever

A review article reports that many dogs did not present symptoms obvious to the owner at the time of positive urine culture. A possible explanation may be immunosuppression secondary to diabetes mellitus. If a lower urinary tract infection is left untreated, many dogs can become at risk for upper urinary tract infections, affecting the kidneys. If a kidney infection has occurred, it often requires a longer period of treatment. Sometimes, it may even lead to dangerous conditions, such as kidney impairment or, rarely, sepsis. Kidney infections are often accompanied by fever and/or flank pain upon palpation.

How is UTI diagnosed?

Urine is collected from the dog and analyzed. Dipsticks may be used to evaluate the color and cloudiness of the urine. Density, pH level, and chemical composition can be read to determine signs of bacterial infection. If the provider observes positive signs of infection, the urine will be sent to lab for confirmation.

How is UTI treated?

Most UTIs will be prescribed antibiotics for treatment. The urine culture will be able to indicate an antimicrobial that specifically targets the bacteria infecting the urinary tract. The duration of an antibiotic treatment may range from 1 week to, sometimes, 4-6 weeks for complicated UTIs or upper UT infections. Another urine culture is recommended after a week of treatment, then again, after a week of treatment cessation. Different antimicrobial may be prescribed if the one originally prescribed is not working properly, likely because of antibiotic resistance.

Since dogs with diabetes mellitus are vulnerable to UTI infections and may not show visible symptoms even with the presence of an infection, owners are recommended to regularly have their dogs screened for prompt treatments.

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References:
- Kour, H., Chhabra, S. Diabetes mellitus in canines: A concise review. The Pharma Innovation Journal 2021; 10(5): 1574-1583. https://www.thepharmajournal.com/archives/2021/vol10issue5/PartT/10-5-181-447.pdf
- Teh, H. A review of the current concepts in canine urinary tract infections. 2021. Aust Vet J. 1-7. https://doi.org/10.1111/avj.13127
- Fleeman, L.M., Rand, J.S. Management of Canine Diabetes. 2001. 31(5): 855-880. https://doi.org/10.1016/S0195-5616(01)50003-0
- Hunter, T., Downing, R. Pyelonephritis (Bacterial infection of the kidney) in dogs. VCA Animal Hospitals. Retrieved from website: https://vcahospitals.com/know-your-pet/pyelonephritis-bacterial-infection-of-the-kidney-in-dogs
- Albuquerque Vetco Veterinary Clinic. UTI’s and Diabetes in Your Dog. 2015. Retrieved from website: https://www.vetconm.com/utis-diabetes-dog/
- Williams, K., Ruotsalo, K., Tant, M.S. Urinalysis. VCA Animal Hospitals. Retrieved from website: https://vcahospitals.com/know-your-pet/urinalysis

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