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Barney and Floyd went for their annual check ups last Monday. They told me at the visit that Barney's urine had quite a lot of bacteria in it so they were going to send it out for culture. I got a call from Barney's vet on Friday afternoon. She read the “still pending” lab culture results to me on the phone and suggested that we go ahead and start on antibiotics even though the final results aren't done yet.
Here's what the culture said:
enterococcus – 10,000-50,000/ml
ecoli – 1000-10,000/ml
Here's the antibiotic he's now on:
Baytril 68mg – 1.5 tabs 2x daily
Since I wasn't able to speak to his oncologist about this I didn't give him the Cytoxan this weekend although I have gone ahead with the other 2 parts of his metronomic protocol – the doxycyline and the Metacam. I've got a message in to the oncolodist for their return on Monday, but I'm wondering what you think.
I'm so anxious/worried over this UTI development and can't believe I didn't notice something sooner with his straining to urinate. This wouldn't be the cancer coming back would it? I pray not.
How soon can I tell if the Baytril is helping? Right now I'm just not sure – it's early evening on Sunday and he's had 3 doses over the weekend. I'm guessing that we might even have to change meds once the final culture results are in – right?
Barney's worried mom,
Did they get the urine with a catheter or with a needle (cystocentesis)? Was it a free-catch? Bladder infections are much more common in females than males due to anatomy, and E coli is a common pathogen since it is normally present in stool. This is not the same E coli that people get from eating undercooked meat and it is not contagious to people or dogs. If the sample was drawn from the bladder with a needle (actually a lot less painful than a catheter!) then it should be sterile so nothing should grow. A sample taken with a catheter can have some contamination from the skin and the free-catch method is the least sterile so I don't even bother culturing those. The cystocentesis is the preferred method. Any blood or white cells in the urine? Cytoxan (cyclophosphamide) can cause hemorrhagic cystitis (bleeding from the bladder) and is usually quite obvious in the winter if you have snow. A low dose may cause some immunosuppression but that would be rare even though Barney is getting 1 weekly dose.
Baytril is a great antibiotic for the bladder and is very effective against E coli. It is not that great for Staph or Strep and some other cocci bacteria so you might need to change meds based on culture results. Dogs can have “silent” UTIs (asympotmatic) which is why urine tests should be run every 3-6 months if a dog is on Cytoxan. I wouldn't worry since this should have nothing to do with recurrence of cancer!
Pam and Tazzie
Thank you so much for your feedback.
The sample was obtained by cystocentesis, yet all those bacteria were present in the preliminary culture results. Since we live in Houston, Tx without snow, detecting blood in the urine while we're on a walk is a bit more challenging. I'll find out more today about whether there were white cells, or blood present. It helps to know the right questions to ask.
Your comment about this likely not having anything to do with cancer recurrence makes me feel a bit better. Thank you for that.
Please give Tazzie a big hug from us!
Linda & Barney B
25 April 2007
Well, we finally got the completed lab / culture results! And as a result of that and the 2 different bugs Barney's fighting, we've now added another antibiotic in addition to the Baytril. It is called Tribrissin. So, he's on a course of the 2 drugs for 21 total days – then he'll go back for repeat blood work and a repeat urinalysis. Right now, he's still straining, dribbling, and there's a trace of blood in his urine, but hopefully these drugs will kick in soon. Barney's oncologist received a copy of the report and she too agreed that it appears we're looking at a UTI.
Pam – I cannot tell you how much I appreciate your response – it really helped to put my mind at ease a bit.
Hugs to all,
Barney B and Linda