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Dr. B.
Dr. B., Veterinarian
Category: Dog Veterinary
Satisfied Customers: 21419
Experience:  Hello, I am a small animal veterinarian and am happy to discuss any concerns & questions you have on any species.
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My dog is on low dose prednisone issues 2.5 mg every 48 hrs.

Customer Question

My dog is on low dose prednisone for back issues 2.5 mg every 48 hrs. It is causing reoccuring uti's. All her labs are great except her BUN level was 74 but vet said could be due to the uti at the time of labs. To be sure we are giving her fluids twice a week and supplements and probiotics to help kidneys to be safe. Another uti has struck her and vet prescribed keflex antibiotic for 2 weeks and is talking about low dose long term as well since its been going on for a year. Prior the antibiotic has been a form of amoxicillian, can't remember name now. I've been researching the keflex but find a lot of warnings if there is already kidney issues. I'm afraid to give it to her now. I've also been giving her goldenseal and echinachia and other homeopathy to help but I don't think they are stopping it just making it a bit less painful for her. She's 16 pounds and 13 years old. Thoughts?
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Submitted: 1 year ago.
Category: Dog Veterinary
Expert:  Dr. B. replied 1 year ago.

Hello & welcome, I am Dr. B, a licensed veterinarian and I would like to help you today. I do apologize that your question was not answered before. Different experts come online at various times; I just came online, read about your wee one’s situation, and wanted to help.

Again I do apologize that my colleagues could not aid you sooner, but can you tell me:

What testing has her vet done in regards ***** ***** persisting UTI?

Was the urine ever cultured to tell you what bacteria was present?

You noted an elevated BUN, but was her creatinine normal or elevated too?

Customer: replied 1 year ago.
We've sent out for cultures 4-5 times in the last 6-8 months each time confirming uti bacteria. I believe one time they said ecoli but they haven't said any specific bacteria the other times.Yes, her creatine level is perfect. All labs are except BUN & this terrible uti.Thank you!
Customer: replied 1 year ago.
We are giving her azodyl to try to get the BUN down & fluids and will retest in 2-3 months to see where her BUN level is then.
Expert:  Dr. B. replied 1 year ago.

Thank you,

In those cultures that were not specific, did they say there was bacteria? Or were they negative?

Just since she is on steroids, have you seen any black or dark stools? Any belly discomfort or vomiting?

Customer: replied 1 year ago.
The other cultures all were positive, I just didn't think to ask what type of bacteria. I assumed it was the same thing still there.No tummy problems and no dark or black stool. We feed her grain & rice free, raw diet, as we recently learned even rice can trigger uti.
Expert:  Dr. B. replied 1 year ago.

Thank you again,

First, I have to note that if her creatnine levels are normal, this makes kidney issues less suspect. This reason is because this should be elevated too if her kidneys are the cause of the elevated BUN. Since it isn’t, I’d be more suspicious that the BUN is up for a pre-kidney issue. Most commonly it will be related to an increased protein intake. And that could actually include her raw diet. So, the BUN could be up because of that. As well, with her being on steroids (which can lower stomach mucus production leading to bleeding ulcers), there is a risk that if she has one this too could lead to the increased protein intake that would then affect the BUN. So, that is something to check into with them and gastroprotectants may be ideal as a pre-treatment for her steroids to make sure that isn’t an issue here

Otherwise, it is worth reviewing with her vet what has been found on all the cultures and what they have been sensitive to. We’d want to double check that the antibiotics tried were and since Keflex can be stressful for kidneys, it would be best to assess all the antibiotics reported able to keep these bacteria at bay (which will be on the lab report) to see if there is a better option for use.

As well, since her steroid dose isn’t an immune suppressive dose (though could dilute he urine as kidney issues could and thus make her urine easier to colonize for bacteria), we’d want to make sure there are no other issues precipitating her signs. So, we’d need to ensure her vet has ruled out bladder stones, urine crystal issues, and bladder tumors. If those are all clear and further to considering long term antibiotics, its worth discussing her urine pH (this should be known to her vets from her urine tests) and possible treatments to acidify her urine and make it less hospitable for bacteria. As well, with this in mind, you could even start her on OTC aloe vera berry juice (available at most health food stores) to gently make her urine less suitable for bacterial growth.

Finally, since your vet suspects her steroids are predisposing her to UTIs, we may need to see if she can be weaned further off them or have them stopped. Therefore, it’d be worth considering additional pain relief (ie Tramadol, Buprenorphine), muscle relaxants, and even mild non-steroidal anti-inflammatories in place of steroids to see if we can manage her discomfort but remove that risk for her urinary tract.

Please take care,

Dr. B.


If you have any other questions, please ask me – I’ll be happy to respond.

**Afterwards, I would be grateful if you would rate my service by clicking on the "Rate my Expert' button at the top of the page as this is the only way I am credited for helping you. Thank you for your feedback!: )

Customer: replied 1 year ago.
Wow! What great information!I like the aloe vera berry juice approach as I'm trying to be as natural as possible in taking care of Faith. How much would I give her each day? Wasn't sure if too much aloe was harmful to dogs.So far tests have shown no crystals, stones ir tumors so that's a relief.
Thank you!
Expert:  Dr. B. replied 1 year ago.

You are very welcome, my dear. :)

I am glad to see that they have checked and ruled those out already. Otherwise, in regards ***** ***** Vera Berry juice, it is quite safe (it’s the raw aloe plant that can cause GI upset). In regards ***** ***** of this, we tend to give 1-2 ml every 5 lbs over 24 hours (it can be given as a single dose or divided into two) .

All the best,

Dr. B.


If you have any other questions, please ask me – I’ll be happy to respond.

**Afterwards, I would be grateful if you would rate my service by clicking on the "Rate my Expert' button at the top of the page as this is the only way I am credited for helping you. Thank you for your feedback!: )

Expert:  Dr. B. replied 1 year ago.


How if everything with your wee one?

Dr. B.