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My 9 mo male GSD dog has UTI. He is hind leg paralyzed and…

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My 9 mo male GSD...
My 9 mo male GSD dog has UTI. He is hind leg paralyzed and we catheter him 3 times a day. Somewhere in the process he got uTi. We realized it as soon as the urine turned milky but vet started on antibiotics only after 3 more days when there was blood in urine. He was also refusing water and constantly licking penis area. He is on Mikacin injections twice a day 300mg. It has been 3 days since he started antibiotic. Today he regained thirst and drank a lot of water (2 litre) but not peeing much.
My issue is he is still having reddish urine towards the end. At the beginning of stream it's normal. The last part is the painful and reddish part.Is there a reason for less urine volume despite drinking water?
Is the antibiotic the right one?
Is it broad spectrum?
How long it takes for Urine to be clear and antibiotic to take effect?
I just gave him apple cider vinegar 1 tbsp with yogurt. Will it help?
Is there anything I can do to expedite the recovery? Should I discuss with vet to change antibiotic?Please consider addressing all the aspects of my query. Thank you so much for your help.
Submitted: 6 months ago.Category: Dog Veterinary
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Answered in 19 minutes by:
12/25/2017
Dog Veterinarian: Dr. Michael Salkin, Veterinarian replied 6 months ago
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Dog Veterinary
Satisfied Customers: 34,859
Experience: University of California at Davis graduate veterinarian with 45 years of experience
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Dog Veterinarian: Dr. Michael Salkin, Veterinarian replied 6 months ago

I'm sorry to hear of this with your dog. To answer you directly...

1) Yes, I would be concerned about pyelonephritis (kidney infection) and oliguria (less urine formed) due to kidney damage. His kidney function needs to be assessed by BUN, creatinine, SDMA testing as well as complete urinalysis.

2 and 4) Amikacin (Mikacin)is dosed at 10 mg/kg subcutaneously or intramuscularly twice daily for 7-21 days or until a urine culture is negative and my patient is asymptomatic. If no response is observed after three days of treatment, therapy should be discontinued and the case re-evaluated.

3) Amikacin has good activity against a variety of bacteria, predominantly gram-negative aerobic bacilli.

4) There's no scholarly evidence that apple cider vinegar + yogurt has any effect on the urinary tract. They won't be harmful, however.

5) Insist upon bacterial culture and sensitivity of the urine. Presumptive therapy with an antibiotic is acceptable but that antibiotic might not be the best choice according to the culture and sensitivity which usually takes 72 hours to be reported.

Please respond with further questions or concerns if you wish.

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Customer reply replied 6 months ago
I live in a small town in India. There is no lab for testing here. How serious is oliguria. Is there any way to know for sure? I'm very concerned at this punt. The reduced urine output is happening since last 24 hours. How concerning is it? Where is all the water he is drinking collecting ? I'm so scared.
Dog Veterinarian: Dr. Michael Salkin, Veterinarian replied 6 months ago

I understand. You would need to collect all of his urine and measure how much was produced in a 24 hour period. It should approximate how much he ingests which generally is an ounce of fluid per pound of body weight daily (2 ounces per kg of body weight daily). It's a concern because kidney failure is life-threatening. Fluid would remain in his tissues rather than being excreted through his kidneys in the form of urine.

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Customer reply replied 6 months ago
Could this be the side effect of Mikacin? If so can the kidney issue be reversed if we stop the medicine? Im reading that mikancin is known to cause serious kidney problems. He has taken 7 doses so far over 3 days
Dog Veterinarian: Dr. Michael Salkin, Veterinarian replied 6 months ago

Mikacin can be toxic to the kidneys. Damage may or may not be reversible.

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