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Our dog has bladder stones, and we made a big mistake and now

don't know what to do...
Our dog has bladder stones, and we made a big mistake and now don't know what to do. We had thought that it was another one of our dogs who had an infection and she was put on antibiotics. We had to have the rx filled at a pharmacy which was weird, and they gave us 2X the dosage which was for 2 weeks. When we discovered that it was our other dog who was peeing in inappropriate places, we started giving her antibiotics also. They are roughly the same size / weight. Then she passed a stone so we took her in to the vet and they did an xray, culture and sensitivity and stone analysis. She has a lot of stones in her. They also gave her amoxicillin for 10 days 2 x a day. We failed to tell them that we had been giving her the same antibiotics our other dog was taking and the results came back for sterile struvites. We have since learned that the antibiotics probably caused a false negative. My husband misunderstood them I think when they called with the results and stopped giving her the amoxicillin 2 days ago because they had told him she didn't have a UTI. So we screwed up. She has started 2 different kinds of antibiotics and now we are not really sure if the stones are indeed sterile or not. We are very unhappy with the vet clinic, we just moved here and it was our 2nd encounter with them. They had her lab results for a day and a half before calling us and just act very unconcerned so we don't really trust them now. So here we are. We need to get back on track quickly with all of this and need to find out for sure what kind of stones she has. We have a couple other stones she has passed, but they are dried up now, would they be able to analyze one of them and tell what kind of stone it is? Or does she need to be off of antibiotics for awhile and have another urine c and s? We will be going to another vet, probably today after we hopefully find one we are comfortable with. Right now we are just worried and can't sleep!
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Answered in 31 minutes by:
8/26/2013
Dr. Taus
Dr. Taus, Veterinarian
Category: Veterinary
Satisfied Customers: 505
Experience: Veterinarian with experience in equine and small animal medicine.
Verified
Hi there,
So sorry to hear about the confusion.

Being on antibiotics will disrupt your culture and sensitivity but not the stone analysis. So you can trust that the stones are struvites, you just don't know if she has an infection or not at this point. Ultimately, struvite stones and infections are a vicious cycle. The bacteria make the urine have a basic pH, which causes stones to form, which makes more irritation in the bladder and places for bacteria to live, which causes infections. Even if you don't have an infection now, you will continue to have them on and off until the stones are gone.

You need to talk to your vet about your options to eliminate the stones. These can include prescription diets to dissolve the stones or surgical removal, depending on how large they are. If there are many stones, surgical removal may be your best option. In the meantime, antibiotics can help relieve signs of having accidents, urinary irritation, etc, but you will constantly be battling recurrent infections. At this point, I don't think I would stop the antibiotics just to do a culture and sensitivity. I would continue the full course of medicine and address the underlying problem, which is the stones.

I encourage you to find a vet you are comfortable with who can walk you through all your options. I'm sorry your experience so far has been negative. How frustrating to try to figure out which dog is having problems! Generally, while these problems are uncomfortable and should be addressed, unless a stone becomes stuck in the urethra and causes an obstruction (rare in females), it's not something to lose sleep over and can be dealt with over the next few days :).

I hope this is helpful. If so, please rate me positively, and don't hesitate to let me know how I can help further.
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Customer reply replied 4 years ago

without another c and s how will they know which antibiotic she should be taking? also she has a recessed vulva, do you recommend surgery to address that issue? and will it harm her that we stopped giving her the antibiotics before the 10 days were up and now starting them again?

I don't expect to be able to fully clear the infection without getting rid of the stones, so seeing an improvement in clinical signs on a broad spectrum antibiotic is a pretty good indicator that the one you've been using is sufficient. If you've already stopped the antibiotic, you might as well have it cultured before you start again, though, just to be sure. It won't harm her to have stopped and then re-start-- it just makes it more likely that the bugs in there are resistant to your antibiotic and you may need something different.

 

Repairing the recessed vulva is certainly a good way to help prevent UTIs (and formation of more stones) in the future. I'd recommend getting the stones resolved first. Whether your surgeon will be comfortable removing stones and doing a vulvoplasty at the same time or doing one and then the other depends on the surgeon, so when you establish a relationship with a new vet, it's something to bring up.

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Customer reply replied 4 years ago

one more question, how long does she have to be off antibiotics before she can have another c and s?

7-10 days is usually sufficient.
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Customer reply replied 4 years ago

could it be possible that she has ureaplasma bacteria that doesn't show up on a regular c and s? thus treating her for sterile stones would be wrong?

Urease-positive bacteria that are usually responsible for stone formation are Staphylococcus and Proteus species that typically show up on a C&S. While Ureaplasma is a possibility, it's unlikely given that common infections occur commonly and ureaplasma is not a common cause of UTI in dogs.

You need to get rid of the stones, whether it is by nutritional management or by surgery. Until you do, the bacterial infections will keep coming back, no matter what the cause. When I do cystotomies, I do them in such a way (which is routine among vets) that I avoid contamination of other structures, and I consider the interior of the bladder to be "dirty." I then treat for UTI and follow up with C&S to make sure the infection is gone.

No test is 100% for every organism out there. If the stones are gone, C&S is negative, and the patient is still showing signs of illness, then we look for uncommon causes like ureaplasma using mycoplasma culture techniques. In any case, even if it was ureaplasma, the stones need to go away to be able to clear the infection. In addition, ureaplasma is often an opportunist and treating the primary cause (stones) does quite a lot toward eliminating the infection.

We never assume the stones are sterile. Even if the C&S is negative, there are likely bacteria up within the thickened, irritated bladder walls and within the structure of the stones that are not exfoliating into the urine where they can be grown in culture. Treating the stones is the only way to remove the nidus of infection and stop the UTIs from recurring.
Dr. Taus
Dr. Taus, Veterinarian
Category: Veterinary
Satisfied Customers: 505
Experience: Veterinarian with experience in equine and small animal medicine.
Verified
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