Dehydration and electrolyte imbalances are treated with intravenous fluid therapy. Antibiotics may be given to prevent or treat infection, and drugs that help restore bladder function are sometimes recommended. For cats who continue to experience urethral obstruction despite medical treatment, there is a surgical procedure called a perineal urethrostomy.
Since side effects of this surgery can include bleeding, narrowing at the surgical site, urinary incontinence, and a greater incidence of urinary tract infection, it is usually considered only as a last resort.
Feline Idiopathic Cystitis Feline idiopathic cystitis FIC —also called interstitial cystitis—is the most common diagnosis in cats less than 10 years of age with lower urinary tract disease. The disease is not fully understood and may involve several body systems in addition to the urinary system. Feline idiopathic cystitis is a diagnosis of exclusion, meaning that it is a diagnosis made after all diseases that might cause similar signs are ruled out.
There is no specific diagnostic test for FIC. Stress and diet changes can increase the risk of FIC. The disease can be chronic and very frustrating for the cat, the owner, and the veterinarian. The current goals of treating cats with FIC are to decrease the severity and frequency of episodes.
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There are numerous medical treatments that result in variable degrees of success but often the veterinarian will start by addressing any behavioral issues. This may include feeding only canned food and reduction of stress. Other Causes Diseases such as diabetes and hyperthyroidism overactivity of the thyroid gland can cause lower urinary tract disease in cats. Although they are much less common causes, FLUTD can also be caused by tumors of the urinary tract, congenital abnormalities birth defects , or injury to the urinary tract or spinal cord. Depending on the underlying cause for FLUTD, the clinical signs may never, or only occasionally, reoccur.
However, recurrence is more common with FIC. To help reduce the chances of recurrence:. This information is based on our client brochure, available in English and Spanish. An oral regimen that is active against the offending organism is recommended and usually includes TMP-SMX, fluoroquinolones, or amoxicillin or amoxicillin-clavulanic acid in cases of gram-positive infections. This can lead to urinary stasis, decreased peristalsis, and increased bladder capacity, potentially contributing to UTI development. This can lead to complications during pregnancy in both the mother and the fetus.
Pregnant women may experience premature delivery, infants with low birth weight, intrauterine growth retardation, preeclampsia, anemia, thrombocytopenia, and transient renal insufficiency. If discovered, antibiotic treatment is given for three to seven days.
In the U. Tetracyclines and fluoroquinolones are contraindicated during pregnancy and should be avoided throughout all the developmental trimesters. Use of TMP-SMX is discouraged during the first trimester due to possible teratogenic effects to the fetus, since trimethoprim is a folic acid antagonist. When two or more courses of antibiotic therapy fail to suppress ASB, then suppressive therapy can be used for the remainder of the pregnancy.
Management of Urinary Tract Infections in Women
Nitrofurantoin 50 to mg once at bedtime is a common option for suppressive therapy; cephalexin to mg once at bedtime is a recommended alternative. This risk is low, however, and many physicians will still use it after weighing the risks versus the benefits of its use.
If a pregnant woman presents with acute cystitis, then the infection is generally considered complicated. Beta-lactams are appropriate and usually work more efficiently when used for more than three days. Pyelonephritis during pregnancy requires hospitalization and treatment with IV antibiotics. Initial preferred agents include ampicillin plus gentamycin or cephalosporins. If there is no response within 72 hours, drug resistance is likely, and cultures should be obtained and the therapy changed appropriately. The two most common causes of initial treatment failure are drug resistance and nephrolithiasis.
Suppressive therapy should then be used for the remainder of the pregnancy. Although not well studied, several preventive measures have been suggested by health care providers Table 3. However, if an individual is susceptible to UTIs, these methods may be worth trying, since they do not pose harm to patients. Recurrent Infections Women who experience recurrent infections are advised to use preventive treatments Table 3. As noted previously, many women with a UTI will develop a recurrent infection within six months of the initial infection.
Continuous use usually consists of six months or more of daily therapy. In these cases, antibiotics can be used as prophylaxis with each act of sexual intercourse; spermicides, diaphragms, or feminine hygiene products should also be avoided. As noted previously, TMP-SMX should be used with caution because of resistant uropathogens that have already been identified. In addition, many health care providers choose not to use fluoroquinolones owing to the fear of emerging resistance and the need to save this medication for more complicated cases.
In these instances, women can be instructed to start a three-day course of an antibiotic at symptom onset and report to a physician if symptoms do not resolve within 48 to 72 hours of treatment completion. Due to the emerging resistance to antibiotics such as TMP-SMX and amoxicillin, choosing an appropriate antibiotic is key to early treatment and prevention of further complications from UTIs.
Urinary tract infection - adults
For women who experience recurrent infections, preventive and suppressive therapy may be beneficial in deterring future infections. References 1. National Institutes of Health. Available at: www. Accessed May 15, Kidney and urologic diseases statistics for the United States. NIH publication no. Mehnert-Kay SA. Diagnosis and management of uncomplicated urinary tract infections. Am Fam Physician.
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Urinary tract infection in adults. Symptoms UTIs don't always cause signs and symptoms, but, when they do, they may include: A strong, persistent urge to urinate A burning sensation when urinating Passing frequent, small amounts of urine Urine that appears cloudy Urine that appears red, bright pink or cola-colored — a sign of blood in the urine Strong-smelling urine Pelvic pain, in women — especially in the center of the pelvis and around the area of the pubic bone Prevention You can take these steps to reduce your risk of UTIs: Drink plenty of liquids, especially water.
Drinking water helps dilute your urine and ensures that you'll urinate more frequently — allowing bacteria to be flushed from your urinary tract before an infection can begin. Drink cranberry juice. Although studies are not conclusive that cranberry juice prevents UTIs, it is likely not harmful. Wipe from front to back. Doing so after urinating and after a bowel movement helps prevent bacteria in the anal region from spreading to the vagina and urethra.
Empty your bladder soon after intercourse. Also, drink a full glass of water to help flush bacteria. Avoid potentially irritating feminine products.