A Shorter Course of Treatment for UTIs
I am fascinated by the similarities and differences between human and veterinary medicine. I haven’t had a chance yet, but I’m planning on reading Zoobiquity, a book that deals with a medical doctor’s "journey from focusing solely on human medicine to a broader, species-spanning approach." (Anybody out there read it? Will it be worth my time?)
One instance where the contrast between how vets treat animals and docs treat people came to the forefront when I was diagnosed with a urinary tract infection (UTI). After a brief physical and an examination of a urine sample, my doctor diagnosed me with an uncomplicated UTI.
"Uncomplicated" in this situation means that I didn’t have a history of recurrent or relapsing UTIs, and I also don’t have another health problem that might make resolving the infection more difficult than it should be. My doctor prescribed a few days worth of an appropriate antibiotic and told me to call her if I wasn’t feeling better in 24 hours or wasn’t completely back to normal when I ran out of the medication. One dose of the antibiotic and I was well on the road to recovery.
The standard of care for uncomplicated UTIs in dogs has traditionally been quite different. My go-to recommendation, which is fairly typical, involves a 14 day course of an antibiotic called amoxicillin-clavulonic acid given twice daily. This protocol is backed up by years of experience that demonstrates its efficacy.
But now, research is providing evidence that we can treat dogs with uncomplicated urinary tract infections more like we treat people suffering from the same condition. A study that compared my twice-a-day for 14 days, amoxicillin-clavulonic acid protocol to a once-a-day for three day regime using high doses of the antibiotic enrofloxacin demonstrated little difference in cure rates between the two groups of test subjects. Cool. Is there an owner out there that wouldn’t rather give three doses of an antibiotic to their dog versus 28 doses, all other things being equal?
Now keep in mind that this research only involves uncomplicated urinary tract infections in dogs. The situation is very different in cats. This species rarely develops an uncomplicated urinary tract infection, except perhaps late in life. In younger cats, the typical clinical signs of a UTI (straining to urinate, producing small amounts of sometimes discolored urine, and urinary accidents) are almost always due to another urinary disorder sometimes in conjunction with a secondary bacterial infection. Also, the high dose, short duration enrofloxacin protocol will not be appropriate for every dog or in every situation, but it is worthy of consideration.
Pets should respond very quickly after starting antibiotics for an uncomplicated UTI. If you have any doubts that your dog is getting better, whatever medication is prescribed, call your veterinarian. He or she will probably recommend rechecking a urine sample. After all, it’s hard to ask a dog, "How does your bladder feel?"
Dr. Jennifer Coates