
Antibiotics can be prescribed initially, and will be changed, if necessary, according to the results of the dog's urine culture and sensitivity profile. Surgery should be considered if your dog has pyelonephritis in the upper urinary tract, or if the urinary tract is obstructed.
If kidney stones are present, surgery should be performed to remove them, unless your veterinarian finds that the stones can be removed by dissolving them via a diet change (this only works for struvite kidney stones), or by using shock wave therapy to fragment them and allow them to pass from the animal's body.
To ensure progress is being made, your veterinarian will schedule a follow-up appointment and perform a urinalysis and urine cultures on your dog one week after antibiotic treatment has begun. These tests are then repeated once the antibiotic course has ended -- at one and at four weeks -- to make certain the dog is not in remission.