Category: bladder problems

Urine samples: how to collect

Tests are used by vets to help them diagnose disease in animals that are ill, which means your vet may ask you to bring in a urine sample (water sample) from your pet to help find out what’s wrong with your dog. Urine samples are usually taken to check for diseases such as diabetes or cystitis. Urine samples are also often used as part of a routine health check to detect hidden disease before the development of obvious symptoms; this allows your pet to be treated earlier and more effectively.

You will need a clean, wide-necked container to collect the sample in, and a clean jar with a tight lid to store it in (your vet will be able to give you one of these if you ask). It is important not to use jars that have previously contained jam or honey as this can affect the results of the test.

In most cases, your vet will ask for a mid-stream sample (a urine sample) collected by placing a suitable container (a small bowl or dish) under the stream of urine whilst your dog wees. Some dogs and bitches will stop weeing every time you approach them with your container. You may be able to catch them out by using a long handled collecting pot. Attach a pot, for example a clean yoghurt carton, to a stick or broom handle using sticky tape. Take your dog out on a lead and once he or she starts to wee, move the carton under the stream of urine to collect the sample.

In most cases your vet will only need a few teaspoons of urine to perform all the tests. If a larger sample is needed your vet will tell you.

Sometimes dogs with incontinence or cystitis will wee on the floor in the house. If you find it absolutely impossible to collect a sample from your pet then a sample collected from the floor may be better than nothing (provided the floor is clean). If you need to collect a sample from the floor you can use a pipette or syringe to suck up the urine and then squirt it into the pot. If you collect the sample in this way then tell your vet as there are some tests that cannot be performed on samples collected from the floor.

If you really cannot get a urine sample your vet will probably suggest that they take your pet into the hospital and collect the sample for you. Samples can be collected directly from the bladder using a catheter passed up the urethra or via a needle placed into the bladder through the tummy wall. Both these procedures are simple and carry few risks for your pet.

Pour the sample into a clean, screw-topped container; write your dogs name, your name and address and the date the sample was taken on the jar. If you cant take the sample to the vets immediately, it is best to store it in the fridge for a maximum of 12 hours.

Urinary incontinence

Urinary incontinence means the loss of ability to control urination and can be caused by a variety of diseases. Incontinence is quite common in dogs but is usually more of a nuisance to the owners than a cause of distress to their pet. Urinary incontinence is more common in females than males because of the anatomical differences in the urinary tract especially the shorter urethra in the female.

In the normal animal urine is produced in the kidney. It drains through tubes from the kidneys to the bladder (the ureters). Urine is stored in the bladder until a convenient time for voiding. The bladder is an expandable bag that slowly stretches as it fills with urine. Urine leaves the bladder and drains to the outside through another tube (the urethra).

In the normal animal urine is kept in the bladder because the urethra is flattened. The urethral wall is made of elastic tissue and muscles that normally keep it flattened so that urine cannot flow. The muscles in the wall of the urethra are stronger in entire females (because of the hormones in the blood). When they have been spayed female dogs have lower oestrogen levels and because the urethra muscles are weaker they may be more prone to leaking urine.

When the bladder is full the bladder wall is stretched and the animal has a feeling that the bladder needs to be emptied. Contractions of the bladder muscle increase the pressure in the bladder and cause urine to flow out through the urethra. The impulse to void urine can be over-ridden by conscious control for some time (until the animal can reach an appropriate site for urination) but eventually the bladder must be emptied.

Incontinence can occur as a result of breakdown of any of the mechanisms that control normal urinary function. In most cases urine leakage occurs because the pressure in the bladder is higher than that in the urethra. This can be due to increased pressure in the bladder, i.e. bladder over-distension, or reduced pressure in the urethra, i.e. weakness of the urethral muscle.

There are many causes of incontinence. Some animals are born with abnormalities in the urinary tract. Others develop problems later in life – neutered bitches are more at risk of developing urethral problems and, in entire male dogs, incontinence is often related to prostatic disease. Sometimes back problems can cause pressure on the nerves to the bladder resulting in incontinence.

Some breeds and types of dog are more at risk of developing incontinence. The most common cause of urinary incontinence is urethral sphincter mechanism incompetence (USMI). This is most often seen in female, large breed dogs and often those breeds that have docked tails, e.g. Old English Sheepdogs and Rottweilers. In animals with USMI incontinence most often occurs when the dog is lying down.

Some animals have an underlying problem with the urinary tract so that it doesn’t work as well as it should. However, they are able to control urination unless something else happens to make extra work for the urinary system. If these animals drink a lot they develop a very full bladder that puts extra pressure on the urethra.

If your dog is incontinent you may see urine dripping from its vulva or penis or, more likely, you will find wet patches where your dog has been lying. Sometimes there are only tiny wet patches or the bed may be soaked. Often the urine is quite dilute and might not smell very strongly.

The time of urine leakage may vary depending on the cause of the incontinence. If the muscles in the urethra are weak urine is more likely to leak when the dog is lying down (because pressure on the bladder is greater) or when the dog is excited (stress incontinence).

Dribbling of urine after urination is more often seen with infections (like cystitis), cancers and abnormal development of the ureters (ectopic ureters).

The age of your pet when you first noticed the problem often provides a useful clue as to the cause of the incontinence. Young animals are more likely to have congenital problems such as ectopic ureters. It is important for your vet to have an accurate description of what the incontinence is like in your dog – so try to explain clearly what signs you have noticed. If your dog appears to be straining without passing any urine they may have a blockage or irritation in the bladder (cystitis) or urethra (urethritis).

A full physical examination will help to rule out potential causes of incontinence. Your vet will feel your dog’s belly to see how big the bladder is. Your vet will need a urine sample from your dog to send for tests in case there is an infection. Routine blood screens are useful to rule out other diseases, particularly those resulting in excessive drinking which may make the incontinence worse.

If your dog has urinary incontinence your vet will need to perform some tests to try to find out what is causing it. X-rays and ultrasound are the most important tests in investigation of incontinent patients. Special X-rays (where contrast is put into the urinary system) may help your vet to identify anatomical abnormalities in the ureters and bladder and your dog will need a general anaesthetic for these. In many cases of urinary incontinence x-rays are normal (but it is still important that they are done to ensure nothing serious or treatable is missed). Ultrasonography can also be helpful in assessing for ectopic ureters, bladder cancers, anatomical defects and chronic thickening of the bladder wall associated with trauma or infection.

If your vet has ruled out medical and structural problems they may want to try some treatment to see if the incontinence can be controlled.

The treatment for urinary incontinence depends on the cause. A specific treatment plan should be worked out for individual cases. If an underlying condition is identified then this should be managed appropriately. If your dog has a number of problems that increase its chance of being incontinent, then removal of just one of them may be sufficient to resolve the problem. Urinary tract infections must be treated and anatomical abnormalities, e.g. ectopic ureters, can be corrected by an operation.

The most common cause of incontinence in bitches is a weakness in the outflow from the bladder (called USMI). There are some drugs that can help to tone up the muscle in the urethra and make the seal better. Phenylpropanolamine and diethylstilboestrol can improve contraction of the urethra. These medications may need to be continued permanently but if this is the case the minimum effective dose must be found.

If your dog has USMI and starts on medical treatment that controls the signs it is likely that they will need to continue to receive this treatment for the rest of their life. Your vet will want to monitor your pets progress and will adjust the dose of treatment as needed.

Cystitis (bladder inflammation)

As anyone who has ever suffered with cystitis (a sore bladder) will know, it is a very unpleasant condition. Although not usually life-threatening, cystitis can be very distressing for your dog. It is important to seek veterinary advice as soon as possible since most cases can be easily treated with a short course of antibiotic tablets.

Cystitis means that the lining of the bladder is inflammed and is usually caused by an infection in the urine. Because the bladder is sore dogs want to empty it more often and so are frequently seen squatting and trying to pass urine.

Cystitis is far more common in female dogs than in males. The first sign you usually notice is your dog passing small amounts of urine very often. Sometimes you will see blood in the urine and occasionally your dog will strain as if trying to pass urine but nothing comes out. In these cases cystitis may be mistaken for constipation. A few dogs with cystitis become very thirsty and some dogs feel a bit ‘off colour’.

Your vet will probably know what is wrong with your dog from your description of the symptoms. If this is the first time your dog has had this problem your vet may well just prescribe some treatment. However, if the problem keeps coming back or does not clear up with the usual treatment, then your vet will want to do some other tests to make sure there is nothing else wrong with your dog.

Tests on a urine sample will show if there is anything wrong e.g. sugar, protein or crystals in the urine. If there is a problem then it may be sent to a laboratory see if bacteria can be grown. If bacteria do grow there are tests that can be done to find the right antibiotics to clear up the infection.

If the problem keeps coming back or fails to clear up properly, your vet may advise that the bladder is examined using X-rays or ultrasound. If your pet has signs of general illness, such as fever or poor appetite, more general tests including blood tests are likely to be carried out.

The most common cause of cystitis in dogs is an infection caused by bacteria. Usually the bacteria gain entry to the body through the urethra (which is the tube leading from the bladder to the exterior).

There are a whole range of different problems which can make it more likely that your dog will develop cystitis. In some cases a bladder stone may have damaged the inside of the bladder. Dogs which have problems emptying their bladder (either because they do not get out for exercise frequently or because they have a blockage or developmental problem) are also more at risk.

Sometimes there is another disease present that makes your dog less able to fight infection, and diabetic dogs have a lot of sugar in their urine making the bladder an ideal place for bacteria to grow.

If your dog has cystitis for the first time and there is no other obvious problem your vet may just give you a course of antibiotic tablets for your dog. In most cases the problem should start to clear up within a few days of starting the tablets. It is very important that you continue to give the tablets until the course is finished, even if your dog seems completely better. If you stop treatment too early the problem may come straight back and the tablets may not work a second time.

Letting your dog get out to empty its bladder regularly will help to make them feel more comfortable. Encourage your dog to drink plenty of fluids as this will help to flush out the infection from the bladder. Cranberry juice is supposed to relieve discomfort in women with cystitis and if you can persuade your dog to take this it may help.

Most dogs recover very quickly from cystitis. However, if there is some other problem which has caused the cystitis then this must also be cleared up or the cystitis will come straight back. If dogs have an underlying cause for the cystitis which cannot be resolved, then they may occasionally need to be on permanent (or at least regular courses of) antibiotics.