Four weeks ago, Delilah had a Urinary Tract infection. She had a two-week course of antibiotics and my instructions were for a urine recheck a week after she finished them.
Delilah finished her last full day of antibiotic on a Sunday. Wednesday night she was going outside more than she normally would. Thursday morning I called our vet and asked if maybe we should check her urine sooner than the recommended week.
My vet said she’d like a STERILE urine sample. The STERILE urine sample is also known as Cystocentesis.
Cystocentesis is a fancy name for a needle inserted through the belly into the bladder, for the purpose of withdrawing a small amount of STERILE urine.
I hate putting my dogs through these types of procedures without exhausting all other options. And since Delilah had only been outside a bit more than normal, with no other symptoms, I felt certain she didn’t have an infection. So I asked my vet if we could check her urine the normal way first.
I was advised to get some wet ones and wipe Delilah’s va-jay-jay BEFORE she peed. SO bright and early the next morning, I found myself with my face down in my dog’s ass, wiping her Hoo-Hah with a wet one.
Either the wipe stung, or the wet one felt good, because right after I finished, Delilah took off doing zoomies around the house. When she settled down, we went outside and using my handy urine sample collection kit, I secured a sample.
We dropped it off Friday afternoon and I was shocked when the vet called me Friday night and said Delilah still had an infection.
WHY A STERILE URINE SAMPLE IS CRUCIAL
My vet was very concerned because either Delilah got another infection while on an antibiotic, OR the antibiotic didn’t work on that particular infection.
It’s also important to find out what type of infection it is as well as where the infection is. For instance, a urine sample can be contaminated in the Urethra (the tube that carries the urine from the bladder out of the body) and not be in the bladder. Without having a clear idea of where the infection is, you can be spinning your wheels trying to treat it.
In Delilah’s case, it’s also important because some antibiotics can really mess with the liver and Delilah’s ALT is already elevated, so we need to tread carefully with antibiotics, not to mention she’d just come off a two week course of them.
My Dr. wasn’t available until later in the day on Saturday, but Dr. Allen was, so I reluctantly made the appointment for 10:20 Saturday morning.
The key to Cystocentesis is having a full bladder, so Delilah had breakfast, went outside and then I couldn’t let her pee again.
I called the vet on my way in and said, “As soon as her feet hit the ground, this dog is going to have to pee. Can you have a room ready for us?”
I have the best vet and the best vet staff on this planet, so they assured my they would be set and if I called when I got there, they’d get her right in.
Sure enough, as soon as I called, they opened the back door and I pulled right up and unloaded Delilah. At first Delilah was excited, because we were hustling her along and talking to her. But when we hit the exam room door, she put the brakes on.
It broke my heart because I knew SHE knew something was going on, because her tail was tucked, and she was hesitant. But like I said, the peeps who work at my clinic are amazing and by the time I’d parked the car, Delilah was back to her happy self.
Dr. Allen came in almost immediately and started talking me through it. Delilah would be placed on her back on padded material. One of the vet techs would be holding her head, talking to her and another would be giving her some belly rubs. If Delilah fussed at all, or seemed the least bit uncomfortable, Dr. Allen wouldn’t do the procedure.
Belly rubs are good, I can’t say I like the needles much though.
While we were talking, Dr. Allen was feeling Delilah’s bladder to make sure it was full.
It was.
At first she was going to do it in the exam room, and I asked if I could hold Delilah and Dr. Allen said, “Only if you can be perfectly Zen, otherwise it will upset her.”
I suggested maybe she should take her out of the room.
So I watched my dog leave the room with Dr. Allen.
I picked up my phone and was going to text Hubby, but changed my mind. Then I was going to text Sue and changed my mind again. So I pulled up a game. I was about a minute in when Dr. Allen came back in the room with Delilah.
“Couldn’t you get a sample?” I asked.
“I got a sample, we’re done, she did amazing.”
Wow, all that worry and Delilah wasn’t even bothered by it.
I thought that was the hard part. No, the hard part was waiting for test results. According to Dr. Allen, it could take up to a week to get the results, as the lab would be checking the bacteria against antibiotics to see which one would work best.
When I got home (less than an hour after I’d left) and was telling Hubby how it went down, I said, “Dr. Allen gets me. She knows exactly how to explain things to me, to make me feel better.” We had a good laugh about that. “She gets me.”
Thankfully we didn’t have to wait the full week. Dr. Allen called on Tuesday evening and said Delilah has an E-Coli infection in her bladder.
E-Coli? Freaked me out. I mean, we’ve all heard of E-Coli outbreaks, and since she was eliminating it in her urine, I was concerned that Sampson could catch it.
It turns out that he can’t. The way Dr. Allen explained it to me is E-Coli naturally lives in the intestines and sometimes, such as in an E-Coli outbreak, some of that fecal matter gets on your food.
Say it with me. EW GROSS.
In female dogs, because of where the pee-shooter rests, directly below the poop shooter (her words, not mine, I told you she ‘got’ me) some of that E-Coli can get into the urinary tract. E-Coli is very receptive to some antibiotics, and resistant to others, which is why the STERILE URINE SAMPLE was key.
So Delilah is now on a three week course of antibiotics (Cefpodoxime) and we will check her urine at about the ten day mark.
When Dr. Allen and I were discussing the antibiotic on the phone, I made sure to thank her for her care on Saturday. I told her how speaking with her made me feel better (and shared the “she gets me” comment with her). After we laughed about that and she joked the next time I was in we should do a drum circle, I told her I wouldn’t hesitate to have that procedure done on my dog again. At that point she told me that even a dog that does well with it one time, may not do well a second time. She also said, if we’d done that the first time I brought Delilah in (when she was peeing blood) she may not have done well, because her bladder was so angry.
Sometimes a STERILE URINE SAMPLE is a necessity, especially if a course of antibiotics hasn’t worked.
She must be wiping from back to front instead of front to back! Maybe she got it from chewing on moms underoos!
Having a vet that gets you has to go a long way towards making you more comfortable when going through these things.
Sorry to hear Delilah’s infection didn’t go away the first time – it’s so similar to Sheba’s! It’s also interesting how each vet does things a little differently. That is the same antibiotic that Sheba is on, but she’s on it for 30 days and we do a re-check (the usual way) at about 3 weeks.
I also wondered if the location of the parts on a female dog had to do with this. Sheba has so much fur back there, things get stuck in it too, so I’m trying to do better at keeping that area clean (we’re planning to give her a bath this weekend but sometimes we just use wipes and trimming to clean it up). Thanks for all the great information, and hope Delilah’s infection gets cleared up this time!
Poor Delilah and poor you! So glad you have such good vet! I wouldn’t have been able to be Zen at all through that – my nerves would be shot.
Great explanation! We always try to get a sterile sample on the first urine sample, it really tells you a lot.
Yes, Dr. Allen really DOES “get” you! I’m glad Delilah did so well!! Hopefully this new round of antibiotics will get rid of the E-Coli!
That stinks! Poor girl! Okay, our advice for her…you know my mom says she has been told to always wipe from front to back to prevent the poop stuff from getting in the peeing area, this is for humans, so being a dog, I might suggest to Delilah, when she is licking herself to lick from front to back, and only once. It might be tough to get her to follow those instructions, but it sure sounds like a good idea! Hope the infection gets cleared up soon as bladder stuff is not fun.
Great post Jodi. Funny and informative. I learned some technical terms too: pee-shooter and poop shooter. I can’t wait to use them. Hope all goes well.
I am always amazed by vets. Not only do they have to deal with someone who can’t tell them where it hurts, they also have to deal do with frantic but loving owners. Good luck to Delilah!
Gawd…I love your vet as much as you, Jodi. 😉 Glad you were able to get the diagnosis with little inconvenience for D-girl. Here’s to a clean bill of health in the va-jay-jay and Hoo-hah regions soon.
Glad you got it figured out!
Poor baby girl!
And I’m sorry, but that visual of wiping off her bits is hilarious, haha!
Yeah, sometimes it needs to be done. Sorry it was Delilah and sorry she needs more treatment. Hopefully this will do the trick.
Yikes – glad you’ve all made it through the procedure; hope they don’t need to do another one!
Healing thoughts to Delilah!
Right by the poop shooter… I need your vet, seriously. Glad to know they identified the infection, but holy crap ecoli is not something I would have ever expected. Glad she did well for that procedure, too, I think if that happened to us the whole office would have heard yelping and fussing about.
When Storm had her UTI, my vet insisted on a sterile sample. They took enough so she could look at it under the microscope, and send some for analysis. Under the microscope, it looked like e coli so we started Storm on an antibiotic which is effective for e coli. The labs confirmed e coli so Storm finished out the antibiotic. The vet did say that with e coli, it is possible to “lick it in”. Ewww.
There is nothing more important than having a vet you love that “gets you” and one that you can easily communicate with. What a great post – As a CVT I did a lot of Cysto’s on dogs and cats. It’s so important since those free hand collections often times just don’t do the trick. When cats come in with bladder issues we almost always did a cysto. We used an ultrasound machine to see the bladder and then if it’s full enough it typically takes a minute to get the sample and we’re done — how is Deliah now? I hope much better!
Wow what an ordeal! I have to apologize about laughing with the wet wipe, but glad it all worked out and she’s on the mend. I know mom sometimes puts off procedures until absolutely necessary because of cost but sometimes it’s not best to do that. Love Dolly