Sad dog

Abby is a 4-year-old, spayed Labrador Retriever who suffers from recurrent urinary tract infections (UTIs). For six months, she had to urinate frequently, and she gave off an odor. 

When Abby’s owner spotted blood in her urine, she took her to the veterinarian, who diagnosed her with a UTI. Her symptoms improved quickly once she was on antibiotics but then returned shortly after she stopped taking the medication.

Her veterinarian prescribed another antibiotic, and her bladder issues again seemed to resolve completely — until a month later, when the blood was back. 

Abby’s story is not uncommon. Dogs with recurrent UTIs are a source of frustration for both owners and veterinarians.

Here’s a look at why it happens — and what veterinarians will do to combat the problem.   

How Does a Recurrent Urinary Tract Infection Differ From a Regular UTI? 

The bladder acts as a storage area for urine once it’s been made by the kidneys. Although the bladder is sterile and free of bacteria, the external genital area contains a large amount of germs. If these bacteria gain entry into the bladder, and begin to grow, an infection can occur, resulting in the symptoms of a UTI. 

Most dogs get simple UTIs, which develop once and can be treated easily with a short course of antibiotics. But dogs who experience more than three UTIs per year — or more than two UTIs in six months — are defined as having chronic or recurrent UTIs.

What Are Common UTI Symptoms?

  • Frequent, small-volume urination
  • Painful urination
  • Bloody or malodorous urine
  • Urine dribbling

If you notice any of these symptoms, take your pet to a veterinarian, who will likely recommend a urinalysis (UA) and a urine culture to make a proper diagnosis. The UA may give clues to underlying conditions, but a urine culture is the only test that can confirm a UTI, as well as identify the type of bacteria in the bladder, so a veterinarian can administer the right antibiotic.

If a dog is experiencing her first UTI, a vet may only collect a UA and prescribe an antibiotic. But if a UTI is recurrent or an underlying condition is present, a UA and a urine culture should be performed.

Why Do Dogs Get Recurrent UTIs?

UTI symptoms often resolve within two days of starting an antibiotic treatment, but some owners do not give the entire course to their pets as prescribed, which can lead to recurrent UTIs. 

In other instances, if a urine culture was not performed, an inappropriate antibiotic may have been prescribed or the dosage and duration were insufficient to fully clear the UTI.

To ensure that a UTI is gone, veterinarians will usually recommend another urine culture five days after the last antibiotic dosage is given.

There are also several underlying medical causes of recurrent UTIs: 

  • Conditions that alter immune function, such as Cushing’s disease, hypothyroidism, diabetes and obesity
  • Kidney or prostate infections, kidney or bladder stones and bladder tumors
  • Weakened urinary sphincters, which may occur after spaying
  • Neurologic problems
  • Steroid usage
  • Structural abnormalities of the genitalia or congenital urinary abnormalities

How Do You Treat and Prevent Recurrent UTIs?

If an underlying cause is present, it must be corrected with medication or surgery to successfully prevent UTIs from relapsing.

But if no underlying issue is identified, veterinarians must use other strategies to prevent recurrent UTIs. Here are some options that your veterinarian may discuss with you:

  • Increased water intake to allow for more frequent urination
  • Antibacterial wipes, which can keep bacteria numbers low in the genital area and prevent them from gaining entry into the bladder
  • Long-term, low-dose prophylactic antibiotic therapy to keep the bladder sterile
  • Cranberry extract, which may prevent some bacteria from causing UTIs
  • Bladder antiseptics
  • Probiotics

Why Is Continued Monitoring of Recurrent UTIs So Important?

Recurrent UTIs are a risk factor for the development of certain bladder stones and may result in kidney infections that can cause significant damage.

All dogs with recurrent UTIs — whether they have symptoms or not — should be given regular urine cultures every three months.

In the event of a recurrent UTI, antibiotics should be used for four weeks, in addition to a prevention strategy advised by your vet. 

As for Abby, she was diagnosed with excessive vulvar skin folds, which caused skin infections that were spreading into her bladder. Once she had surgery to correct the abnormality, she was monitored with regular urine cultures for one year — and never experienced another UTI. 

Dr. Donna Spector is a board-certified internal medicine specialist who practices in the northern Chicago area. She also owns a consulting business and provides daily clinical case consultations and continuing education to more than 1,800 primary care veterinarians.