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Bladder Problems

Japanese Beagle Purin plays at being shy

Bladder problems are a common health problem in dogs. The medical term for bladder trouble is cystitis, Greek for inflammation of the bladder. By any name, it causes discomfort and misery. People with cystitis describe a cramping, burning sensation when they attempt to void urine. Dogs with bladder trouble may display any or all of the following symptoms:

  • Straining to urinate
  • Urinating in frequent but small amounts
  • Blood tinged urine
  • Urine accidents in the house
  • Excessive licking at the genital area
  • Excessive water intake
  • No symptoms at all

It’s important to note that apart from these nagging symptoms, most dogs with cystitis don’t feel sick otherwise.

Causes

Practically anything that creates irritation or inflammation of the bladder wall can cause cystitis. Common factors, in order of prevalence, are:

Bacterial Infection. The bladder should normally be a sterile place free of bacteria. But if bacteria gain access to the bladder and conditions are right, an infection results. Bacteria typically reach the bladder by traveling up the urethra (the tube that carries urine from the bladder out of the body). Females are especially vulnerable to an ascending infection due to their relatively short urethra. Less often, the infection may start in the kidneys and travel downstream through the urinary tract to the bladder. Bacterial infection causes inflammation, which yields the telltale symptoms.

Certain conditions create a favorable situation for infection to develop in the bladder. Systemic diseases such as Diabetes, Cushing’s disease and chronic kidney disease weaken the immune system and create dilute urine, overcoming the bladder’s natural defenses. Overweight dogs can have deep skin folds around the urinary opening, and this is an excellent place for infection to start. Neurologic problems, such as spinal injuries, may inhibit proper bladder emptying. Bacteria thrive in stagnant urine.

It’s important to note that bladder infections are neither contagious from one animal to another, nor from dogs to people. Anatomic differences make bladder infections much less likely to happen in male dogs as compared with females. In fact when a male dog has a bladder infection, there is usually another underlying cause, such as a prostate infection in an intact male, or bladder stones (see below).

Bladder stones are rock-hard concretions of minerals such as calcium, magnesium or phosphate that form in the urinary bladder. These are the second most common cause of cystitis in dogs and often accompany a bacterial infection. They are not to be confused with kidney stones (same stone, different location), which are more prevalent in people. Bladder stones form over time due an excess of dietary minerals in the urine. Contributing factors include diet, genetics, pH of the urine, and other factors that have yet to be determined. Bladder stones don’t always cause symptoms. Some are soft, smooth and remain clinically silent for years. Others may be rough like sandpaper or serve as a perfect substrate for bacteria. Once a bladder stone gets infected, then cystitis results.

Your veterinarian may suspect bladder stones if a case of cystitis fails to resolve or keeps reoccurring over time. Most bladder stones can be diagnosed on x-rays or ultrasound. Treatment often requires surgical removal, although some stones can be chemically dissolved using a special diet.

Urethral obstruction. A stone of just the right size can exit the bladder but get stuck in the urethra. This causes a urethral obstruction. This is much more common in male dogs than in females, due to the male’s long and narrow urethra. A urethral blockage can also be caused by injury or a tumor. Symptoms depend on the degree of obstruction. A partial obstruction creates symptoms that look like cystitis: difficult urination, frequent small squirts. A full obstruction prevents any urine from passing at all, and a dog with this problem will quickly become sick and lethargic. If your male dog is having trouble passing urine, seek veterinary care immediately.

Bladder Cancer is relatively uncommon in dogs, accounting for only 1% of canine cancers. Of these, the most common type is transitional cell carcinoma. Symptoms of bladder cancer are identical to those of cystitis. Obstruction can also occur if the tumor is located near to where urine exits the bladder.

Congenital defects. Certain malformations of the bladder or female internal genital tract can lead to repeated bladder infections and other urinary trouble. These are fairly rare and are typically diagnosed in young females. A separate problem is a hypoplastic or recessed vulva. This is a somewhat more common situation in which a young female dog’s external genitals remain relatively small as her body develops. The vulva is hidden in deep folds of skin, where dirt and debris easily accumulates and infection can eventually develop.

Diagnosis

If your veterinarian suspects your dog has cystitis, she or he will start with a full history and physical examination. This includes palpating the bladder—rarely, stones can actually be felt from the outside—and examining the external urinary opening. Next, a urinalysis confirms the presence of infection or inflammation, crystals, bacteria or a pH imbalance. Many veterinarians will go ahead and treat a first-time cystitis without the need for further diagnostics. For recurring or complicated cases, the following tests are commonly indicated:

  • Urine culture
  • Bloodwork
  • Endocrine testing
  • Xrays
  • Ultrasound
  • Surgical biopsy

Cystoscopy, which employs a specially designed endoscope to see inside the bladder, is another useful diagnostic tool; however it is generally available only to specialists at large veterinary referral hospitals.

Treatment

Simple bladder infections are usually easy to treat if they’re diagnosed right away. Your veterinarian will prescribe a 2-3 week course of antibiotics and perform a follow up examination to make sure all’s well afterwards. For more complicated infections, underlying issues must be addressed:

  • Treat concurrent disease (such as Diabetes or a kidney infection).
  • Remove or treat bladder stones and provide proper diet and/or medication to prevent reoccurrence.
  • Surgically correct congenital abnormalities
  • Institute a weight loss program when deep skin folds are a problem.

Prevention

It’s not possible to prevent bladder problems altogether, but a few measures can help:

  • Promote water intake. Provide plenty of fresh, clean water for your dog to drink.
  • Feed a high-quality commercial diet.
  • Keep your dog at a healthy body weight.
  • Administer any medications exactly as prescribed by your veterinarian.
  • Complete the full course of treatment and follow-up examinations as recommended by your vet, even if symptoms have ceased.

 

What are anal sacs?

Anal sacs are internal scent glands located adjacent to the anus in dogs. The glands secrete a strong-smelling substance that empties onto skin and anal tissue through ducts. These watery secretions are usually tea-colored, yellow, or grey-brown. Some people describe the odor as fishy or musky; most agree that it is distinctive and not particularly pleasant.

Anal glands assist in scent identification and marking behaviors. Glands are compressed by stools during defecation and expel glandular material (anal sac fluid) along with the bowel movement. The glands can also empty with exercise, fear, agitation, or self-defense.

What is anal sac impaction?

Sometimes the sacs do not normally empty with these routine activities, and become impacted. Anal sac impaction is an extremely common condition in clinical veterinary practice. Sometimes the anal fluid will harden, and normal sac emptying becomes a painful process. This can cause great discomfort, and is the foremost reason for rear-end scooting in dogs; if left untreated, impacted anal sacs can become infected or abscessed. Some dogs require regular anal sac expression, while others will never have an issue. High-fiber diets result in bulky stools that may help in compression of the sacs, and may be useful in chronic case management. Hypoallergenic diets may be useful as well.

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What is anal sac expression?

The discomfort of impacted anal sacs is often relieved by squeezing, or expressing, the sacs to remove the trapped fluid. Expressing can be performed internally or externally.

During internal expression, a gloved finger is inserted into the rectum and each gland is squeezed individually with the finger and a thumb. The thumb and finger are placed externally over each gland, and both glands are squeezed together with external expression. Internal expression may empty glands more effectively than external expression. Please seek advice regarding anal sac expression from your veterinarian and do not attempt sac expression at home.

What are signs of anal sac disease?

The most common sign of anal sac disease is scooting of the rear quarters along the ground. Other signs can include a foul odor, redness around the anus, and a pus-like discharge. Dogs may lick aggressively and continuously around the anus and tail area. The skin surrounding the area may be red and irritated as a result of the licking.

What are other types of anal sac disease?

Anal sacculitis is usually caused by inflammation of the sacs. This can progress to bacterial infection of the sacs and anal sac abscesses. Perianal fistulas (long inflamed tracts in the skin surrounding the anus) are usually formed secondary to inflammation or infection, but can also form due to immune conditions. Lastly, cancers of the anal sacs and perianal tissues can be seen as well.

How are they diagnosed?

Many of these conditions can be diagnosed and treated on physical examination. Most veterinarians will need to perform a digital rectal exam as well. If necessary, your veterinarian will recommend blood work, x-rays, fine needle aspirate and cytology, or biopsy to confirm the diagnosis.

How are they treated?

Treatment depends on the diagnosis. Common treatments include soothing creams, antibiotics, and anti-inflammatory medications. Dietary modification is often used to prevent recurrence.

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Bladder Problems

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