Hello I am Dr. Joey. Thanks for trusting me to help you and your pet today. I am a licensed veterinarian with over 15 years of experience. I
Sometimes these chronic UTIs can be extremely tricky to deal with. On the one hand there is the issue of trying to eliminate or at least control the existing infection. On the other hand is long-term consideration for why she may have this.
As to the first issue of trying to eliminate, at this point the first step would be if not done within the past 6 weeks to culture her urine again. You need to know this is truly still E.coli (as it probably is) but more importantly if any antibiotic that can be given by mouth may work. For many of these terrible infections we tend to finally turn to a drug called nitrofurantoin (which can be expensive). If not already tried then treated every 8 hours for 3 to 4 weeks is probably a start. If this works then she can remain on a lower dose given once daily to prevent. In addition to this (or another appropriate antibiotic choice) I would recommend starting her on a urinary antiseptic such as methenamine mandelate which she would stay on long-term. This medication helps sterilize the urine which makes it more difficult for bacteria to grow. Not many vets have used this drug much and your vet may need to consult with an internal medicine specialist first. I have actually used this in many patients and published papers on resistant UTI issues. So, I know it can help. This plan may give you a start to eliminating this.
The second issue is the why is she getting these? It may be her bladder was compromised from the bladder stone surgery (this is a possible complication) in the sense that the normal protective mechanisms of the bladder may not work as well; such as she cannot entirely express all contents in her bladder when she goes or the wall of the bladder itself may harbor infection. This is actually more of an academic question since there is not a lot we can do to treat this. I only mention this because I feel it important to understand her problem may not be just that she has an infection we cannot get rid of, but that she actually has a mechanical issue with her bladder that predisposes her to infection and therefore is likely to become re-infected in teh future after this infection is eliminated (let me know if that did not make sense). And this is why a longer-term plan for preventive is important-- such as use of daily antibiotic at low dose and methenamine mandelate.
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Hello Dr Joey. I talked to the new vet and couldn't get her interested in anything you'd told me at all.They just took some blood to check the liver and sold me painkillers for the arthritis and another bottle of TRIMACARE 80 MG which doesn't seem to be even slightly working after 2 a day for 2 weeks.
Where can I find a vet who will try what you said?
I am in Bournemouth U.K.
Thank you for your help I will rate you soon, you have helped me have faith there is an alternative to what we have been trying.