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From Jun 23, 2012, all vets at Toa Payoh Vets will practise evidence-based medicine. In cases of urinary tract infection, urethral obstruction and urinary stone removal, urine test is the minimal test to be done.

Blood test, X-rays, ultrasound, urinary stone analysis (in urinary stone removal) should be advised and recorded that advices have been given. These tests (esp. urinary stone analysis) should be done, whenever relevant and possible unless the owner has economic reasons for not wanting tests done. An example is given below:

Friday, June 15, 2012

1030. Consistent professional advice for struvite UTI

I have spoken to Dr V and Dr D regarding the need to give a consistent advice on the management of struvite UTI in dogs. Many Singaporean owners check the internet and are more sophisticated than in the old days.

A case is illustrated:
Case of the female Shetland, one year old. Dr Daniel's case
Jun 10, 2012. Complaint of blood in the urine for 2-3 months.
X-ray of bladder advised but not accepted

Urine test

   pH 9.0 (5-8)
   SG 1.026 (1.005-1.030)
   Protein +
   Blood trace
WBC 30
RBC 10
Bacteria 2+
Triple phosphate occasional

Tentative diagnosis should be UTI with struvites. Dietary management, acidification of the urine and antibiotics should be the treatment, not just antibiotics.

Follow-up urine test in 4 weeks is the minimum. X-rays of the bladder will be preferred. Most owners don't bother with follow-up. It is important.

Note: Triple phosphates are "struvites".