Stiftung Tierärztliche Hochschule Hannover (TiHo)TiHo eLib

Barking up the wrong tree : Signs of bacterial lower urinary tract infection in five dogs with idiopathic epilepsy mistaken as side effects of antiseizure drugs

Unspecific clinical signs as polydipsia, polyuria, ataxia and behavioral
changes are known side effects of antiseizure drugs (ASD) in dogs and
reduce quality of life (QoL) of dogs and their owners. Concurrent diseases
like lower urinary tract infections (lowUTI) might be misinterpreted
as side effects in dogs receiving ASD therapy. Five dogs
were identified during recruitment for an idiopathic epilepsy
(IE) treatment trial with ethical permission. Of these animals (n = 38;
female n = 17, male n = 21); five (13.16%) dogs were diagnosed with
lowUTI caused by E. coli. Affected dogs were female (intact n=3;
neutered n = 2), weighting over 20 kg. Therapy was phenobarbitone
(PhB; n = 5, >3 months), potassium bromide add-on therapy (n = 2).
Reported chronic side effects were: mild ataxia, polyuria/polydipsia,
behavioral changes, polyphagia and recent deterioration consisting of
restlessness (n =5), apathy (n = 4), overgrooming anogenital region
(n = 2), marked ataxia (n = 2), incontinence (n = 2), exercise intolerance
(n = 1) and malodor (n = 1). Pyuria, hematuria and bacteriuria
were detected in affected dogs. Urine analysis revealed positive nitrite
(n = 2), proteinuria (n = 2) and specific gravity (mean: 1015, 6, range:
1002-1022) before antibiotic treatment. E. coli (>106 CFU/ml) was
isolated from cystocentesis samples in all dogs. Amoxicillin-clavulanic
acid (13-15 mg/kg BID, n=34) therapy improved the condition of all
dogs within 24-48 hours. Samples of urine were unremarkable at
follow-up. Clinical signs were misinterpreted for weeks in each dog,
reducing QoL, potentially aggravating epilepsy. Further studies are
needed if polydipsia and diluted urine in dogs treated with ASDs can
increase risk for lowUTI in addition to potential immunosuppressive
effect of PhB.


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