PAPER

Comparison of three techniques for the diagnosis of urinary tract infections in dogs with urolithiasis
OBJECTIVES: To identify an appropriate sampling technique(s) to accurately detect the bacteria causing urinary tract infections in dogs with urolithiasis. METHODS: Twenty-one dogs with urolithiasis were included in the study. Three types of samples were taken from each dog. Urine was collected by cystocentesis, and a urinary bladder mucosal biopsy and urolith were retrieved during cystotomy. The samples were then cultured on blood agar and MacConkey’s agar to identify the bacteria associated with urinary tract infections. RESULTS: Bacterial urinary tract infection was found in 16 cases (76 19 per cent). The most prevalent bacteria found to cause urinary 

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I. S. GATORIA, N. S. SAINI, T. S. RAI P. N. DWIVEDI
Journal of Small Animal Practice (2006) 47, 727–732

tract infection were Escherichia coli (n=7), followed by coagulasepositive Staphylococcus species (n=4), Klebsiella pneumoniae (n=2), Pseudomonas aeruginosa (n=2) and Proteus mirabilis (n=1). In the case of a positive urine culture, the same bacteria were also cultured from the urinary bladder mucosal biopsy alone or from both the urinary bladder mucosal biopsy and urolith. However, in the case of a negative urine culture, bacteria were found to be present in the urinary bladder mucosal biopsy or urolith cultures in 23 81 per cent of dogs. The uroliths that gave positive culture 

results were either infection-induced uroliths composed of struvite and calcium carbonate phosphate, ammonium acid urate only or metabolic uroliths composed of calcium oxalate and calcium phosphate, or calcium phosphate only. All the uroliths that gave negative culture results were metabolic uroliths composed of calcium oxalate and/or calcium phosphate, and uric acid and calcium phosphate. CLINICAL SIGNIFICANCE: When the culture from the urine obtained by cystocentesis is negative, cultures of urinary bladder mucosal biopsy and urolith are recommended in dogs with urolithiasis in order to accurately assess the microbiological status of the urinary tract.
Department of Veterinary Surgery and Radiology, and Department of Veterinary Microbiology, Guru Angad Dev and Veterinary and Animal Sciences University, Ludhiana 141 004, Punjab, India

Journal of Small Animal Practice

Á Vol 47 Á December 2006 Á Ó 2006 British Small Animal Veterinary Association

727

These bacterial UTIs may cause problems of equal or greater severity than the uroliths (Stone and Barsanti 1992. a sheepdog (n=1) and a crossbreed dog (n=1). The study included the following breeds: spitzs (n=6). such as calcium oxalate. Streptococcus. Preoperatively. a 5 ml urine sample was centrifuged in a sterile tube at Â1700 g for 15 minutes. the signalment and history of the dogs were recorded. Bacterial isolations were performed on the urine samples collected by cystocentesis and urinary bladder mucosal biopsies and uroliths collected during cystotomy. 2002 and April 31. Bacterial UTI. cystine. boxers (n=2). Bartges and others 1999). It was then spread uniformly with the help of a flame-sterilised nichrome wire. Any antimicrobials being administered were discontinued at least 48 hours before the collection of samples. and they all underwent a complete physical examination. It is therefore critical to identify the bacteria and to conduct antimicrobial sensitivity tests in order to completely eradicate the bacterial UTI. Qualitative cultures were carried out for the isolation and identification of bacteria in urine. the number of bacteria were expressed as CFU/ml of urine. 0Á5 mg/kg meloxicam was administered as analgesic to each animal. between January 1. A serial dilution of the urine sample ranging from 1021 to 1026 was made. After incubation. Proteus.I. Gram staining and standard biochemical reactions (Quinn and others 1994). Klebsiella. During cystotomy. Hamaide and others 1998). The bacteria most frequently involved in UTIs include Escherichia coli. dalmatians (n=2). appropriate plates with a dilution sufficient to produce non-confluent growth. Only qualitative culture of the urinary bladder mucosal biopsy was performed. For the quantitative culture. were selected for colony counts (Quinn and others 1994). whereas in patients with metabolic uroliths. The sample was macerated in 2 ml of brain-heart infusion broth and incubated at 37°C for six to eight hours after which subcultures were inoculated to the blood agar and MacConkey’s agar MATERIALS AND METHODS The study was conducted on 21 dogs with urolithiasis that were referred to the Punjab Agricultural University. German shepherd dogs (n=3). These plates were incubated at 37°C for 24 hours. The role of bacterial UTI varies with the type of urolith. and after applying the dilution factor. All agar plates were incubated at 37°C for 24 hours. obtained in a sterile Petri dish. especially caused by urease-producing bacteria such as Staphylococcus intermedius and Proteus species is often an important predisposing factor in the initiation. the bacterial UTI is a frequent complication occurring secondarily (Klausner and Osborne 1979). those giving rise to 30 to 300 colony forming units (CFU)/plate. Plain abdominal radiographs. The present study was therefore conducted to compare the results of bacterial culture of urine. Supernatant was rejected and a loopful of sediment was inoculated to blood agar and MacConkey’s agar plates. individual colonies were identified on the basis of colony morphology. an incisional biopsy from the mucosal edges of the bladder (greater than 5 mm2 in size) was Journal of Small Animal Practice Á Vol 47 Á December 2006 Á Ó 2006 British Small Animal Veterinary Association . 2003. Staphylococcus. All three samples were immediately stored in a refrigerator at 4°C for four to six hours before bacteriological analysis. that is. a spread plate method was performed. For the qualitative culture. and in four dogs (19Á05 per cent) both urethrotomy and cystotomy were performed under general anaesthesia with a combination of 0Á5 mg/kg diazepam and 10 to 15 mg/kg thiopental sodium. as well as uroliths. whereas quantitative cultures were carried out to determine the significant bacteriuria (the number of bacteria per unit volume of urine). and a 0Á1 ml inoculum of each dilution in duplicate was placed on the surface of each agar plate. Shortliffe and others 1984). Following incubation. complete blood count and plasma urea nitrogen and plasma creatinine evaluation was conducted to assess the status of each animal. These bacterial UTIs frequently occur in association with canine urolithiasis. The dogs had a mean (sd) age of 7Á35 (0Á59) years. Urocystoliths were also retrieved during cystotomy in a sterile Petri dish. Urine samples were submitted for gross and microscopic urinalysis. In 17 dogs (80Á95 per cent) cystotomy alone was performed. growth and recurrence of struvite (magnesium ammonium phosphate) uroliths (Osborne and others 1999). S. Lhasa apsos (n=2). Gatoria and others INTRODUCTION Bacterial urinary tract infections (UTIs) are a major clinical problem in dogs and occur in about 14 per cent of all dogs at some time in their life (Ling 1984). calcium oxalate and other sterile uroliths in the urinary tract may become infected with urease-producing or nonurease-producing bacteria during a UTI (Thompson and Stamey 1973. Bacteriological processing and analysis of samples Both qualitative and quantitative cultures were conducted on the urine sample. However. At the time of presentation. Average number of CFU/plate were calculated from this dilution. Waldron 1993. In cases of canine urolithiasis. Ludhiana. Enterobacter and Pseudomonas species (Jarvinen 2002). The uroliths were also analysed to determine their chemical composition. it has been recommended that a bladder mucosal biopsy. Sample collection procedures Urine was collected either by prepubic cystocentesis before surgery or by direct cystocentesis during cystotomy in sterile syringes. bent in a L-shape. dobermanns (n=4). Bacteria contained within uroliths probably represent those present at the time of the urolith formation (Osborne and others 1993). should be retrieved aseptically during cystotomy for aerobic bacterial culture in order to identify UTIs that cannot be detected by urine culture (Ruby and Ling 1986. urate or silica. and the bacteria isolated are similar to those found in patients with UTIs without urolithiasis. urinary bladder mucosal 728 biopsies and uroliths in dogs treated for urolithiasis to identify an appropriate sampling technique(s) to accurately detect the bacteria causing UTIs in dogs with urolithiasis.

the three cultures revealed identical bacterial isolates. standard procedure as described by Quinn and others (1994) was again followed. Thereafter. E coli was cultured either from both the urine and bladder mucosal biopsy or from the bladder mucosal biopsy or urolith alone. AMAU Ammonium acid urate plates. In seven of these 16 cases (43Á75 per cent). 9Á09 per cent). Urocystoliths were placed in absolute alcohol for two hours. In five of 21 cases (23Á81 per cent). the urine and bladder mucosal biopsy cultures revealed identical bacteria that were not cultured from the urolith. In three cases (18Á75 per cent). 27Á27 per cent). and 1 ml of the salineurolith suspension was added to 4 ml sterilised trypticase soya broth.105) Pseudomonas aeruginosa (. In seven cases (43Á75 per cent) E coli was cultured from the urinary tract. MAP Magnesium ammonium phosphate. Only qualitative culture was also performed of the urocystoliths. S intermedius was cultured from three cases (18Á75 per cent). Proteus mirabilis was cultured from all three samples. 9Á09 per cent). the urolith cultures revealed bacteria that were not cultured from the urine and bladder mucosal biopsy. The bacteria isolated from urine culture by the qualitative culture technique were identical to those isolated by the quantitative culture technique. In three cases (14Á29 per cent). Comparative bacterial cultures of urine. Klebsiella Journal of Small Animal Practice pneumoniae and Pseudomonas aeruginosa were cultured from both the urine and the bladder mucosal biopsy.102) Escherichia coli (. the bladder mucosal biopsy cultures revealed bacteria that were not cultured from the urine and urolith samples. after which they were washed with sterile saline four to five times and crushed with a sterilised pestle and mortar. bladder mucosal biopsy or urolith.Comparison of techniques for diagnosis of urinary tract infections in dogs Table 1. Staphylococcus aureus was cultured from the urolith alone. In nine cases (42Á86 per cent). S intermedius was cultured either from all three samples or from the urine and bladder mucosal biopsy together or from the biopsy alone. bladder mucosal biopsy and urolith in 21 dogs Dog Urine (CFU/ml) 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18-21 Escherichia coli (. K pneumoniae and P aeruginosa in two cases (12Á5 per cent) each and P mirabilis and S aureus Escherichia coli Staphylococcus intermedius Klebsiella pneumoniae Pseudomonas aeruginosa Proteus mirabilis Staphylococcus aureus FIG 1. UA Uric acid.103) Escherichia coli (. Bacteria isolated from the urinary tract of dogs (n516) Á Vol 47 Á December 2006 Á Ó 2006 British Small Animal Veterinary Association 729 . no bacteria were cultured from the urine. CaCO3PO4 Calcium carbonate phosphate.106) Klebsiella pneumoniae (. more than 105 CFU/ml (n=6.105) Escherichia coli (. urinary bladder mucosal biopsy and urolith are shown in Table 1. In two cases (9Á52 per cent).105) No growth No growth No growth No growth No growth No growth No growth Comparative culture results Biopsy Escherichia coli Escherichia coli Escherichia coli Escherichia coli Klebsiella pneumoniae Klebsiella pneumoniae Pseudomonas aeruginosa Pseudomonas aeruginosa Staphylococcus intermedius Proteus mirabilis Staphylococcus intermedius Escherichia coli Escherichia coli Staphylococcus intermedius No growth No growth No growth No growth Chemical composition of urolith Urolith No growth No growth No growth No growth No growth No growth No growth No growth No growth Proteus mirabilis Staphylococcus intermedius No growth No growth No growth Escherichia coli Staphylococcus aureus No growth No growth CaOx CaPO4 CaOx and CaPO4 CaOx and CaPO4 CaPO4 CaOx and CaPO4 UA and CaPO4 CaOx and CaPO4 CaOx and CaPO4 MAP and CaCO3PO4 AMAU UA and CaPO4 CaOx and CaPO4 UA and CaPO4 CaOx and CaPO4 CaPO4 CaPO4 (n=1) CaOx and CaPO4 (n=4) CFU Colony forming units. but in two cases each.105) Staphylococcus intermedius (. more than 103 CFU/ml (n=3. In one case. Sterilised saline (1 ml) was added to the crushed urolith.105) Proteus mirabilis (. standard procedure as described by Quinn and others (1994) was followed. In two cases (9Á52 per cent). RESULTS Bacterial UTI was found in 16 cases (76Á19 per cent).103) Pseudomonas aeruginosa (.103) Staphylococcus intermedius (. 54Á55 per cent) or more than 106 CFU/ml (n=1. CaPO4 Calcium phosphate. In one case. Thereafter. The broth tubes were incubated at 37°C for six to eight hours.105) Klebsiella pneumoniae (. The results of the comparative study of bacterial cultures of the urine. after which subcultures were inoculated to blood agar and MacConkey’s agar plates. CaOx Calcium oxalate. The urine samples that were positive for bacterial cultures quantitatively yielded a bacterial count of more than 102 CFU/ml (n=1. DISCUSSION Bacterial UTI was found in 16 cases (76Á19 per cent).

in the present study. In dogs. S intermedius and Proteus species (potent urease producers) were commonly isolated from the dogs with infection-induced struvite uroliths (Osborne and others 1999). Even though these were metabolic uroliths. Case and others (1993) also reported three urate-containing uroliths to be positive for coagulase-positive Staphylococcus. In dogs. E coli followed by coagulase-positive Staphylococcus species were found to be the most common bacteria causing UTIs. Infection by ureaseproducing bacteria was often an important predisposing factor in the initiation. Jarvinen 2002) and bovines (Singh and others 1982). Klausner and Osborne 1979. Bacteria harboured inside the uroliths might not always be the same species as those present in the urine (Osborne and others 1993). bladder mucosal biopsy and urolith sample. or calcium phosphate only (n=1). However. calcium phosphate only (n=2). So. when infection develops with this type of urolith. In some dogs it appears that antibiotic use before sample collection had an impact on the results of urolith culture. It has been reported that any bacterial growth developed from samples collected under aseptic conditions would be considered significant (Lulich and Osborne 1995. with E coli being the most common and coagulase-positive Staphylococcus species being the second most common organism. these metabolic uroliths might be associated with UTI. Citrobacter freundii (2Á0 per cent) and Providencia rettgeri (2Á0 per cent) from the urine of 51 dogs with UTI in which urolithiasis was a common predisposing factor. Gatoria and others was cultured in one case each (Fig 1). cystine or silica. 18 per cent by two species and 6 per cent by three species. bladder mucosal biopsy and urolith. Since urate uroliths are metabolic uroliths. Infection-induced struvite uroliths often contained some quantity of calcium phosphate and calcium carbonate phosphate (Osborne and others 1999). UTI is often absent in patients with metabolic uroliths such as calcium oxalate. apatite. their initiation and growth were not associated with bacteria. However. was isolated from the urine. The uroliths in these dogs were found to be composed of calcium oxalate and calcium phosphate (n=4). 23Á81 per cent) (amoxicillin [n=3] and cefalexin [n=2]). Streptococcus species (13Á7 per cent). S intermedius was isolated from the urine. or calcium phosphate only (n=1). Klausner and Osborne (1979) reported that cultures of the inside of such metabolic uroliths are usually sterile. these uroliths might predispose the dog to the development of UTI by damaging the urothelium and/or by impeding the urine flow (Klausner and Osborne 1979). In this study. where bacteria were cultured from the urine. In dogs. in the 16 cases (76Á19 per cent) cultured positive. However. UTI was caused by a single species of pathogen. all the urine samples that were positive for bacterial cultures quantitatively yielded a bacterial count between 102 and 106 CFU/ml. the uroliths were found to be composed of struvite (magnesium ammonium phosphate) and calcium carbonate phosphate (n=1). although not as a cause of these uroliths but developing secondarily in the presence of these uroliths in the urinary tract where the organisms isolated were often urease negative (Klausner and Osborne 1979). However. both of which are non-ureaseproducing bacteria. Klebsiella species (9Á8 per cent). the organism distribution was similar to some extent to the distribution commonly listed in the literature. growth and recurrence of struvite (magnesium ammonium phosphate) uroliths (Klausner and Osborne 1979. the same organism was also cultured from the bladder mucosal biopsy but not from the urolith (n=9. Á Vol 47 Á December 2006 Á Ó 2006 British Small Animal Veterinary Association . Enterobacter cloacae (2Á0 per cent). Ling (1984) reported that approximately 75 per cent of UTIs in dogs were caused by a single species of pathogen. or ammonium acid urate only (n=1). In the dog with ammonium acid urate uroliths. urate. it is a sequelae rather than a predisposing cause. Osborne and others 1999). P aeruginosa (3Á9 per cent). It implies that in the present study. In the present study. 42Á86 per cent). Proteus species (15Á7 per cent). Shortliffe and others 1984). Kruger and Osborne 1986. Comer and Ling (1981) reported that isolation of more than 102 bacteria/ml in a urine sample obtained by cystocentesis was considered to be indicative of UTI. a urease-producing bacterium. calcium oxalate only (n=1) or uric acid and calcium phosphate (n=1). Hamaide and others 1998).I. where identical bacteria were cultured from all three sampling techniques (n=2. Ruby and Ling (1986) isolated predominantly coagulase-positive Staphylococcus (47 per cent) followed by Streptococcus (10 per cent) and P mirabilis (3 per cent) from the struvite uroliths in dogs. Hamaide and others 1998). such as in the dogs in which no bacteria were isolated by any sampling technique (n=5. calcium oxalate and other sterile stones in the urinary tract might become infective with urease-producing or non-urease-producing bacteria during the UTI (Thompson and Stamey 1973. The uroliths were found to be composed of calcium oxalate and calcium phosphate (n=5). But infection with urease-producing bacteria might be an important factor in the formation of urate uroliths due to the producJournal of Small Animal Practice tion of increased amounts of ammonium that enhance the precipitation of ammonium urate (Porter 1963. Similar findings have previously been reported in dogs (Weaver and Pillinger 1975. Brown and others 1977. but not from the urine and bladder mucosal biopsy (n=2. Since these were metabolic uroliths. two dogs revealed identical bacteria from the urine. Klohn and others 1986. the uroliths were found to be composed of calcium oxalate and calcium phosphate (n=1). in the present study. Radostits and others (2000) also reported that a nidus favoured the deposition of crystals around itself to form a urolith. P mirabilis. S. 9Á52 per cent). bladder mucosal biopsy and urolith sample. where bacteria were cultured from the urolith only. the cultures from the inside of these uroliths were negative whereas the urine and bladder mucosal biopsies were found to be positive for bacterial growth. In the dog with struvite and calcium carbonate phosphate uroliths. 9Á52 per cent). Kogika and others (1995) also isolated E coli (prevalence of infection 35Á3 per cent) followed by Staphylococcus species (23Á5 per cent). These findings suggest that antibiotic use before collection 730 of samples had an inhibitory effect on bacterial growth. However. the cultures from inside the uroliths were positive for S aureus and E coli.

On the other hand. Hamaide and others 1998). Bacteria contained within the uroliths probably represented those present at the time that urolith was formed (Osborne and others 1993). C. Adherence of bacteria to the urothelium could explain positive bladder mucosal biopsy culture results in the presence of negative urine and urolith culture or only negative urolith culture results. W. & UEHLING. & LING. A. (1999) Canine urate urolithiasis: etiopathogenesis. M. D. B. Singh and others 1982). Veterinary Clinics of North America: Small Animal Practice 29. or calcium oxalate and calcium phosphate (n=1). 701-711 KLOHN. L. Balish and others 1982). V. RUBY. bladder mucosal biopsy and urolith culture) to identify urinary tract infections in dogs with urolithiasis. 161-183 BRODEY. Journal of the American Veterinary Medical Association 126. JENSEN. K. A. when the culture from the urine obtained by cystocentesis is negative.. 204-206 COLLINS. Bacteria isolated were E coli in two dogs and S intermedius in one dog. M. 1-9 BROWN.. C. In 11 cases (52Á38 per cent) where bacteria were isolated from urine obtained by cystocentesis. M. E. A. J. Negative culture of the urine and bladder mucosal biopsy may be due to host defence mechanisms. K. N. (1955) Canine urolithiasis: a survey and discussion of fifty-two clinical cases. Singh and others (1982) also isolated E coli from the interior of two metabolic uroliths out of the 30 urolith nuclei examined from bovines. N. M. KOEHLER. D. W. R. which further results in positive biopsy cultures. S. & STEVENS. B. R. J. the uroliths were found to be composed of uric acid and calcium phosphate (n=2). 421-425 KLAUSNER. & OSBORNE.. C. A. no bacteria were isolated from the urine. V. bladder mucosal swab. as reported by Osborne and others (1999). F. Journal of the American Animal Hospital Association 34. Journal of the American Veterinary Medical Association 179. D. M. D. References BALISH. HAGIWARA. Veterinary Record 95. L. In 10 cases (47Á62 per cent). M. L. it is not necessary to culture bladder mucosal biopsy or urolith. CHEW. J. Journal of the American Veterinary Medical Association 203. one sampling method cannot be recommended above the others. M.. PARKS. 891-895 HAMAIDE. cultures of bladder mucosal biopsy and urolith are recommended in dogs with urolithiasis in order to accurately assess the microbiological status of the urinary tract. It has previously been reported that these urothelial cells normally produce a layer of glycosaminoglycan that coats their surface (Parsons and others 1977.. K. S. & HEUTER.. O. S. Hamaide and others (1998) also isolated S intermedius from the bladder mucosal biopsy of two dogs in which urine and urolith cultures were negative. Veterinary Clinics of North America: Small Animal Practice 9. Conclusions If urine culture obtained by cystocentesis is positive before surgery. But when these urocystoliths cause damage to the urothelium. L. (1986) Ammonium urate urinary stones. & ULRICH. LING. J.. N. L. (1974) Staphylococcal infection of the urinary tract and its relation to urolithiasis in dogs. it is not necessary to culture bladder mucosal biopsy or urolith.. they might alter the anti-adherence activity of the glycosaminoglycan layer. In dogs.. In five (23Á81 per cent) of these 10 cases. 14Á29 per cent). bacteria were isolated either from the bladder mucosal biopsy or the urolith. but not from the urine and urolith (n=3. J. Journal of the American Veterinary Medical Association 213. M... Suomen-Elainlaakarilehti 108. A. JOHNSON. F. F. The results of this study also suggest that for urine samples both qualitative and quantitative culture techniques should be undertaken. Clark (1974) reported Staphylococcus epidermidis and Streptococcus faecalis from the culture of a urolith composed of uric acid and phosphate. thereby becoming impervious to treatment by antibiotics (Shortliffe and Spigelman 1986). LULICH.. (1995) Etiologic study of urinary tract infection Journal of Small Animal Practice Á Vol 47 Á December 2006 Á Ó 2006 British Small Animal Veterinary Association 731 . T. S. The surface coating of glycosaminoglycan and water non-specifically inhibits bacterial adherence to urothelial cells and therefore enhances the mechanical washout of bacteria during micturition. Journal of the American Veterinary Medical Association 170. 1060-1063 BARTGES. A. L. S.. if no bacteria are isolated from urine samples. These bacteria might embed within the interstices of the urolith. SANDERSON. negative urolith culture from these cases suggested that the dietary and/or metabolic factors might have been involved in the genesis of these sterile uroliths. Collins and others (1998) isolated Pseudomonas species from the bladder wall of a dog in which urine culture was negative. HAUPTMAN. 423-430 JARVINEN. A. A. P. In the present study. M. catheterization and the midstream voided methods. L. G. J. G. (1981) Results of urinalysis and bacterial culture of canine urine obtained by antepubic cystocentesis. J. 315-318 KOGIKA. bacteria can be isolated by the other two sampling methods in 25 per cent of cases. Therefore. P. to rule out an underlying UTI following a negative urine culture. (1982) Bladder mucin: a scanning electron microscopy study in experimental cystitis. T. BOLLE.Comparison of techniques for diagnosis of urinary tract infections in dogs and this nidus might be a group of desquamate epithelial cells or necrotic tissue that was occasionally formed as a result of local infection in the urinary tract. Journal of Urology 128. which has also been known to alter the anti-adherence activity of the glycosaminoglycan layer at the transitional cell surface (Parsons and others 1984). (1993) Urolithiasis in Dalmatians: 275 cases (1981-1990). (2002) Treatment of urinary tract infections in the dog. Similarly. & GROSSO. the results of this study suggest that if bacteria are isolated from urine culture before surgery. 96-100 CLARK. & WALKER. PAVAN. Ruby and Ling (1986) also isolated coagulasepositive Staphylococcus from 14 per cent of the non-struvite uroliths. regardless of the number of bacteria present (Lulich and Osborne 1995.. (1979) Urinary tract infection and urolithiasis. Urology Research 14.. (1998) Prospective comparison of four sampling methods (cystocentesis. C. A. MARTINEZ.. MAMIZUKA.. (1977) Recurrence of canine urolithiasis. R. (1998) Surgical treatment of urate calculi in Dalmatians: 38 cases (1980-1995).. Weaver and Pillinger 1975. J. where bacteria were cultured from the bladder mucosal biopsy only. J. 419-422 CASE. E. Isolation of bacteria from the urinary tract tissue (such as bladder wall or renal biopsy) obtained under aseptic conditions would be indicative of UTI.. J. V. & GREENE. the same bacteria were also isolated either from the bladder mucosal biopsy alone (42Á86 per cent) or from both the bladder mucosal biopsy and uroliths (9Á52 per cent). J. BIRCHARD. FRANTI. J. So. OSBORNE. R. K. The negative urine cultures might also be due to host defence mechanisms or presurgical antimicrobial therapy given to the dogs (Brodey 1955. diagnosis and management. W.. K. bladder mucosal biopsy and urolith cultures should be performed in dogs with urolithiasis. 833-838 COMER. S. Therefore. enhancing the adherence of bacteria to the urothelium. However. & REVERDIN. J. FORTUNATO. A further explanation of the positive biopsy culture might be the production of urease by urease-producing bacteria. L. KRUGER.

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