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I took on an elderly Chihuahua after the old lady next door died. She’s got a few problems, but the main one is recurrent cystitis, which is happening every few weeks now. I’m constantly getting antibiotics from the vet, but is there anything else I can do?

Paul Manktelow advises…

Firstly, thank you for taking this little one into your home. When owners die, these poor old dogs often end up in rescue centres with little hope of finding a home again, so it’s great that you have offered her a sanctuary to live out her last days.

Cystitis is usually noticed by owners as a result of the increased frequency of urination, or a change in the colour or smell of the urine. In severe cases, it can lead to extreme pain and you often see affected dogs passing blood or pus in their wee.

It is a condition that usually arises due to inflammation of the bladder wall, but there are multiple things that can cause this to happen. The most common cause in female dogs would be infection, which can ascend up the urinary tract. If the condition is responsive to antibiotics, then it could indicate that infection is indeed the cause. However, when a condition recurs frequently, it may indicate that there is another underlying cause and the bacterial infection is actually secondary to this.

In these types of cases, you might expect to see something that is chronically affecting the bladder and some common examples are stones or masses. Certain types of bladder tumour can cause recurrent signs of cystitis.

As the first line of investigation, it would probably be worth taking a fresh urine sample so your vet can analyse it for infection and the presence of crystals (which could indicate you have stones forming in the bladder). Your vet can also do bacterial cultures of the urine to help identify exactly which bug is causing the problem and the most appropriate antibiotic to use.

I would also advise doing some imaging of the structures of the bladder. You mentioned that she is elderly and has some other problems, so an anaesthetic for X-rays might not be appropriate. However, you can do ultrasound scans of the bladder in conscious animals without the use of anaesthetic, so this may be an option. This would certainly help to identify any stones or masses in the bladder.

Certain types of bladder stones can be dissolved by changing the diet, so this may be an option. However, if there are very large stones present or a bladder tumour, then surgery is often indicated, so you might want to start thinking about whether this would be an option for her, considering her age and her other health issues.

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