Bladder Wall Thickening: Causes and Treatment

Introduction

Your urinary bladder is a balloon-shaped organ that stores urine from the kidneys until it’s released through the urethra. The bladder is located in the pelvic cavity between the pelvic bones. It can hold around 2 cups of urine.

When the bladder is filling with urine, the muscles in the bladder wall relax. When it’s time to urinate, the bladder wall muscles tighten to help push urine out through the urethra.

A thickening of the bladder wall can be a sign of several medical conditions. It’s usually accompanied by other symptoms, too. Many of these conditions are easily treatable with an early diagnosis.

It’s important to report any changes in your urinary habits to your doctor. Bladder infections, for example, can lead to kidney infections. These can be quite serious if not treated early.

The muscular wall of your bladder tends to grow thicker if it has to work harder to urinate. It can also thicken if it becomes irritated and inflamed. Scarring of the bladder wall may also cause it to thicken.

Common causes of bladder wall thickening include:

Inflammation due to urinary tract infection (UTI)

A UTI is often the result of bacteria entering the urethra and then the bladder. These infections are more common among females than males.

UTIs are often associated with sexual intercourse, but a woman who isn’t sexually active can also develop a bladder infection. This is simply because of the amount of bacteria in and around the vagina.

One of the major responses to a UTI is inflammation of the bladder wall, a condition known as cystitis. Prolonged inflammation can lead to thickening of the wall. Some other causes of cystitis include inflammation triggered by cancer treatments, like radiation and chemotherapy, or prolonged use of a catheter.

Noncancerous tissue growths

Abnormal tissue growth in the bladder wall causes tumors to grow and the wall to thicken. Noncancerous (benign) tumors include papillomas. For some cases, viruses may be the cause of these growths.

Other benign bladder tumors include leiomyomas, but these are rare. They result from an overgrowth of smooth muscle cells in the bladder wall.

Fibromas are another benign bladder tumor. Abnormal growth of fibrous connective tissue in the bladder wall causes these.

Cancer

Cancerous (malignant) tumors tend to form first in the innermost lining of the bladder wall. This lining is known as the transitional epithelium.

The abnormal growth of cells in the bladder wall may be related to smoking tobacco or exposure to chemicals. Chronic irritation of the bladder wall or previous radiation exposure can also be the culprit.

Hemorrhagic cystitis

Sometimes irritation and inflammation of the bladder wall causes bleeding from the bladder lining. This is considered hemorrhagic cystitis. Causes may include:

• radiation therapy
• chemotherapy
• an infection
• exposure to certain chemicals, such as insecticides or dyes

Amyloidosis

Amyloid is a type of abnormal protein that’s made in your bone marrow. Amyloidosis is the buildup of amyloid in an organ. The bladder is one of several organs that can be vulnerable to this disease, but it’s not common.

End stage renal disease can trigger the abnormal growth of amyloid when dialysis doesn’t filter out amyloid that may be present. Autoimmune inflammatory diseases, such as rheumatoid arthritis, can also trigger amyloidosis, as well as other conditions. There’s also an inherited version called familial amyloidosis.

Bladder outlet obstruction

Bladder outlet obstruction (BOO) is a blockage at the base of the bladder where it empties into the urethra. For men, an enlarged prostate or prostate cancer can result in BOO. Other causes of BOO for men and women include:

• bladder stones
• tumors
• scar tissue in the urethra

Symptoms of bladder wall thickening usually relate to changes in your urinary habits. You may urinate more frequently, or you may notice that it feels different when you relieve yourself. You may also notice changes in the urine itself.

Underlying causes, such as infections or tumors, can lead to some of the following symptoms:

Fever

Cystitis may cause a low-grade fever. A fever is a symptom of many conditions. But if a fever develops at the same time as bladder-related symptoms, see your doctor right away.

Pain when urinating

Painful urination is a symptom of many conditions as well, ranging from sexually transmitted diseases (STDs) to bladder cancer. A bladder or kidney infection can also cause a burning sensation when you’re urinating. This is one of the surest signs that you should seek medical treatment soon.

Urgency or difficulty urinating

A bladder disorder can make it difficult to fully empty your bladder. This can cause frequent urination, feeling like you always have to urinate, or both.

When the bladder wall thickens, the bladder may not be able to hold as much urine as it normally does. This can create those urgent feelings of having to urinate more frequently. BOO can also make it harder to urinate.

Cloudy urine or blood in urine

You may also see a small amount of blood in your urine. Sometimes this occurs from something as harmless as a strenuous workout. It could also be a sign of cystitis, bladder cancer, or another urinary tract problem.

Often, blood in urine can only be seen under a microscope. If you can see blood in your urine yourself or notice your urine turning cloudy, see your doctor, even if you have no other symptoms yet. It can be a sign of several potentially serious conditions. It’s best to get an early diagnosis sooner rather than later.

Foul-smelling urine

Foul-smelling urine or urine with a very strong smell could simply be related to food or beverages you recently consumed. However, it may be a sign of infection. Once a bladder infection is effectively treated, the related foul smell should disappear.

The underlying causes of a thickened bladder wall can differ between men and women.

BOO is more common among men, because it’s often linked to prostate problems. An enlarged prostate forces the bladder to work harder to empty itself of urine. This in turn causes the bladder wall to thicken. Prostate treatment can help reduce the burden on the bladder.

UTIs are more common among women. Thorough treatment can ease the strain on the bladder and allow thickened bladder walls to return to normal.

If you notice symptoms of bladder wall thickening or any symptoms related to your urinary tract system, see your doctor.

They’ll likely have you undergo several tests, such as a urinalysis. For this test, a sample of your urine is checked for signs of infection, blood cells, or abnormal protein levels. If your doctor suspects bladder cancer, they’ll check for cancer cells, too.

If cancer is a possibility, a cystoscopy may also be performed. During this procedure, a thin, flexible scope is guided up the urethra to check the lining of your urethra and bladder. A cystoscopy can also evaluate recurrent infections in the urinary tract.

In addition, a woman may undergo a pelvic exam to help diagnose an infection or other disorder.

Treating a thickened bladder wall means treating the underlying condition that caused the change in the wall.

For example, UTI treatment usually involves a course of antibiotic therapy. To prevent UTIs, practice good hygiene. Wipe front to back to reduce the risk of germs from the rectum reaching the urethra.

Surgery can remove noncancerous tumors that are causing you symptoms. The tumors usually won’t recur.

Cancerous growths can sometimes be removed with surgery, too. Additional cancer treatments, such as chemotherapy or radiation, may also be necessary.

Prostate treatment is a somewhat controversial subject. Prostate surgery can sometimes lead to incontinence or erectile dysfunction. If prostate symptoms are minor, your doctor may recommend a watch-and-wait approach to monitor your prostate regularly. Prostate cancer is often a slow-growing cancer. This means aggressive treatment isn’t always best.

If excess bladder emptying due to urge incontinence is a problem, your doctor may recommend anticholinergic drugs. These medications relax the detrusor muscle of the bladder.

If urinary retention is occurring due to BOO, your doctor may prescribe medication, such as tamsulosin, to help your urine flow be stronger.

A range of conditions can trigger bladder wall thickening. If you suspect that you have a condition causing you bladder problems, see your doctor, even if it just seems like a minor annoyance at first. Doing so will prevent your symptoms from worsening. Some bladder conditions can lead to life-threatening kidney problems.

Early treatment can prevent long-term harm and provide fast relief for uncomfortable symptoms.

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Home remedies may help ease symptoms of a kidney infection when used in addition to prescribed treatment from a doctor. Kidney infections can be serious if not treated.

A kidney infection is a serious medical condition that requires prompt treatment. These infections often start as a urinary tract infection (UTI) or a bladder infection and then spreads to affect one or both kidneys.

While most kidney infections are easy to treat and recover from quickly, in rare cases, they can lead to serious health problems, especially if left untreated.

Not only that, but not properly treating an infection can leave you feeling pretty uncomfortable, as symptoms like painful urination are anything but pleasant.

You may be able to use home remedies together with your prescribed medical treatment to ease some symptoms and improve kidney health, but you shouldn’t try to treat yourself alone. Always go to a doctor first, for diagnosis and to discuss treatment options.

A kidney infection, also known as pyelonephritis, usually forms when a urinary tract infection spreads to one or both of your kidneys.

The kidneys filter waste products from your blood and into your urine and regulate the water and electrolyte content in your blood. These are both essential health functions.

Kidney infections are usually caused by bacteria that has entered your kidneys and bladder by way of your urinary tract. They can also be caused by bacteria from another infection elsewhere in your body, bladder or kidney surgery, or a blockage of urine flow such as by a kidney stone, tumor or enlarged prostate.

They can be either sudden or chronic and usually quite painful. They can also be serious and life threatening if not treated appropriately.

People assigned female at birth tend to be more susceptible to kidney infections because their urethras are shorter than those of people assigned male. This makes it easier for bacteria to enter their urinary tract, especially since it’s closer to the vagina and anus. Pregnancy increases this risk factor.

Other risk factors include:

• being prone to urinary tract infections
• having a weakened immune system
• having problems regularly emptying your bladder completely when urinating

Symptoms of a kidney infection

Kidney infection symptoms usually appear about 2 days after initial infection and can vary between children and adults. Common symptoms among adults include:

• pain in your abdomen, back, groin, or side
• frequent urination or the sensation of needing to urinate
• burning or pain while urinating
• blood or pus in your urine
• cloudy or foul-smelling urine
• nausea or vomiting
• fever
• chills

In children under 2 years old, a kidney infection may only come with a high fever as a symptom. Adults over 65 may only experience mental confusion and jumbled speech as their symptoms.

If a kidney infection isn’t treated swiftly or appropriately, symptoms can become severe and result in sepsis, which is a life threatening condition. Sepsis symptoms include:

• chills
• fever
• rapid breathing and heart rate
• confusion
• rash

UTIs are uncomfortable, but they’re not an immediate medical emergency. Some people make the mistake of assuming the same is true with a kidney infection.

Kidney infections are serious conditions that do require medical attention. Untreated, a kidney infection can quickly cause long-term kidney damage or kidney scarring. These infections can also cause sepsis, which can lead to sepic shock.

Because of this, a kidney infection can be fatal if it progresses. It’s important to have it treated immediately by a healthcare professional.

Note that kidney stones, if left untreated, can also cause a blockage that can lead to infection and sepsis. This may require a procedure done with intravenous antibiotics by a urologist.

Medical treatment for kidney infections

Antibiotics are always the first line of defense against a kidney infection. If the kidney infection isn’t severe, a doctor will likely give you oral antibiotics to take once or twice a day for 7 to 14 days.

It’s important to take the entire course of antibiotics, even if you feel better within several days. Stopping early could lead to antibiotic resistance or re-infection. A doctor will also encourage you to drink plenty of water.

In some cases, kidney infections may require going to the hospital. You’ll be given fluids and antibiotics intravenously through an IV, both of which can help treat the infection.

In addition, lab work and imaging may be done to determine the severity of the infection as well as the cause, such as a blockage due to a kidney stone or anatomical abnormality.

If you have recurring UTIs that increase your risk of frequent kidney infections, a doctor will help you establish the cause of their frequency and help you prevent further infections from occurring.

Some people prefer to treat medical conditions with home remedies or complementary remedies.

Because of how serious kidney infections are, it’s important that you don’t rely on home remedies. Instead, take the prescription antibiotics a doctor gives you and use home remedies to help ease symptoms or pain.

You can also use home remedies to avoid UTIs and improve kidney function.

1. Drink a lot of water

Drinking plenty of water can help flush bacteria from the body, helping eliminate the infection faster. It can also help clear out the entire urinary system.

Drinking plenty of water can also help prevent UTIs that can lead to kidney infections, so it’s a good practice to keep. You should aim to drink at least eight glasses of fluids daily.

2. Drink cranberry juice

Cranberry juice has long been used as a remedy for UTIs and bladder infections. There’s some evidence that drinking cranberry juice may help or prevent UTIs in some people.

Many people prefer the sweet flavor of cranberry juice to water. However, cranberry juices full of added sweeteners aren’t great for you. A cranberry supplement or pure cranberry juice is a better alternative to get the benefits of cranberries.

Shop for cranberry supplements and pure cranberry juice online.

3. Avoid alcohol and coffee

The kidneys’ most important role is to filter out harmful substances and toxins, and both alcohol and caffeine can require extra work from the kidneys. This may hinder the process of healing from an infection.

Alcohol and antibiotics also shouldn’t be mixed, so avoid alcohol during your treatment for this reason as well.

4. Take probiotics

Probiotics have two big benefits when it comes to treating kidney infections.

The first is that they’ll help keep your body’s healthy bacteria in check, even though the antibiotics may get rid of both “good” and “bad” bacteria.

There’s also evidence that probiotics can aid in decreasing antibiotic-associated diarrhea in patients.

You can find probiotics at your local grocery store, online, or through a subscription service, like Uqora.

5. Get some vitamin C

Vitamin C is a powerful antioxidant that helps protect tissues in the body from oxidative stress, which can help promote kidney health.

There’s also older animal-based research from 2003 and 2011 that shows that vitamin C can prevent kidney scarring during acute kidney infection and boost the enzymes within the kidneys.

You can take vitamin C supplements or eat foods that are dense in this nutrient.

6. Try parsley juice

Parsley juice is a nutrient-dense diuretic that can increase the frequency and amount of urination. This can help flush out the bacteria in the kidneys faster, making antibiotics even more effective.

If you don’t like the taste of parsley outright, you can mix it into a smoothie with strong-flavored fruits, including cranberries or blueberries for best results.

7. Consume apples and apple juice

Apples are also nutrient-dense. Their high acid content may help the kidneys maintain acidity in the urine, possibly inhibiting the additional growth of bacteria.

They also have anti-inflammatory properties, which may be beneficial in helping the kidneys heal following the infection.

8. Take an Epsom salt bath

Both Epsom salts and warm water can ease pain. This can help make the uncomfortable side effects of the kidney infection a little more tolerable while you wait for the antibiotics to take effect.

Since abdominal pain is sometimes a symptom of antibiotics, as well as kidney infections, Epsom salts could also help even after symptoms from the kidney infection are resolved.

Shop for Epsom salts online.

9. Use non-aspirin pain relievers

Nonaspirin pain relievers can help relieve discomfort. Ibuprofen (Motrin, Advil)and acetaminophen (Tylenol) can also help break fevers caused by the infection.

However, note that if you have kidney dysfunction or acute kidney injury as a result of a kidney infection, it’s important to avoid nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Motrin, Advil) and naproxen (Aleve).

10. Apply heat

While you wait for the antibiotics to kick in, you can use heat therapy to reduce pain. Apply a heating pad or a hot water bottle to the affected area, and keep it on for about 20 minutes at a time.

Shop for a hot water bottle online.

Apple cider vinegar is one of the most popular home remedies, no matter what type of condition you’re trying to treat. It’s touted by some as a remedy for kidney infections, too, thanks to its antibacterial properties.

That being said, there’s no evidence or research available that supports this usage.

Baking soda is sometimes used as a home remedy for kidney infections, with some believing that it can help detoxify the kidneys by helping them filter better. There’s no evidence to support this, either.

On the contrary, it may even be dangerous to attempt to use baking soda for this purpose. One 2013 study found that misuse of baking soda actually led to hospital admission for some people for electrolyte imbalances, respiratory depression, or metabolic alkalosis.

Anyone can get a kidney infection. However, since UTIs can turn into kidney infections, you can lower your risk of kidney infection by lowering your risk of a UTI.

Tips for reducing your UTI risk include:

• drinking plenty of fluids
• wiping front to back
• avoiding holding your pee
• peeing immediately after sex
• staying away from scented bath products, douches, and pads or tampons if you have a vagina
• taking probiotic supplements

How long does a kidney infection last?

Most people start to feel better once they’ve been taking prescribed antibiotics for a few days. Antibiotics are typically prescribed for a course of 2 weeks. It’s important to take the entire course even if you feel better before you’re done.

Does your urine change color during a kidney infection?

You may sometimes experience dark reddish-brown or cloudy urine with a kidney infection. If you haven’t seen a doctor or haven’t been diagnosed, this is a telltale sign that you should get checked out.

How can you improve your kidney health?

Lifestyle habits that benefit your overall health, like staying hydrated and exercising regularly, can be vastly beneficial to your kidney health.

Similarly, you shouldn’t smoke, and you should go see your doctor for regular checkups to monitor your blood pressure. If you’re at risk for kidney infections, you should have your kidneys tested and monitored.

A kidney infection is a serious condition that requires prompt treatment with antibiotics prescribed by a healthcare professional.

Home remedies can be used as a complementary treatment to help ease other symptoms, but make sure you ask a doctor before using them to ensure they won’t interfere with your treatment.

Urinary tract infections in women

Fedorovich Oksana Alexandrovna

Urologist

Contents

1. Diagnosis and treatment of urinary tract infections
2. Natural defense factors against urinary tract infection
3. Categories of patients susceptible to the development of UTI

Urinary tract infection is the most common among other types of infectious diseases. One in five women (20%) experience at least one episode of urinary tract infection during their lifetime. In 15% of them, infections are recurrent, this is when 2 episodes appear within 6 months or 3 within a year.

In general, sexually active women of reproductive age are affected.

Urine is a waste product of the body that is produced in the kidneys. During the day, a healthy body produces 1-1.5 liters of urine. The bladder capacity is 200-300 ml. Therefore, it is normal for a person to empty their bladder 5 to 8 times in 24 hours.
It is a mistake to assume that a decrease in the number of urination per day indicates some kind of special well-being. On the contrary, this may indicate an overdistension of the bladder and the beginning of its serious illness.

Diagnosis and treatment of UTIs

Very often, a woman independently establishes the diagnosis of “cystitis” and begins the process of self-treatment, which begins with the preparation and ingestion of herbal decoctions. It cannot be said that this is the wrong path to health, but it only hopes for folk remedies – this is a very reckless step.

Lower urinary tract infection is a microbial process. Before starting treatment, even with herbs, it is strongly recommended to consult a urologist who, taking into account the symptoms of the disease, will prescribe the necessary tests (general urinalysis and urine culture for microflora) and draw up a treatment plan that is right for you.

Natural defense factors against UTIs

Nature took care of woman’s health. In connection with the anatomical and physiological features of the organs of the urinary system, the female urethra has a highly effective mechanism for eliminating bacteria penetrating into it. It is worth noting that the urethra of healthy women is able to clear invading bacteria more efficiently than the urethra of women with recurrent urinary tract infections.

A bladder with a normal frequency of urination should remove the small amount of bacteria that in healthy women can enter it, as well as more actively expel a significant amount of bacteria that can enter the cavity and urethra in women with recurrent urinary tract infections.

Categories of patients susceptible to the development of UTI

Based on the development of urinary tract infections (UTIs), there are 3 categories of women:

• Premenopausal women
• Postmenopausal women
• Older women

1. Premenopausal women (up to 45-55 years of age). Risk factors for UTIs are:

• a history of episodes of urinary tract infection in the mother or a history of infection in the ill woman herself in childhood.

Relapses are affected by the characteristics of sexual life, the use of hormonal contraceptives, frequent changes of sexual partners, and non-compliance with basic rules of sexual hygiene.

2. Postmenopausal women . Risk factors for UTIs are:

• estrogen deficiency;
• previous diseases of the kidneys and urinary tract;
• non-secretory status.

Urogenital disorders of the climatic period include a complex of complications associated with the development of atrophic processes in estrogen-dependent tissues of the urinary system, which reduces their protective role against microbes located in the immediate vicinity of the entrance to the bladder.

3. Elderly women . This category of women is particularly susceptible to recurrent infections. 25% of women over 65 have bacteriuria, i.e. persistent detection of bacteria in the urine.

Risk factors for UTI:

• age-related changes in immunity;
• difficulty emptying the bladder;
• often long-term diabetes mellitus.

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Urinary tract infections – scientific articles on animal veterinary medicine

Shchelchkova K.M. – veterinarian of the therapeutic department of the ITC MVA.

Urinary tract infections (UTIs) are inflammatory diseases of the urinary system caused by bacterial or fungal microflora, acute or subacute in nature with the possible development of complications.

Often, urinary tract infections are the result of migration of bacteria through the genital tract and urethra into the bladder, possibly seeding from inflammatory skin areas near the urethra. A complication may be the spread of bacteria to the ureters and kidneys (ascending route of infection).

The proximal urethra and also the ureters and bladder are sterile due to the fact that the body has natural defense mechanisms against infection.

The distal urethra and vulva have a normal microflora that includes intestinal microorganisms. Vaginal or prepuce swabs usually reveal a wide range of bacteria, most of which are uropathogenic.

Risk groups for urinary tract infections

1. An important factor is the age of the animal.

In dogs and cats, urinary tract infections are diagnosed mainly in animals older than 10 years. In animals under 1 year of age, the risk of infection is minimal.

2. Females are more prone to infections of the urinary system due to the anatomical structure of the genitals and urethra. Uropathogenic microorganisms enter with the fecal flora, colonizing the perineal region of the external genital organs.

3. Bacterial microflora can cause both infections of the urinary system and infectious diseases of the reproductive tract, such as endometritis, pyometra and others.

4. Congenital anomalies may lead to increased susceptibility to infection.

5. Ascending infection with pyelonephritis often occurs with ectopic ureters. Vulvovaginal strictures can also predispose to urinary tract infections.

6. Dogs and cats with urethrostomy and cystotomy.

7.
Urolithiasis disease.

Infections of the urinary system are both a cause and a consequence of the formation of uroliths. Infections caused by urease-producing bacteria lead to the formation of struvite stones in dogs.

Infection with urease-producing bacteria leads to the deposition of magnesium ammonium phosphate on the surface of other types of uroliths, complicating diagnosis and treatment.

8.
Installation of the urethral catheter and its fixation for a period of 4 days, according to statistics, leads to 100% infection of the bladder and urethra.

9. Uncastrated males over three years of age.

This is associated with the development of prostatic hyperplasia and other diseases of the prostate.

10. Dogs and cats with discopathy , spinal injuries, neurogenic urinary disorders.

These diseases can affect the frequency and volume of urination. Daily urine can remain in the bladder and not be evacuated in a timely manner, which predisposes to the development of infection.

11. Animals receiving high doses of immunosuppressive drugs (corticosteroids, anticancer therapy). It is important to rule out urinary tract infection in these patients prior to initiating drug administration and to monitor their condition during treatment.

Protective properties of the body itself against infection

1. Normal urine flow.
2. Complete emptying of the bladder.
3. Urethral high pressure zone.
4. Peristalsis of the urethra.
5. Prostatic secretion and its antibacterial fractions.
6. The length of the urethra.
7. Vesicoureteral valves, peristalsis of the ureter itself.
8. Urine contains a significant amount of IgG and secretory immunoglobulin, which is important in the prevention of urinary tract infections.
9. Natural antimicrobial properties of the mucosa, surface layer of glucosaminoglycan, timely death of non-viable cells.
10. Antibacterial properties of urine itself: urine pH, hyperosmolarity, urea concentration.

Diagnosis

1. History taking

It is necessary to determine the activity of the infectious process. Whether there is pollakiuria, difficulty and retention of urination, hematuria, weakening of the jet, involuntary urination, pathological smell of urine.

Most animals with chronic urinary tract infections have minimal clinical signs.

Blood tests are required to exclude systemic diseases, screening for hidden diseases.

2. Clinical examination of the animal

On palpation, there may be pain in the area of ​​the bladder, kidneys, and prostate gland. Body temperature may rise, general depression of the state can be observed.

3. General clinical analysis of urine

In the general analysis, you can see active urine sediment: bacteria, leukocytes, erythrocytes, cylinders, an increase in the number of epithelial cells. If the kidneys are involved, leukocyte casts, granular casts, and renal epithelium may be seen.

4. Ultrasound diagnostics

Allows you to evaluate the internal architecture of the kidneys, prostate, bladder and urethra. Ultrasound may suggest a urinary tract infection, but additional diagnostic tests are needed to confirm.

5. Bacteriological culture of urine

To identify pathogenic microorganisms, it is obligatory to carry out bacteriological culture with determination of sensitivity to certain antibiotics and antimycotics.

Urinary sampling by cystocentesis (gold standard culture for urinary tract infections) is required.

If an infectious process in the prostate gland is suspected, urine can be collected for culture by taking a middle portion of urine (in this case, the possible seeding of pathogenic microflora from the distal part of the urethra should be taken into account).

The urine sample must be sterile. During catheterization, the catheter passes through the distal part of the urethra and collects bacteria, thus contaminating the sample and can cause iatrogenic infection.
Urine that is obtained naturally flows down the distal part of the urethra, so the sample can also be contaminated with bacterial flora.

Infectious agents

The table shows the most common pathogens with percentage of the total number of isolated bacteria in dogs. (Lingetal., 2001).

Microbiological study listing the most common bacteria in urinary tract infections

The presence of fungal microflora may be a sign of localized infection secondary to several predisposing factors, such as:

• diabetes mellitus;
• previous antibiotic therapy;
• decreased immune system;
• chronic viral infections;
• systemic fungal infection.

Among the causative agents of fungal infections of the urinary system, yeast fungi of the genus Candida dominate. The most common species is C. albicans, but other types of fungal infection can also occur. Six different species of the genus Candida have been isolated from cats and dogs.

Diagnostic approaches in the treatment of infections of the urinary system

1. The diagnosis is made by the result of bacteriological urine culture.
2. Select an appropriate antibiotic for a course of at least 14 days.
3. Males are treated with a course of 4 weeks or more due to the high probability of an inflammatory process of the prostate gland. It is necessary to use antibiotics that penetrate the prostate.
4. In animals with suspected pyelonephritis, treatment may be 4-8 weeks or more.
5. Urine culture is repeated 5-7 days after the end of treatment.
6. Monitoring the effectiveness of antibiotic therapy for infectious diseases of the urinary system requires multiple urine collection from the patient for bacteriological culture.