episioplasty for chronic UTI

[DebbieGilbert]

On Daisy's first birthday, she was diagnosed with a urinary tract infection. Over the years, the UTIs became more and more frequent, until she was on antibiotics almost continuously. I was afraid she would develop resistance to all antibiotics and there would be no way to treat the infections anymore. My vet (an old country doctor -- we live in a small rural town) kept trying to persuade me to feed Daisy a prescription diet to control urinary stones. I refused, because we never found any evidence that she had stones -- just a lot of bacteria. Finally, I demanded a referral to a specialist.
We were sent to Georgia Veterinary Specialists in metro Atlanta, and as soon as one of the internal-medicine vets began examining Daisy, he immediately diagnosed the problem. A flap of skin over the vulva was causing bacteria to get trapped in Daisy's urinary tract. She underwent reconstructive surgery (episioplasty) in May 2009. Since then, her problem has almost entirely disappeared. She has had only one minor UTI, and that was more than a year ago. I am very grateful that we finally got a diagnosis and that it was treatable with surgery.

But I was wondering, how common is this problem? Is it something that happens more in Shelties than in other breeds? I'd like to hear from other Sheltie owners who have been through this experience.

 

[sable]

I haven't been through something like this, but I am so happy you got to the bottom of what was causing the problem. Persistents is a great tool. Good for you for being persistent.

 

[missjenneygirl]

Where I have seen chronic UTIs is when a bitch has been spayed very young, and her "tulip" stayed very small. One argument for waiting to spay is, after the first heat cycle, the vulva is larger. During her cycle hormones caused the vulva to swell in anticipation of breeding. After the cycle, the vulva shrinks back to size, but larger then previously. With a teeny-weeny tulip, add to that a spayed bitch that may be overweight, it gets "tucked in". Bacteria gets trapped, and causes a UTI.
The other argument is, do we really want bitches in season just to possibly or hopfully prevent future UTI problems? No.

 

[SheltieChe]

I think it is very reasonable to expect if the dog has repeatedly UTI after UTI to look for some obstruction/ anatomy defect.
As much as our industry likes people to buy diapers for their kids until they school age, wearing diaper often results in increase UTI for human kids, specially girls.
I am glad your pup's problem has been resolved.

 

[corbinam]

From what I can remember Megan (megansmom on the forum) had some sort of surgery during her spay. Maybe a vulvoplasty? So it's along the same lines, but because of a recessed vulva it can trap bacteria.

I've been told by a few vets that Lexi's vulva is recessed, and she has had a history of UTIs (none recently, *crosses fingers*)

 

[take4roll10]

From what I can remember Megan (megansmom on the forum) had some sort of surgery during her spay. Maybe a vulvoplasty? So it's along the same lines, but because of a recessed vulva it can trap bacteria.

I've been told by a few vets that Lexi's vulva is recessed, and she has had a history of UTIs (none recently, *crosses fingers*)

I pretty sure Megan had a vulvaplasty when she was spayed.

I believe Bailey has a recessed vulva as well. The vet said she had an underdeveloped vulva. I'm not sure if that's the same thing. She had a lot UTI's as a puppy. I debated if I wanted to let her go through a heat or not. We spayed her before she went into heat. So far so good. (fingers crossed). I just make sure she is clean. She is pretty good at cleaning herself after she goes to the bathroom, but if she is looking a little dirty, I clean her with a baby wipe. She also takes a daily vitamin C pill because her urine had a low acidic level. Vitamin C has really helped prevent UTI's for her.

I hope Bailey doesn't have any more issues, but if she starts having frequent UTI's again, I will take her to a specialist to find out if surgery will help her.

 

[Sumac3890]

Wow this post has really touched me. I wish I had known about this surgery with my Katie. Maybe if she had this surgery she would still be with me today. She was born a hermaphrodite and had reconstructive surgery at 8 weeks and at a year old kept getting bacteria in her urine that in turn caused crystals and was on antibiotics all her life. Which I feel led her immune system to not be as strong and then the cancer came.
I am so glad for you that you found a soloution and don't have to keep her on antibiotics. Sorry for the rambling.

 

[DebbieGilbert]

My worst nightmare was that if we could no longer treat the bladder infections, the bacteria would travel higher up into the urinary tract and cause kidney damage. I believe the episioplasty was not a "cosmetic" surgery but a potentially life-saving procedure.

Each time Daisy got a UTI, we would do a culture and find weird types of bacteria that normally don't live in the urinary tract. The specialist told me what was happening is that when Daisy squatted down to pee, sometimes the urine would splash up, hit the vulva and get trapped. So basically, dirt from the ground was getting up inside her. Not a good situation.

Even though the surgery seems to have fixed her problem, I still sprinkle a little bit of Cranberry Relief powder on her food every night to try to keep the urinary tract healthy.

Oh, by the way, the vet also did say Daisy has a "juvenile" vulva, which you can't really enlarge through surgery. But the UTIs were caused by the extra skin folds, not by the small size of the vulva. I don't think size is a problem if you aren't planning to use the dog for breeding.