Health ? Idiopathic Renal Hematuria (after e.coli) - Page 1

Ok, health-savvy folks. My friend's 4.5 month old puppy had a UTI, e.coli was to blame, it wasn't diagnosed properly right off the bat (no culture was done until my friend really pushed at a different vet, after first vet said there was no infection and he had bloody urine for some other reason), and it lingered. The pup has gone through 2 courses of antibiotics (different drugs- I believe amoxy first, ceph second) and they thought he was on the mend. Then, halfway into the 2nd course of abx, he started again having obvious blood in his urine. Vet recommended internal medicine specialist who ran more tests which came back normal for breed and age, mostly, and an ultrasound. Specialist says it's Idiopathic Renal Hematuria, which to me, just sounds like they're admitting they haven't a clue why this is happening. That's basically a diagnosis of exclusion, unless I'm mistaken. 

Can lingering e.coli in a young pup damage tubules or kidneys/lining/whatever and cause inflammation that might lead to this problem while the kidneys appear ok? The only thing he noted was that maybe their color seemed "off" but he saw nothing concerning about their structure, size, shape, etc., so genetic or congenital causes are apparently ruled out. 

I'm not a vet, but the puppy had a bad infection, it wasn't treated properly at first, and now this. It just doesn't seem like coincidence to me...can anyone shed some light on this? Hexe, maybe? 

Infections can certainly cause damage, & did you say he was on Keflex? Administering Keflex to dogs is an off label use. Keflex has had many troubling side effects, & although it's used, it's not generally recommended. Side effects can include seizures and although I couldn't find any renal side effects in dogs it is excreted in the urine, mostly unchanged, so while that means it is very good for UTIs it also puts renal structures in jeopardy especially if the pup is dehydrated.

Probably both the infection & the med contributed to this. I might consider taking the pup to an unrelated veterinarian ( to the previous vets) for an eval, & keep the puppy well hydrated.

Sad that this happened. Good luck to your friend! 

jackie harris

Thank you, Jackie. 

Is Jackie the only one here that can help? I swear, every time I post something, no one responds. I'm starting to get a complex. 

E. coli can damage the kidneys:

E. coli (Escherichia coli) is the name of a germ, or bacterium, that lives in the digestive tracts of humans and animals.

There are many types of E. coli, and most of them are harmless. But some can cause bloody diarrhea. Some strains of E. coli bacteria (such as a strain called O157:H7) may also cause severe anemia or kidney failure, which can lead to death.

Other strains of E. coli can cause urinary tract infections or other infections.

And of course, bloody urine is a symptom of a UTI. It's possible the strain the dog has is resistant to the antibiotics. I would get the dog to another vet, or ask the current vet to do a culture on the urine. Bloody urine is most likely a bladder infection, not kidney problems. Damage to the kidneys would cause reduced urinary output.

SS, thank you for answering. Not to appear ungrateful, because I do appreciate you posting, but if you read my post, you'll see we're way past the copy/paste about e.coli and what symptoms kidney damage vs. bladder damage would have. All the regular stuff plus ultrasound has been done to figure this out. Cultures, urinalysis, repeats of both, full blood work-ups and repeats of them.....  I know exactly what e.coli is, what it can do, etc. and my question is whether it can actually damage the structure of any of the organs or tissues, tubules, etc. in the excretory system to where damage could be seen, OR, if it could still be to blame for the blood despite everything "looking" normal. My guess is yes...but I'm not a vet so shockingly, vets don't really care what I think. 

Just got up here on the west coast... 

Not only can it still be the e.coli causing problems, but the antibiotics themselves may be an aggravating factor.  I would put the pup on probiotics and use some alternative treatments along with urinary tract support supplements.  There are several different options.  Colloidal silver, herbs, homeopathy, essential oils.  I would personally use a combination of treatments.  Are there any other symptoms besides the hematuria? 

It is ridiculous to give a diagnosis of idiopathic renal hematuria when there was an underlying cause.  This is why I treat most of my dogs' ailments at home without a vet.  What a waste of money for your friend.  

Something I'm not seeing in your posts.

There were cultures done, what was the results of them?  If there was anything found, did they do a sensitivity screening to identify what drugs would work on it?  It takes up to two weeks for those results to come back and many vets and drs skip it and just use broad based antibiotics.

Jenni, wow!

Good luck! I'm way out of my depth here... :(  Hope Hexe will check in with suggestions. I DO know E. coli can be very resistant to antibiotics, because of the excessive use of them on livestock.

Kidney damage SHOULD be obvious by testing the blood and urine. Certain markers like creatinine, protein, etc. would be diagnostic.

Thanks for the replies. 

I was somewhat deliberately vague because I am going to try to show this to my friend and I didn't want it to appear I'd led you all to my way of thinking. From Day 1, I suggested good probiotics, because the pup was being treated for coccidia b/c littermates had it. He never got sick, until, while on albon, he was switched to a raw diet (which of course I love, BUT I don't do that when they're on abx, esp. when they're little and esp. not without probiotics also) w/no probiotics. He started having blood in his urine shortly thereafter and the first vet did a urinalysis and said there was nothing there. 

They called me and I said there is no way to know w/a urinalysis alone what could be in there and to go back or go to a different vet. Blood in puppy urine is usually UTI. Puppy also acted a little quieter than normal but not markedly so. Pup was put on Amoxy. I stressed the importance of probiotics, told them to get him off of raw UNTIL this quiets down, especially if they are not going to put him probiotics (he'd decided not to but didn't tell me that; he thought it would be too much all at once).

Second vet does an actual culture and calls and says e.coli and to recheck bloodwork and culture after the course of Amoxy is over. Bloodwork was better, no more blood in urine. Then pup goes back for a recheck a couple weeks later and there are again/still e.coli in urine, so I *think* they put him on cephalexin (trying to verify this). Halfway through that course, he starts having very obvious bloody urine, not traces, but very very bloody urine that no one could miss. Pup acts like he feels fine. I don't think they have EVER done a 2 week culture. 

Almost 2 months ago I suggested Standard Process Renal Support as a good supplement since we're not getting a good answer and the repeated courses of abx aren't ideal (I got a dog 3 more happy years who was in SEVERE renal failure with this stuff). I thought he'd been on it a month or so, then today found out again, owner had not given it to him, thinking it was "too much all at once" or whatever. The poor pup has been on abx now most of his short life and that is not helping his immune system mature, imho. I'm getting frustrated because very well-meaning owner is frustrated w/vet answers, yet asks me what I think and also dismisses my suggestions. 

Yesterday, ultrasound was done of bladder and kidneys and structurally everything looked good. Internal medicine specialist vet said only thing "off" is color of kidneys on sonogram but did not think it significant. Soooo...my question is if there is not a genetic or congenital issue w/this pup, could e.coli damage the kidneys and make their color appear "off" on a sonogram? Or, could medication do that? I am not an ultrasound specialist. Hell, I'm not a vet at all. LOL

The poor people and poor pup (who feels fine and doesn't know why everyone bothers him all the time)....I hate non-diagnosis diagnoses! 

This I why I am AGAINST raw feeding! With the way meat is raised and slaughtered in this country, contamination with E. coli is almost inevitable, and young animals often don't have a mature enough immune system to fight it off!  :(  Many antibiotics knock out the immune system, leaving the dog open for any other bugs that come along. I had a female with a chronic bacterial infection in her spine, due to spondylitis and reduced blood flow, and I was constantly monitoring her temp. for flareups. When she did spike a temp, i MADE SURE the antibiotic she was put on was one of the ones that does NOT knock the immune system down. I can't remember which ones do and which don't. That was a long time ago, and I am sure a lot of new drugs have come along since then anyway.

My suggestion would be to do a c&s on the urine to find the right antibiotic, then give it with probiotics. E. coli is a tough bug to knock out.  I really haven't a CLUE about the ultrasound. You can't see colour on ultrasound sonograms, AFAIK, so I have no CLUE what the vet meant! You can see if the kidney is enlarged or malformed in some way, and if the urine is flowing through it properly.

Have they done blood and urine tests to check for kidney damage? I'm not clear on that. As I stated before, E. coli can damage the kidneys, and the only sure way to check for damage is to test the blood and urine for things like protein, urea, nitrates, creatinine, etc. I need to look it up, but I don't think kidney damage results in bloody urine. That is diagnostic of a UTI.

Edit: Okay, certain kidney problems can cause bloody urine. Number one is cancer of the kidney or various benign kidney neoplasms. Blood in the urine is considerd a huge red flag, and should be treated PROMPTLY.