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Jazzy is three years old and is peeing blood and straining to urinate repeatedly and often has blood in her urine. She has had several courses of antibiotics to no avail. She is eating and drinking normally but is urinating in the house which she never normally does. Please can you suggest a preventative solution as well as something to cure the cystitis . Thank you

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Having cystitis means that there is inflammation in the bladder which is causing the blood in the urine and straining to pee.  Here is an article about cystitis that goes over some of the causes:

https://vcahospitals.com/know-your-pet/cystitis-in-dogs

As mentioned, cystitis can be caused by a number of conditions such as bladder stones, a urinary tract infection (or some other source of inflammation in the bladder), a tumor or some other lesion inside the bladder itself.

Here is an article about bladder stones:

https://www.petmd.com/dog/centers/nutrition/bladder-stones-in-dogs-what-are-the-signs-treament

and here is an article about urinary tract infections:

https://www.mspca.org/angell_services/recurrent-canine-urinary-tract-infections/

If a urinary infection was already diagnosed and treated for with antibiotics, it means that there was a failure in the treatment.  This could be due to a number of reasons such as the incorrect antibiotic due to the resistance of the bacteria, the antibiotic not being used long enough, that the infection is not being reached by the antibiotics. As the article above mentions, it can also be due to a number of underlying diseases such as diabetes, kidney disease, or a number of other diseases that cause urinary tract infections to repeat.

For example, there could be a bladder stone that has bacteria within it and there could be a urinary tract infection and bladder stones at the same time.  There could also be another illness such as diabetes that causes there to be sugar in the urine which leads to leading to repeat urinary tract infections.

Unfortunately, when the first (or even second) treatment for these things does not work, there needs to be additional therapies and also tests performed to find the underlying cause that your veterinarian will be able to perform and find the underlying cause for this.  This could include sampling more urine and running a culture, performing x-rays or an ultrasound of the bladder, bloodwork to check the kidneys, or a number of other potential tests depending on what they find on their physical exam and from taking a detailed history.

Once there is an underlying disease has been found, only then can a prevention plan be put into place.  If it is bacterial in origin, there are preventative drugs containing cranberry that has been found to indicate it could be effective (https://pubag.nal.usda.gov/catalog/5183627) but the study size was quite small.  Also, if it is diabetes, then insulin would be the prevention, if it’s bladder stones, then removing the bladder stones, etc.

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