Pete Wedderburn
13th January 2020 - 3 min read

Coco has had more than her fair share of health problems, including severe digestive upsets, but she had been on a special low-fat diet which has successfully controlled this issue. For the last three years, she has suffered from repeated bouts of another problem: cystitis, with recurrent urinary tract infections.

White Bichon Frise

Signs Of Cystitis

  • Staying up all night
  • Not sleeping at all
  • Continually asking to go outside to pass urine
  • The following morning – blood in urine

These symptoms are often treated simply with antibiotics for a urinary tract infection which she responded well to.


Six months later, she had a second bout, with similar signs. This time, a more detailed investigation was carried out:

  • Collecting a urine sample for a full analysis
  • Taking x-ray pictures of her abdomen to check for unusual causes like stones in her bladder.


The x-rays were clear, but microscopic analysis of her urine showed that it contained tiny crystals known as calcium oxalate. These crystals are like tiny pieces of gravel in the bladder (they are known as “uroliths”, or bladder stones). It was likely that they had been irritating the bladder wall, making it vulnerable to bacterial infection.

Treatment with antibiotics had fixed the short term crisis, but to keep her healthy, we had to try to stop these crystals from developing.

Causes of Cystitis

Calcium oxalate uroliths develop in the bladder because of increased levels of calcium and oxalate. There are many causes of such increased levels in the urine, but the most significant factor being genetics.

There are also some dietary factors that lead to increased formation of calcium oxalate uroliths. If affected dogs are given special diets, with reduced levels of specific nutrients, they are less likely to have these crystals in their urine.

Cystitis Treatment

Ideally, Coco could have been put onto a standard low-crystal diet, but her situation was complicated, as she was already on a special diet. We managed to find a specially designed diet that we hoped would meet her requirements: a low-fat pet food with ingredients aimed at promoting urinary health.

Urinary Tract Infection

Two years passed and Coco had another episode, with the same classic signs as before.


Coco seemed normal when I examined her: a dog with cystitis often shows few signs of being unwell apart from their desire to pass urine frequently. I tested the urine sample in our practice laboratory, and this confirmed the diagnosis: the dip-stick test confirmed that it contained high levels of blood, protein, and white blood cells. Coco had a severe urinary tract infection. Coco was given immediate treatment with antibiotics, and although I knew this would almost certainly give her short term relief, I sent off her urine sample to a specialist veterinary laboratory for detailed analysis. 


The results were encouraging: there was no longer any sign of calcium oxalate crystals. Coco’s special diet was doing its job. This meant that it was likely that Coco had developed a simple bacterial infection of the bladder. This tends to be a simpler problem than crystal-related infections: a course of antibiotics is usually enough to cure the problem.

antibiotics in hand


To be certain that the antibiotics are effective, it’s important to find out the precise bacteria involved, and the laboratory was able to do this from the sample collected. They cultured a specific bacteria that are commonly associated with urinary infections, and their tests confirmed that it was sensitive to the antibiotic I had chosen for her. Some bacteria are resistant to some antibiotics, and that’s why it’s so important to have urine samples submitted for culture in cases like this.