Bacterial cystitis is one of the problems frequently encountered by veterinary practitioners. Urinary tract infections are quite common in dogs younger than 2 years and older than 6 years, reaching 50% in females over 10 years of age. Among cats, animals older than 10 years are more prone to bacterial cystitis.
The disease develops when pathogenic bacteria are able to attach and multiply in the urinary tract. Statistically, the most common bacterium causing bacterial cystitis is Escherichia coli, or E. coli.
E. coli was isolated in 44% of dogs and 67% of cats with urinary tract infection. Among cats, recurrent cystitis was observed in 15% of animals. In dogs, recurrence of urinary tract infections was reported in fewer than 10% of cases. Treatment requires the use of antibiotics, but the main problem with antibiotic use is the formation of resistant flora.
D-mannose is a simple monosaccharide and an isomer of glucose. It can be found in many fruits and berries. Mannose dissolves easily in water and has a slightly sweet taste. D-mannose helps improve the functional state of the urinary bladder.
The monosaccharide is a nutrient medium for bacteria, including E. coli, which often causes inflammatory processes. Bacteria have pili on their surface — special structures that make the bacterium motile and increase its ability to adhere and its pathogenicity.
With the help of pili, bacteria can move easily and attach to the wall of the urinary tract, triggering inflammation. D-mannose binds pili, causing bacteria to lose their pathogenic qualities. Thus, mannose helps prevent recurrence of bacterial cystitis.
At the same time, the monosaccharide does not suppress the growth of necessary beneficial microflora. Moreover, D-mannose supports the growth of beneficial lactic acid bacteria in the urogenital system.
The use of this monosaccharide is safe in patients with diabetes mellitus because it does not increase blood glucose levels. About 90% of the substance is excreted unchanged in the urine within 30–60 minutes after administration. No side effects from intake of this monosaccharide have been found.
The use of D-mannose may be considered not only in patients with recurrent cystitis, but also in sporadic cystitis and asymptomatic bacteriuria.
Functional supplements containing cranberry in addition to mannose may be useful as part of therapy for dogs with struvite urolithiasis, as they help achieve an optimal urine pH of less than 6.0.
However, a cranberry-containing product should not be used for patients following acidifying diets. Functional supplements with cranberry are not recommended for patients with urine pH below 6.5, oxalate crystalluria, oxalate urolithiasis or nephrolithiasis.
In such cases, products containing only D-mannose may be recommended. The dosage for cats and dogs is 0.5–1 gram per 10 kg of body weight twice daily. The duration of use and the required maintenance dose of the flavored supplement are determined by the veterinarian. Lifelong use of D-mannose is acceptable in recurrent complicated cystitis.