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Old 01-12-2012, 05:08 AM
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4.5 month old puppy - health issues - really at a loss!

Hi,

Thanks to those who posted to my previous post.

I thought I would start a new thread as I'm now really at a loss.

Dougal, 4.5 month old male, is weeing a lot! This has been going on probably since we got him at 9 weeks, but I put it down to housebreaking, puppy behaviour etc until a few weeks ago.

SYMPTOMS

1. Possibly always been there since we got him at 9 weeks, although we put it down to housebreaking/puppy behaviour.
2. Urinating up to every 10 mins. Proper amounts of wee, not dribbles/spots. He knows he's doing these and 99% of the time gets outside. Other times he usually knows and managed to get to the back door and I'm just not quite quick enough to let him out. Definite urgency to go!
3. No problems whilst asleep, either during the night (crated for 6/7 hours) or whilst asleep during the day.
4. Drinks a lot, but I'd not say it's excessive, but more than my other older dogs.

FEEDING
1. Was on CSJ kibble, (UK brand), I'm currently in the process of changing him onto Orijen.
2. He's constantly very hungry. Currently he's on 540g per day, split into 3 meals, but he'd definitely eat more, and looks fod food off my other dogs as he finished before they do!
3. Quite a bit of water with food.

TESTS/TREATMENT SO FAR

1. Antibiotics given at 12 weeks for ? UTI although this was a "ruling out" thing as we had aggression issues with him biting my DH and children (proper aggressive biting, not play biting/mouthing). This has now been overcome with training, dominance suppression etc).
2. Clavucill antibiotics for last 14 days for ? UTI. Also, I've increased water with food (for reasons below), cranberry capsule 1 per day, also Glucosamine for last 7 days on advice of vet.
3. Urinalysis done 14 days ago, showed leukocytes in vets office, but when sent to lab, no bacteria, no blood etc, but showed struvite crystals (in quite high numbers) and PH of 8.0. Vet prescribed Hills C/D but I said no, started the increased water with food, cranberry tablets and changing to Orijen to try to acidify the urine.
4. Urinalysis done 2 days ago. This time came back completely normal - no struvites, no bacteria, but PH of 8.0 still. Vet said PH is not a concern.
5. Response to antibiotics - he seemed much better after a week of antibiotics. He had improved so he was only weeing every 1 hour, I was just breathing a sigh of relief and then wham, the next day he was back to every 15 mins, then 10 mins the next day.

In himself this dog is fine, seems healthy etc. The problem is just the ridiculously frequent urination and the fact it seems to be getting worse as it's now a dribbling issue as well as proper wees!

My problem is, my vet is kinda jumping on any bandwagon he finds. He has always been fantastic with my older dogs, was great with my GR that we lost last year, who had throate cancer, heart problems, bad arthritis etc, and we got him over all of those things to live until nearly 14 a happy life.

But.......

When the struvites came up I was convinced there must be a bacterial UTI. I pushed and pushed to ensure the lab had cultured the urine and he said they had, but nothing found. He wasn't best pleased when I didn't want to use Hills C/D, and was happy to leave him for 6 weeks on the Hiills. I pushed for another week of antibiotics as I felt there was some improvement, and I have read all that I can about trying to get rid of the crystals another way. I also pushed for another urinalysis to check for bacteria.

So.....on Tuesday,. I took in a fresh urine sample 15 mins before the lab were due to collect. the following day they had the results showing no bacteria. My reaction was,"but have they definitely cultured it?" vet said "yes", I said "but I thought that it took several days to culture", vet said "not always". Incidentally, both samples have been free catch ones I've done. No suggestion yet of doing a sterile sample direct from his bladder. I know my vet wouldn't do this without anaesthetic anyway.

So........now I don't know where to go with this. There's obviously a problem, as this frequent urination isn't right. Vet said next stage is to have him in for the day and test for diabetes insipidus, and then if that shows nothing, to x-ray him to see if there are any anatomical abnormalities.

He won't x-ray without knocking him out, and so this is considered more invasive.

Am I going crazy here? I actually still believe he has a UTI, but that the lab haven't cultured the samples long enough to allow anything to grow. Does anyone else think this could be possible, or am I clutching at straws?

Obviously, if the diabetes tests turn out normal (am praying they do!), then obviously the next stage is x-ray at which stage I'll also request a sterile urine sample be sent to the lab.

Anyone else's thoughts would be very gratefully appreciated! DH thinks "a little knowledge is a dangerous thing" and thinks we should stop questioning the vets advice, but hey, 1 week after being told it was due to crystals without bacteria, and being prescribed Hills c/d which isn't appropriate for a 4 month old large breed puppy, we test again and there's no crystals at all! I'm so glad I did put my foot down on that score!

Thanks guys
Karen
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Old 01-12-2012, 05:25 AM
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Welcome to GRF! I don't have any advice...but go with your gut & someone here will help.

Good Luck! 4.5 months so many body changes...growing so fast...I'd be freaking out too! Tailer peed any time I peed for months! I had to time my pees so I could get him out first...that took some planning! .
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Old 01-12-2012, 07:23 AM
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lol. Tht's pretty funny!

Thanks v. much though!

Ah well, we'll just have to go through the motions to try and work out what his problem is......

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Old 01-12-2012, 07:34 AM
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How much water is he consuming each day?
You may want to gather that piece of the puzzle...measure every drop that goes in his water bowl and into his food....then subtract what is left at the end of the day.

It might be helpful to know if he is peeing because he has taken in "X" number of ounces (what goes in has gotta come out) or if it is a matter of lots of frequent peeing...
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Old 01-12-2012, 07:41 AM
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Hi,

I haven't yet measured this. I have a rough idea, but it's tricky as currently I have 1 water bowl which all 3 dogs and 3 cats drink from.

I will have to try to monitor this as best I can!

Thanks for the advice
Karen
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Old 01-12-2012, 07:45 AM
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I hope you can get this figured out. Maybe it is time to switch vets (since they should do a urine culture from a STERILE sample that should take a few days to get back from the lab) and they also should be able to xray without sedation for most dogs (unless the dog is unruly or aggressive, which I doubt is the case). Also, is there a vet school in the area?
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Old 01-12-2012, 08:14 AM
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Do you crate?
If so, consider crating for 3 days...and everytime he is out you pull up the waterbowl for all dogs...then back to his crate (where he has access to his water pail with the measured water).


Quote:
Originally Posted by Beacon View Post
Hi,

I haven't yet measured this. I have a rough idea, but it's tricky as currently I have 1 water bowl which all 3 dogs and 3 cats drink from.

I will have to try to monitor this as best I can!

Thanks for the advice
Karen
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Old 01-12-2012, 08:30 AM
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Quote:
SYMPTOMS

1. Possibly always been there since we got him at 9 weeks, although we put it down to housebreaking/puppy behaviour.
2. Urinating up to every 10 mins. Proper amounts of wee, not dribbles/spots. He knows he's doing these and 99% of the time gets outside. Other times he usually knows and managed to get to the back door and I'm just not quite quick enough to let him out. Definite urgency to go!
3. No problems whilst asleep, either during the night (crated for 6/7 hours) or whilst asleep during the day.
4. Drinks a lot, but I'd not say it's excessive, but more than my other older dogs.
^ Reading this, I'm thinking UTI and not too concerned...

The dog of crystals and high ph is concerning though. To me, the simplest answer is that the UTI is causing the high PH which is causing the crystals. Offering a lot of water should help prevent kidney stone, but geez. I guess I'm not sure why they aren't trying a different approach as far as the UTI.

As far as the urinalysis... they usually only take a day that I've experienced with our dogs. That part does not necessarily concern me too much. The free catch urine is surprising because my vet makes a big deal about that not being completely accurate. My dogs have never had to be put under anaesthetic for sterile samples. But I think they always said that there would be more bacteria with the free catch?

I really hope it's simply a UTI that's out of hand.

I think the other possibility is something isn't formed right. From what I remember when we discussed something similar for my Jacks when he kept getting UTI's is that something could be bent or formed improperly. Basically a spot where the bacteria junk gets caught up instead of being flushed out. They were discussing barium study type xrays or possibly an ultrasound... which obviously involves anaesthetic.

If your dog was just peeing or leaking indescriminately and there wasn't any sign of infection, I think there is another structural fault / condition which causes incontinence.

^ With our dog, I should say he was about 6 or 7 months old. The likelihood is he had a UTI that just never was efficiently wiped out. So he'd get better, we'd stop the meds, and he would relapse again. We wound up switching his food (to something with lower protein) and began supplementing with cranberry juice. He hasn't had a UTI in about two years, but I couldn't tell you whether it was simply we finally got rid fo that UTI or the change in diet and cranberry juice made a difference. He had crystals in his urine too, but I remember our vet not being too concerned about those.
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Old 01-12-2012, 08:58 AM
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You will get struvite crystals in urine with high(alkaline) pH. What I was taught in school, back in the dark ages, that the presence of crystals in and of it self, was not necessarily a problem. Bowdense, a member here, had issues with her pup with medullary wash out from pyschogenic water drinking. She had to limit his water intake... We do cystocentesis with a needle to get a sterile urine sample for culture. Usually takes several days to get results back. In a young dog, I would also be concerned about an anatomical issue as well. An ultrasound is very non invasive and we never sedate an animal unless it wants to eat us.
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Old 01-12-2012, 12:16 PM
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Thanks guys. I think you've all pretty much said what I was thinking. I'm convinced (rightly or wrongly) that there's a UTI that isn't being picked up for some reason, whether it's because it's not being cultured for long enough, or it's not a sterile sample, or whatever, but it just seems like the most likely culprit really!

My old dog, who frankly was the most placid chap ever, was always sedated for x-ray - I really don't know why because he would've let you chop his leg off without doing anything, but I just figured that was standard stuff really!

I don't know if anyone knows of any other reason the PH would be at 8.0 other than a bacterial infection? That seems to be the only "constant" with the urine. INcidentally, I asked the vet if they'd done a USG reading in either urinalysis, as my understanding is that the urine specific gravity reading is quite significant in diagnosign diabetic insipidus, but apparently they didnt' do USG readings......

Hmmm...........

Thanks guys. Will see how he gets on. My 2nd culprit would also be the anatomical deformity. The only thing is that he's fine whilst asleep, which you'd figure he'd be worse if he was asleep if it was something physical rather than a disease, if you know what I mean?
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