[Genevieve's mom]

I've posted about Breezy for the past few months. The first problem was a UTI which I think she had when we picked her up from the breeder. We had to make an overnight stop on our way home and she had to pee every hour. Since it was dark outside, we couldn't tell if any pee was coming out or if she was just squatting due to an urge as opposed to a full bladder. A few days later, she began leaking urine when lying down. She's had diagnostic testing and our internal medicine vet ruled out ectopic ureter or ureters. This leaves the vet with only urinary sphincter mechanism incompetence (USMI) as a reason for the involuntary urination. USMI can happen in a female adult dog after spaying but that's not the case with Breezy. She's only 20 weeks old. The vet prescribed Proin which is used to tone her sphincter and it seems to have stopped the incontinence. My question - has anybody else experienced this with their puppy? If yes, once the puppy was old enough to be spayed (I've been told no spay til at least one heat/season AND at least one year old due to growth plate issues) did spaying cause the USMI to continue? Did the USMI go away after a heat/season?

Based on the diagnostics, it appears that this problem in our puppy is a congenital issue. I've contacted the breeder. What should I reasonably expect the breeder to do? We have over $4,000 in veterinary expenses so far.

Thank you for any advice.

 

[Tagrenine]

Congenital does not equal genetic. I’m glad you guys have come to diagnosis. I don’t know what would be reasonable to expect here. There is no surgery right now, just let her have a heat, which could fix it, and the literature suggests that it usually works.

 

[Prism Goldens]

I suspect this is going to be a 'goodness of her heart' scenario. ..
did breeder send you home w insurance opportunity? Did you use it? Did you sign up for the AKC free 30 days insurance?

 

[Genevieve's mom]

Congenital does not equal genetic. I’m glad you guys have come to diagnosis. I don’t know what would be reasonable to expect here. There is no surgery right now, just let her have a heat, which could fix it, and the literature suggests that it usually works.

Can you give me some direction on finding "the literature suggests that" letting her have a heat usually fixes the problem? I haven't come across that as yet but would be very happy if that corrects the leakage problem!!

I too am glad we have something figured out. Yes, I signed up with the same insurance company whose flyer came from the breeder but I received the same offer at my vet's office. Since the insurance required a comprehensive vet exam for coverage to start, I signed up within 24 hours of the vet exam. Had I signed up the day we picked up our puppy, they wouldn't have started the coverage until the exam was done anyway. Waiting periods were waived but since she had a UTI the day I took her to the vet - picked up the puppy on Friday in Southern Cal, vet appt on Monday in San Fran Bay Area - the insurance says 'not covered - pre-existing'.

Have either of you heard of USMI in a puppy? Or do you have any experience with USMI developing in an adult female after spay?

Thank you.

 

[Tagrenine]

Incontinence: Urethral Sphincter Mechanism Incompetence - DVSC

Urethral sphincter mechanism incompetence (USMI) is the most commonly diagnosed cause of urinary incontinence in adult dogs, and is second only to ectopic

dvsc.com

Canine Urethral Sphincter Mechanism Incompetence - WSAVA2006 - VIN

www.vin.com

This states around 50%. There’s a paper I want to buy but I will try to do that tonight

 

[Genevieve's mom]

Incontinence: Urethral Sphincter Mechanism Incompetence - DVSC

Urethral sphincter mechanism incompetence (USMI) is the most commonly diagnosed cause of urinary incontinence in adult dogs, and is second only to ectopic

dvsc.com

Canine Urethral Sphincter Mechanism Incompetence - WSAVA2006 - VIN

www.vin.com

This states around 50%. There’s a paper I want to buy but I will try to do that tonight

Thank you. I will check these out later tonight.

 

[Genevieve's mom]

Incontinence: Urethral Sphincter Mechanism Incompetence - DVSC

Urethral sphincter mechanism incompetence (USMI) is the most commonly diagnosed cause of urinary incontinence in adult dogs, and is second only to ectopic

dvsc.com

Thank you Tagrenine. I had read this article before but had forgotten. Yes, it says 50% of puppies with USMI resolve after their first heat.

I had not come across the VIN article but everything I've read is pretty similar when it comes to treatment.

Just an FYI - Not sure if this would matter, but the breeder sent an email towards the end of June offering to refund our fee. We accepted her offer but she has not returned our money.

We have pet insurance but they have stated they will not be paying on this issue as the puppy had a UTI the day our vet first examined her.

The urinalysis yesterday came back with bacteria - "unclear morphology" - and we are now awaiting the culture results.

We have an appt with Internal Medicine at UC Davis this week for possible further diagnostics.

Keeping our fingers crossed that her first heat will resolve everything but don't want to rely on this so we are hoping UCD can help.

 

[Genevieve's mom]

Incontinence: Urethral Sphincter Mechanism Incompetence - DVSC

Urethral sphincter mechanism incompetence (USMI) is the most commonly diagnosed cause of urinary incontinence in adult dogs, and is second only to ectopic

dvsc.com

Canine Urethral Sphincter Mechanism Incompetence - WSAVA2006 - VIN

www.vin.com

This states around 50%. There’s a paper I want to buy but I will try to do that tonight

The UTI has cleared up as the last UA culture was negative for bacteria - nothing grew - in spite of the "unclear morphology" regarding the bacteria they found.

We had our appointment at UC Davis with Internal Medicine yesterday. The team of Davis vets also came to the conclusion that Breezy has USMI. That was the conclusion of our local internist as well. They do not share the opinion that this will resolve with the first heat, or with maturity.. Further, they cautioned us about having her spayed which is likely to make the incontinence worse. We are continuing with Proin but with an increased dose of 25 mg twice a day instead of 12.5 mg twice a day. This is because she is still leaking urine from time to time. And she has gained a bit of weight since she has grown a bit from the initial dosing. She is a growing puppy.

I asked whether we should forget about spaying her when that time comes but they did not think that was a good solution. First, because of a risk of Pyometra, and second, because of the increased risk of mammary cancer. So, leaving her intact does not appear to be a good option in our situation.

They mentioned a surgical procedure that would involve placement of a "hydraulic urethral occluder" which would involve placing a "port" in Breezy to allow for changing the amount of pressure in the device. This device would be in her for the rest of her life and two thirds of dogs undergoing this procedure have improved continence but also have a complication rate of about 15%. This procedure can only be done once a dog has reached their full adult size. In Breezy's case, it would not be feasible for at least another year or more. I don't yet know the cost but have messaged the UC Davis vets for a rough estimate.

If anybody has had this procedure on their dog I would be very interested in the outcome.

Another treatment for this can be collagen injections but that would not help with USMI in a puppy. That is an option for an adult dog who develops USMI as a result of spaying.

I am constantly heartbroken over this puppy. She has no idea that she is peeing on herself. I know it's not her fault but the stress and the frustration are overwhelming. We have to take her outside nearly every hour. This is not a normal, healthy puppy. We do not want to return her to the breeder. Over the past few months we have grown very attached to her. We love her. Plus we are concerned that the breeder would have her euthanized as I don't believe this breeder would keep her as an "outside" dog. Dogs deserve to be part of their family - not confined to being in a yard or an outdoor kennel.

Our puppy was born with this "defect". What would a responsible breeder do in this situation?

 

[Genevieve's mom]

Just reread the dvsc.com article. They call the procedure an "artificial sphincter". I wish the article had a "published" date on it. I have no idea how old this article might be.