Harry's Medical Woes

[Guest Harry702]

For those of you who don't know, we're in the midst of trying to figure out if Harry's sudden denial of his housetraining routine is medical or not. Bringing you up to speed....

 

Over the past few weeks, Harry has had trouble "holding it" for his normal 8-9 hours while we're at work. This culminated in two days in the same week where he peed (a lot) in the house, once in front of DH as he walked through the front door upon arrival at home from work. Harry has been great at the whole housetraining bit until one fateful day in October when we left him for the day and both returned home later than usual... we just left him too long. Our fault, not his. These instances plus an accident on Christmas day that we chalked up to simply too much stress for him.

 

Outside, we've noticed that he'll often line up to pee, will lift his leg, but nothing comes out... he's always done this a bit, but it seems to happen a lot more frequently now. He's fine as long as we take him out every 5-6 hours or so. He just really seems to have trouble holding it the way he did only a few months ago.

 

Before coming home with us in April, Harry had some sort of urinary tract issue in his foster home. Our vet analyzed the info we got from his foster, and she suspects that he had incontinence related to urinary tract inflammation resulting from his neuter surgery.

 

After that rough week, we decided to take Harry in to the vet. Vet palpated his prostate and found no swelling or pain. She took a sample for a urinalysis, but explained that she thought it was likely behavioral based on his symptoms and her exam. She called later that night: urinalysis showed traces of blood in his urine. She wanted him back in for a urine culture... got those results last week: no infection.

 

So... Harry has an ultrasound scheduled for next Monday to check for bladder or kidney stones. Assuming all goes well with that, the vet wants to rule out medical issues and start focusing on a potential behavioral problems.

 

My question (finally!) is this: Are there any other medical issues that could cause these symptoms/behaviors? Any other tests or possible diagnoses we should bring up with the vet before putting the medical excuse to rest?

 

Just want to make sure we're covering as many bases as possible.

[Burpdog]

Several greys have responded to antibiotics even though nothing showed in the cultures. I call it one of the greyhound mysteries....

 

Sending prayers.

[Trudy]

Have you noticed if he's drinking more water while you are away and that could be why he can't make it the full day anymore?

[SPDoggie]

I was gonna say the same thing as Trudy.

[grey14me]

Several greys have responded to antibiotics even though nothing showed in the cultures. I call it one of the greyhound mysteries....

 

Sending prayers.

 

I agree, and I'm surprised the vet didn't give antibiotics simply based on the blood in the urine. It can't hurt to try the antibios...

[MandysMom]

I know Mandy is a female, so she's a little different, but we started having intermittent issues where she started having difficulty sleeping through the night, I had her checked for a UTI. We did several rounds of low level antibiotics and it would clear up for a month or two, then start back up. I finally got pretty insistent, we went on a course of Baytril ($$$$$$ and obvious stomach upset, but it really helped.) The vet told me that her urine was exceptionally alkaline, which was probably irritating her system. We started giving her a cranberry pill every evening (I just get the regular human ones at Walmart). She has not had a problem since. I had also asked a holistic vet, who agreed that even if it didn't help, it wouldn't hurt. The $6.00 I spend every two months on the cranberry pills is probably the best money I spend.

 

Not sure if it will help Harry...

[Guest EnzaFerrari]

I was going to ask about the water. I've noticed that since the heater started running more, Enza drinks a lot more...a lot more.

 

I've also heard that some food makes the pups drink more too - did you switch?

 

Course add in the lifting to pee and nothing...I got nothing on that one.

 

**hugs to Harry**

[CaliforniaGreys]

I was gonna say the same thing as Trudy.

This would have been my first question as well.

If they did a UA and grew a culture, and no bacteria grew, I guess I would ask about a course of antibiotics as well. Although I'm not sure how the vet would gage which antibiotic to use. I know Baytril is expensive, but it would be my first choice.

Please let us know how you make out

[Guest Harry702]

I'm not sure how to answer about the water... I know for sure that he drank a lot of water all at once on Christmas day just before "the incident." I was making a recipe with chicken broth and had a few ounces left over so I dumped them into his water bowl with some water as a treat. He slurped that down like he'd never see another drop... sure enough, about 40 minutes later, DH walked into the living room to see a very desperate looking Harry lifting a leg on the shoe bench.

 

The heat/dry weather issue is a good point... we've noticed that Harry will get spastic about his water bowl every now and a again. Most of the time he hardly drinks, but every once and a while he'll go crazy when we put a fresh bowl down and drink the sucker in one visit. Now that you mention it, this did start happening in November or so...

 

Still doesn't 100% explain the two incidents in one week recently. After the Christmas incident, we started to be more careful about how much water we gave him at once... trying to give him plenty of water without giving him the opportunity (or the need) to drink a day's worth of water all a once.

 

Regardless, I'm thinking we'll suggest a course of antibiotics as a "just in case" measure when we see the vet on Monday. The weather might just be drying him out. He's gone about two weeks now with no accidents, but we've been trying not to ask him to hold it for as long as usual, either.

 

Thanks for the suggestions and keep them coming.

[Guest Javagirl]

I am reaching into my not so extensive GT memory and I seem to remember the infamous George having "unruly pee" issues in March of last year. I specifically remember the cranberry pills being a positive factor. Maybe George's mom could help you or you could search out those threads. I'm pretty sure that she had success in getting him back to his former self.

 

Hugs to Harry, hang in there little man (and Katie and Andrew)!

Kristyn and Ladd

 

ETA: Her SN is 'JumpinGeorge'

Edited January 21, 2009 by Javagirl

[Guest SoulsMom]

Well, really no thoughts on what to ask the vet but here is what I went through with Archie (non-grey):

 

I once had to go out of town and didn't want to kennel him (I was living in a new city). So I hired a pet sitter. Archie is very fearful of strangers, but they got along ok when they met. Alas, he wouldn't let her take him out that first day, and he never relieved himself in the apt either

 

Fast forward to a few months later. Archie and I had moved and I was out of work so home with him all day. Thus, I didn't notice any urgent need to "go" because we were always on a walk. But one day there was a drop of blood in his urine. His sample came back clean so we went for the ultrasound. His bladder was full of "masses". Initial dx was cancer. He had surgery and when they got in there it turned out to be polyps caused by bladder stones(which were not visible on the ultrasound). Caused by him "holding" it for so long . . . .Archie had a third of his bladder removed, along with the stones and has been fine ever since.

 

So, just something to think about. Your statement about getting home late in October and the urine coming back clean reminded me of what Archie went through.

 

ETA: he did have some "leakage" issues for about a year until his bladder got stronger though. Poor guy, he would never even no it was happening and would seem so upset by it

Edited January 22, 2009 by SoulsMom

[greyhead]

Our Shane started having the same problem, having accidents, leaking, being unable to go more than 4-5 hours without an out. No infection, so the vet proposed to consider it an aging issue -- he was 5 years old!! -- and put him on lifelong medication for that. Further blood testing showed mild kidney disease. So I'd ask the vet to test his kidney values -- BUN and creatinine -- liver values, and take in a first-catch urine sample to check for specific gravity and protein. (The urine will be okay as long as it's refrigerated if you have a late-day appointment.)

[Guest LindsaySF]

It can't hurt to check for stones just in case, but I would put him on antibiotics anyway. Some UTI's go undetected but the dog recovers after some antibiotics.

 

Good luck!

 

[Beckylpa]

Our almost four year old male Sam is having similar problems. On December 4 he was no longer able to hold it four to five hours while I was at work. He started urinating in his crate twice a day. We are seeing a specialist on Feb. 3 to have an IVP done and maybe a neurological exam. He is a big water drinker so I have been limiting his water in the morning and at lunch time. Since I started this some days he has been able to hold it for three to four hours. The strange thing is that he can hold it all night, usually 9 hours. We have had numerous blood tests, urinalysis, and xrays done. He had two very serious infections since we got him in July 2008. He also "drips" urine regularly, like he has no idea it is happening. Proin and antibiotics didn't help with the dripping. I will be watching to see how things go for Harry and keeping my fingers crossed for him. My vet is questioning if Sam has ectopic ureter.

[Guest Harry702]

Well... just got a voicemail from Harry's vet. His ultrasound was completely clear, everything looks good, perfectly normal. It's his recommendation that we try addressing it as a behavioral issue before treating him for an infection that is not presenting in tests or in his symptoms. I agree with him... it could be a combination of a lot of factors (stress, more water than his usual, etc.), but I've had a sinking feeling that it was a behavioral problem from the beginning. DH and I be discussing a return to the crate while we're away tonight.

 

Don't get me wrong, I'm glad Harry is healthy, and of course I don't want him to be sick... but we've got some serious work ahead.

[NeylasMom]

I personally, because of his history, would treat prophylactically, preferably with Baytril. Get him on a stomach med, pepcid would prob be fine right off the bat to try to prevent an upset stomach as a side effect of the AB.

 

Also, has your vet done blood work to look at kidney values and has your vet considered both types of diabetes? The latter is not all that common but we've seen it. I remember a particular dog whose foster mom was suspicious. We thought it was just a UTI but lo and behold the dog had the less common type of diabetes. The only symptoms were excessive water drinking and having to pee as a result.

 

I know the arguments against treating with ABs when you don't have proof of an infection, but on the flip side, what if you start limiting water intake, crating so if he does have an accident it's on his bedding, etc. and he is really sick? IMO, you rule out the infection first and there is certainly evidence here that the culture could have missed an infection. George's mom is certainly the one to attest to the possibility of that.

 

Just my thoughts. I could see going either way here, and I know you trust your vet, but the risks of giving ABs are just not that great imo to not make it worth it to try them.

[greyhead]

I agree with Neyla's Mom. For one thing, blood in the urine is not a behavioral issue. For another, greyhounds are generally over-trained to refrain from having accidents. By "over-trained" I mean that by virtue of their early lives and strict kennel training, the training makes a bigger impression on them than simple house-training makes on other breeds. This makes it far less likely that they will express psychological discomfort by having accidents. There are plenty of other things they could do instead -- chewing things up, barking, growling, velcro-ing, etc., etc.

 

It's too easy to call something a behavioral issue when all that's going on is that the vet doesn't know what's going on.

 

Just by way of background, I've had one dog whose hookworms were missed due to negative fecals and whose symptoms were then misdiagnosed as due to "emotional problems." His symptoms of hypothyroidism (e.g., aggression) were similarly dismissed initially as excessive alpha behavior. Our other dog was mislabeled as "anxious" because of his reluctance to go very far on walks; turns out he had kidney problems and osteoarthritis in all his paws. I could go on and on.

 

Tests aren't infallible, and sometimes the right tests are not conducted. Even when they are conducted, the results can be misinterpreted (e.g., that a negative fecal means there are no worms).

 

This is not a rant against vets or tests. I respect both greatly. But I am a psychologist by training, and I've observed over the last several decades that our whole culture has encouraged us to see psychological problems where, in fact, the behavior has a physical basis. This is true regarding both animals and humans. So now when I see a behavior change, I keep looking until I find the physical basis for it, and there always has been a physical basis.

 

Good luck. Hopefully, if you keep talking to GT people, you'll get enough information about their experiences to be helpful in resolving this.

 

[Guest Harry702]

Thanks again for snapping me back to reality... I have a call into the vet about exploring other avenues before giving up on a potential medical issue. The more I think about it, the fact that he does this so inconsistently makes it hard for me to call it behavioral (he's been perfect since his bad week, now almost a month ago). We've been trying to be better about anticipating his needs, but it's not as though we constantly catch him sniffing the furniture looking to life a leg. I don't know... I keep going back and forth... but I know we owe it to Harry to make sure he really is feeling okay before we start treating him like he's doing something wrong.

[greyhead]

Thanks again for snapping me back to reality... I have a call into the vet about exploring other avenues before giving up on a potential medical issue. The more I think about it, the fact that he does this so inconsistently makes it hard for me to call it behavioral (he's been perfect since his bad week, now almost a month ago). We've been trying to be better about anticipating his needs, but it's not as though we constantly catch him sniffing the furniture looking to life a leg. I don't know... I keep going back and forth... but I know we owe it to Harry to make sure he really is feeling okay before we start treating him like he's doing something wrong.

There ya go!

[Guest EnzaFerrari]

I think I would treat it as if he had a UTI or some sort of infection, especially if he does not have a bad reaction to the medicine. I know when Enza had hookworms, the tests kept coming make as normal even though she was clearly sick. She lost 6 lbs in two weeks and had the Big D for a week. Our vet and I threw up our arms and treated her as if she had hookworms because those were her symptoms. Two fecal tests later, it came up as positive, but by then she was already half way through treatment.

 

I also know from experience with human UTIs, that if you are drinking more or not collecting at "just" the right moment, the bacteria may not show up.

[Guest Harry702]

Had a long phone conversation with Harry's vet. I just want to preface this by saying that she's been fabulous... she has analyzed Harry's previous medial history and a record of emails from his vet while in foster care. She explained that, back then, they were clearly dealing with a sick dog. The urinalysis presented with lots of blood and bacteria, and his prostate was inflamed... that, plus his consistent inability to hold it for more than a few hours, clearly indicated a UTI. He has none of those indications now (the blood in his urinalysis was trace... as in, one identifiable red blood cell). He's able to hold it, consistently, for over 6 hours. He's had no accidents in over three weeks. None of this indicates a medical issue.

 

I mentioned that the urine culture could be incorrect and she agreed that it's always possible. Apparently, when a culture gives a false negative, it is typically an e. coli infection that will present with diluted urine. Harry's urine is normal, bordering on concentrated. When I brought up Baytril she explained that she'd prefer not to go that route unless there was at least one identifiable symptom or behavior indicating infection. She said Baytril is their "big gun" antibiotic, and they don't like to hand it out unless it's absolutely indicated. She said we could try another, less virulent, antibiotic, but that she still thinks its best to have a solid indication that there's an infection. She said if he regresses at all, or if his behavior deteriorates... call back and we'll re-evaluate. I understand her stance, as a doctor, on this issue... she sees a lot more sick animals than I ever hope or plan to... no one wants their weapons to go away or become less effective.

 

She agrees that blood work is a good exhaustive measure. She explained that diabetes will typically present in a urinalysis as diluted urine with abnormally high glucose levels... Harry's urine is neither of these things. She's going to pull a blood sample and check, just to be sure. We'll hear from her tomorrow about that. Overall, I feel confident that she's really trying to help us make sure this isn't medical. Certainly, if he deteriorates, even a little bit, we'll be back on the phone with her. Poor pup. I can't wait to pick him up from the vet. I know he's probably not thrilled to be there.

 

Thanks for the concern and suggestions everyone. I really feel like we're trying to do the right thing for Harry.

 

I also know from experience with human UTIs, that if you are drinking more or not collecting at "just" the right moment, the bacteria may not show up.

 

Sadly, I have the same experience. I sympathize.

Edited January 26, 2009 by Harry702

[Guest LindsaySF]

I personally, because of his history, would treat prophylactically, preferably with Baytril. Get him on a stomach med, pepcid would prob be fine right off the bat to try to prevent an upset stomach as a side effect of the AB.

Agreed. Because he has a history of UTI's, I would suspect another one.

 

If the vet doesn't want to give antibiotics, then you can try the cranberry pills and see if that helps at all.

 

 

Also, has your vet done blood work to look at kidney values and has your vet considered both types of diabetes? The latter is not all that common but we've seen it. I remember a particular dog whose foster mom was suspicious. We thought it was just a UTI but lo and behold the dog had the less common type of diabetes. The only symptoms were excessive water drinking and having to pee as a result.

The other type of diabetes is Diabetes Insipidus. My dog Cody has it.

 

 

She explained that diabetes will typically present in a urinalysis as diluted urine with abnormally high glucose levels...

The high glucose levels is true of Diabetes Mellitus. Not true of Diabetes Insipidus. DI urine is very diluted, but otherwise normal. It doesn't sound like Harry has DI, but I just wanted to mention that.

 

 

Our almost four year old male Sam is having similar problems. On December 4 he was no longer able to hold it four to five hours while I was at work. He started urinating in his crate twice a day. We are seeing a specialist on Feb. 3 to have an IVP done and maybe a neurological exam. He is a big water drinker so I have been limiting his water in the morning and at lunch time. Since I started this some days he has been able to hold it for three to four hours. The strange thing is that he can hold it all night, usually 9 hours. We have had numerous blood tests, urinalysis, and xrays done. He had two very serious infections since we got him in July 2008. He also "drips" urine regularly, like he has no idea it is happening. Proin and antibiotics didn't help with the dripping. I will be watching to see how things go for Harry and keeping my fingers crossed for him. My vet is questioning if Sam has ectopic ureter.

Please talk to your vet about Diabetes Insipidus. The excessive water drinking and "dripping" are both classic signs of DI. If he does have DI, limiting his water intake can be extremely dangerous!

 

I have a dog with DI, if you want to chat you can email me at Lindsay@weadoptgreyhounds.org. (You don't have enough posts to send PM's yet).

 

 

 

 

~Lindsay~

 

[turbotaina]

She agrees that blood work is a good exhaustive measure. She explained that diabetes will typically present in a urinalysis as diluted urine with abnormally high glucose levels...

 

Just wanted to throw in that you'd be looking for diabetes insipidus, not diabetes mellitus, which rarely ever presents in dogs, but is common in cats. Diabetes insididus ("water diabetes") seems to be more common in greyhounds (common enough that the CRRG gives it several paragraphs). It's a diagnoses of exclusion, but normally you see tons of drinking, tons of peeing and a very low USG - urine just doesn't concentrate because the dog is drinking so much. You wouldn't be looking at glucose levels for DI.

 

At any rate, doesn't sound like that's the case here. I don't know if you've ever met Bentley, one of our adopted hounds, but he has it. I know of two other greyhounds adopted out by us that also have it.

 

ETA: Lindsay, you and I were on the same wave-length there

Edited January 26, 2009 by turbotaina

[NeylasMom]

He's fine as long as we take him out every 5-6 hours or so. He just really seems to have trouble holding it the way he did only a few months ago.

 

He's able to hold it, consistently, for over 6 hours. He's had no accidents in over three weeks. None of this indicates a medical issue.

 

I'm confused. Is he able to hold it for longer than 6 hours and has he not had any accidents since around Christmas? I understood from your first post that he was still having accidents if left for his usual amount of time. If he's truly been symptom free for 3+ weeks, then I would agree with your vet, but that wasn't the way it sounded to me especially since you mentioned taking steps to address it behaviorally. What is there to address if he isn't having any symptoms?

[Beckylpa]

I know this is not the place to post this but I am having some computer problems (and I mean the user, not the machine!). Lindsay from WAG I have a question for you about DI and I can't get my email to you. Sam's specific gravity was 1.015 on Dece. 11, 2008. How does that sound for an almost four year old male greyhound? You can email me at beckylpa@yahoo.com if you prefer. Thanks! Becky