Possible Uti Or Crystals

[NeylasMom]

I'm waiting for my vet to call me back, but thought I'd get the necessary GT input in the meantime. Last week Neyla had a few accidents overnight, not all in succession, but within a couple of days of each other. They were full pees, not small amounts. I also noticed that her urine volume was a bit high and concentration was diluted when she'd do her first pee of the day, but later pees are concentrated so no concern for the kidneys here. I considered doing a urinalysis, but recognized that I had recently increased her food. Since we feed raw, increased food = increased water intake so I chalked it up to that (it's probably not the first time that's happened).

 

We saw our vet for her toe issue on Thursday when I didn't mention any of this, then go figure the next day, on our walk, she starts squatting to pee every 10 steps. Mostly she's just straining and a few drops are coming out. She did this for the last 20 min or so of our walk, we went inside and that was that - she hasn't done it since. One thing to note - she has done this behavior twice before. Once was quite some time ago, at the dog park - I posted here, people thought it was marking (I thought it was strange b/c she's never done it in the years I've had her), urinalysis was negative. Then she did it again maybe a couple of months ago. That day, we had walked to the dog park. She started doing it as we were leaving the dog park and continued to do it the full 25 min walk back, but never did it again.

 

Anyway, after the straining behavior this time, I decided to take a free catch sample in after that and it was negative although there was a small amount of blood in her urine. My vet suggested a sterile urine culture to be on the safe side so I took her to a closer vet who sees some of my fosters. She didn't have a full bladder and had a lot of gas in her tummy so he didn't want to do the culture. He suggested doing an x-ray to look for crystals and the urine culture when the gas is gone or at least a culture of a free catch.

 

Like I said, I'm waiting to hear from my vet. I think it's probably all nothing, but he said it's possible she's got a crystal in there that sometimes causes irritation and sometimes doesn't (the far apart straining incidents) and that irritation from a crystal would explain the blood.

 

Thoughts on this? I'm not sure her gas is going anywhere (it's from some new chinese herbs we're trying for her toe) so I'm leaning toward the culture of a free catch urine sample (I do know the downsides to that) and maybe the x-ray.

 

Oh my girlie, always a weird dog, nothing can ever present simply with her.

 

 

[Batmom]

Blood in urine is not something to be ignored, ever. If she doesn't have a history of UTIs, I'd probably start her on a likely antibiotic and see if that fixes things for this go-round.

 

Vets are annoying about culturing free catches, aren't they? Even mine are . A culture is a wonderful thing when there is a history of repeated UTIs, or a UTI that doesn't respond to a course of reasonable treatment, but I personally don't feel it's necessary when there isn't that background.

 

If you're looking for things, ultrasound might be of more use than x-ray.

[MaryJane]

Before she goes out in the AM, I would clean her with some antibiotic solution and they try and get an early morning free-catch sample for a culture. When the sample goes to the lab for culture, ask the vet if they can make a notation to spend a little more time on the sample to see if there are crystal fragments - sometimes you can see them but it takes longer on the examination. If the lab tech sees crystals, then you have your proof on what is causing this.

 

It would be interesting to see if there are also white cells in the urine in addition to the red, if so, then there is a likely irritation or infection. In your case, I probably wouldn't start any antibiotic yet until you get an answer on the urine. But, please be aware that I tend to be very, very conservative on antibiotics.

[NeylasMom]

Thanks, both of your responses are really helpful.

 

MaryJane - I don't think there were any WBC in her urine. The report is in my car so I can't tell you for certain, but since both Dr. Rhody and my vet said it was negative aside from the small amt of blood, I assume there were no WBCs. I will double-check though. I like the idea of getting as clean a sample as I can and doing the culture that way and to ask them to look for crystals (had no idea that was an option).

 

Batmom, the reason I'm hesitant to just do ABs is because she's on these chinese herbs for her toe that are already upsetting her stomach. We have a lot going on with that right now and I don't want to throw something else into the mix unless I'm sure she needs it. Normally I wouldn't be opposed to it although I would of course prefer some additional "evidence", if for no other reason than to have something to check against post-AB to make sure they cleared up the problem, if that makes sense.

[Guest Alexandra_W]

Looking for crystals would be an indicator for were to continue the search. But the test can be misguiding, they can have some crystals without any problems, and the sample can show only some crystals, but crystals still are the problem.

 

Blood in the urine is a common sigh with crystals, and if there is crystal in the urine, I should go on with X-rays. As he has shown some sympthoms and discomfort.

 

(My boy had some crystals in the urine recently, was checked visually (in microscope I guess), and just noted down, as he has no symptoms of 'trouble' from that region at all. But if he ever gets some, they will do an X-ray no matter what the symptoms are (ie WBC, blood, straining or whatever), to check that it isn't stones.

[MaryJane]

Thanks, both of your responses are really helpful.

 

MaryJane - I don't think there were any WBC in her urine. The report is in my car so I can't tell you for certain, but since both Dr. Rhody and my vet said it was negative aside from the small amt of blood, I assume there were no WBCs. I will double-check though. I like the idea of getting as clean a sample as I can and doing the culture that way and to ask them to look for crystals (had no idea that was an option).

 

The lab people should already note whether they see crystals in the microscopic but, the check is pretty quick and if there are few crystals, they're likely to be missed unless the doctor notes that this is a possibility.

 

Also, some labs may consider a small amount of crystals normal and not report them unless the doctor specifies otherwise.

[NeylasMom]

I'm really late following up on this but finally grabbed the urinalysis results. Noting only the things listed that were not completely negative:

 

protein: + (choices are neg, trace, + - ++++)

Blood: Htr (neg, NHtr, Htr, + - +++)

Epith/hpf: 1-2 (none, 1-2, few, mod, marked)

Debris: slight (none, slight, mod, marked)

Bacteria: noted (noted, not noted)

 

WBC count is 0-5, which is the lowest choice aside from TNTC, which I assume means there was a problem with the sample (RBC was the same).

 

Neyla hasn't had any additional accidents and hasn't repeated the weird straining behavior since we ran the test. I haven't heard back from my vet either, I think the msg probably didn't get to her, but I haven't followed up b/c we have our appt with the orthopedist on Thursday so I figure we'll just have one big pow-wow about both afterward.

[NeylasMom]

***UPDATE AND ADDITIONAL QUESTIONS***

 

So I didn't do the urine culture back in March. By the time I heard from my vet, I was really strapped for cash until I got paid again and by the time I did, her symptoms were gone. So about a week ago or slightly more, she had a few accidents in the house again. I also noticed she was really dragging on walks, which isn't totally unexpected b/c she's got her toe issue, but it still seemed like more than usual so I thought if she had crystals that were reappearing again, she could be uncomfortable. Took in a free catch, but per my vet I didn't catch it until it had been flowing a bit.

 

My vet just called to say that nothing grew on the culture, but there were definitely crystals. She is recommending a cranberry supplement for now, and is consulting with the other vet about diet issues (I feed raw, which she isn't overly familiar with). She said no rush, but if the symptoms continue, we should do x-rays to check for stones. Otherwise, we can see if the symptoms go away and/or do a urinalysis to check for crystals in a while (although the crystals never showed up in the urinalyses).

 

My best guess is that she suffers from these periodically, and that they come and go so what my vet is suggesting (treat with cranberry for about 2 wks when symptoms start) makes some sense, but her symptoms are often subtle so I worry that she'll be uncomfortable without me knowing it. Also, finding accidents in the house is not the ideal way to find out they're back.

 

Any input or suggestions? I'm going to post to my rawfeeding list as well to see if there are any dietary changes in particular they'd recommend.

[MaryJane]

Protein was showing up the last time she had a urinalysis and even though it is a small amount, I would check that out further by getting some blood work done (specifically BUN and Creat for kidney function) and rechecking the urine for protein.

 

Check out the link below - it has some pretty good info. The first item (on the link) talks about some diets specifically for stones are low protein diets. Since there was protein in the urine, I would want to investigate this further.

 

One of the last items (on the link) talks about adding cranberry juice to the diet daily. I personally don't know of any adverse effects of adding cranberry juice but, I probably would not do 1/2 cup every day -- I would start with about 1/4 every other day or every 2nd day and see how she does on a weekly basis.

 

http://www.ehow.com/how_4500406_prevent-ca...s-crystals.html

[Guest Greensleeves]

I would look into getting an ultrasound of the bladder; if there are stones, they may be more visible than on an X-ray (it will also show other masses, like polyps or tumors). Jasmine just had surgery for bladder stones yesterday; they were DEFINITELY large enough to cause her discomfort, but too small too appear on an X-ray. But they showed up loud and clear on the U/S.

[NeylasMom]

Ack, i keep seeing mentions of surgery to remove bladder stones. I hope she doesn't need surgery!!! Do stones develop if crystals go untreated or are they sort of a separate entity?

[Batmom]

Your earlier urine sample showed bacteria. I'd treat her for an infection. Infections can cause crystals (and stones).

[MaryJane]

It looks like there may be a little vicious circle going on here -- excess protein can cause crystals/stones causing irritation which provides a growing area for bacteria. On the other hand, using bacteria as the starting point, that can cause kidney issues (if it moved upstream) which could be why protein is passing and possibly providing the components for crystals/stones.

 

There are three separate issues here but, they can all be interconnected. Responses on the thread differ in which they would tackle first -- maybe best thing is to tackle all -- get ultrasound, get urine culture, and get bloodwork for kidney values.....

 

 

[NeylasMom]

One note on protein in the urine - from my understanding, it's not uncommon to see trace or +1 amounts of protein in the urine in a raw fed dog. I'm still keeping it in mind of course since there are symptoms we're trying to sort out, but I'm less concerned about that. I'll see if I can find old urinalysis results to check protein levels in teh past.

 

Batmom, despite the noted comment, the vet who did that urinalysis told me it was negative. They do them in house so I'm wondering if it was negligible amounts or some type that isn't cause for concern regarding infection??? I don't understand why they would tell me it was negative otherwise. This wasn't my normal vet, but a vet we use for fosters, so I'll call them as well.

 

Thanks all for the suggestions, keep 'em coming.

 

ETA: I found two old urinalysis results, one of which was not during her normal annual exam (I'll have to check, but likely when she was having some symptoms) and protein is negative in both results. So I take what I said about not being overly concerned about that back. I'll call the other vet to ask about the bacteria noted, and then talk to my vet about how to proceed given all of this. FYI, I ordered some pH test strips yesterday so I can check her pH at home in case we are dealing wtih a crystal issue due to high pH..

Edited June 10, 2009 by NeylasMom

[Batmom]

Note that you can also see crystals if the sample has sat around for a bit before testing. The crystals are an artifact of the sample sitting around, not something that is in the urine and needs to be treated.

Edited June 10, 2009 by Batmom

[MaryJane]

ETA: I found two old urinalysis results, one of which was not during her normal annual exam (I'll have to check, but likely when she was having some symptoms) and protein is negative in both results. So I take what I said about not being overly concerned about that back. I'll call the other vet to ask about the bacteria noted, and then talk to my vet about how to proceed given all of this. FYI, I ordered some pH test strips yesterday so I can check her pH at home in case we are dealing wtih a crystal issue due to high pH..

 

 

If you are going to spend money on getting a test strip for PH, consider getting one that one that has protein, blood, and glucose on it too.

 

 

 

[GeorgeofNE]

George developed high ALT (I believe that's a liver enzyme??) when I tried a "natural herbal" supplement to calm him. It took a full month for the values to go back to normal after stopping them. I no longer give him anything like that.

 

I'd stop the Chinese herbs if it were my dog; just 'cause they're natural doesn't mean they don't have side effects!

 

There are two kinds of urine crystals; one kind shows up on x-ray, and the other doesn't. I'd be inclined to repeat the urinalysis before I paid for x-rays.

 

Good luck!!

[Guest SoulsMom]

Archie had the blood in his urine, but no crystals. Ultrasound showed polyps (which they thought were tumors) and surgery revealed some rather large bladder stones. They were hidden by the polyps and couldn't be seen on the 'sound. Why not go ahead and schedule one just to see?

 

From what understood when I went through it with Archie the crystals can be what has come off of the stones. Can be, but not always . . . .

[NeylasMom]

I'd stop the Chinese herbs if it were my dog; just 'cause they're natural doesn't mean they don't have side effects!

 

This is good to know. I'm pretty sure these problems were going on before we started the chinese herbs, but I'll keep it in mind. In fact, I think we started them right after the last urinalysis was run.

 

I think I need to talk to my vet about treating for a bacterial infection first, but I also want to find out what her urine pH is right now. MaryJane, sadly I didn't know those strips were an option and I've already ordered the basic ones that test pH for urine and saliva. Do you know of a specific brand that's good in case I need to get them? Certainly being able to check for protein too would be helpful. If they're not expensive, I may just go ahead and order them too, we'll see.

 

You know, I love my vet, but I really wonder what I'd do without GT to help me think of things to discuss with her. I'm actually wondering if she hasn't really reviewed the old urinalysis results recently b/c I'm questioning her suggested course of action.

[MaryJane]

 

Here is a generic that's about $15

 

http://biousa.com/multistix--chemstrip-gen...CFYZM5Qod1Eq9eg

 

Here is another one with different options... (I believe the "Chemstix" by Roche is the original one)

 

http://www.mohawkmedicalmall.com/Merchant2...p?parentCat=178

 

Years ago when I bought the protein stix (just the protein) from my local pharmacy -- 100 stix cost me $40.