Yet Another Incontinence Thread

[DaisyDoodle]

In the last couple of weeks Daisy has had three incidences of full-bladder-voiding incontinence (which occurs while she's sleeping). She's had a regular UA done, which did not indicate a UTI but contained "abnormal" cells. She subsequently had a cystocentesis. All neg/normal except urine was not concentrated. However, urine always looks normal to slightly dark. Blood work today was normal, except low BUN. From talking with vet, I suspect this # is low because I have inadvertently kept the girls on a low protein food too long (didn't realize it was low protein).

 

My GP vet wants me to put Daisy on PPA (Proin) or DES. (My 15.5 yo mix, Lucky, has been on PPA for years, but she's not a sighthound.) He got online while I was still there and got feedback from other vets, including a neurologist. They said there might be a problem if a dog has high blood pressure, but that otherwise, the research doesn't seem to indicate a link to stroke or seizures with PPA. He agreed, however, that DES might be better for her, given what I told him about problems with greyhounds with PPA. After reading on GT about all the problems with PPA and that DES requires blood work--which I wasn't told about--I'm really hoping to find another solution.

 

First, I'm curious if there is anything else that I need to look into, diagnosis-wise. A couple of things that I've noticed is that Daisy's breath is really bad, and her gums are inflamed, even though she had a dental last summer when she had her toe amp. She has one slightly enlarged lymph node in her R jaw. Vet did an aspiration this morning. I'm waiting on the results. I asked the vet if I should start her on an antibiotic, but he didn't think it was necessary.

 

I told him I would do research here and with OSU before putting Daisy on any medication. I've already found several things here.

 

Some folks have mentioned milk as a treatment for incontinence. Could it be that conventional (non-organic &/or non-rbgh free) cows' milk contains enough estrogens from dosing the cows that it could have an effect on the incontinence? Daisy likes plain yogurt, so I'll try to increase the amount she gets every day for starters.

 

I also found a post from last March suggesting a grain-free diet. Considering Daisy's food allergy issues, this may be worth a try, in spite of the fact that Daisy has been on the same food for several months. She had been on a grain-free diet previously; so again, hopefully no drama in making this change. (Except I kept them on the other diet to keep Lucky's poops solid because she's 15.5 and has stool incontinence issues.)

 

I'm also going to contact my acupuncture vets to ask if acupuncture will help in Daisy's case, as it does help with Lucky's incontinence (though she dribbles rather than fully voiding).

 

Has anyone had any experience with DES? Any problems? I was told I shouldn't use it with Lucky because she has a large, benign, mammary tumor.

 

Thanks for any and all input.

 

DD

[Guest greybookends]

Some dogs have problems with Proin some don't. I don't think it is a breed issue. Sheana has been on it for many years without a single problem. Start with the lowest dosage possible and work your way up as needed.

 

Many people are allergic to penicillin. Most are not. you don't throw the baby out with the bathwater.

[greyhoundgang]

You're doing all the right things and asking good questions.

 

I'd definitely go to raw feeding if you can. If not, the grain free kibble is something to try.

I'd also consult with a holistic vet - AVHMA- has a list of them around the country. Acupunture can help in some cases. As can herbs, tinctures and homeopathic remedies.

 

One we offer is Azmira - Kidni Kare. However, you have to try different ones to see which will work for your dog and condition. they aren't expensive.

 

slippery elm is also good have around - make the gel - to help with tummy issues. Prozyme can be helpful too.

[Guest 2dogs4cats]

I am not clear on what the vet thinks the incontinence is a result of? You said the urine wasn't concentrating which makes me think possible kidney trouble? If it's kidney trouble, most likely the drugs won't help and will damage the kidney more. I would think you would need to find out why the incontinence is ocurring before deciding what treatment path to take.

[Batmom]

If they just did a strip test on the urine, you may want to talk about doing some other tests. When the urine isn't concentrated, it can be hard to pick up things like protein, blood, evidence of bacteria on a strip. Would also want to know what the "abnormal" cells were.

[TwiggysMom]

I kind of hate posting this because people are going to think I am a crazy nature lady.

 

Had an older bounce foster who originally had been adopted somehow without being spayed. Our group had her spayed (along with all her other med work, dental, etc). She seemed to not have control of her bladder - voiding her bladder while in the process of jumping up on the couch, among other incidents).

 

A very experienced, long-term volunteer mentioned spay incontinence as a possible cause. I did a bunch of online reasearch (Okay, can't trust everything you read on the net, but...) I read enough anecdotal evidence of relief from this using corn silk tea (get a bunch of corn silk, boil it up good, and use a couple tablespoons per meal). I figured it couldn't hurt, and tried it.

 

Can you believe, that from the time I started using this, she never had another accident? It certainly could have been pure coincidence, but I really do believe this helped.

 

This time of year, corn silk isn't readily available (it was summer when I tried it, and the market didn't charge me anything for the bag-full of corn silk I took); but you can buy it in tea form online and from some ethnic markets (esp hispanic).

 

Crazy lady tirade over

 

(edited b/c oh, for crying out loud, I really can't type!)

Edited February 23, 2011 by TwiggysMom

[DaisyDoodle]

I am not clear on what the vet thinks the incontinence is a result of? You said the urine wasn't concentrating which makes me think possible kidney trouble? If it's kidney trouble, most likely the drugs won't help and will damage the kidney more. I would think you would need to find out why the incontinence is ocurring before deciding what treatment path to take.

 

I assume because the blood work was essentially normal that the vet wasn't worried about the concentration. I must admit, though, that I have the feeling that there's something else going on. At the very least, I felt it was sort of a cavalier response to just put her on PPA or DES for the foreseeable future.

 

Lucky has had both Cushings and Addisons and pee accidents and urine that doesn't concentrate were two of the signs, but there were several elements of blood work that were off with those adrenal conditions. Beside, when Lucky's urine didn't concentrate, it practically looked like water; while Daisy's looks normal or even a bit dark to me.

 

Since Daisy has an enlarged lymph node and since my first GH, CoCo, had lymphoma, I'm feeling a tad neurotic to call this "just incontinence".

 

I'm leaning toward food sensitivity at this point, along with Daisy eating the shrubs in the yard when DH forgets to muzzle her. (Azaleas are supposed to be toxic.)

 

Thanks to everyone for their input. Right now, living in two places so it's not really practical to feed raw, but I may consider it down the road. I have read about the corn silk thing, but not in detail, so I need to do more homework on that first.

 

DD

 

ETA Not sure how elaborate the first UA was, but the junior vet looked under a microscope to note abnormal cells. The cystocentesis was a urine draw directly from the bladder and there were no abnormal cells noted in that sample. I assume the abnormal cells were some sort of gunk in the container or a leaf that fell into the container as Daisy tinkled by a bush when I collected the sample.

Edited February 23, 2011 by DaisyDoodle

[Batmom]

Swollen lymph node + funky color + relatively sudden onset could be an infection. I'd probably give a 10-14 day course of antibiotics (Clavamox, Baytril) before anything else ......

[4My2Greys]

I'm not sure if your referring to something I posted, but Nadir was troubled with incontinence daily, which included full bladder voiding while he was even lying down, back in late 2008 through about Mar-Apr 2009. Several UA's showed blood and as the vet put it, a lot of junk, in his urine. During this time he was on Baytril for 6 wks and Clindamycin for 9 wks with little improvement. I decided to try home-cooking for him after the vet suggested putting him on Prescription Science diet. I switched from a Lamb & Rice kibble to preparing ground beef & rice. Unknowingly I was continuing to feed him the very food that was the source of his problem, rice. When I switched him and my others to a grain-free or more importantly a rice free food his problem quickly resolved itself. It also cleared up my bulldog's constant ear infections. I've been feeding TOTW Pacific Stream with very good results. I did raw feed, which I do prefer, for about a year and a half, but unfortunately it got to costly. I would definitely try a diet change before resorting to something like Proin.

It's also interesting to read someone's experience with using cornsilk. I've read that it is an excellent remedy for chronic inflammation in the urinary tract and is very safe to give. Another thing you might want to investigate is the use of D-Mannose in combination with cornsilk to eliminate a urinary tract infection.

[GeorgeofNE]

Swollen lymph node + funky color + relatively sudden onset could be an infection. I'd probably give a 10-14 day course of antibiotics (Clavamox, Baytril) before anything else ......

 

 

I agree.

 

Dilute urine is NOT dark. Dilute urine can be almost as clear as water, so this is a confusing combination. I would insist on a retest with first morning urine.

 

I would be concerned about "abnormal cells" too.

 

Did they suggest an ultrasound?

[DaisyDoodle]

There have already been two urine samples done, one that I caught in a container and a cystocentesis with a needle to draw urine directly from the bladder. The second is the one that said there was a concentration problem. From my visual inspection of her pee, I don't see any concentration problem, so I'm assuming this result was some sort of artifact of trying to keep her bladder full to get this test done. The first was analyzed in-house by my GP vet. The second was drawn by my acupuncture vet and sent to a lab--IDEX, if I recall correctly.

 

Stuff to add--Daisy is not straining to pee, but does seem to be going out a bit more. (But that may be from me being paranoid about her having another accident.) She is drinking a bit more than usual, but not a ridiculous amount like Lucky did when her Cushings started.

 

I have to ask if anyone checked the pH of her urine. I'm assuming both places did, but I didn't get word of that result, so I need to double check. I know some foods can cause problems with the pH balance of a dog's urine. She has also been drinking water at the in-laws lately, maybe that doesn't agree with her.

[DaisyDoodle]

Daisy has not had another incident of peeing in her sleep since before the cystocentesis. I have been giving her more yogurt and started to switch her back to her old food.

 

The aspirate came back as an infected salivary gland, so we start an antibiotic today.

 

We have an ultrasound scheduled for Tuesday, which, hopefully, will show nothing major, but perhaps give use a clue as to why the peeing in her sleep was occurring.

 

All in all, I'm glad I didn't start the PPA or DES. Unless this becomes a regular issue, I prefer to just wash a dog bed or two rather than put her on medication.

 

I guess if the ultrasound is negative, this is just going to remain a little mystery.

 

Thanks All,

 

DD