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Blood From Penis - Not Responding To Meds *great Update*


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Guest MnMDogs

November 9 - Update- today he had his second FU ultrasound and it's normal. He had an ultrasound August 24 and it showed no change. So a thickened urethra with no known cause, but likely cancer. He has been on Piroxicam since July 17 and today he had a normal ultrasound.

 

The vet can't explain it, and he'll remain on Piroxoacam for a little while longer, but for now, we can safely assume he does not have cancer. To say we're ecstatic is an understatement!!!

 

I tried to post a pic but I can't... Suffice to say he's adorable and happy!

 

Since June 13, we've been in a bit of a vet visit hell. Macy is taken care of (with a giant incision, and hopefully a cleanly removed tumor). But Greg has us and the vets perplexed.

 

He's had random blood dripping from penis (not hematuria), when he gets excited. It's not responding to abx (Clavamox), and he had ultrasound and X-ray which showed nothing, his clotting times are normal. Here's a timeline of events, does anyone have any ideas? My vet suggested an internal med consult, but I'm not sure what another exam will show since nothing has shown any abnormalities so far.

 

Early June - Greg seemed particularly interested in licking his penis, and Macy in sniffing it. He had been holding urine for 12 hours despite dog door (storms), so we suspected UTI.

 

Mid June (about June 15) - we were noticing drops of bright red blood on the tile. It was Greg. The last time this happened, he was diagnosed with a bladder infections, so meds were prescribed (amox in error), and I dropped off a urine sample. The sample came back clean but we kept up the abx.

 

Within a few days there was no improvement, so the vet made a house call and examined him (also checked BP due to him having head tremors again). Everything was normal.

 

5 days later, blood was still dripping from his penis, only when excited, and only 3 - 5 drops at a time. Vet was concerned with tumor or stones, so we did U/S and X-ray on June 25. Both showed no evidence of cancer or stones. But a catheterization showed e-coli. Vet said that doesn't usually cause blood, but to keep on the Clavamox. At that time, we realized he was prescribed Amox, not Clavamox, so we changed and started Clavamox on July 2.

 

We thought things were clearing up, but we found 2- 3 more drops of blood on the tile yesterday :(.

 

Does anyone have any idea what might be happening? I am hesitant to move forward with an internal med consult since he's a stress case at the vet, and I really have no idea what another consult could show that all the tests didn't.

 

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Time for Dr Couto? Less stress for Greg, probably less money than an internal med consultant, and Dr Couto is the expert who's pretty much seen it all when it comes to greyhounds.

 

http://www.coutovetconsultants.com/

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Guest MnMDogs

Probably... ugh, I just want it to be fixed. I'll need to request all of Greg's records, but probably the best thing. Greg apparently has a strangely tapered urethra too... of course.

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Sheath infection or foreign body? Prostate issues? Urethra blockage? Tumor? Since ABs aren't fully clearing the problem, I would think about something physical that would need to be removed before it can heal. Something in his sheath or penis which would be difficult to see. You might need to sedate him to get a thorough physical exam.

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Sorry you're dealing with this, Carol. I second the consult with Couto. Or go ahead and do the specialist consult. A good specialist is worth his/her weight in gold and they very often find things that regular GP vets miss.

 

Sending you lots of good thoughts.


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Guest MnMDogs

Sheath infection or foreign body? Prostate issues? Urethra blockage? Tumor? Since ABs aren't fully clearing the problem, I would think about something physical that would need to be removed before it can heal. Something in his sheath or penis which would be difficult to see. You might need to sedate him to get a thorough physical exam.

Prostate normal, everything ruled out with exams and diagnostics so far. He had a pretty thorough exam on June 13 (before blood started, but sheath and prostate examined), US and xrays ruled out stones and tumors.

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Sheath infection or foreign body? Prostate issues? Urethra blockage? Tumor? Since ABs aren't fully clearing the problem, I would think about something physical that would need to be removed before it can heal. Something in his sheath or penis which would be difficult to see. You might need to sedate him to get a thorough physical exam.

Ask your vet to do a sheath flush. I went through the same thing and in the end, a new vet did a penis flush and all kinds of gunk came out. Hope it is something this easy for you.

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Guest MnMDogs

Sorry you're dealing with this, Carol. I second the consult with Couto. Or go ahead and do the specialist consult. A good specialist is worth his/her weight in gold and they very often find things that regular GP vets miss.

 

Sending you lots of good thoughts.

Thanks, Meredith. It's been a long 30 days or so... compounded with the fact I'm moving in under 4 weeks, and I'm just frustrated. I want this taken care of before I leave Ryan to hold to fort for a while.

Ask your vet to do a sheath flush. I went through the same thing and in the end, a new vet did a penis flush and all kinds of gunk came out. Hope it is something this easy for you.

Really??? Oh if it's this simple I will be ecstatic.

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Are you sure a foxtail didn't get "in there"? I don't know but I know they can get into a vagina because they had a picture of it in foxtail article I read. It too presented with abnormal bleeding. A sheath flush and thorough exam does sound like a good plan?

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Fuzzy had chronic sheath infections, and when he had an episode, sometimes he would drip blood. In the beginning that was how I knew the issue was back. Eventually, I would flush his sheath every week with warm water, and he was good, after that for three years. We were treating him with antibiotics for months before I switched internists and he came up with this solution.

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Thank you, Irene! Do you know what antibiotic worked? I've emailed my vet about the suggestion that it may be sheath related, I hope to hear back from her soon.

 

They did check for fox tails I believe. I'll also double check on that as well!

 

Just a question about the sheath infections - Greg's was examined on both June 13, and June 25... are they obvious?

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Thank you, Irene! Do you know what antibiotic worked? I've emailed my vet about the suggestion that it may be sheath related, I hope to hear back from her soon.

 

They did check for fox tails I believe. I'll also double check on that as well!

 

Just a question about the sheath infections - Greg's was examined on both June 13, and June 25... are they obvious?

Keflex was the last antibiotic we used. He took it for about a month to make sure that the infection was gone. From then on, we flushed his sheath every week. Our vet gave us a syringe, we cut the sharp tip off and just flushed with warm water.

Edited by Houndtime

Irene Ullmann w/Flying Odin in Lower Delaware
Angels Brandy, John E, American Idol, Paul, Fuzzy and Shine
Handcrafted Greyhound and Custom Clocks http://www.houndtime.com
Zoom Doggies-Racing Coats for Racing Greyhounds

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Any updates? Has his sheath been thoroughly examined with a scope? Foreign material deep in the sheath can't always be seen even with a sedated exam. Was the ultrasound done by your regular vet or a specialist? If your regular vet, are they experienced enough with ultrasound to be completely sure the prostate is normal?

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Any updates? Has his sheath been thoroughly examined with a scope? Foreign material deep in the sheath can't always be seen even with a sedated exam. Was the ultrasound done by your regular vet or a specialist? If your regular vet, are they experienced enough with ultrasound to be completely sure the prostate is normal?

We're bringing him in next week to see an internal med specialist. Thank you so much for asking these questions... I would post a pic of how the blood appears, but I am bad at re-sizing and a huge pic might be a bit much! It's just 1 - 3 drops when his penis is exposed. That's it, never more than a few drops a day, sometimes every other day.

 

The US was I think done my my regular vet (I was out of town), since Greg is terribly fearful and she knows him. But actually, I think the radiologist does all the review, so I would think he would be able to tell. Greg also had a manual prostate exam. But these are all questions I'll ask when he goes back in, and make sure they scope thoroughly.

My boys sheath infection was not found until he was tripping smegma(cheesy stuff). There was so much that it was restricting his ability to empty his bladder and the urine was just dribbling out when he was laying down.

Oh man, that's terrible! Will make sure it's thoroughly examined when we go back!

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:goodluck Hope all he needs is a good cleaning and he will be good as new.

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Aston had a bad sheath infection once that had no sheath-specific symptoms. He was peeing indoors, which was unusual for him.
The vet flushed his sheath and was rewarded with brown cheese. :( His penis was so inflamed, but he hadn't shown any signs of pain or being overly attentive, etc., and there was no visible discharge. I felt awful that he had been so stoic through what must have been so painful.

He was also prone to UTIs later in life, the last of which was caused by proteus mirabilis, oddball swarming bacteria that were difficult to find on culture, apparently. He just kept peeing indoors despite all behavioral items getting ruled out to the best of our ability, and he wasn't incontinent. I had to insist on yet another culture. Was a culture/sensitivity run recently on Greg's urine?

E. coli can, in my own personal experience, cause bleeding (in humans). I don't see how it couldn't in dogs? it still causes painful irritation of the urinary tract lining.

I hope Greg feels better soon. :grouphug Ongoing mystery issues can be wrenching. I'm thinking of you.

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Well, we just saw the internal med specialist today, the blood is definitely coming from his penis, not the sheath...it was fully examined. He has a swollen distal urethra, and just had ANOTHER traumatic catheterization today to scrape cells and spin them to send to a preferred pathologist. Apparently when this was done the first time, only urine was sent, and it wasn't sent to the pathologist that the specialist prefers. We should have results tomorrow.

 

The problem is, she had to use a 1 French (I think that was the unit) catheter once it hit the swollen portion of the uretha, not the 5, so we can't even move forward with an urethrascopy if we learn nothing from these cells.

 

Very frustrated, and just want to know what's going on.

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Aston had a bad sheath infection once that had no sheath-specific symptoms. He was peeing indoors, which was unusual for him.

The vet flushed his sheath and was rewarded with brown cheese. :( His penis was so inflamed, but he hadn't shown any signs of pain or being overly attentive, etc., and there was no visible discharge. I felt awful that he had been so stoic through what must have been so painful.

 

He was also prone to UTIs later in life, the last of which was caused by proteus mirabilis, oddball swarming bacteria that were difficult to find on culture, apparently. He just kept peeing indoors despite all behavioral items getting ruled out to the best of our ability, and he wasn't incontinent. I had to insist on yet another culture. Was a culture/sensitivity run recently on Greg's urine?

 

E. coli can, in my own personal experience, cause bleeding (in humans). I don't see how it couldn't in dogs? it still causes painful irritation of the urinary tract lining.

 

I hope Greg feels better soon. :grouphug Ongoing mystery issues can be wrenching. I'm thinking of you.

Hold the phone. Where was this information when I was banging my head on the wall over Zuri's drinking/peeing issues? ;) For the second time, the issues seem to have resolved after a course of Cephalexin despite a negative culture and no signs of infection on his U/A, but here we are months later and we ran blood work and a U/A just to be safe before putting him on an NSAID and everything is clean except he has blood in his urine. And now he's having accidents in his crate when I'm gone, but this seems more like his old SA has reared it's ugly head, but without a clear explanation. Weve seen a specialist who pretty much ruled everything out and said it was behavioral, but I don't think that explains the ABs seemingly helping, or the fact that there is now blood in his urine. I wonder if he could be experiencing something like what you're describing?

 

Did you eventually find the bacteria on culture? Was it just a matter of running multiple cultures? Were they free catch or sterile?

Edited by NeylasMom

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Proteus isn't hard to culture. For our dog, we needed to use Clavamox and Zeniquin together for several weeks to knock it out. But, the strain you have may be sensitive to different antibiotics.

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If it is Proteus mirabilis, it could possibly be a hospital acquired infection. My Lucy was running E.Coli UTIs when they were doing bladder draws and on the last one, they cultured Proteus and a 2nd bacteria. My first thought is that the procedure/equipment was not as clean as it should have been. Needless to say since then I have been getting her urine by free-catch.

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Guest MnMDogs

Well, the mystery continues . I've sent Dr. Couto an email hoping he has some insight.

 

Everything is completely normal except a swollen distal urethra. No evidence of cancer on cytology, but it apparently can't be ruled out.

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