Irritated, Raw Vagina - Update Post Vet Visit #41

[NeylasMom]

Neosporin also has a spray-on version that might work more effectively in this application.

 

Did the vet consider a kidney infection rather than a UTI???

She didn't mention it. We're waiting on culture results though.

 

So far no more vomiting from the ABs. I'm cleaning with wipes after pottying and doing Neosporin once or twice a day. I've been pretty successful at keeping her from licking so I am guessing it's already feeling much better.

[Feisty49]

Annie started licking her vulva area more than a general cleaning worth three days before her annual check-up, which was convenient. The vet said Annie's vulva was irritated and said to wipe it once a day with Seventh Generation Baby Wipes because they have no perfumes or additives to irritate and then put a bit of Desitin on the area. It worked.

[NeylasMom]

Ugh. We were making good progress, the area was looking a lot better and now it's worse again. Culture was negative. We almost finished out her ABs anyway, but she missed the last couple of days because she got so finicky about taking them. I guess it's time for a bite not collar.

[cleptogrey]

i would talk to your vet, she might need another round of antibiotics or a different one. better to continue the treatment than let it really flare up.

[NeylasMom]

We are going back to the vet tomorrow. If anyone has any suggestions for things for me to ask her, please share. I'm feeling really frustrated and pretty much like a crappy dog mom at this point and expecting to feel worse after our visit tomorrow. I don't really know if the vet will have anything new to offer, but I will feel better hearing things from my regular vet rather than the one we saw last time when she was out of town.

 

I'm honestly a bit confused how there can be bacteria, WBC and RBC on the urinalysis and nothing can grow on culture. The presumption was the infection was external from her irritating it and not from a UTI so nothing grew on culture because there was only a tiny amount of bacteria from the pee passing by the infected outer area? And she was on the ABs for at least 10 days - would bacteria from her working on it really not clear up in that timeframe? We did see a lot of improvement while she was on them so presumably they were effective for whatever bacteria was there. I hate the idea of putting her back on ABs - I had to resort to pilling her by the end and had to be careful about administering after giving her food or she would throw up, plus just general concern about overuse of ABs - but of course will do it if she needs it.

 

The collar and washable diaper are on their way from Amazon in the meantime. Will figure out which is less aversive for Skye and use one or the other to keep her from licking completely for a while. We are still doing baby wipes and Neosporin as well.

 

Oh, Greysmom, thanks for the spray Neosporin suggestion - that has been helpful at least although I'm starting to wonder now if it's keeping the area too damp. I don't know.

[Rickiesmom]

You might also consider colloidal silver as a wash for the area - it's a pretty good anti-bacterial and won't harm her if she licks.

[cmc333]

Which AB's did you use? I had a westie once that had re-occuring infections there too. Sometimes they could grow a culture, other times not. Her pee was too acidic and it was actually burning her skin and causing it to be infected. We tried so many things I cannot even remember. Baytril usually worked best as far as AB's. I also gave her a "bikini cut" down there so there was absolutely no hair there. I would wipe her with baby wipes and hold her legs apart till she dried. (She was so very patient with me). I was trying ways to get her pee less acidic when she died so I never found a solution,.

 

Could your vet check her Ph?

[NeylasMom]

You might also consider colloidal silver as a wash for the area - it's a pretty good anti-bacterial and won't harm her if she licks.

Thanks, I was wondering about that. Mine is really old so I'll ask the vet.

Which AB's did you use? I had a westie once that had re-occuring infections there too. Sometimes they could grow a culture, other times not. Her pee was too acidic and it was actually burning her skin and causing it to be infected. We tried so many things I cannot even remember. Baytril usually worked best as far as AB's. I also gave her a "bikini cut" down there so there was absolutely no hair there. I would wipe her with baby wipes and hold her legs apart till she dried. (She was so very patient with me). I was trying ways to get her pee less acidic when she died so I never found a solution,.

 

Could your vet check her Ph?

They did run a u/a and didn't say it was abnormal, but this was my vet's original theory I think so we can revisit it. I do have pH strips so I could check with those as well.

 

One thing we had some success with early on (I think) was the Vetriscience UT strength stat supplement and one thing I suspect is that it changes the pH. When she started licking more again I tried to get her on those but she'd become so fussy after me trying to get the ABs in her that she wouldn't take them. I attempted again recently and most evenings she will eat one so maybe those will help.

 

ETA: Oh, first round of ABs, that I thought didn't do anything, but this was much earlier in was Clavamox. She started vomiting from that toward the last few days so this time they tried Cephalexin.

 

The thing about the possibility of it just being urine pH is that she didn't have this problem for years and then it came out of nowhere. The l-theanine was the only thing I could think that caused a change, but she's been off that since we saw the vet so 3 weeks ago.

Edited August 3, 2016 by NeylasMom

[cleptogrey]

it can take quite a few tries till you hit the right antibiotic. i know from my late father who had old man urinary problems between his catheter and never emptying his bladder. he ended up w/ a weird strain of bacteria in his kidneys that was nearly impossible to pinpoint. he was on more antibiotics than you can imagine until an infectious disease dr. cultured it properly. also, a friends dog had major reoccuring urinary problems, that dog went thru more rounds of antibiotics, more types until bingo! the right one was hit.

 

btw, have you tried an elimination diet, remove one article of food(you feed raw, right?) per a week and see of the situation changes. yes, you will need to go down the list, but it's a possibility.

[MaryJane]

Was the urine a first morning specimen? If not, I suggest using a sterile container, and after cleaning her a few times with warm water and a facecloth (no wipes - you don't know what might be on them). You probably want to get an accurate specific gravity and I suggest getting the actual results of all the items rather than their call that it is normal.

 

When Lucy gets an infection, she goes 20 days on antibiotics determined by the culture sensitivity and that usually gets her clean for 6 to 9 months. A few times, we have started antibiotics before the culture came in but, that never worked real well so now we just wait for the results as she usually runs one of 2 different ones and on a rare occasion, 2 different ones at the same time.

 

A few reasons why a bacteria might not have grown out -- if you used an antibiotic on the outside to clean/soothe her, could have killed anything but kept them alive long enough for the slide but, not the culture. It also depends on where the urine specimen was placed for pickup - if they have a locked container outside and it was hot, they little buggers could have gotten fried - I had the opposite happen with one of Lucy's urine - they placed the urine outside in -3 degree weather - it took me awhile to figure that one out and I was pretty upset.

[greysmom]

What about taking a sample directly from the bladder - cystocentesis???? Is that the right term??? - just to make sure you get a sterile, testable sample??

[MaryJane]

What about taking a sample directly from the bladder - cystocentesis???? Is that the right term??? - just to make sure you get a sterile, testable sample??

 

 

I've had that done twice for Lucy because they wanted to make sure they were getting a good catch - what a laugh. The first time was OK and since I had been hesitant I felt pretty rebuked about the whole thing but, the 2nd time the urine grew out two different bacteria and one of them is usually classified as a contaminant - I think they did something wrong in the procedure - maybe using a non sterile container (they didn't let me see procedure) or not sterilizing the area properly. What is funny is that months later when I was insisting that I was going to do a free-catch urine on her next sample for the next month, the vet was bringing up the example of the previous free catch being contaminated when it was the sterile draw that was contaminated. Her assistant cleared up the misinformation. Since then - I'm back to only doing free catches.

 

Other people here seem to have great luck with them, I haven't ....

[Batmom]

Is it a UTI or a skin infection in that area? One of ours had a skin infection for a time. What worked best was cleaning the area gently a couple times a day with alcohol-free baby wipes and applying panalog. Wouldn't want to use a diaper.

 

Also, are you sure she's not having a little leakage from time to time? That can lead a dog to lick overmuch, which can lead to irritation.

[cleptogrey]

just saw this and thought of you....not too sure on how true, but what the hell, here's the link http://www.petmd.com/dog/slideshows/7-vinegar-uses-pet-owners?utm_source=Facebook&utm_medium=SocialMedia&utm_campaign=petMD_7VinegarUsesforPetOwners_05182016

[Rickiesmom]

One other thought, though I'm not sure it's applicable since a UTI has not been conclusively diagnosed. But FWIW my Jeff had a UTI, sample was cultured and the bacteria (staph) were sensitive to Baytril. We retested 4 days after a 2 week course of Baytril, infection was still there. Did another culture, bacteria still sensitive to Baytril.

 

X-rays showed nothing, but an ultrasound revealed bladder stones. So Jeff is now on a stone diet for 6 weeks and on Baytril for the same duration.

 

Both samples sent for culture were taken via cysto, and I second the suggestion to go that route with the next one. Hope you get to the bottom of this soon!

[NeylasMom]

I love my vet. So wish we could have just seen her the last time. She feels pretty confident it's an external infection from all of the irritation. Apparently her vulva isn't completely normally shaped so easy for stuff to get "trapped" in there. I asked her about swabbing and culturing, but she felt pretty strongly oral ABs weren't necessary, just keeping her on the Vetriscience UT supplement to prevent the infection traveling up into her urinary tract.

 

So, Silver sulfablahblah topically instead of Neosporin and we're going to use Apoquel rather than Rimadyl to bring down the inflammation, which I am much more comfortable with. They also cold lasered her while we were there. And the collar should be here tomorrow to keep her from licking it.

Edited August 4, 2016 by NeylasMom

[tbhounds]

Just an FYI-apoquel only treats atopy (itchiness) not inflammation. I would clean the area with diluted chlorhexadine prior to applying the cream.

[NeylasMom]

Just an FYI-apoquel only treats atopy (itchiness) not inflammation. I would clean the area with diluted chlorhexadine prior to applying the cream.

Maybe what they can claim based on efficacy studies done so far? Though the website does mention relieving inflammation in addition to itching. Violet was prescribed Apoquel when her face swelled up for some unknown reason and it brought the swelling down quite quickly. I'm certainly willing to give it a shot.

 

Chlorhex is a good idea. I've been cleaning Zuri's toe with that - not sure why I didn't think of it for her.

[Batmom]

Silver blahblahblah presumably SSD? Silver sulfadiazine? Awesome stuff.

[NeylasMom]

Silver blahblahblah presumably SSD? Silver sulfadiazine? Awesome stuff.

Correct.

 

Consider me officially an Apoquel fan. With a few momentary exceptions, Skye hasn't even glanced at her hoohaa. Maybe the cold laser helped as well. All I know is the inflatable collar and panties arrived and I haven't even opened the box yet. Hopeful we're on the right track.

[greysmom]

I'm another Apoquel believer. Lilly was having horrible itching issues earlier in the Spring - she was biting herself raw and licking her hind end much like Violet - and within an hour or two of her first dose, she's hasn't had any itching or swelling.