Uti? Or Something More? At My Wits End!

[Guest maciegrey]

Hello there!

 

I've been a lurker of this forum for awhile but have decided to join. My girl, Macie, is turning 9 on Sunday. Over the past few years, she's had reocurring UTIs due to her makeup. The vet says she's got a pocketed vulva, but she just started experiencing UTIs around age 6. For the most part, she's easy to read. She'll mess in the house and you can tell she's irritable and she'll be put on medication. We also use medicated wipes to keep her clean.

 

This time, it's different. Macie was very irritable and snippy. She did not mess in the house but was more-so drippy when she went to the bathroom. My husband took her to the vet on the 3/26 and we were told she had another UTI. She was put on 500 mg of Amox. A few days later we didn't see any improvement in her behavior. On Monday when we took her for a walk, she peed and when she stopped it kept leaking out of her and her fur was covered in it.

 

Tuesday morning when we woke up, she was very lethargic. Her back legs were wobbly and she was having trouble pulling herself up on 2 stairs. I took her to the vet. Anyone who touched her she would snap. She had a fever of 103. Our vet changed her medication. We're now giving her enrofloxacin, clavamox, and galliprant for the pain. Since the change of medication on Tuesday, she's less lethargic and less snippy. She is able to get up the stairs now. However, she is still leaking. Every time she goes out to pee I have to wipe her down. Every.Single.Time. She's yellow in that region.

 

I've requested my records, if she does not get better I'm thinking about a second opinion. This time it's different. She's never had her urine stain her fur this bad and never had weakness in her hind region before. Anyone ever experience having to wipe down your dog after urinating?

 

Here is a photo of her from Monday (the day before her weakness)

https://imgur.com/a/2UPK0

[MaryJane]

I'm going to suggest that she get a urinalysis and urine culture to make sure that the antibiotics that she is on are the right ones. She may also have to be put on something like DES (not Proin as that can cause sudden death in greyhounds due to erratic blood pressure) for the incontinence although, better to wait until the antibiotics are done to see if that clears up the incontinence.

 

I would stop using medicated wipes and just use a warm washcloth to gently clean the area by patting it rather than wiping - sometimes the wipes are just not gentle enough and if they are used to wipe, they could be harsh enough to cause little cuts (like paper cuts) in that area. Also, there could be a reaction to the medication on the wipes.

[Houndtime]

Is she a candidate for a vulvectomy? I am not sure what a pocketed vulva is. I had a girl with extra skin closing the vulva area. She had the surgery and never had another problem.

[brindlebaby]

We had the same leaking issues with both of our recent greys. After seeing specialists, testing, etc... DES was the only thing to stop the leaking. We get it by mail order thru APS Pharmacy in FL. I hope Macie feels better and you get solutions.

[Guest maciegrey]

I'm going to suggest that she get a urinalysis and urine culture to make sure that the antibiotics that she is on are the right ones. She may also have to be put on something like DES (not Proin as that can cause sudden death in greyhounds due to erratic blood pressure) for the incontinence although, better to wait until the antibiotics are done to see if that clears up the incontinence.

 

I would stop using medicated wipes and just use a warm washcloth to gently clean the area by patting it rather than wiping - sometimes the wipes are just not gentle enough and if they are used to wipe, they could be harsh enough to cause little cuts (like paper cuts) in that area. Also, there could be a reaction to the medication on the wipes.

Thanks for the reply! If you don't mind me asking what is DES?

We had the same leaking issues with both of our recent greys. After seeing specialists, testing, etc... DES was the only thing to stop the leaking. We get it by mail order thru APS Pharmacy in FL. I hope Macie feels better and you get solutions.

Thanks for the information... it sure has been a struggle. After paying a ton of $$$ and putting her on all these medications, sometimes I wonder if it's enough. Kills me. It's like having a baby. I wish dogs could talk!

[NeylasMom]

Had she been having any signs of weakening in her hind end? Change in gait, slower to get up and down from beds, not getting on furniture as much, reluctant to jump in car, etc? She's at the age where things like LS or disc issues would pop up.

 

My almost 9 yo has disc issues (and a really recessed vulva). Recently I was wiping her after walks and there would be a lot of pee on the wipe. It coincided with some days where she was much more symptomatic than normal from her disc issues and since those have gone back to normal, I haven't been finding the extra pee. My best guess is because her hind end was bothering her, she wasn't squatting until she was done. That may be what's happening here as well. Or if the infection is really raging, it may be painful to urinate. I would get the infection treated and address the weakness and then see if this is still happening. I would not start her on Proin or DES until you're positive those things are resolved since it seems likely there's a connection and neither medication is harmless.

[greysmom]

I will ask again too about surgery - epesioplasty or vulvaplasty. One of mine had reoccuring UTIs due to a hooded vulva. Surgery cleared up the UTI issue immediately. But you do need to address her hind end weakness as well as it can contribute to leaking.

[MaryJane]

Thanks for the reply! If you don't mind me asking what is DES?

Thanks for the information... it sure has been a struggle. After paying a ton of $$$ and putting her on all these medications, sometimes I wonder if it's enough. Kills me. It's like having a baby. I wish dogs could talk!

 

DES is Diethylstilbestrol. You usually start by giving it every day for 5 to 7 days and if that works, you decrease to about once a week. My Lucy has been on it for a few years - she also has recurrent UTIs but, we always get a urinalysis and culture the urine before starting antibiotics.

 

Vets might suggest using Proin to treat incontinence and it is worth re-emphazing that this can cause SUDDEN DEATH in greyhounds (blood pressure) - so don't use Proin - not worth the risk.

 

 

edited to add -- there is also another hormone treatment that is used which I investigated but, it was more expensive than the DES and at the time, did not have enough reporting on contraindications (my Lucy has seizures, long nerve disease, and IBD).

Edited April 6, 2018 by MaryJane

[MP_the4pack]

If the above suggestions don't work, an ultrasound may be warranted.

[Guest maciegrey]

Had she been having any signs of weakening in her hind end? Change in gait, slower to get up and down from beds, not getting on furniture as much, reluctant to jump in car, etc? She's at the age where things like LS or disc issues would pop up.

 

My almost 9 yo has disc issues (and a really recessed vulva). Recently I was wiping her after walks and there would be a lot of pee on the wipe. It coincided with some days where she was much more symptomatic than normal from her disc issues and since those have gone back to normal, I haven't been finding the extra pee. My best guess is because her hind end was bothering her, she wasn't squatting until she was done. That may be what's happening here as well. Or if the infection is really raging, it may be painful to urinate. I would get the infection treated and address the weakness and then see if this is still happening. I would not start her on Proin or DES until you're positive those things are resolved since it seems likely there's a connection and neither medication is harmless.

Thanks for your response. I've always thought her gait has been strange as she got older, but Tuesday was much different. She has always liked to come upstairs and still jumps on the couch/beds. Haven't seen reluctance. I just took her outside for a walk and she went again and once she stood up it kept trickling out and on her legs. Ever since switching off the amox and to clavamox/enrofloxacin and galliprant for pain she can get up the stairs again and is more alert.. but she continues to need to be wiped down. I requested our recent test results from our vet.

I will ask again too about surgery - epesioplasty or vulvaplasty. One of mine had reoccuring UTIs due to a hooded vulva. Surgery cleared up the UTI issue immediately. But you do need to address her hind end weakness as well as it can contribute to leaking.

Did your pup always have uti's since it was young? Or only in older age due to the hooded vulva? Our vet has mentioned the surgery. How old was your dog when it go the surgery? Thank you

 

DES is Diethylstilbestrol. You usually start by giving it every day for 5 to 7 days and if that works, you decrease to about once a week. My Lucy has been on it for a few years - she also has recurrent UTIs but, we always get a urinalysis and culture the urine before starting antibiotics.

 

Vets might suggest using Proin to treat incontinence and it is worth re-emphazing that this can cause SUDDEN DEATH in greyhounds (blood pressure) - so don't use Proin - not worth the risk.

 

 

edited to add -- there is also another hormone treatment that is used which I investigated but, it was more expensive than the DES and at the time, did not have enough reporting on contraindications (my Lucy has seizures, long nerve disease, and IBD).

Thanks for the information. It's always so hard to judge if we're seeing the right Doctor for our grey since they are such a unique breed.

[Guest maciegrey]

Here were her recent results from 3/26... She had the back end weakness and fever on 4/2.

 

Color: Amber

Appearance: Hazy

Spec. Gravity > 1.050

WBC: 6-15/HPF

RBC: 10-17/HPF

Casts: None seen

Epilethel cells:5-8/HPF

Crystals: Struvite - large amount

Bacteria: Moderate number of cocci

Yeast/Spermatoza- none seen

urobillogen - normal

glucose - ketone- bilirubin: negative

protein +30

nitrites/leukocytes/blo0d- neg

pH 8.0

 

^^ those were the results when she was put on amox.

[tbhounds]

You need a new vets opinion-with chronic utis bladder stones can develop-must get an abdominal x-ray done sooner rather than later.

[greysmom]

We adopted Lilly as a puppy and she had reoccurring UTIs until she had the surgery done at 7 months due to a hooded vulva. Kidney stones and infections (as opposed to urinary tract) are also as possibility as tbhounds mentioned above.

[Newgreymom]

It sounds like she may struvite stones in her bladder. An ultrasound may be a good choice...Keep us posted

[tbhounds]

It sounds like she may struvite stones in her bladder. An ultrasound may be a good choice...Keep us posted

Simple lateral X-ray will do ;-)

[Newgreymom]

Simple lateral X-ray will do ;-)

Thanks Tracy. Good to know!

[Guest maciegrey]

Thanks everyone for the feedback!!

[Guest maciegrey]

I wanted to thank everyone for their responses. Over the past several weeks Macie's condition got worse and better. She had a fever a few weeks back and they switched antibiotics. When I returned from a work conference and she was done with pain medication and she seemed well and then started to become listless, lose her appetite, start hacking, and panting/breathing hard.

 

The vet I was taking her to hadn't returned my call when I called in to say she was panting really hard and her gums looked pale so I took her to my parents vet who took her in right away. Upon examination, he could not pin point what was going on but believed the UTI was a distraction to the true issue. He took a blood panel to check for anemia and xrays for her heart. It turns out that all this time there was something more going on. My poor girl has cancer . I'm so devastated but I hate to see her breathing so hard/uncomfortable and I know I have a difficult decision to make soon....I've been driving myself crazy and trying to do all this research, but there were so many spots on that xray in her chest .

 

FINDINGS: Numerous small round soft tissue nodules are present throughout the pulmonary parenchyma. Scant to mild pleural effusion is suspected. The cardiovascular structures are within normal limits. There is no evidence of intrathoracic lymphadenopathy. There is no evidence of tracheal narrowing or deviation. There is no evidence of pathologic esophageal distention. There is questionable remodeling associated with the dorsal spinous process of the T11 vertebra that could also be artifact. Mild spondylosis is considered incidental. No other osseous abnormalities are detected. The visible cranial abdomen is unremarkable without overt mass effect. No other significant abnormalities are seen. CONCLUSIONS: Numerous pulmonary soft tissue nodules with scant pleural effusion is most consistent with metastatic neoplasia. Fungal or other granulomatous disease is thought much less likely. Remodeling associated with the dorsal spinous process of T11 is suspected to be benign and incidental, although an aggressive lesion at this site cannot be definitively excluded. An alternative primary site of neoplasia is not identified.

 

CONCLUSIONS: Numerous pulmonary soft tissue nodules with scant pleural effusion is most consistent with metastatic neoplasia. Fungal or other granulomatous disease is thought much less likely. Remodeling associated with the dorsal spinous process of T11 is suspected to be benign and incidental, although an aggressive lesion at this site cannot be definitively excluded. An alternative primary site of neoplasia is not identified.

[MP_the4pack]

I'm sorry to hear that.

It can't hurt to get Dr Couto's opinion. He's an oncologist specializing in greyhounds.

I don't have his info right now, but search this forum his contact info is all over.

[tbhounds]

Well crap and shame on your vet. Definitely seek Dr Coutos opinion.