Soph the vet, yet another question if you have time or inclination...

[Shelly in IL]

We have a 6 year old Airedale. Great dog.

 

Here is the problem. She has chronic bladder infections, and drinks tons of water. After anti-biotics, we gave her Cranberry Comfort (as per vet) to help sooth her bladder. She soon would vomit after eating food that had that on it. That was new for her.

 

We eventually stopped feeding it - too much vomiting - but the occasional (2-3x's a week) still persisted. We kind of got used to it and let it go for a couple weeks. Finally, last week, I awoke to 11 piles of vomit and 1 big piddle stain (all on my pretty dining room area rug, but that is another story)

 

Got her to the vet, we did blood draw and a urine culture. She was free of bladder infection as per urine, but her liver culture levels were high - high enough for them to think liver disease.

 

She was on Rimadyl for several weeks, 2 years ago after a fall - they are now telling me that 2 doses of Rimadyl could cause liver damage (and they were the ones that gave it to me - why would you diagnose, if that would cause other problems?)

 

Anyway, the course of treatment is Amoxil (or something like that with Amox... in the name) and prescription Hill's l/d dog food. They are wondering about an infection (in her liver I suppose), and if that doesn't do it after a retest in 4 weeks, they plan to medicate otherwise.

 

They are also saying that this will not shorten her life. Any suggestions? Anyplace to get the HIll's l/d food anyplace cheaper than $55 a bag? Sorry if this is too much to answer with too little info. This is a new vet to us (well, 2 years a bad fall and several bladder infections later), and I want to make sure they are handling this properly.

[Jean in Newcastle]

Do you know about the 'Ask the Vet' social group? If you ask your question there, Soph is a lot more likely to see it.

[Tammyla]

Shelly, you might post this on Soph's social group.

[Soph the vet]

Hi Shelly,

It depends on how high her liver enzymes are. There are many causes for liver damage in a dog. The Rimadyl certainly could have done it if she was on it for longer than a week. We usually monitor liver enzymes every 3-6 months in dogs that use it continually. That said, they are using antibiotics in case she has a liver infection or a liver abscess, not uncommon. An ultrasound and liver biopsy are the only way to definitely diagnose a liver condition, but not cheap. Liver enzymes just tell your vet that there is liver damage. How was her bilirubin? That number gives a hint at how severe the damage may be. Also, did they do a bile acids test? That is a test for actual liver function. Again, not a specific diagnosis but will help monitor response to therapy down the road if you have a baseline now.

I would definitely feed the l/d if you can swing it. Try other vet clinics to get prices. Your vet can always call them to "prescribe it". And see how her liver enzymes are in a couple of weeks. As for other things that may be going on, there are parasites that can affect the liver depending on what part of the country you live.

Thankfully, the liver is a very "forgiving" organ, unlike the nervous system or the kidneys, in that it repairs itself quite nicely given that it is not something like liver cancer which is also a possibility but again you would need an ultrasound and biopsy to diagnose that.

[hornblower]

Not Soph but

 

- yeah rimadyl is a wonderful drug but has side effects. But pretty much every drug has side effects. Lots of dogs take rimadyl with no probs. It's too bad this has happened to your dog, of course.... but I would try to not look back at that, beyond just marking it as a possible causal factor

 

-so currently they're assuming infection & treating with antibiotics as what you posted is an abx.

 

- is she spayed & have you considered that the bladder probs may be spay incontinence? A culture from a free catch will often show bacteria because it gets contaminated en route. Leaking at night, small & big puddles can all be signs of spay incontinence and not necessarily an infection. There are a couple treatment options. My female is currently on estradiol 1 mg, once a week.

 

- has diabetes been ruled out? The drinking lots is a flag

 

- Dr Pitcairn's book has a recipe for home made diet for liver support. I strogly suspect it would be considerably cheaper than any commercial product

http://www.amazon.com/Pitcairns-Complete-Guide-Natural-Health/dp/157954973X/ref=sr_1_2?ie=UTF8&s=books&qid=1233591965&sr=1-2

 

-lastly, I haven't looked at this book but I know people have been happy with it

http://www.amazon.com/Hope-Healing-Liver-Disease-Your/dp/1434319164

[Soph the vet]

I'm assuming diabetes was ruled out with the chemistry panel. The incontinence thought by Hornblower was a good one and certainly a possibility. It can also be related to liver disease just from drinking more because of more solute (bilirubin in urine) which causes more water to go into urine making the dog more thirsty, yada, yada, yada.

But yes, Proin (phenylpropanalamine) is something your vet can put her on for incontinence but I would get the liver thing clarified first.

[Shelly in IL]

She normally has no problem in the urine dept. If she ever leaks at all, it is only a drop at most. I'm thinking that the problem she had last week was due to her liver - as she was drinking just a ridiculous amount and never has indoor accidents. Diabetes was ruled out.

 

She had problems with urinary tract infections when she was a puppy. They were solved when we had her spayed (we did it early for that reason) and have only recurred within the last 2 years (post fall, post rimadyl). Any connection?

 

Thanks for all your help, guys! Praying for no cancer!

[hornblower]

how were the uti's diagnosed? what were the symptoms?

[Shelly in IL]

Symptoms - constant and unpredictable piddling (it made her hard to potty train)

 

We would catch her urine and the vet tested it. Treated with antibiotics several times (recurring) and then spayed her. Like I said, the spaying cured her of most all of those problems until she was 4 and fell and hurt her back.

[hornblower]

Ok, the reason I asked is that leaking - either small drops or big puddles when asleep, can be caused by spay incontinence. It's believed to related to the drop in estrogen following a spay - the idea is that the hormones help to regulate the bladder sphincter. Hence one of the treatments is estrogen :-)

 

I'm still not clear whether she's been leaking at all since the spay or whether that was happening only before?

 

If she's not been leaking since the spay, I wouldn't worry about it. But if it returns, keep it in mind. It could be infection or it could be spay incontinence. My ***** has both, though we seem to have the chronic bladder infections under control now & the estradiol is keeping the incontinence in check.

 

Checking free catch urine is not always a good way of testing for infection as there can be & usually is bacteria in that area (I do it lots myself btw, it's just that I don't consider a + result as necessarily an infection. In other words, I'm factoring in a change of false +).

 

A cystocentesis, where they collect urine through a syringe directly from the bladder, is a more precise test for culturing. The only slight prob with cysto is that you sometimes get false positives for blood, making everyone think about bladder stones..... Well, and some dogs protest having needles poked into their bladder, though most do tolerate it.

 

Oh & I agree with Soph about imaging. I had xrays & u/s done on my ***** and that gave us a much better idea of what was going on & how to proceed. Expensive but worth it.

Edited February 2, 2009 by hornblower
ooops. Ok, all those asterisks are female dog. Sorry everone, it's a common word for me.

[Beth in OH]

Anyplace to get the HIll's l/d food anyplace cheaper than $55 a bag? /QUOTE]

 

Our 8 1/2 yo golden retreiver has been eating Hilld k/d (not l/d, but roughly the same price: $60 for the 40 lb. bag) for probably the past 5 years. Our vet switched her to it to address her chronic bladder infections--your story brought back memories. The food is expensive per bag, but it is so nutrient dense that 2 cups per day maintains my dog's weight at an appropriate level. We have found it doesn't end up costing us much more than a regular high quality food, such as Iams.

 

Best of all, our dog does great with this food. She LOVES it, there's no stomach upset (although many other things make her throw up), and she has not had any more problems with piddling and bladder infections. If it's any consolation to you, we have found the expensive Hill's to be worth every penny. It has definitely had an impact on vet bills ;) Sorry Soph!

 

Beth

[Soph the vet]

Anyplace to get the HIll's l/d food anyplace cheaper than $55 a bag? /QUOTE]

 

Our 8 1/2 yo golden retreiver has been eating Hilld k/d (not l/d, but roughly the same price: $60 for the 40 lb. bag) for probably the past 5 years. Our vet switched her to it to address her chronic bladder infections--your story brought back memories. The food is expensive per bag, but it is so nutrient dense that 2 cups per day maintains my dog's weight at an appropriate level. We have found it doesn't end up costing us much more than a regular high quality food, such as Iams.

 

Best of all, our dog does great with this food. She LOVES it, there's no stomach upset (although many other things make her throw up), and she has not had any more problems with piddling and bladder infections. If it's any consolation to you, we have found the expensive Hill's to be worth every penny. It has definitely had an impact on vet bills ;) Sorry Soph!

 

Beth

Hey, I am all for people not spending more money at the vet. Have you seen my sig line "the vet with no pet"? I have 3 dc to feed!! :lol:

[Soph the vet]

She normally has no problem in the urine dept. If she ever leaks at all, it is only a drop at most. I'm thinking that the problem she had last week was due to her liver - as she was drinking just a ridiculous amount and never has indoor accidents. Diabetes was ruled out.

 

She had problems with urinary tract infections when she was a puppy. They were solved when we had her spayed (we did it early for that reason) and have only recurred within the last 2 years (post fall, post rimadyl). Any connection?

 

Thanks for all your help, guys! Praying for no cancer!

If the leaking has stopped, I would not worry about it. I find young puppies to have real UTIs to be quite rare. Often it is a congenital defect like an ectopic ureter or more commonly puppy vaginitis, which can mimic a UTI on urinalysis that is freely caught. A vaginal swab diagnoses it and then you are supposed to let them go through one heat (the only reason to go through a heat) before spaying so that estrogen works on the vulva lips to puff them out and the hair doesn't irritate the vaginal vault anymore resulting in vaginitis. If you spay them before a heat and they have puppy vaginitis because of vulva conformation then they may always have a problem. So I am confused as to why your vet would recommend spaying early for a UTI. I've never heard of that. Unless he secretly wanted to take a look in the abdomen asap to see if there was an ectopic ureter, but usually those dogs are dripping all the time.

[Shelly in IL]

Would a fasting blood draw be a good indicator for glucose levels? She was a 74 on her glucose test, but this was after a full 8-10 hours of vomiting. I am just hoping that that would still be accurate... thanks.