Bladder Issues - Any Suggestions Appreciated

[Pugmum]

I have a 9 yo pug girl (desexed) who, after an idiopathic siezure in December, started having bladder problems. Apparently not related. they did find bacteria and diagnosed a UTI which cleared - eventually - with antibiotics.

But the symptoms have not changed she still urinates a lot, and only a small amount each time (although the flow is quite good sometimes and a bit dribbly at other times.) She can go all night without needeing to go outside, and has not had any accidents inside. If we walk for half an hour she will go about 6 -8 times the first taking about 1 minute. at home she may go out two or three times in an hour (and then not at all for an hour or two)

We have been to the vet and to the specialist. She has had stones ruled out by x-ray and ultrasound.

We went to the specialist about the siezure but he also did the ultrasound to check her bladder. at that time (a month ago) the advice was keep going with the treatment and if its not cleared then we should have a look (lapriscopy SP?) Well the infection is now gone - but the small frequent urinations have not

She's also been on the Hills cd food for a few weeks - thats not made a difference.

I'm reluctant to keep stressing her taking her to vet if she is otherwise happy has no infection, and passes urine - to possibly still have no answers, as we have been so much already.

Can anybody think of anything that would not have shown on the xray, ultrasound, blood or urine tests that could make her think she needs to empty her bladder so often or make her bladder unconfortable ?

I'm going mad following her about to see how often and how much she urinates.

Appreciate any suggestions, no matter how 'out there'...you just never know. Thanks

[~Anne~]

Did they do a urine culture to rule out infection after she finished the anitbiotics but still continued with symptoms?

[Pugmum]

Yes, they did and it was clear. I also have the normal urine tests done at the vets nearly each week to check that the bacteria does not return. Last test was clear of blood (which had previously been there) but had some struvyte crystals hence the Hills cd diet she is now on. If anything, she is going even more now and I dont know if thats due to the different diet.

I think they have ruled out all the easy to find nasties and would want to go to surgery for a look next, but they dont know what they are looking for. At one stage they thought it was bladder cancer but the ultrsaound did not back that.

[~Anne~]

Yes, they did and it was clear. I also have the normal urine tests done at the vets nearly each week to check that the bacteria does not return. Last test was clear of blood (which had previously been there) but had some struvyte crystals hence the Hills cd diet she is now on. If anything, she is going even more now and I dont know if thats due to the different diet.

I think they have ruled out all the easy to find nasties and would want to go to surgery for a look next, but they dont know what they are looking for. At one stage they thought it was bladder cancer but the ultrsaound did not back that.

Can they have an infection with out blood though? I am angling toward it still being a bladder infection.

I'll try to explain where I am heading. I have a rescue Pug that came in (and stayed ) that had a horrible history with bladder infections and struvites.

She had two operations to remove stones within 18 months. Before she was operated on the second time, she was leaking puss it was so bad. After the first, she was given the usual antibiotics but the owners did not have her on a prescription diet. The stones returned, she was left for some time befroe being taken to the Vet, and the stone this time was as big as a small mandarin! She was surrendered by the owners.

She was placed on antibiotics, and as she was out in a regional area, I had a carer pick her up approx 4 days after the operation. The Vet had only given her a 14 day course of anitbiotics and she had already been on them for a week. Her baldder was weak and she was a little incontinent and we expected this to improve. Within a day or so of ceasing the antibiotics, she started to leak urine more and started to wet the crate at night. She went back to the Vets and was put on another 14 day course of antibiotic. A few days later she was transferred to me.

Within a week of her finishing her antibiotic with me, she again began to toilet often, small amounts and inside. This time she was taken to my Vet and he did a urine culture to determine what the bug was so that the antibiotics she would be put on would be the appropriate and best for that bug. She was also put on long term antibiotics this time. Her course was an 8 week course. That course finished mid November and we haven't had an issue since. She is still on CD and I will keep her o it for life to make doubly sure.

What I learned was:

There are two trains of thought when it comes to stones and bladder infections. One is that the urine is alkaline which assist the bacteria to develop for the infection and causes the stones and the alkilinity is caused through diet or something.

The other line of thinking is that the infection causes the urine to become alkaline which causes the stones.

We decided to follow the second line and to get the infeciton totally cleared, which it was plainly evident, that a simple 14 day course of antibiotics was not going to achieve and never had, hence why the poor girl had to have 2 major operations to remove stones. Most people I have learnt, follow the first and that is - et the diet correct and the infections will cease as will the stones.

The first indication each time of any issues or continuing issues was her urination habits.

If she had an infection, there is a chance it is still there.

I am probably 100% wrong but who knows?

Edited February 11, 2010 by ~Anne~

[Pugmum]

They have been checking in the urine samples I give them and say that the baceria that was there is gone now. The specialist (David Davies in Adelaide) recommended not to go directly into the bladder if the free catch sample is clear of bacteria. If any baceria returns I'll get them to take a sample directly from the bladder and send it for another test where they grow the bacteria to see what it is.

Thing is - not at any time have the frequent small urinations abated. The first one after she has not gone for an hour or more takes ages (about a minute) and she squats till she's amost touching the ground. The shorter ones she wont go down as far and I can see better what is coming out. The urine does not look couldy and I cant see any other excretions like pus.

One vet thinks could be behavioural - I think that is vet speak for 'has no more ideas'. Then again..... :-(

I am taking her for a check tonight and will discuss the long term antibiotics, it cant hurt and its not like anything else has helped.

Poor thing she had massive ear infections before all this, and a skin fold infection since. I think her immune system is pretty well shot at the moment. we have been at the vets a LOT :-(

[Pugmum]

I forgot - Thanks for the resposnses Anne,

This is eating me up and I dont know who to dicuss it with. I htought the seizure was a probelm, but this is overshadowing everything else.

[~Anne~]

I forgot - Thanks for the resposnses Anne,

This is eating me up and I dont know who to dicuss it with. I htought the seizure was a probelm, but this is overshadowing everything else.

I can also offer an ear and advice for the seizures. Monte, the gorgeous boy in the pic under my name, is an epilpetic and was diagnosed over 5 years ago. He has clusters of seizures.

With Olivia's culture, they took the sample from her bladder while she was under having her elongated palate resected at the same time. We thought we'd kill 2 birds with one stone.

So far so good with her. No sign of infection and we still encourage her to keep drinking as much as we can to keep the bladder flushed.

[Pugmum]

ah - so you have seen all this.

Maggie is a tad old for the normal onset of epilepsy, apparently its usually before the age of 4, and she turned 9 a few days after her siezure. The specialist said he would not do the MRI to see if she has a tumor until her breathing is fixed, and I guess that what your girl had done.

Pugs are tough little things and its hard to tell if they are in pain, thats my big worry.

[~Anne~]

Yes, I agree, 9 years of age is a little abnormal for epilepsy, although not entirely out of the question.

Is it coincidence though? Here you have a dog that presents with symptoms that appear to be unrelated...but sets of symptoms do not appear to be normal either.

I must also say that I can't understand why your Vet said they wouldn't do a CT without fixing the breathing first??? I have had many Pugs operated (due to running a Pug Rescue) who also had issues with breathing. Where possible, we did as much as we could under each GA, but many times we had to schedule separate ops. I can understand that there are greater risks involved in administering a GA to a brachy breed, and particularly a dog that suffers from brachycephalic airway obstruction and I would think that your Vet has weighed up pros and cons so maybe I am speaking out of turn.

Has she been scheduled for the bracchy op though?

Have you considered getting a second opinion on both issues?

[Pugmum]

Yes, both issues are unrelated, but I'm puzzled that they happened at the same time (I need to let that go dont I ? :-) )

The specialist said that the MRI takes two hours under GA and her recovery would be risky with her breathingt he way it was that day. No point killing to look for a tumour that may not be there. It was very hot that day and she was stressed so she sounded like a chain saw. Our regular vet see's her more relaxed and in cooler temps and does not think its worth doing the op. We manage her heat issues, we have good aircon on hot days and we walk before sun up (wet if need be) etc.

Last night the vet still did not think the breathing was worth doing anything about.

But now we have no struvite crystals anymore, but a fair bit of blood in the urine again. She has been clear of bacteria for over 3 weeks so theres apparently no need to keep her on ab's.

I asked what could be giving her the blood given what tests have ruled out so far - possibly a polyp that should have turned up on ultrasound...... The next step is the operation to gi into the bladder and have a look, but he did not recommend it yet as she is pretty happy and normal (or as normal as a pug gets according to the vet). I'm supposed to keep her on the Hills cd for a while and see what happens. Yesh - like thats going to stop me worrying and watching her pee.

Do you give your pug that is on this diet bones ? I dont know how to keep her teeth clean if sh cant have anything else. Vet thought it may okay once or twice a fortnight?

[~Anne~]

Are they 100% positive there isn't a bladder infection? Where is the blood coming from if there isn't? It all sounds so bizarre. She shows all the symptoms of a dog with a bladder infection such as high alkaline urine (re - formation of crystals) and squatting and straining and frequently urinating and yet they so there isn't any infection?

If there isn't any infection, then there must be something else and yet scans show no growths or anything out of the ordinary.

One Vet says the breathing needs to be done, the other says it is fine and yet one of them feels it is so bad they won't put her under a GA for an MRI.

I would get a second opinion for sure. There is too much conflicting advice being given by the specialist and the normal Vet. Did the specialist also do a urine analysis or only the normal Vet?

Edited to add - Yes, I give all of them bones, but not as food. They are given bones once a week or two to maintain gum and teeth health. They are given large shank bones that they can't swallow. I have had many problems with rescues and with my epileptic boy choking so we removed bones from the diet except for thos given to gnaw on for dental health.

Edited February 12, 2010 by ~Anne~

[Boronia]

This herb helped Penny, she was prone to kidney stones, no problems since I have been giving her 3 leaves in her food, twice per day...

http://www.herbs2000.com/herbs/herbs_pellitory_wall.htm

you can get the seeds from http://www.herbsarespecial.com.au/contact_us.html or google for other seed suppliers who may have some in stock.

Hope this helps. :D

[noisymina]

Have you given pro-biotoics following the anti-biotics?

The bladder may just be irritated or sensitive following the infection and the anti-biotics.

Anti-biotics are concentrated in the urinary system.

[tez]

Have you or the vets considered that the seizures and urinary problems are related? It could be that the seizure activity has messed up the signals to your dogs bladder( not worded very well...sorry!). I looked after someone in the past that had an acquired brain injury (not from a seizure but seizures can cause a brain injury or a seizure can result from a brain injury) who consequently lost the ability to urinate as the messages from her bladder to her brain were damaged. Don't know how you could test this with a dog though!

[Pugmum]

Are they 100% positive there isn't a bladder infection? Where is the blood coming from if there isn't? It all sounds so bizarre. She shows all the symptoms of a dog with a bladder infection such as high alkaline urine (re - formation of crystals) and squatting and straining and frequently urinating and yet they so there isn't any infection?

If there isn't any infection, then there must be something else and yet scans show no growths or anything out of the ordinary.

One Vet says the breathing needs to be done, the other says it is fine and yet one of them feels it is so bad they won't put her under a GA for an MRI.

I would get a second opinion for sure. There is too much conflicting advice being given by the specialist and the normal Vet. Did the specialist also do a urine analysis or only the normal Vet?

Edited to add - Yes, I give all of them bones, but not as food. They are given bones once a week or two to maintain gum and teeth health. They are given large shank bones that they can't swallow. I have had many problems with rescues and with my epileptic boy choking so we removed bones from the diet except for thos given to gnaw on for dental health.

Apparently the infection has been gone for weeks now. The blood comes and goes, was there one day, net the next etc. I asked what could this possibly be ? the answer was that maybe a polyp that should have shown on the ultrasound or may be a small lesion in the baldder that bleeds accasionally. his thoughts were that we should not go the surgery route while she is otherwise happy.

Both the specialist and the vet did a urine analysis - both a fee catch, also had one taken straight from the baldder and one was sent to a lab to grow the bacteria. This was the first time that blood was there on Tues night, none there Wed. it seems to come and go. :-(

If I go to another vet I wont be getting a second opinion, i'd now have a third! any suggestions for a really god Vet in Adelaide ? We have been to the Specialist Referral Centre (David Davies) they dont do normal consult, only specialist consults and I've heard really good things about them. And we also go tothe Brighton Veterinary Hospital.

[Pugmum]

This herb helped Penny, she was prone to kidney stones, no problems since I have been giving her 3 leaves in her food, twice per day...

http://www.herbs2000.com/herbs/herbs_pellitory_wall.htm

you can get the seeds from http://www.herbsarespecial.com.au/contact_us.html or google for other seed suppliers who may have some in stock.

Hope this helps.

Thank you - there is a spcialst herbal place here in Adelaide that do pet consults. I'll see if they have this :-) I have been waiting for Maggie to come off all other medication before I did anything herbal. I really do think she needs some natural help. Thanks again.

[Pugmum]

Have you given pro-biotoics following the anti-biotics?

The bladder may just be irritated or sensitive following the infection and the anti-biotics.

Anti-biotics are concentrated in the urinary system.

thats a good point. Poor Maggie had a nasty ear infection that took two different ab's before it cleared, then the bladder infection that took over 3 weeks of ab's to clear, and as soon as she came off them she had an infection on her skin fold (face) which took two more weeks of ab's.

In the absence of anything else I have asked the vet what could be irritating her bladder or weakening it, because thats what its beginning to look like to me. They dont know...

I have been to scared to put her on anything they have not recommended in case I make things worse. Would that be okay with the Hills cd she is on at the moment ?

[Pugmum]

Have you or the vets considered that the seizures and urinary problems are related? It could be that the seizure activity has messed up the signals to your dogs bladder( not worded very well...sorry!). I looked after someone in the past that had an acquired brain injury (not from a seizure but seizures can cause a brain injury or a seizure can result from a brain injury) who consequently lost the ability to urinate as the messages from her bladder to her brain were damaged. Don't know how you could test this with a dog though!

I keep being told that they are not related - yet they started at about the same time. As the seizure finished she just dropped her whole bladder load. I've never seen her go like that (and inside, which she never does) And i'm fairly certain that this started from then on - although I was so worried about the seizure that my attention was not on her bladder routine at the time. She did have an infection, and there is blood in her urine now which seems to point to there being an issue in the bladder more than the brain now. I'm not 100% convinced that there is not a connection between the two, although I dont know what to do to check it.

[Guc's Dad]

I've never seen her go like that (and inside, which she never does) And i'm fairly certain that this started from then on - although I was so worried about the seizure that my attention was not on her bladder routine at the time.

For the bladder problems, get UrineFREE for the carpet. They have a 25% discount on this month only for online orders (until end of month) at www.urinefree.com.au. Enter discount code "ST8491" at checkout. Hope you save some money.

Any update as to what is causing all the problems?

[Pugmum]

The 'do nothing' scenario' did not last long, Maggie seemed to get worse (going out every hour at night etc) and last Friday she came in with blood on her. A sample of her urine looked like someone had cut themselves

A different vet at our regular practice looked at her and said they would send off for a cutlure and sensitivity test and if that still came back clear then she'd need a cystoscopy done at the specialist. He put her on anti-inflammatory and a more obscure ab (I dont have the name on me). the Anti-inflammatory made her more confortabel straight away and on day 5 of the ab she seemed to need to squat less. That was yesterday, and this morning she was still squatting less than a week ago. I'm beginning to be hopeful that this can be fixed. we get the results tomorrow.

She has had all these tests before though - so that is a bit confusing.

I dont know wether to be very, very cross they didn't do more sooner - or very, very happy that at last they are.

As for the carpet - a 3 yo light carpet and sick dog do not mix. I am so good at claening patches that the patches I have cleaned are lighter than the carpet aournd it. As soon as my princess is better the carpet can be announced DOA and a more suitblel replacement found. It will be cheap compared to the vet bills.