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Hi. I'm Dr. Gotthelf. I have been a vet for 35 years and I would like to use my experience to help you with your pet's medical problem.
Do you know if he is just leaking urine or if he has so much urine it just comes out when he is sleeping? Some dogs drink lots of water and produce more urine. Some dogs get an infection called urethritis that can respond to antibiotics and steroids. Do you know if a bacterial culture of the urine was done, even though you stated that there was no bacterial infection (but you indicated that he was on antibiotics)?
Hello, Dr. Gotthelf,The culture was done once and it was negative. It never comes out when he's sleeping,
He was treated I guess empirically twice with antibiotics, and it repeated itself once even during the therapy. He strains to urinate, but it does not look as it is painful.
Last two episodes were ~ 6 months apart. It just started yesterday after he swam in the pool and most likely, he was not dry enough to come back in the AC. When he is at home, he won't urinate, but when you take him out (when he has this) He will pee or try to pee every 20 yards or so. Today we took him to our vet again, who checked again the urine (no culture, though) and said it does not look like an infection, also chateterized him and said that there was not much urine left. So I guess he does have stranguria but manages to eliminate most of it?
Of other things, he had cryptorchidism which was corrected at the time of neutering, and has extra toe on both front and back left paw. No other issues whatsoever, even when he has this, he plays, interacts and eats normally.
In terms of resolving itself it usually lasts less than 24 hours.
OK, that's good information. Since he is emptying his bladder, then it is most likely just limited to the urethra. Since your vet easily put in a catheter and there was no evidence of urinary stones or sand, and no obstruction (like a tumor mass) then the next thing to do is to fill the bladder full with a radioopaque dye (Like Hypaque or Reongraphin). When he urinates it out they would take a series of X-rays of the pelvic and penis area to see where there might be a constriction. Since there is frequency of urination, that usually indicates irritation or inflammation. Some dogs do get swelling of the urethra and that can cause a slow stream. In that case a high dose of a steroid orally may increase the diameter of the urethra as the swelling subsides.
Thanks. I will discuss doing this with my vet. He was mentioning something about alpha blockers. Do you think this would play a role?
I meant about utilizing alpha blockers for therapy.
If there is urethral stricture, it can be treated by dilation?
If they work, then you can use them. The most common drug is phenoxybenzamine (Dibenzylene). Some of them will cause urinary leakage as they relax the urethra, which is what you are trying to clear up. When the bladder fills and some pressure comes down the urethra, the muscle is supposed to constrict and seal off the bladder during the resting phase. When the dog urinates, the urethra relaxes as the bladder muscle squeezes out the urine. When the bladder is filling with a relaxed bladder, this is called dyssynergia usually caused by a nerve problem in the spinal cord and it is not supposed to be that way.
Urethral stricture would have been picked up when the vet inserted the catheter. If there is an area of scar tissue within the distal urethra, sometimes a surgical procedure to make a new urethral opening (pre-scrotal urethrostomy) can be done.