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My dog has been urinating frequently, small amounts, and is…

My dog has been...

My dog has been urinating frequently, small amounts, and is not drinking any more than normal. a UTI has already been ruled out through a culture where no bacteria grew, although she does have blood cells in her urine which was originally thought to be a UTI. She has had an Ultrasound to rule out stones as well. I feel the vet has been thorough but nothing has worked.

Veterinarian's Assistant: I'll do all I can to help. Problems with drinking can be serious. I'm glad you noticed it. The Expert will know what to do. What is the dog's name and age?

Haley and she is just about 13

Veterinarian's Assistant: Is there anything else important you think the Veterinarian should know about Haley?

I think she also feels she has to defecate frequently as well, although it is always a small amount. She just seems to be uncomfortable with her back end, like she is just not satisfied that she is empty.

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Customer reply replied 1 month ago
This is for a dog not a cat, I don't know why it says cat veternarian
Answered in 42 minutes by:
3/12/2018
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Dog Veterinary
Satisfied Customers: 33,254
Experience: University of California at Davis graduate veterinarian with 45 years of experience
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I'm sorry to hear of this with Haley. Her ultrasound images need to be reviewed because at her age and with her signs a transitional cell carcinoma in her bladder/urethra needs to be an important consideration. It's relatively easy to miss an early cancer in that area when ultrasounding. Another worrisome consideration is that the cancer may have metastasized to her rectum resulting in the urgency to defecate. Less commonly, a recto-urethral fistula (abnormal connection between her urethra and rectum) may have arisen. Please respond with further questions or concerns if you wish.

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Customer reply replied 1 month ago
Our vet had us sent to an expert / specialist for the ultrasound so I would hate to think that something was missed in the ultrasound. Cancer was not mentioned at all in the ultrasound report. Is there another test that maybe could be done to confirm that there is not cancer that we may be missing? The did say that the bladder was was thicker than normal, possibly due to irritation. Also that her kidneys were starting to deteriorate. It was suggested that anti inflammatories could help the bladder irritation and inflammation, but our vet is concerned that would speed up the deterioration in the kidneys. The bloodwork showed kidney levels higher than a year ago, but not to they level that they were concerned about kidney disease until the ultrasound. Ultrasound also showed enlarged adrenal glands, so there is the concern of Cushings, but she shows no other symptoms of Cushings. The vet made it sound like further tests to confirm Cushings and treatment for Cushings would put more stress on the dog than it would really help her at this time.

Thank you for the additional information. I agree that the specialist wasn't likely to miss a cancer. In some cases, however, CT imaging is necessary to "see" it. A thickened bladder is seen with both infection and neoplasia. It wouldn't be unreasonable to presumptively treat a bacterial urinary tract infection with a broad spectrum antibiotic in spite of a negative culture because we do see falsely negative results particularly when a pyelonephritis (kidney infection) is present because such an infection doesn't shed bacteria all of the time.

The newest canine nonsteroidal antiinflammatory drug (NSAID) grapiprant isn't a COX inhibitor and so spares the kidneys.

I don't test for Cushing's unless my patient is both polyphagic (increased hunger) and polydipsic/polyuric (increased thirst/increased volume of urine). I agree with her vet that testing isn't appropriate for Cushing's. Please continue our conversation if you wish.

Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Dog Veterinary
Satisfied Customers: 33,254
Experience: University of California at Davis graduate veterinarian with 45 years of experience
Verified
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Customer reply replied 1 month ago
Thank you. I will mention the NSAID that you suggest above as I really think that it could be helpful. We did 2 different antibiotics prior to the culture, with no change, but it has been awhile since then so I will mention that as well.
Thank you for the agreement that it doesn't seem worth it to pursue the Cushings route. She definitely doesn't have an increased appetite, she is actually finally get back to an almost normal appetite.
I will call the vet again today and discuss these other items. Thank you!

You're quite welcome. Thank you for your kind accept. I appreciate it. I can't set a follow-up in this venue so please return to our conversation - even after rating - with an update at your convenience. You can bookmark this page for ease of return.

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Dr. Michael Salkin
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Dog Veterinary
Satisfied Customers: 33,254
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Experience: University of California at Davis graduate veterinarian with 45 years of experience

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