Purchased Tuesday, 2/3/15: Female, 9-wk old, un-spayed, 2-lb pure-breed Yorkie. No incontinence observed. Beginning

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Customer: Purchased Tuesday, 2/3/15: Female, 9-wk old, un-spayed, 2-lb pure-breed Yorkie. No incontinence observed.
Beginning Thursday, 2/5/15: Puppy urinating in her sleep, both at night and while napping. Wakes up soaked, in a puddle of water-like, odorless urine. Persistent, UN-concentrated urination in and out of the house, small puddles and dribbling. No sign of blood or discomfort. Excellent activity and appetite.
1st vet visit: Saturday, 2/7/15 - Presumed UTI - prescribed Clavamox .5ml BID - no missed doses
2nd vet visit: Tuesday, 2/10/15 - UA showed bacteria; ultrasound a thickened bladder wall. Prescribed Albon .75ml QD; continue Clavamox UF; no missed doses.
To date, 2/17/15 - Symptoms remain unchanged
Answered by Dr. Michael Salkin in 22 mins 8 years ago
Dr. Michael Salkin
48+ years of experience

132,690 satisfied customers

Specialities include: Dog Veterinary, Dog Medicine, Dog Diseases, Small Animal Veterinary

Aloha! You're speaking with Dr. Michael Salkin
While a bacterial UTI can certainly cause the urinary incontinence you've noted, it's important to recognize that a UTI may have arisen secondary to a congenital defect such as an ectopic ureter. It's important to culture such dilute urine two days after the course of antibiotics have been completed to make sure that the urinary tract has, indeed, been sterilized. If it has and Darla remains incontinent, ectopic ureter becomes an important differential diagnosis and so ultrasound of her urinary tract is indicated in an attempt to identify such a congenital defect.
Clavamox is a good choice when a culture and sensitivity hasn't been performed. It's nicely broad spectrum. Albon (sulfadimethoxine), however, doesn't have a place in treating UTIs in dogs. Please respond with further questions or concerns if you wish.
Thank you for your response. Darla has another follow-up appointment tomorrow, and I will ask for another ultrasound, to include the urinary tract this time. I will also have a UA after the completion of the antibiotics as you suggested.Questions: (1) Do you feel there is any value in having blood work done?, (2) Do you recommend any home remedies, i.e. adding organic Apple Cidar Vinegar to her food?, (3) Could this simply be an "immature bladder"?I greatly appreciate your time and attention to these inquiries. My husband and I have been visiting with Darla @ the breeder's since she was 5 weeks old, and even though she's only been home with us for 2 weeks, she has completely stolen our hearts!
Sounds good.
1) No, I'd hold off on blood work and concentrate on the urinary tract for now. If nothing untoward is found either by bacterial culture and sensitivity or ultrasound, we can pursue more unusual causes of urinary incontinence such as overfilling due to polydipsia (increased thirst)/polyuria (increased volume of urine) as seen with a number of metabolic disorders.
2) No, not until the etiology of her incontinence is identified. There's quite a bit of anecdotal information concerning the use of apple cider vinegar but please note there isn't a whit of scholarly study that suggests it's of any value in dogs.
3) No, "immature bladder" isn't recognized in dogs.
I can imagine. What's cuter than a 2 lb Yorkie! Please continue our conversation if you wish. You're quite welcome.
Thank you again Dr. Salkin for your speedy and thoughtful response. I've been searching online for information, and several Yorkie chat forums discuss this napping incontinence in Yorkie puppies which mysteriously abates at about 6 months of age. The "immature bladder" is a frequent term I've come across.Our highly recommended breeder is very concerned (20+ yrs experience), and hasn't had this issue before. Darla's parents are both 3YO, 5.5-6 lb, (and the breeder has raised several generations) so praying that no "runt/teacups" in her bloodline will bode well for her health.If you can think of any other courses of treatment or tests we should explore, your advice would be greatly appreciated!THANKS MUCH!
I understand. I don't know what the mechanism of such an "immature bladder" would be, however. The proper sequence to follow with Darla is the following:
1) Complete the antibiotics, wait 2 days and perform a bacterial culture and sensitivity on urine obtained by cystocentesis - percutaneous aspiration of her bladder.
2) If negative for bacterial growth but she remains incontinent, ultrasound her urinary tract in an attempt to identify a congenital defect such as ectopic ureter.
3) If positive for bacterial growth and a congenital defect can't be found, select another antibiotic as determined by the culture and sensitivity. Continue treating for 10-14 days and once again perform a bacterial culture and sensitivity 2 days after the course of antibiotic has been completed.
I can't set a follow-up in this venue and so would appreciate your returning to our conversation with an update - even after rating - at a time of your choosing.
Sounds like an excellent plan. I will bring a printout of our dialogue along to Darla's appointment tomorrow morning. Your detailed response and concern for her treatment means more to me than I can properly express in this format. This is my first time using this online resource, and you have impressed me greatly. THANK YOU VERY MUCH Dr. Salkin.Regards,
Suzanne Straw
aka Darla's Mommy
It's my pleasure. Thank you for your kind words and accept. I appreciate it. I hope to hear from you soon.
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Dr. Michael Salkin
132,690 satisfied customers
48+ years of experience
Dr. Michael Salkin
48+ years of experience

132,690 satisfied customers



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31,131 satisfied customers

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