Roxy Dog

[Codester]

I am very happy that I found this forum and the wealth of information here.

My dog Roxy is 50 lbs, 12 1/2 years old and has had problems with her bladder leaking for the past 2 years. She is a husky/ beagle mix. The vet said that it was likely caused because she was spayed and it is common for older female dogs to lose control of their bladder. They put her on 50mg of Proin, which she is still currently taking. She also takes Cosequin.

Just this past week, Roxy was leaking much more than usual and actually peed in the house, right in front of me. She has never done that before and it was very uncharacteristic. The next day, she was straining to pee constantly outside and needing to go out all the time. Upon inspection, I found blood in her urine, so in to the vet we went for a urinalysis.

The vet gave a call back that said they couldn't find any infection, but that didn't mean that there wasn't an infection. They prescribed her antibiotic moxacilin, which they said should help with the blood in her urine.

They asked for us to bring her back in to run some blood tests, and the results pointed to symptoms characteristic of cushings. She is drinking buckets, peeing rivers, panting, and always acts like she wants food right after we feed her.

The vet recommends a low-dose dexamethasone suppression test. The reason she likes this test is because it is 95% accurate in determining whether a pet has Cushing’s, whereas the other tests are less accurate. Roxy would need to stay there most of the day as they have to take serial blood samples at least 4 hours apart. The cost for this test is approximately $280.

If the test is positive, ideally she would like to refer Roxy for an abdominal ultrasound to assess her liver and adrenal glands. We can, however start her on medication that will be life-long to begin treating her. The estimated medication cost for first 30 days is approx $180, followed by a blood test. She said they may be able to decrease medication after initial 30 days, and she would need blood work done every 6 months afterward.

Money is very tight for me as I live in Alaska and have a family to raise. We have already spent $360 dollars on her this past week and I hate that money makes it somewhat of a determining factor. Is there anything else I can do to manage her condition without medication? At her age, it's hard to guess how much longer she would have anyway..

She has bright eyes, seems very alert, jogs and runs around outside and seems like she's in good condition. Will the medication help to increase her life-span or will it mainly just give her increased comfort? Has anybody tried using essential oils to help?

Thank you all in advance for your time and replies

[Squirt's Mom]

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[Squirt's Mom]

Hi and welcome to you and Roxy! :)

I just wanted to take a second and let you know that using Essential oils on dogs is not a good idea. There is a liver enzyme required to process the oils from the body and dogs have very little of this enzyme, cats have none. By the time the animal is showing signs, it is often too late and organ shut down has begun. I realize that is not at all what the MLMs that sell EOs tell you but they have one goal in mind - making money. If you want to try a 'natural' approach get with a holistic vet if there is one in your area or use whole plant herbs, not just the volatile oils. The plant has many more benefits to offer that are completely missed and that do not cause damage that EOs can. I have a slew of links if you are interested.

I'm sure others will be along soon to welcome you and share their stories with you!
Hugs,
Leslie and the gang

[Renee]

Hi there fellow Alaskan!!

Where are you in AK? I am in Anchorage. Who is your vet / vet clinic?

A few things come to mind for me:

1. Have you ruled out bladder stones? This may be the cause of some of Roxy's issues.

2. Can you request your vet to run a culture and sensitivity, rather than just a UA? The reason for this is that a UA can have false positives. I would be hesitant to believe there is no infection, with the presence of blood and straining to urinate.

Now, the LDDS is the preferred method of diagnosing cushings, but I would suggest you not even move forward with that until you can for certain rule out some other issues that are similar to cushings.

Has your vet ruled out diabetes and thyroid? If not, then you might ask your vet about those.

The ultrasound is an excellent idea, but I'll be honest with you, if you are in anchorage, the only place to get a high resolution ultrasound is at Pet ER with Dr. Love. It's about $600-700. :( It is a good tool though. I opted to get a CT when it came time for imaging, and I am very glad I did, but that is about double the cost of the ultrasound.

[Codester]

Hi and welcome to you and Roxy! :)

I just wanted to take a second and let you know that using Essential oils on dogs is not a good idea. There is a liver enzyme required to process the oils from the body and dogs have very little of this enzyme, cats have none. By the time the animal is showing signs, it is often too late and organ shut down has begun. I realize that is not at all what the MLMs that sell EOs tell you but they have one goal in mind - making money. If you want to try a 'natural' approach get with a holistic vet if there is one in your area or use whole plant herbs, not just the volatile oils. The plant has many more benefits to offer that are completely missed and that do not cause damage that EOs can. I have a slew of links if you are interested.

I'm sure others will be along soon to welcome you and share their stories with you!
Hugs,
Leslie and the gang

Thank you for your input. My wife is way into Young Living Essential Oils, which are of the highest quality. She states that there have been numerous cases where oils have helped dogs with different problems. I would definitely be interested in any links you have on this matter.

[Codester]

Hi there fellow Alaskan!!

Where are you in AK? I am in Anchorage. Who is your vet / vet clinic?

A few things come to mind for me:

1. Have you ruled out bladder stones? This may be the cause of some of Roxy's issues.

2. Can you request your vet to run a culture and sensitivity, rather than just a UA? The reason for this is that a UA can have false positives. I would be hesitant to believe there is no infection, with the presence of blood and straining to urinate.

Now, the LDDS is the preferred method of diagnosing cushings, but I would suggest you not even move forward with that until you can for certain rule out some other issues that are similar to cushings.

Has your vet ruled out diabetes and thyroid? If not, then you might ask your vet about those.

The ultrasound is an excellent idea, but I'll be honest with you, if you are in anchorage, the only place to get a high resolution ultrasound is at Pet ER with Dr. Love. It's about $600-700. :( It is a good tool though. I opted to get a CT when it came time for imaging, and I am very glad I did, but that is about double the cost of the ultrasound.

Thanks so much for your reply. I live in Girdwood, which makes trips to the vet a little more difficult.. We take her to VCA animal hospital, the one that is at 12531 Old Seward Hwy near Dimond. Dr Overstreet is the doc who has been going over Roxy's results.

1.) I havent considered bladder stones.. After her taking the antibiotics for 5 days now, she is doing much better. She appears to be leaking less, on a more normal schedule of going outside and isn't straining to pee anymore. I suspect the straining to pee and blood in the urine was from an infection.

2.) I think one of her recommendations was to culture and test it. Would this help rule out weather it is cushings or not? It's probably much cheaper than the LDDS. This seems more like the direction I would like to go because it would be much cheaper than the LDDS.

Im not sure if the vet has ruled out diabetes or thyroid, but I will ask her about it next time I give a call.

The ultrasound would absolutely be out of my budget.. So I guess we won't be doing that..

[Renee]

Given what you are describing, I would wait for the abx to run their course, then follow up about a week later with a culture and sensitivity. This should tell you if the abx worked at all, and if any infection is still present. It will also tell you what abx to use in order to get rid of the infection, if it is still present. The culture will not rule out cushings.

The reason I think bladder stones may be a possibility is because you described urine leakage, straining to urinate, and the presence of blood. You would need to have xrays to rule out stones. Xrays are usually around $150, the culture and sensitivity $110.

I take my pugs (and all the rescue dogs) to Highland Animal Clinic, which is on Klatt and Old Seward. If you ever want a second opinion, Dr Jen is the vet you'd want to ask for.

[Codester]

Given what you are describing, I would wait for the abx to run their course, then follow up about a week later with a culture and sensitivity. This should tell you if the abx worked at all, and if any infection is still present. It will also tell you what abx to use in order to get rid of the infection, if it is still present. The culture will not rule out cushings.

The reason I think bladder stones may be a possibility is because you described urine leakage, straining to urinate, and the presence of blood. You would need to have xrays to rule out stones. Xrays are usually around $150, the culture and sensitivity $110.

I take my pugs (and all the rescue dogs) to Highland Animal Clinic, which is on Klatt and Old Seward. If you ever want a second opinion, Dr Jen is the vet you'd want to ask for.

I like this train of thought and suggestion. I think I will lean towards going this route.

On probably an un-related note, I forgot to mention that she has tons of lumps all over her. The vet has checked her out and states that they are benign cysts, but I thought it might be worth mentioning here.

[Squirt's Mom]

EO info

http://www.granolaliving.com/2012/07/why-we-dont-offer-doterra-young-living-or-other-multi-marketing-brands-of-essential-oils/

http://harebrainthoughts.blogspot.com/2013/07/friday-review-young-living-essential.html

http://realessentialoileducation.com/?p=1872

http://www.naha.org/explore-aromatherapy/safety/#general

http://gogreenct.wordpress.com/2014/04/14/seeds_of_thought/

http://gogreenct.wordpress.com/2014/03/22/aromatherapy_safety/

http://www.takingcharge.csh.umn.edu/explore-healing-practices/aromatherapy/are-essential-oils-safe

http://www.crunchybetty.com/21-things-you-should-know-about-essential-oils

http://www.cancer.gov/cancertopics/pdq/cam/aromatherapy/patient/page2

http://www.dailymail.co.uk/femail/article-2051976/How-aromatherapy-oils-poison-Tiny-particles-oils-damage-liver-kidneys.html

http://www.naturesgift.com/warnings.htm

http://www.a-t-c.org.uk/safety-matters/essential-oil-safety/

http://theida.com/aromatherapy-education/the-quality-of-essential-oils

http://www.thebarefootdragonfly.com/friends-dont-let-friends-drink-essential-oils/

Deceitful marketing is a big issue for us. There is no such thing as a therapeutic grade essential oil:
http://www.cropwatch.org/Therapeutic%20Grade%20Essential%20Oils%20corrected .pdf

A must read article on using essential oils safely:
http://www.naha.org/explore-aromatherapy/safety

https://skeptoid.com/blog/2014/04/05/essential-oil-claims-the-dangers-keep-on-coming/

Animal info (Glucuronyl transferase liver enzyme needed to process toxicity of volatile oils that cats do NOT have at all and dogs have very little of)
d-limoene is found in essential oils from citrus, like lemon, orange, etc.

In Kirk's Current Veterinary Therapy XIII 1999. pp.556
~Dogs experiencing epidermal necrosis associated with d-limoene are usually in pain and systemically ill. Anemia and liver and kidney damage may also occur. Supportive care is usually essential until the condition resolves. Severe forms of this condition are similar in severity to what is seen in third degree burn victims, with extensive skin damage resulting in skin sloughing, depression, shock, coma and often death.

Muller and Kirk's Small Animal Dermatology 1995. pp.590
~Natural insecticidal dips or sprays containing citrus extract d-limonene, 50% of the 24 animal cases developed clinical signs of adverse health reactions whether or not product was used appropriately or inappropriately. 92% of animals experienced one or more of an adverse health condition. Study from Jrnl. of Veterinary Emergency Critical Care Society 2012 pp1-6

~Toxic Epidermal Necrolysis associated with flea dips containing d-limonene --Vet Hum Toxicol 1992 Feb
TEN --a life-threatening skin condition that the top layer of skin (the epidermis) detaches from the lower layers of the skin (the dermis) all over the body. Sepsis is secondary problem often fatal disease.
~Erythema Multiforme major and disseminated intravascular coagulation developed in a dog 24 hrs. following application of a d-limonene insecticidal dip. Despite intensive supportive care, the dog developed severe necrosis and widespread hemorrhage within organs and died -- J Am Vet Med Assoc. 1995 Nov.

~EPA Records over a 10 year span: Showed 544 cases of domestic animals were called in to the EPA regarding d-limonene products and domestic pets were either killed, severely harmed, moderately harmed or minor.

[Codester]

So I got a reply back from the doctor after asking about ruling out the possibility of other problems such as diabetes or thyroid. The doctor said regarding the other conditions I mentioned that can cause excessive drinking and urination, her bloodwork and urinalysis do not support them. Diabetes will cause in increase in blood glucose levels and glucose in her urine. These were both normal. Additionally, her thyroid hormone level is within the normal range which does not support the idea of hypothyroidism.

She had another suggestion that is slightly less expensive to rule out Cushing’s: a urine cortisol creatinine ratio (UCCR). Most dogs with Cushing’s will have an elevated UCCR, however, it can be elevated for other reasons, such as stress. Therefore, it is not a test used to diagnose Cushing’s but rather to rule it out. This means that if Roxy’s UCCR is within the normal range, she does not have Cushing’s.

[molly muffin]

Everything you are saying seems to point to a urinary infection which the urine culture and sensitivity can rule in or out, possible bladder stones as a cause as Renee mentioned.
I wouldn't pursue the other test, even UCCR until the bladder situation is completely cleared up. Cushings doesn't cause blood in the urine but bladder stones and even crystals can cause that.
Once you know that the bladder is okay, no more straining a culture is negative, give it about 2 weeks, then you can do a UCCR if you still want to or feel there is a need. But you need to give it time so that there isn't any high cortisol caused by the bladder. (anything going on can cause the cortisol to be raised during that time)

Those are my initial thoughts. Welcome to the forum.

[Renee]

All good thoughts Sharlene. I completely agree!

Even if cushings is at play, it is a slow progressing disease, there is no rush to get quickly to a diagnosis and start treatment.

[Codester]

Everything you are saying seems to point to a urinary infection which the urine culture and sensitivity can rule in or out, possible bladder stones as a cause as Renee mentioned.
I wouldn't pursue the other test, even UCCR until the bladder situation is completely cleared up. Cushings doesn't cause blood in the urine but bladder stones and even crystals can cause that.
Once you know that the bladder is okay, no more straining a culture is negative, give it about 2 weeks, then you can do a UCCR if you still want to or feel there is a need. But you need to give it time so that there isn't any high cortisol caused by the bladder. (anything going on can cause the cortisol to be raised during that time)

Those are my initial thoughts. Welcome to the forum.

After being up all night long with my Roxy girl, I made her a vet appointment this morning. We just finished the 10 days of antibiotics, and she seemed to be doing great until last night. Now she's back to straining to pee with dark blood in her urine. I let her out for 15 minutes, come back inside and within 15 more minutes she needs to go back outside again. She also, uncharacteristically peed right in the middle of the living room floor while the family was out of the house yesterday.. :-(

Do dogs with cushings normally have blood in their urine? It sure seems like something else is at play.. We will see about the culture and sensitivity test today and I'll let you all know what they find.

[Renee]

Straining to pee is a big deal. I encourage you to get her x-rayed to check for stones! This is not a typical cushings issue, although UTI's can be common.

[molly muffin]

Straining to pee and blood in urine are not symptoms associated with cushings. They are associated with as we've mentioned before, stones, crystals, kindey/bladder and UTI's. A very bad one at that. But stones is my biggest worry as it can be life threatening if they cause a blockage.

[Renee]

Just checking in and nagging a bit! I sure hope your vet has xrayed your girl to rule out bladder stones.

[Codester]

Just checking in and nagging a bit! I sure hope your vet has xrayed your girl to rule out bladder stones.

I appreciate your nagging and concern!

We got her 3 x-rays and a urine culture/ sensitivity test. The vet said that they did not see any stones, but found that her back is very arthritic with some calcium deposits, she has an enlarged spleen and she has some sort of lobe growing on her liver.

They prescribed her more antibiotics (moxacillin) since she responded well to them. They recommended giving her some cranberry capsules to help out as well.

We wont get the results from the culture back for a week or so..

I'm really hoping that we can figure this out because it is already getting way out of my budget :( :( :(

[Squirt's Mom]

I had a Pit mix who had struvite crystals; she never developed the stones, but she had the crystals most of her short life. Struvite crystals and stones typically start with infection and cranberry can help make the internal environment too acidic for the bacteria to stick and cause problems. Any acidic fruits and veggies will help but you don't want to overdo. Crys would eat mandarin oranges, pineapple, cranberry, regular oranges, and seems like another but I can't remember at the moment. She got her fruit as treats when the others got something else. ;) You will want to know which type stones or crystals Roxy has IF that turns out to be the case since foods that help one type can make another type worse.

[Codester]

Roxy got her test results back today and this is what the vet said, "On her urinalysis her specific gravity or concentration of her urine is low. We often see this in dogs with urinary tract infections as they tend to be drinking more water as their bodies way of trying to clear the infection. If it remains low after the infection has cleared, then we will explore other potential causes for this. She has some protein in her urine...likely from the blood in her urine and the infection.
Her culture was positive for E. Coli."

She recommends Roxy go on antibiotics for 20 days, followed up by another urine culture test a week later to make sure that the infection is truly cleared and to also check to see if the blood is resolved and if she is concentrating her urine better.

If we clear the infection but she is still having blood in her urine, she would recommend the abdominal ultrasound to give us better visualization of her kidneys and bladder to see if there are any underlying causes for her urinary tract infections.

[molly muffin]

It means that right now, her urine is very dilute. You definitely need to clear the infection first and I'll tell you from what we have seen e-coli can be a bugger to get rid of. So 20 days at least, wait a few days minimum or even a week before retsting, as we have seen it come back once thought cleared. So, yes no point in even going after cushings testing or further analysis until that is cleared up.

The good thing is that you know what kind of infection it is and can be aggressive in treating it.

[Codester]

So Roxy just ran her course of 21 days of Antibiotics for her Ecoli infection. The vet told us that after she's done, we need to take her in to test her urine again. Will a urinalysis test tell us what we need to know, or is it a different test such as a culture? or sensitivity?

[Renee]

Hey there - I would do the culture & sensitivity myself, since it is going to be much more accurate than just a simple UA.

How are Roxy's symptoms?

[Codester]

She has been doing much better since being on the Antibiotics, able to control her bladder better and seems to be urinating less frequently. She still however has a few symptoms that concern me. She still has a tremendous thirst for water, she is panting quite frequently and she always asks for more food right after I feed her. The symptoms are more pronounced certain days more than others..
We went ahead and got the urinalysis and culture test, so we will see what the find from that within this week.
We started giving her cranberry extract last week per the vet's recommendation and she is still taking 50mg of proin a day.

[molly muffin]

Have you got the results back yet on the urinalysis and culture?