Recovering from surgery

[lvoss]

IME, it is not typical for them to have housebreaking issues after a UTI. Usually once the UTI is cleared up so is the problems with urinating in the house. I have also never had a vet give a single injection of antibiotics as treatment for a UTI. Usually they are given a 10-14 day course of antibiotics.

[Kananga]

@lvoss:

IME, it is not typical for them to have housebreaking issues after a UTI. Usually once the UTI is cleared up so is the problems with urinating in the house. I have also never had a vet give a single injection of antibiotics as treatment for a UTI. Usually they are given a 10-14 day course of antibiotics.

I was told the injection form is relatively new, but it provides up to 2 weeks worth of antibiotics.

IIRC, it was Convenia.

[Kananga]

Regardless, I think I may get a 2nd opinion. Thanks Ivoss.

[lvoss]

Here is a link that I found doing a search on Covenia. It sounds like it is not necessarily the best choice for UTIs.

http://answers.yahoo.com/question/index?qid=20090107175922AAe2TEO

[lvoss]

Did some more research and found that Convenia is recommended for treatment of skin infections. Its product handout is available online, http://www.convenia.com/pdfs/Convenia_prescribing_information.pdf

[tanza]

In reading what they gave him, sounds to me like they are treating him for a infection related to the incision and NOT an UTI?…. and that would make sense since they "harrassed" you for not keeping an e-collar on him and said he had an infection due to licking.

I would for sure get a second opinion.....

[Kananga]

Good catch, both of you. I stopped at home to let Kananga out to check on him. He didn't have any accident, but when I took him out to go, I noticed (As before) his urination stream is a bit weak and it seems like he's trying to cut it off early. Meaning perhaps he's still in a bit of pain.

I also grabbed his paperwork while I was there. I confirmed they used Convenia. They did, however, diagnose him with a Lower Tract Urinary Infection. It sounds like the diagnosis was accurate (to some extent) but I'm strongly questioning the prescribed meds.

I did call them today and they said "it could take up to a week to show signs of improvements". But I'm not buying that. Last time I called they gave bad advice, I have my doubts with this call. I'm going to look into a 2nd opinion.

EDIT: Decided to call back and have the vet call me directly. I explained my concerns over Convenia being prescribed when "I have read" that it is only reccomended for treating skin infections. That and I explained my concerns over his lack of improvement and side effects (being lethargic). We'll see what they have to say.

[tanza]

Hope that you get some answers… and that your boy feels better soon.... I think that your concerns are very well justified.

[lvoss]

I also hope you get answers and if you don't then definitely seek a second opinion. Don't let them bully you.

[Kananga]

I have to mention the call I had to the "other vet" not too far from here. I did some research and found a vet that is closer that had great reviews. Called them up and couldn't be more pleased with how accommodating they are. The woman I spoke with was extremely helpful and very knowledgeable. They said they'd open up an appt for him if I wanted a 2nd opinion and that they could have him in right away.

I think after all of this I may give them a try regardless of what happens. It honestly sounds like they are more concerned about the pet than they are the revenue.

[Basenjimamma]

Kananga, I sure hope things clear up for you and him. I wouldn't hesitate getting a second opinion, if no improvement is seen within the very near future..
Accidents like that sounds more like physical to me as well, especially if you notice his stream being weaker. Could he have a blockage?

[Kananga]

Heard back from the vet.

I'm not entirely impressed. This is the summary of what I was told:

-Convenia is in fact used for internal infections and has been successful at treating such, it's typically the first choice for treating UTIs.
-They have been using Convenia for 4 months and have not had any issues
-It was mentioned that the weak urination stream and accidents could be caused by irritation of the internal sutures or he was having a relapse with housetraining (and that it can happen after a neuter). Essentially being told that having him neutered after being a year old can cause issues
-I explained that he was fine for 4-5 days after surgery and these issues came up after, when he should be improving, not getting worse
-She didn't have an answer for me and said it could be necessary to try an oral antibiotic

Again, not impressed. I mean logically the neutering should no correlate with the symptoms considering 1) It started 4-5 days after the surgery, and 2) The symptoms occurring directly correlate with the diagnosis of a UTI. Not to mention he's been healing great. The incision site looks fantastic.

I'm not a veterinarian but this is my logical conclusion.

I did not agree to oral antibiotics, instead I asked for a copy of the urinalysis to be faxed to me and that I'd wait it out. I did not tell them this, but I wanted a copy so that it could be useful for when I bring him in to a different vet.

[Basenjimamma]

Good for you for standing your ground. Did they have any issues faxing you that analysis? Time to move to a new and improved Vet.

[Kananga]

I've got the analysis.

(If anyone can translate this, I sort of understand it)

Urine WBC - Positive - 0-2/hpf
Urine RBC - Positive - 0-2/hpf
Urine Epithelial Cells - Negative
Urine Bacteria - Positive - cocci
Urine Crystals - Negative
Urine Casts - Negative
Urine Sperm - Negative

Urine Specified Gravity - 1.017
Urine Urobilinogen - 0
Urine Glucose - 0 (I'm assuming this is something that would show up at an older age if he was positive for Fanconi?)
Urine Ketone - 0
Urine Bilirubin - Negative
Urine Protein - 0
Urine Occult Blood - 0
Urine pH - 6.500
Urine Color - Normal
Urine Appearance - Normal

Tentative Diagnosis - Cystitis

I do know his urine color is different from normal. Usually it is yellow, very apparent, but lately it has been much more clear. Probably from him drinking more water than normal.

[tanza]

I agree with your "logical" conclusion… and you are correct about Glucose in the urine and Fanconi.

I would for sure take up the offer for a 2nd opinion... it is clear (at least by why you have written) that he is not feeling well and that this medication is clearly most likely not working. (I am not a vet either, so this is just my opinion). As far as the neuter causing issues... all of mine were neutered at 3yrs to 6yrs and we never had a problem... so I don't buy that either. And using an antibiotic for 4 months is not very long to know if it really works on "everything" or not... again IMO... unless they have had an unusal amount of UTI's to have used it on....

You know it is interesting sometimes with Vets... while certainly they are the experts, many seem to forget that we are the ones living with our pets everyday. We notice things like a difference in they urine stream, color, their general well being... and it is a good Vet that listens to what you are telling them. Granted they most likely get more people that show up with the "I think this has been going on for a few weeks"..... or "I don't remember when it started".... putting everyone including the pet at a disadvantage, but when you have an owner that knows their pet, knows when something is not right... and ignores what you say... time IMO to find one that will listen....

[renaultf1]

@tanza:

I agree with your "logical" conclusion… and you are correct about Glucose in the urine and Fanconi.

I would for sure take up the offer for a 2nd opinion... it is clear (at least by why you have written) that he is not feeling well and that this medication is clearly most likely not working. (I am not a vet either, so this is just my opinion). As far as the neuter causing issues... all of mine were neutered at 3yrs to 6yrs and we never had a problem... so I don't buy that either. And using an antibiotic for 4 months is not very long to know if it really works on "everything" or not... again IMO... unless they have had an unusal amount of UTI's to have used it on....

Just curious…Have you ever heard of them "nicking" something in surgery for a boy and then having issues permanently afterward? I've heard about it in girls, but not boys and figured I'd asked someone "who has seen/heard everything." Could a problem show up a few days after surgery as internal swelling starts to go down?

[EskiLovr]

When I worked for a veterinarian, it was not unusual to see UTI or kidney problems after a surgery. The normal procedure before surgery is to take away food and water for 12 hours, then the surgery, and then there might be some time after where the animal doesn't want to drink. This combined with the fact that the kidneys have to filter out all the drugs used in the surgery means that the urinary system is put under some stress. This can sometimes bring on UTI's and other infections as well as kidney stones and other urinary problems.

I agree with you that it does not seem like your veterinary office is taking you very seriously, and I would take the other vet up on the 2nd opinion. It will put your mind at ease, and that in itself would be worth the cost, because I can tell you are pretty worried.

[tanza]

@renaultf1:

Just curious…Have you ever heard of them "nicking" something in surgery for a boy and then having issues permanently afterward? I've heard about it in girls, but not boys and figured I'd asked someone "who has seen/heard everything." Could a problem show up a few days after surgery as internal swelling starts to go down?

Yes, it does happen but usually in bitches.. but I have found that 99% of the time this happens with low cost Vet clinics for spay/neuter, not regular practices (unless you don't have a good surgeon to begin with). Many times with the Low Cost Clinics they have Vet students or Vet's new out of school that donate their time.. while there is nothing wrong with that, there should be an experienced Vet that observes the procedure. And if it happens, typically they will leak urine when sleeping as a first sign, which doesn't seem to be the case here….

[Kananga]

@tanza:

Yes, it does happen but usually in bitches.. but I have found that 99% of the time this happens with low cost Vet clinics for spay/neuter, not regular practices (unless you don't have a good surgeon to begin with). Many times with the Low Cost Clinics they have Vet students or Vet's new out of school that donate their time.. while there is nothing wrong with that, there should be an experienced Vet that observes the procedure. And if it happens, typically they will leak urine when sleeping as a first sign, which doesn't seem to be the case here….

Yea, that is not the case. I think it's clearly a mild lower-UTI. Drinking more water than normal should be the clear indication.

And I do think, as mentioned, stress and lack of water was a probable cause of the UTI. Can't think of how else it could have came about. Only other scenario is when he held his bladder for 20 hrs early on in the month, but i'd imagine the UTI would have come about sooner.

I have an appointment scheduled with the new vet tomorrow morning.

[Patty]

I do hope this is soon resolved Kananga - I feel for you and your worries and the poor little boy.
Once again I have found this forum helpful - a friend of mine whose Basenji suddenly became incontinent was told by her vet that it could be a UTI or if she didn't respond to her teatment it could be the result of a tumour!! He gave a course of antibiotics and she is still incontinent so now my friend thinks she must have an op. Thanks to Ivoss's comments about UTIs needing more than one course of antibiotics I'll get on to her to ask her vet for a further course.
Thank you so much.