Recovering from surgery

[Kananga]

Oh he's back to normal. Lazy as usual… :rolleyes:

Actually I think he's tired from his walk this morning.

[Basenjimamma]

He looks so tired…almost drunk. That is so funny, like that wall is holding him up.

[Kananga]

He's getting better, I think, but still having accidents. Over the weekend I was having to take him out every 3-4 hrs. Even then he had issues holding it till we got outside, which resulted to me carrying him now. Of course this morning while I was getting dressed he couldn't hold it. He had the injection on Friday so I'm not so sure how long it takes for a big improvement. He did sleep a lot over the weekend which was odd. I think he slept about 90% of the day.

[lvoss]

Usually with antibiotics significant improvement is seen in 24-48 hours. This should be especially true if he was given an injection since it was a single dose. If he is still urinating in the house, he will need to go back to the vet because the antibiotics were not effective. My vet always recommends a culture when a UTI is suspected to make sure the antibiotic is one that will actually be effective for the bacteria present.

It may also be time to consider a second opinion from another vet.

[Kananga]

@lvoss:

Usually with antibiotics significant improvement is seen in 24-48 hours. This should be especially true if he was given an injection since it was a single dose. If he is still urinating in the house, he will need to go back to the vet because the antibiotics were not effective. My vet always recommends a culture when a UTI is suspected to make sure the antibiotic is one that will actually be effective for the bacteria present.

It may also be time to consider a second opinion from another vet.

Do you think he's just having issues with house training since he was having accidents while he had the infection originally? Meaning, is it simply a mental issue versus a physical?

I would hope the antibiotics are working. I'm testing him today to see if he has an accident while I'm away (8 hrs). The accidents are not typically consistent. He had one accident leading to go outside in the hallway over the weekend, which I stopped him right away and then he was ok. Although I have been carrying him out to go since to prevent any accidents. This morning was the only other accident he had but it still concerned me. He's always had great bladder control and it was strange since he started urinating while he was sitting. Of course it was on my side of the bed. :rolleyes:

I did stop him right away, picked him up and put him in the bathroom for a minute while I cleaned everything up. He proceeded to empty his bladder in there. Easier to clean up because of the tiled floors, still not fun.

[tanza]

I doubt very seriously if it is a mental thing… I would say physical... and I agree with lvoss that usually in 24 to 48 hours you see the improvement. I know my vet usually give Clavamox for UTI's and it is a course of at least 14 days. Also have had Baytril too. Do you know what they gave him?

[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.