Recovering from surgery

[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.

[tanza]

Good luck at the new Vet and the appointment…. and really they can get a UTI for lots of reasons... while I never had one with a UTI after surgery (any kind of surgery), but I have had a couple with UTI's.... with nothing going on before hand... at least not that I remember

[Kananga]

New vet saw Kananga today. Her thought was to put him back on his pain medication, which are actually anti-inflammatory. She thinks that since I stopped giving him his meds, he is feeling more irritation, causing the weak stream and causing him to have accidents. I wasn't aware they were anti-inflammatory medication, would have been nice to have known that from day 1 instead of being told they were pain meds.

She said she'd call me back on Thursday to see how that is going, and if that isn't working she'll have another urinalysis done.

I think even though I was more concerned than I should have, I'm glad I went to this vet. I was very impressed with how the entire staff treated both myself and my dog. The vet in specific was fantastic. Very friendly, intuitive, and knowledgeable (specifically with Basenjis). I was impressed that Kananga was quite relaxed for being at a clinic. They have a much more warm vibe there. So I think regardless I'm going to switch to them.

We'll see how the medication works.

[Kananga]

In regards to the excessive drinking, she mentioned the warmer weather may prompt him to drink more. It has been humid lately.

Also I asked about Convenia. She said she typically dislikes giving medication, but for infections that is her top choice. She said it travels through their urine when it gets flushed out, which directly contacts the source of the infection (when dealing with UTIs). She seemed to have been familiar with this a lot more than the other vet. But she said she did not want to put him on another antibiotic unless he doesn't respond to the anti-inflammatory and the 2nd analysis comes back positive.

[tanza]

Great news… 90% is having a Vet that you and your pets like.... sounds like you found one!!!!

[Kananga]

I'm starting to think it's behavioral.

Last night he couldn't make it more than 3-4 hours without having an accident. Today I was gone for a little over 10 hours and there were no accidents. Could he simply just be careless when I'm around? Or is he acting up?

Regardless, as some of you have seen with the other thread, I'm considering litterbox/pad training him as a permanent solution. It's honestly too time consuming to be taking him out every couple hours and once winter rolls through it'd be a nightmare.

[Basenjimamma]

Do you think he is testing you? If he can make it through the night but not during the day, we know it is not physical, right?

[lvoss]

Not true, my girls tended to have more accidents when I was home because they were active and excited about me being there. Really, if he is still having accidents then another urinalysis needs to be done. It could be that there is a behavioral component but it is more likely that the bacteria causing the UTI were not susceptible to the drug since we know this behavior started with a UTI. My vet always recommends a culture and sensitivity test for UTIs because they can be a challenge to clear up even if the infection is considered low grade. Since his behavior has remained consistent since the UTI diagnosis, I would definitely ask have another urinalysis done. At this point you should have seen improvement.

[Kananga]

@lvoss:

Not true, my girls tended to have more accidents when I was home because they were active and excited about me being there. Really, if he is still having accidents then another urinalysis needs to be done. It could be that there is a behavioral component but it is more likely that the bacteria causing the UTI were not susceptible to the drug since we know this behavior started with a UTI. My vet always recommends a culture and sensitivity test for UTIs because they can be a challenge to clear up even if the infection is considered low grade. Since his behavior has remained consistent since the UTI diagnosis, I would definitely ask have another urinalysis done. At this point you should have seen improvement.

No, I do agree. The other vet (new one) is supposed to touch base with me tomorrow to see if the anti-inflammatory medication has helped. I'll let her know that it hasn't been very effective. She'll be more than happy to do a urinalysis.

For now though, I'm going to give the pads a try. I picked up a 30ct package to test with him. He might be happier to be able to go when he needs to.

[Kananga]

Well I don't think a 2nd test is necessary. There are signs of improvement and he has not had an accident since Tuesday. I've tested him on several occasions and he simply shows no loss of control. His urination seems better and overall isn't acting up.

The vet also thought it wasn't necessary considering he hasn't gotten worse. That would be signs of the antibiotics not working. Either the antibiotic is a slower acting one, compared to oral antibiotics, or the anti-inflammation medication did the trick.

[Basenjimamma]

I am glad to hear that Kanagan is doing better, I will keep my fingers crossed that it will be all done before you know it..

[Kananga]

Yea, he just unleashed 2 weeks worth of energy with an endurance B-500, which at one point resulted in him flying head first into me. I think I need to see a vet now.

It was the 2 week mark today. I had to let him return back to normal. Maybe that was it.