Editor’s note: This new column will run the first week of each month, dealing with questions about veterinary problems. This month’s column features questions from readers who emailed in over the last few weeks.
Dear Dr. Amy,
I’ve been having a lot of problems with my 8-year-old miniature schnauzer “Dixie.” She is such a sweet girl and very well trained for going outside when she needs to do her business. But the poor thing keeps getting episodes where she has to pee frequently, has blood in her urine, and cries and acts more clingy. Each time we put her on antibiotics for a week or two, she gradually gets better for a month or two. This time, she didn’t really respond at all, and I feel so sorry for her. Every time she has an accident she looks so guilty, and I know it’s not her fault. What can I do?
Janice in Weddington
I have seen this situation many times, and it is not her fault. Schnauzers often times have a predisposition to bladder stones, and I suspect this may be an underlying issue with Dixie. They can be hereditary and often times create periods of inflammation and bleeding. In addition, the cracks and crevices of the stone can hide bacteria and create repetitive, resistant infections. Often times, the magic solution to this dilemma is twofold. Treat the infection completely by culturing the urine and completing a longer period of therapy with antibiotics based on the sensitivity on the culture, even for as long as 4 to 6 weeks. In addition, I’d suggest screening for a stone with ultrasound (my preference as it can find stones as small as 1 or 2 centimeters in size) or abdominal radiographs (x-rays), depending on the veterinarian’s preference, to rule out an underlying cause.
If stones are present, as I suspect, they can be treated medically with prescription dissolving diets (with one type called struvite) or with surgery (called a cystotomy) for the non-dissolvable stones called calcium oxalate. The stones can be sent to the University of Minnesota for stone analysis to confirm the stone type and learn what preventative measures can be taken to slow or prevent the reoccurrence. I suspect once both aspects of the problem have been addressed, the frustrating cycle for both you and Dixie will be resolved. I hope that helps.
Dear Dr. Amy,
My beautiful Himalayan, “Chanchita,” has been drinking more and losing weight for the past few weeks. She is about 10 years old, and my veterinarian did senior blood work and found out she has hyperthyroidism. Can you explain what exactly is going on with her, and is it treatable?
Jessica in Marvin
I absolutely agree blood work was the best step in looking into Chanchita’s history. The three most common causes of weight loss and excessive drinking in older cats are hyperthyoidism, diabetes and kidney disease. They all are treated very differently and have quite different diet recommendations and follow-up.
Hyperthyroidism is the only one of the three conditions that can be cured (rather than managed), either with surgery or, my preference, radioactive iodine therapy, which only involves a single injection at a referral center, with no surgery or anesthesia. They usually need to stay at the center for five days until the radioactive levels are safe for return to the home, but the survival times and complications are the best. If this is too cost prohibitive, surgical removal of the thyroid gland can be performed as well, but possible complications include anesthesia risks, as well as temporary disturbances of their calcium levels the first week after surgery (due to the parathyroid gland that sits right beside the thyroid gland that controls calcium). The third option for managing thyroid disease (due to financial concerns, or if a pet is not a candidate for surgery or iodine treatment, due to other issues such as kidney disease), is daily medication called tapazole (methimazole) that will slow down the thyroid gland. All these treatments are aiming to reduce the risks of hyperthyroidism, including weight loss, overactive metabolism, high blood pressure, stroke and excessive drinking and urinating. I find treating and managing thyroid disease to be very rewarding and helpful for owners and their pets.
Dr. Amy Haase resides in Waxhaw and has nine years’ experience in small-animal general practice and emergency medicine. She is a member of the American Veterinary Medical Association and the Veterinary Emergency and Critical Care Society. She enjoys acting as a non-biased patient advocate for those with confidential questions about their pets or related to general medicine. E-mail your questions to her at firstname.lastname@example.org.