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Help please, advice needed

Kasianni
May 31st, 2012, 11:13 AM
I posted last week about Mika having blood in urine. Went to vet last Tuesday, did a urine test, no infection but inflammation. As of last Wednesday, day after vet visit, Mika had no more blood in urine. Mika was on metacam for 10 days, ended this past Monday. Today, her first pee was dark, looked again to have dark blood in it. I am freaked out a bit. Called vet, wants to do a urine culture this time where they take urine directly from the bladder with a needle. My question is, has anyone done this and is it painful and complicated??? I don't want to put Mika through anything invasive. Why do they do it with the dog awake?? Does it not hurt them? Has anyone been through this, advice would be much appreciated.

hazelrunpack
May 31st, 2012, 11:20 AM
Yep, we've had them done. It's harder to watch that it seems to be on the dogs. :o Macie just had a cystocentesis done on Tuesday, in fact. No sedation usually needed. It's not particularly painful--usually the dog doesn't react at all. Not even our little wuss Grace so much as whines when she has it done. It's the best way to get a sterile sample and some of our girls are prone to UTIs so we've had the procedure done quite a bit.

Kasianni
May 31st, 2012, 11:27 AM
Yep, we've had them done. It's harder to watch that it seems to be on the dogs. :o Macie just had a cystocentesis done on Tuesday, in fact. No sedation usually needed. It's not particularly painful--usually the dog doesn't react at all. Not even our little wuss Grace so much as whines when she has it done. It's the best way to get a sterile sample and some of our girls are prone to UTIs so we've had the procedure done quite a bit.

Really? It sounds so painful, and my heart is aching just thinking about it hehe.
I do not want to cause her any pain. How do they know they are getting the bladder and not something else, is it dangerous? You say that some of your girls are prone to UTI's? Is the symptom blood in urine? I don't get it, Mika's urine analysis last week showed no infection, only inflammation and she had dark blood in urine but it went away for a week and is now back a little bit. Have you experienced this before? (Two weeks prior to the blood in urine she had a boo boo on her two and had a shot of antibiotics, I wonder if that shot masked the infection?) I don't know, I am worried, thinking the worst.

hazelrunpack
May 31st, 2012, 11:40 AM
I know what you mean about it sounding so painful. I can't watch when they do it--the dog picks up on my facial expression and tenseness and then they tense up. :o If the tech takes them in another room and someone loves them up while it's being done, they don't even seem to realize it's being done. :D (In this case, Mom is a bad influence! I just hate needles so much I can't help but react! :laughing:)

Macie is having similar problems but with white blood cells. Clavamox seemed to clear it up, but there were still 3-5 WBC per microscopic field, so we extended the antibiotic for another week. Testing at the end of that week showed even more WBCs. So we had an ultrasound done--it showed inflammation (cystitis) in the front of the bladder, which is likely due to the infection. They did the cystocentesis to get a sample for a culture and sensitivity and we'll go from there... She needs another ultrasound six weeks after the microscopic tests are clean to make sure the cystitis is clearing up once the infection is gone.

But if your vet is to rule out an infection as the cause and/or find an effective treatment, he's going to need a sterile sample and that's the best way to get it. :o I think it's a pretty straight shot to the bladder with little structure in the way, so it's not that tricky a procedure. And it goes really quick!

Rgeurts
May 31st, 2012, 12:34 PM
I'm sorry for both you and Mika. It's so difficult not knowing and thinking the worst... I tend to do that too much as well :grouphug:

Nookie is going through something similar as well. About 6 weeks ago he started showing the signs of a bladder infection, so he was put on a 10 day course of Clavamox. A few days after it was done, the symptoms came back, so he was put on Amoxiclav for 21 days. Last Saturday, he started with the usual urination urgency/frequency that he gets with an infection, and he was still on the antibiotic (the last dose was Monday morning). He does a lot of whining/pacing and is very unsettled when he has an infection (he has always been prone to them). So we took him back to Dr. Marsden on Tuesday. He had only been off the antibiotic for a little over 24 hours, so I was thinking a Urinalysis was probably a waste of time and money, and it may have been, at least in part, as they did not see any signs of infection. What they did see, however, were several Struvite crystals.

We are quite familiar with bladder stones as Thorin had them as well. He never showed any signs of anything being wrong at all, until I saw him pee blood :eek: :eek:
I think I mentioned this before, but his stones were calcium oxylate. The only way to get rid of them was surgery. He had one lodged in his urethra. The blood was caused from that and also the stones in his bladder. They were pretty jagged and had cut up the inside of his bladder pretty bad.

If your vet hasn't done an xray yet, that's the very first thing I would ask him to do. Thorin had a few "pee tests" that didn't have any crystals, so just because your vet isn't seeing them in the urine doesn't mean they aren't there. They will cause the inflammation, bleeding and can also cause secondary infection, but not always. Nookies recent (and seemingly difficult to get rid of) bladder infection is probably caused by the struvite crystals. Dr. Marsden did suspect cystitis as well and put him on a Chinese herbal supplement for the swelling/discomfort and it did help.

Nookie has also had the sterile sample taken quite awhile back. He's a HUGE wimp (seriously... BIG baby lol. Screams like he's being killed if he stubs his foot while playing), but he seemed to handle it very well :)

Good luck!! :)

ScottieDog
May 31st, 2012, 01:04 PM
I can understand your worries about Mika :grouphug:. I had a Scottish Terrier that had many UTIs. She had many other health issues too. This was a tough little dog that didn't give signs of being sick--characteristic of the breed known as the "Diehard". Our internal medicine vet did several of the sterile urine draws straight from the bladder. I was not in the room when these were done, but my little dog did not seem to suffer any ill effects. The worst part were the ultrasounds. She had to have her tummy shaved and about a week afterwards she got very itchy as the hair began to grow back.

It was discovered that my dog had a polyp in her bladder and did need bladder surgery. Bladder cancer actually runs very high in my breed, but is a relatively uncommon cancer for most dogs. Please know that--I don't want to add to your worries. The sterile draw is actually very important. The sterile sample will allow the vet to culture the urine and find out the appropriate antibiotic for the infection. My little dog's infection (completely asymptomatic) was so severe she was on a 3 month antibiotic course before she could have surgery.

Kasianni
May 31st, 2012, 01:53 PM
I'm sorry for both you and Mika. It's so difficult not knowing and thinking the worst... I tend to do that too much as well :grouphug:

Nookie is going through something similar as well. About 6 weeks ago he started showing the signs of a bladder infection, so he was put on a 10 day course of Clavamox. A few days after it was done, the symptoms came back, so he was put on Amoxiclav for 21 days. Last Saturday, he started with the usual urination urgency/frequency that he gets with an infection, and he was still on the antibiotic (the last dose was Monday morning). He does a lot of whining/pacing and is very unsettled when he has an infection (he has always been prone to them). So we took him back to Dr. Marsden on Tuesday. He had only been off the antibiotic for a little over 24 hours, so I was thinking a Urinalysis was probably a waste of time and money, and it may have been, at least in part, as they did not see any signs of infection. What they did see, however, were several Struvite crystals.

We are quite familiar with bladder stones as Thorin had them as well. He never showed any signs of anything being wrong at all, until I saw him pee blood :eek: :eek:
I think I mentioned this before, but his stones were calcium oxylate. The only way to get rid of them was surgery. He had one lodged in his urethra. The blood was caused from that and also the stones in his bladder. They were pretty jagged and had cut up the inside of his bladder pretty bad.

If your vet hasn't done an xray yet, that's the very first thing I would ask him to do. Thorin had a few "pee tests" that didn't have any crystals, so just because your vet isn't seeing them in the urine doesn't mean they aren't there. They will cause the inflammation, bleeding and can also cause secondary infection, but not always. Nookies recent (and seemingly difficult to get rid of) bladder infection is probably caused by the struvite crystals. Dr. Marsden did suspect cystitis as well and put him on a Chinese herbal supplement for the swelling/discomfort and it did help.

Nookie has also had the sterile sample taken quite awhile back. He's a HUGE wimp (seriously... BIG baby lol. Screams like he's being killed if he stubs his foot while playing), but he seemed to handle it very well :)

Good luck!! :)


Thank you everyone for all the information. We have already been and are back home. The test took the vet less than 5 minutes. He suggested I not be there in the room because the dogs behave better when their worried Mommies are not there lol. Mika did not even flinch. It sounds so much worse then it is I suppose. I will have the results for Saturday hopefully. Vet asked me when I gave her the last antibiotics because it affects the test?? I was giving her clavaseptin but she vomits with that one so I stopped but can't remember when I gave her last one. I think it was Tuesday morning. I know it was not yesterday. He said after 2 days its not in system so I think we are good? Does antibiotics change the results? I forgot to ask. Geez we worry so much about our pups don't we. Some people don't get it and tell me, stop its just a dog. Yeah okay, just a dog to you but so much more to me. I can't help it.

MaxaLisa
May 31st, 2012, 02:19 PM
I would be sure to rule out tick diseases too.

Kasianni
May 31st, 2012, 02:56 PM
I would be sure to rule out tick diseases too.

Would there not be other symptoms? The only thing we have seen to date is blood in urine. I know there are a few tick diseases, Rocky Mountain Spotted Fever, Babesiosis, Anaplasmosis, Ehrlichiosis, and Lyme Disease which she was just tested for mid May. Probably more but surely there would be other signs?

MaxaLisa
May 31st, 2012, 03:23 PM
They can be very deceptive. Sometimes only bloodshot eyes, or sometimes a leg that drags, or some dogs might just get afraid of the dark.

Has any bloodwork been run? I would be curious to look at the CBC portion, and also some of the chemistry.

Kasianni
May 31st, 2012, 03:42 PM
They can be very deceptive. Sometimes only bloodshot eyes, or sometimes a leg that drags, or some dogs might just get afraid of the dark.

Has any bloodwork been run? I would be curious to look at the CBC portion, and also some of the chemistry.

No CBC yet, that is the next step. Funny you mention a leg that drags. In December, I was playing ball with her and suddenly she was limping. That night she would not put weight on her foot. Took her to vet next day, had x-rays, nothing they could see. A few days on metacam and she was fine. Then in March it happened again. She would not put weight on her foot but the next day she was fine. Nothing since then. For ticks though, would I not have had to find one on her? I don't know how she would get a tick disease, from May thru November she is treated with Revolution each year.

MaxaLisa
May 31st, 2012, 03:51 PM
There is no tick preventative that is foolproof. Here, Revolution does nothing for our local ticks, but it seems to be regional.

Me, I'm paranoid enough about tick disaeses, that I would combine any treatment with an aggressive course of doxycycline, and note all the different things that respond. I would run full bloodwork first though, and do get a copy! I just ran bloodwork on my dog, vet said that everything was within normal limits, and it wasn't - can't say how many times I've seen that happen. Also, values at the edges of the normal might give you a clue.

Since you aren't finding a UTI, but inflammation, I would look for something more systemic :(

Of course, an xray, for stones, as mentioned above, is important too!

Kasianni
May 31st, 2012, 03:53 PM
There is no tick preventative that is foolproof. Here, Revolution does nothing for our local ticks, but it seems to be regional.

Me, I'm paranoid enough about tick disaeses, that I would combine any treatment with an aggressive course of doxycycline, and note all the different things that respond. I would run full bloodwork first though, and do get a copy! I just ran bloodwork on my dog, vet said that everything was within normal limits, and it wasn't - can't say how many times I've seen that happen. Also, values at the edges of the normal might give you a clue.

Since you aren't finding a UTI, but inflammation, I would look for something more systemic :(

Ok, well now something else to get freaked out about. :(

hazelrunpack
June 1st, 2012, 12:51 AM
It is possible that there might be tick-borne disease present--anaplasmosis, for instance, can lower platelets which can cause unusual bleeding. But unless her health markedly degrades, I'd see what the results are from the culture and sensitivity first. If there are further mysteries to be solved, time enough then to continue the search.

MaxaLisa is right--ask for a copy of the bloodwork when/if it's run and look for any abnormalities. I've also seen a lot of reports listed as 'normal' when they showed pretty clear evidence of tick-borne disease. Anaplasmosis, for instance, generally results in low white blood cells and low platelets, but the early stages are subtle. The CBC values may actually be in the low normal range, but typically if we see that pattern with both of those components low, we start treatment right away. We now request copies of all bloodwork results. Ask your vet about anything that looks out of the ordinary to you.

I'm so glad the cycstocentesis went well! Piece o' cake, eh? :D As I said, it seems to be harder on the moms than on the dogs! :laughing: Now for some useful results from the C&S and a quick recovery for Mika! :goodvibes:

Kasianni
June 1st, 2012, 12:33 PM
It is possible that there might be tick-borne disease present--anaplasmosis, for instance, can lower platelets which can cause unusual bleeding. But unless her health markedly degrades, I'd see what the results are from the culture and sensitivity first. If there are further mysteries to be solved, time enough then to continue the search.

MaxaLisa is right--ask for a copy of the bloodwork when/if it's run and look for any abnormalities. I've also seen a lot of reports listed as 'normal' when they showed pretty clear evidence of tick-borne disease. Anaplasmosis, for instance, generally results in low white blood cells and low platelets, but the early stages are subtle. The CBC values may actually be in the low normal range, but typically if we see that pattern with both of those components low, we start treatment right away. We now request copies of all bloodwork results. Ask your vet about anything that looks out of the ordinary to you.

I'm so glad the cycstocentesis went well! Piece o' cake, eh? :D As I said, it seems to be harder on the moms than on the dogs! :laughing: Now for some useful results from the C&S and a quick recovery for Mika! :goodvibes:

Yes, :laughing:it was a piece of cake. Just love her so much can't stand the thought of her in any pain. I should have the results tomorrow, Monday the latest. How do they test for Anaplasmosis or does it show in the CBC?

hazelrunpack
June 1st, 2012, 12:55 PM
There are titers done for some of the tick diseases, but they're finding that they aren't very reliable (for humans, for instance, the titers are missing up to 30% of the cases! :eek:) and there appear to be some emergent diseases they can't even test for, yet. So here the vets (and human doctors, for that matter) go on tick exposure and symptoms and may not even look at the blood.

The hints in the CBC can be subtle--low end of normal, or high end, depending on which disease, but still 'normal' and that muddles the picture. Sometimes they want to test blood a couple weeks apart to see what, if anything, has changed, and if indications are clearer the second time, they'll treat then.

There is a snap test that checks for exposure to heartworms, anaplasmosis, Lyme's disease and a canine ehrlichiosis available from Idexx Labs--it's fast and dirty--a drop of blood and results in just a few seconds. It's less expensive than the titers (which require a different sample/test for each organism) and is probably about as reliable. Was it the snap test they used for your girl in mid-May when she was tested for the tick diseases?

At this point it's probably just something to keep in mind if they can't find another cause for the bleeding. If worse comes to worst, perhaps your vet would agree to a short course of doxycycline (which seems to work against most of the tick-borne diseases) to see if there's an improvement. Doxy is cheap but can be hard on the tummy.

Kasianni
June 1st, 2012, 01:16 PM
There are titers done for some of the tick diseases, but they're finding that they aren't very reliable (for humans, for instance, the titers are missing up to 30% of the cases! :eek:) and there appear to be some emergent diseases they can't even test for, yet. So here the vets (and human doctors, for that matter) go on tick exposure and symptoms and may not even look at the blood.

The hints in the CBC can be subtle--low end of normal, or high end, depending on which disease, but still 'normal' and that muddles the picture. Sometimes they want to test blood a couple weeks apart to see what, if anything, has changed, and if indications are clearer the second time, they'll treat then.

There is a snap test that checks for exposure to heartworms, anaplasmosis, Lyme's disease and a canine ehrlichiosis available from Idexx Labs--it's fast and dirty--a drop of blood and results in just a few seconds. It's less expensive than the titers (which require a different sample/test for each organism) and is probably about as reliable. Was it the snap test they used for your girl in mid-May when she was tested for the tick diseases?

At this point it's probably just something to keep in mind if they can't find another cause for the bleeding. If worse comes to worst, perhaps your vet would agree to a short course of doxycycline (which seems to work against most of the tick-borne diseases) to see if there's an improvement. Doxy is cheap but can be hard on the tummy.


Ahh its called the "snap" test! That is the test they both had. Both Theo and Mika tested negative. I do it every year prior to starting the heartworm prevention. That is why she was at the vet a few weeks ago and at same time had the antibiotic shot for the sore on her little toe.
I am curious, don't remember if I asked already. Mika was taking clavaseptin, up until Tuesday. I believe Tuesday morning was the last one (or 6 pm) and the urine culture was yesterday at 1pm. So its 48 hrs(ish) since the last one. Vet said it should be out of system, but how does it affect the culture if its still in her system. I hope I didn't do it for nothing. The vet would have said something you'd think?

hazelrunpack
June 1st, 2012, 01:31 PM
The vet should know the wash-out time for the antibiotic. We had to keep Macie off the Clavamox for 72 hours prior to the cystocentesis. Clavaseptin looks like about the same thing--a combination of amoxicillin and clavulanic acid. If you contact the manufacturer of Clavaseptin through their website, I'll bet someone could tell you whether two days was long enough to have it wash out of Mika's system... If the vet erred, he should make good on that and repeat the test on his dime, but you'll have lost the time it takes to get results.

We had Macie's done Tuesday (29th) and so far the only result is that they found a gram-negative organism that hasn't been identified yet but it's growing and they'll be doing the sensitivity pattern soon. :shrug: So if that's a normal turn-around time, we're probably talking 5 days from sample to results...

Kasianni
June 2nd, 2012, 06:17 PM
Vet called me today with the preliminary results of the urine culture. No bacteria at all, he says that is good news. He will call me Monday when he gets all the results. Love that he is open on Saturdays.
SO, I know it sounds odd but I was hoping there was an infection because that would explain the blood. Since there is no infection, (I mean its good news) there is another reason there is blood. When I saw the blood Thursday, I took her in right away and since then no blood. Her first pee in the morning was darker but I saw no blood. He said if it continues, need an ultrasound to rule out bladder stones, or a mass. Now that last word scared the crap out of me. I just finished chemo myself and the thought of her having a mass makes me ill. He said "I am not saying its that" just one reason for blood in bladder. He said sometimes masses are local and don't spread and not to worry yet. Well crap, I am worried cause I don't know what else it could be. . I hope its nothing serious, she is full of spunk, and even the vet said she is a healthy dog so I wonder...what it is. I am wondering now if what I saw Thursday was blood. Is the first urine in the morning darker?
Today is Mika's 6th birthday, she was spoiled, got lots of toys, etc and I made her a nice dinner.

hazelrunpack
June 3rd, 2012, 01:14 PM
There are a lot of things that can result in bloody urine that don't involve cancer. UTIs (which might have been ruled out--did you ask about the length of time for the antibiotic to wash out?), bladder stones, sometimes just idiopathic irritation of the bladder lining, and lowered platelets from tick-borne diseases, among other things. So there are a lot of things to rule out before you even start thinking about a mass--but I know how easy it is to say "don't worry" and how hard it is to actually not worry! :grouphug:

The first urine of the day is generally more concentrated, so usually darker than later in the day. But it should be a dark yellow, not reddish. Sometimes it's hard to tell color, depending on light, unless you bring out something white to catch it in. White plastic lids from, say Cool Whip, work well if you're just looking for color and not for a sample--just slip it under so she pees in it, let it lay in the grass, and then check the color when she's done (and hope she doesn't kick it aside like my girls do when they're done! :laughing:)

Keep us posted on the rest of the results! :goodvibes: And give her a hug from me, pls! :D

Kasianni
June 3rd, 2012, 03:03 PM
There are a lot of things that can result in bloody urine that don't involve cancer. UTIs (which might have been ruled out--did you ask about the length of time for the antibiotic to wash out?), bladder stones, sometimes just idiopathic irritation of the bladder lining, and lowered platelets from tick-borne diseases, among other things. So there are a lot of things to rule out before you even start thinking about a mass--but I know how easy it is to say "don't worry" and how hard it is to actually not worry! :grouphug:

The first urine of the day is generally more concentrated, so usually darker than later in the day. But it should be a dark yellow, not reddish. Sometimes it's hard to tell color, depending on light, unless you bring out something white to catch it in. White plastic lids from, say Cool Whip, work well if you're just looking for color and not for a sample--just slip it under so she pees in it, let it lay in the grass, and then check the color when she's done (and hope she doesn't kick it aside like my girls do when they're done! :laughing:)

Keep us posted on the rest of the results! :goodvibes: And give her a hug from me, pls! :D


That is what I am wondering about..she has a urine sample taken when I first saw blood but it was 2 weeks to the day from having an injection of antibiotics, which last 2 weeks or more in the system so that is maybe why the test didn't show infection but only inflammation..do you know if this is possible?? Then of course Thursday the urine culture which was only 48 hours after the last does of clavaseptin, so I don't know. there has not been any blood since Thursday morning but I she has been drinking lots of water and her pee is almost clear, hardly even yellow but I don't know if drinking all the water is masking any blood. I do know its good for her to drink to flush everything out. I am trying not to worry, and yes, its easier said then done. Thank you for you help and experience, I do appreciate when you reply to all my questions. :) Oh and I did ask the vet when he called yesterday about the duration of the antibiotics and he said they leave the body very quickly and should be gone in 48-72 hours..well heck, it was only 48 hrs when he did the culture so I have my doubts now.

Rgeurts
June 3rd, 2012, 05:14 PM
Kasiani, I know what you mean by saying you had hoped for an infection, to explain the symptoms. I've been there myself on many occasions. She had a shot of Convenia, didn't she? If so, I know it stays in the systems for more than 2 months. I don't know how long it would take to be out enough to be able to see infection or grow a culture, but you may want to ask your vet. Nookies last test showed no infection either, just Struvite crystals, but he still acts like he has an infection and it was only a little over 24 hours after the antibiotic. If your vet did do a Urinalysis and C&S too soon, I would expect him to foot the bill for another... they aren't cheap. Have you had a xray to look for stones?

Kasianni
June 3rd, 2012, 06:02 PM
Kasiani, I know what you mean by saying you had hoped for an infection, to explain the symptoms. I've been there myself on many occasions. She had a shot of Convenia, didn't she? If so, I know it stays in the systems for more than 2 months. I don't know how long it would take to be out enough to be able to see infection or grow a culture, but you may want to ask your vet. Nookies last test showed no infection either, just Struvite crystals, but he still acts like he has an infection and it was only a little over 24 hours after the antibiotic. If your vet did do a Urinalysis and C&S too soon, I would expect him to foot the bill for another... they aren't cheap. Have you had a xray to look for stones?

No, next step is x-rays. Well both urine tests I think were done too soon. I will talk to him tomorrow when he calls. I tried to mention it yesterday but he seemed to think enough time had passed. Mika has two vets, they both work at same clinic, the one she saw Thursday is not her usual vet, he is good but I prefer the other, maybe I will call the other one. I too think if they were both done too soon that he should foot the bill. I just want to know what is going on.

hazelrunpack
June 4th, 2012, 08:27 PM
Any updates today, Kasianni?

Kasianni
June 5th, 2012, 01:22 PM
Any updates today, Kasianni?

Hi! Thanks so much for asking. :) No news from the vets yet, I thought he would have the results by now since he had the preliminary one's within two days.
Mika has had no blood in her urine since that one episode Thursday morning. I am getting her to drink more. She is acting like herself, spunky, full of energy, and shows no sign of anything wrong. I kind of get anxious each time she pee's, so hoping not to see blood.

hazelrunpack
June 5th, 2012, 08:12 PM
Sounds like she's on the mend!! I hope she's over whatever it was! :goodvibes: