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  #1  
Old May 15th, 2010, 02:16 PM
twomutts twomutts is offline
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mysterious problem

Hi, I am new here and really hope I'm posting appropriately. I'm looking for some insight into this problem. My wonderful 12 year old border collie/Australian cattle dog mix, Blue, began vomiting in the early morning, Thursday. (First some solid stuff; food and grass, then mostly clear, frothy mucosy liquid.) He strained to move his bowels but produced only tiny yellowish blobs. He was obviously uncomfortable, panting and restless. He refused food, even the scrambled egg I made him. (He loves them.)
I feared a blockage and made a vet app't.
Friday morning, (yesterday) I took him to the vet who palpated his abdomen thoroughly and said he didn't think it was a blockage. (Blue was "empty") He suspected colitis and wanted to do bloodwork to check liver and kidney function, before medicating. This revealed normal function, with only one type of white blood cell elevation that he suspected was from the stress of the situation. There was no fever. However, he said Blue's prostate was huge. Blue was neutered in his first year, so I am puzzled by this. He prescribed metronizadole (aka flagyl) and a bland diet and told me to call him Monday.
Well, it's now Saturday afternoon and nothing has changed. He is still unable to defecate (although he refuses food, so is still empty) but he strains trying and his back legs tremble from the effort. He is drinking water but occasionally vomits it up. I don't think the meds are improving him and I would think they would have by now, if it was simply colitis. Also, I don't understand why his prostate would be enlarged in the absence of testosterone. He is definitely sick, lethargic and uncomfortable. I am sick with worry. Could a simple enlarged prostate cause these symptoms, or are we talking about cancer here? Would the prostate cause him to keep trying to poop, or is he possibly blocked in the small intestine? I've done some reading but I still feel mystified.
Thanks in advance for your thoughts.
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Old May 15th, 2010, 02:29 PM
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I will PM Dr Lee for you and see if he can think of something. He is our "resident" vet and is very good.
Meanwhile, I would be thinking of a second opinion. JMO
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Old May 15th, 2010, 03:12 PM
twomutts twomutts is offline
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Thank you, JMO, that is what I am thinking of. I am unfortunately unemployed but will figure something out. Hate that I have to wait for Monday but the 'emergency service' is twice or thrice the cost.
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Old May 15th, 2010, 04:40 PM
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Hi twomutts, as far as the prostate goes, most hormone related problems don't happen in sterilized dogs, but that's not to say it CAN'T happen. He is an older dog, so prostate problems aren't totally unusual.

Metronidazole is a great drug to treat stomach problems, so I would stick with it for now.

But I understand what you are saying, and I believe you are on the right track with thinking an enlarged prostate could possibly block the bowel and cause him to have to strain to go poo. I am not 100% familiar with where the prostate is located on a male dog, but your idea makes total sense to me.


I would do some research into seeing if there are medications to reduce the size of a dogs prostate, as I know they make them for humans (thanks to lovely prescription commercials! ). In all honesty you probably are going to have to do further testing anyways, probably an ultrasound, to see if there is a tumor or some other form of prostate cancer. I'm sure that's not what you would want to hear, but considering his age it is something you need to check for.
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Old May 15th, 2010, 05:49 PM
twomutts twomutts is offline
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Thanks for your thoughts, Kathryn. I agree that more testing needs to be done. But, in the moment, does anyone know how quickly metronidazole works? I think it is supposed to be very fast-acting and I don't want to force it on him if it is not helping, especially since I think it hurts his stomach. (My sister had to take it once and it hurt her stomach.) He's so miserable it's just breaking my heart.
(FYI, Kathryn, the dogs prostate gland can be palpated via the rectum and the vet agreed that it might be triggering his urge to go.) But why would it be enlarged? He also said that it felt "healthy" for what that's worth.
Again, my thanks.
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Old May 15th, 2010, 06:12 PM
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Hi there 2mutts! welcome to the site. When was the last time your dog had something to eat? its seems weird that he would be straining if he has nothing in him? can you entice him with some boiled beef and rice or potatos and maybe a bit of yogurt? I am afraid I know nothing about prostate?? sorry

The metronidazole is for an upset tummy and an anti inflammatory I think. My dog is just finishing up the same meds but his problem was diarrea.

Does his bum look sore to you? You can also try to give him some pumpkin if you can get him to eat. It works wonders in dogs for both firming up the stool or loosening it! It has to be pure pumpkin not the pie filling.l

How does he seem to you? lethargic? able to walk properly? the meds he is on should not make him sick really?
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Old May 15th, 2010, 07:09 PM
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Thanks for your response, Winston. I have been trying to entice Blue with all manner of appetizing foods since this started, Thursday morning. (I spent this afternoon making beef broth for him because he still drinks water.) He won't touch solids and so far he won't touch the beef broth either.
He is lethargic and weak and he is walking gingerly; his back is a bit hunched up and I know his tummy is tender because of how he responds when I touch it.
His bum doesn't look sore but we did just notice some nasty looking discharge from his penis, so I'm starting to think some kind of prostatitis. (But his bloodwork was clear and his temperature is normal...?)
I do give them pumpkin from time to time but he won't eat anything right now. Again, thanks for your interest. I appreciate the input.
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Old May 15th, 2010, 07:38 PM
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I really think you have to try anything at all for food., cheese, sardines, rice, potaoes, sweet potatoes, yogurt anything??

1) last bowel movement?
2) last time he ate?

Does your vet have after hours service? I am thinking based on what you have said for your dog's sake you may need to take him?
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Old May 15th, 2010, 08:55 PM
twomutts twomutts is offline
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Hi Winston,

1) last normal (formed) bowel movement was Wednesday afternoon. He has passed small blobs since then but the vet assured me that he is not full of poop that can't get out. I need to trust the vet on this.

2) last meal was a Wednesday evening snack. (say 9:00 p.m.) While it is worrisome and I recognize not-eating as a serious symptom, I do not believe it to be life-threatening in the short term. His internal organ function was measured as normal yesterday. That said, I have tried tempting him with all kinds of treats; he is simply anorexic. (another symptom of prostate problems I have learned)

I am keeping him hydrated and he seems a little more comfortable tonight. He is still bright-eyed and alert and he is panting less. His temperature remains at 101.5 which is normal. Since seeing the discharge from his penis, I am reassured that this probably some type of prostate infection and therefore treatable. (unless, god forbid, it is also cancerous.)

At any rate, I can't afford to panic.
Thanks for your interest. I will continue to update.
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Old May 15th, 2010, 09:08 PM
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Please keep us updated on his progress...I just worry that he hasnt had anything to eat although hydrated. The metronidazole I would have thought would have helped with any nausia....Sounds like you have it covered..
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Old May 15th, 2010, 09:20 PM
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I am very worried about Blue. I recommend that you follow up with your veterinarian for an abdominal ultrasound and prostatic biopsy or aspirate. Chest X-rays may also be helpful.

In non-neutered dogs with enlarged prostate, my top possibilities include benign prostatic enlargement (hormone influenced), prostatic cysts and prostatic infections (predisposed by hormone influence), and cancer.

In neutered dogs with enlarged prostates, my top concern is cancer. Cystic disease and infection are also potentials but I would be concerned about cancer until proven otherwise. While there is some controversy over this (some studies show equal risk and some do not) - it appears that neutered male dogs may be up to four times more likely to develop prostatic cancer than non-neutered dogs. For all dogs, the risk of prostatic cancer is at 0.29-0.6%. Thus the overall risk is low whether neutered or not. For this reason it is not typically discussed prior to neutering. Also neutering reduces the risk of many other diseases and causes of death and FWIW neutered animals typically live 1-2 years longer than non-neutered pets.

Back to Blue...

The straining to defecate is more likely from colonic inflammation. The inflammation of the colon with make the pet feel that they need to defecate. If there is a prostatic tumor, they often release chemical mediators that lead to generalized inflammation and diarrhea and other signs can occur. Also if there is abdominal lymph node involvement, there may be no way of addressing the diarrhea and intestinal inflammation without addressing the prostatic disease.

The choice of metronidazole is a standard antibiotic therapy for diarrhea. I would pursue further diagnostic understanding of the prostate. The answer for the diarrhea might be there. You could also simultaneously work up the diarrhea with fecal test, giardia ELISA, fecal culture, abdominal ultrasound, etc...

I hope that this helps. Please let me know if there is anything I can do.
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Old May 15th, 2010, 11:28 PM
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I am certainly in agreement with Dr LEE, and I would consult with another vet asap. I know this is expensive, but your dogs life could hang in the balance.

I am not sure the discharge from the penis is an indication of prostate troubles. I imagine your vet did check for a bladder infection (UTI), I had a pug once that got so many crystals it blocked up his urethra. He did not eat, vomitted, and had a discharge. Cleared right up with antibiotics, but could have been life threatening.

Please for Blue's sake, see an emergency vet.
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Old May 16th, 2010, 09:19 AM
twomutts twomutts is offline
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Thank you so much Dr. Lee for your informative response to my questions. You answered most of them and I appreciate your consideration. I am certainly most concerned about prostate cancer, as I understand it is not really treatable. I am returning to the vet for further diagnostic testing tomorrow morning... is this leaving it too long?
Blue actually seems to have improved slightly in the last 24 hours but now has quite a bit of discharge from his penis when he pees; it looks like pus and blood. And he still has not eaten. He is still drinking water.

I do have a couple of further questions for you. We do not drink milk in my house but we do drink an organic soy milk. I give this to the dogs most mornings with their breakfast and sometimes in the evening as well. I have read that soy products contain compounds that mimic estrogen. In your opinion, is it possible that this could be enough to influence the prostate gland?
Also, I am planning to continue with the metronidazole until I have met with the vet again. Will it help with the colonic inflammation? Would it have any effect on either cystic disease or prostate infection? Is there anything that I can do to help Blue to feel better until tomorrow?

Again, many thanks for your input and concern.

Thank you, pugsrule, for your thoughts and concern. His bloodwork on Friday showed no signs of infection, bladder or otherwise but I'll certainly ask the vet about it.

Thanks all of you for caring. He is a truly great dog and I hate to see him so low. We can all hope this is something treatable.
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Old May 16th, 2010, 11:53 AM
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Quote:
Originally Posted by twomutts View Post
1)I am returning to the vet for further diagnostic testing tomorrow morning... is this leaving it too long?

2) I have read that soy products contain compounds that mimic estrogen. In your opinion, is it possible that this could be enough to influence the prostate gland?

3) I am planning to continue with the metronidazole... will it help with the colonic inflammation?

4) Would [metronidazole] have any effect on either cystic disease or prostate infection?


5) Is there anything that I can do to help Blue to feel better until tomorrow?
1) It sounds like Blue is getting a little better so no. Also performing a biopsy or aspirate on an emergency basis is not likely to hasten getting an answer by that much.

2) There are concerns that tofu and soy products turn men homosexual due to increased estrogen levels. While I don't think that estrogen levels are a factor in orientation, the fact is that we don't see any morphologic changes with soy consuming males. So even if there is a slight increase in estrogen (and FWIW I have no idea if this process occurs in canines or not) it would not be significant enough to change prostate pathology.

3) Most likely. So I would continue the metronidazole.

4) Less likely. While metronidazole gets into many tissues, including seminal fluid, it is not a drug of choice for the prostate. The most likely bacteriums for the prostate include: E. coli, Staphylococcus, Klebsiella, Proteus, and Mycoplasma canis. Based upon likely bacteriums and absorption levels within the prostate, the following are first choice antibiotics: Sulfonamides (TMS: trimethoprim sulfa, etc.) and enrofloxacin (baytril). Doxycycline, other fluoroquinilones (marbofloxacin), clindamycin and erythromycin are also good choices.

5) If your veterinarian prescribed any pain medications like tramadol, then I would continue that. Otherwise I would not recommend any over the counter OTC drugs. While there are many prostate holistic options like lycopene etc. at this point I think you need answers before proceeding on and relying on treatment measures.
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Old May 16th, 2010, 03:44 PM
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Thank you so much, Dr. Lee. This information is a big help to me. I appreciate very much your time and your interest.
I will post an update when I know more.
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Old May 16th, 2010, 03:56 PM
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I have no advice to give,just good wishes for Blue to get better
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Old May 16th, 2010, 07:32 PM
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Wishing you good reoprts for tomorrow.

BTW on one pug we have, he had an enlarged prostate, and with ultrasound it had some different echoic (sp?) points, eventually we did take it out when he had bladder stone surgery, but before that we gave him stillbesterol, and it did definitely take the prostate down to a near normal size. Now it will not cure anything, but it can sometimes help until something can be diagnosed. I have read that stillbesterol when injected directly into the prostate can reduce the size in hours. We gave it orally, but saw a difference within a day or two.

We still have this pug, the prostate though enlarged several different times, was not infected or cancerous when we had it removed last year. In way of explanation, we hesitated to do any surgery on him as he is a paraplegic rescue of undetermined age, but definitely a senior. He had 2 major surgeries last summer, and is still doing well today. So never give up hope, they have a will to live many times, that supercedes diagnosis.

Hugs Joan
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Old May 16th, 2010, 09:23 PM
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Wow, Joan, thank you! This post made my day!
I'm glad your little pug continues to live, despite ongoing prostate issues; it gives me great hope. And I think you are right about their will to live. I hope Blue is still enjoying himself enough to fight whatever this is off, and bounce back like your pug. (I think he is; he had a pretty good day today.)
Again, my thanks.
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Old May 16th, 2010, 09:31 PM
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Sending Blue and twomutts

Dr. Lee, your wealth of information and knowledge is truly appreciated for all on this forum! Thank you!
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Old May 16th, 2010, 09:34 PM
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I hope you can get some answers from your vet tomorrow. Maybe you could print out what Dr Lee told you and take it with you to the vet. I know it helps me to remember to ask me vet specific questions that I otherwise would probably forget.
I have my and sending lots of and for Blue and you.

FYI - JMO means just my opinion. Sorry to confuse you.
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Old May 17th, 2010, 02:55 PM
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Update on Blue

Here is an update for anyone who has followed this thread. Over the weekend, we noticed that there was some blood and pus on Blue's bed and also oozing from his penis. Along with this, he seemed brighter and more energetic. He wanted to go for a walk on Sunday! I talked with the vet this morning and he asked me to bring Blue in with a urine sample. Again, Blue was eager to come along in the car and we had a short walk before we went to the vet.
The sample indicated a definite infection. (I still don't really understand why the blood work didn't reveal this, or why there is no fever, but there is a lot I don't understand.) The vet prescribed an antibiotic called "sulfamethoxazole" containing trimethoprin. The hope is that the infection is causing the prostate enlargement and that the antibiotics will reduce the swelling and lead to eating and normal evacuating.
So, my fingers are crossed. He needs to eat soon.
Thanks to all who expressed an interest and 14+kitties, I'm sorry I didn't understand what "JMO" meant until you told me! Thanks.
Anyone who has any experience with this problem, I do appreciate hearing the experiences others have had. Pugsrule's story made me especially happy.
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Old May 17th, 2010, 03:48 PM
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Twomutts, glad to hear that Blue's results are leading you somewhere at this point. As the owner of two senior mutts myself I know how you are feeling about all of this. You and Blue are in our thoughts and prayers, please keep us updated on his health. There is always hope!
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Old May 17th, 2010, 04:25 PM
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Further Update!

He is EATING!

Thanks for your kind words, Dog Dancer. I hope your senior mutts are well.
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Old May 17th, 2010, 04:37 PM
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I am so happy for you and Blue!! I hope the meds clear up everything for him.
Now stick around and post some pics of Blue please.
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Old May 17th, 2010, 06:22 PM
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I am sure Dr Lee can answer the question, but since the prostate surrounds the urethra, it is quite possible that an enlarged prostate, by restricting the urine flow, can be a cause of UTIs . I believe this would be more common than a UTI causing the enlargement of the prostate.

On the UTI, it is so important to give extra water till the infection clears up. I give water 4-5 times per day with some tuna in it to encourage extra drinking. this is almost as important as the antibiotic. they always have free choice water, but giving the water with an incentive in it, can increase their water consumption almost 100%.

BTW UTIs do not show up on blood tests, and they generally do not raise the temp until quite severe. I have had lots of these with 5 handicapped pugs. They are very prone to UTIs as I have to express their bladders manually, and this is not as efficient as nature. Once you have this bladder infection cleared up, if I were you, I would pick up some chemstrips at a pharmacy, and keep track of Blue's urine ph, and blood content for a bit till you are sure the prostate is not causing the problem. I find that most often, the urine ph wil increase (more alkaline) before the blood appears, or the bacteria can be seen under a microscope. this gives you a real jump on any problem.

So glad Blue is doing better.

Joan
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Old May 17th, 2010, 09:23 PM
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Joan, thanks so much for your very informative post. (Wow, you're like a super-woman looking after 5 handicapped pugs! I applaud you!)
I had no idea that UTIs don't show up with blood work or that there is often no fever. Great information that I'll remember. Also will try adding incentives to the water supply! He's been drinking quite a bit of the beef broth I made for him, in addition to water and I've also been giving him some electrolyte solution from time to time.
I'm really hopeful that the antibiotic will bring down the size of the prostate but if it is not simply an infection, I guess it won't. We'll see. I'll definitely pick up some chemstrips, as well, as I suspect this is not the end of the problem.
For now, I'm so relieved that he's eating and acting like himself again.
I'll post pictures as soon as I can figure out how!
Thank you so very much for your info and support.
Elise
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Old May 17th, 2010, 10:58 PM
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Elise, its not the 5 handicapped pugs that drive me carzy, its the 4 other pugs including a diabetic with hepatitis!! Just kidding i love all 9.

So glad Blue is doing better. Please let us know as you go along.

Hugs Joan
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Old May 17th, 2010, 11:47 PM
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Sounds like you and Blue have been through the wringer lately! So glad he's doing better now!

for continued good recovery!
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Old May 20th, 2010, 01:04 PM
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Blue continues to recover; he is now eating as much food as I'll give him and having normal bowel movements. (if still a bit loose...) Also, he will actually drink his antibiotics if I mix them with something he likes, so I don't have to sluice the 8cc's into his mouth twice a day. He's still on the metronidazole, for now, and I'm also giving him probiotics twice a day.
The prostate swelling seems to be completely gone but the vets say he needs to be on antibiotics for at least 2 weeks, so that's the plan for now. I'm happy to report that he is acting just like his old self.
I don't know how to post pictures here but I may figure it out eventually...
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Old May 20th, 2010, 01:24 PM
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Glad to hear Blue is eating and doing so much better. Yes thank you for asking my two mutts are fine. I can't wait for you to figure out how to post pictures! Hugs to you and Blue, keep up the good work.
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