possible cushings/diabetes/uti??

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possible cushings/diabetes/uti??

Posted : 3/21/2008 1:11:23 PM

hi, Max is a 12 year old male german shepherd/husky mix - neutered. He's been in great shape for the past 12 years minus the past 3 months. About 3 months ago we noticed that he was limping on his front right leg. We thought that he might have stepped on something, so we took him to the vet. The vet looked at his paw, took a look at how he walked, and said it was "arthritis". He prescribed Prednisone 5mg once a day and gave a month's worth. During this time, we noticed an increase in his eating - he was always begging for food before going to sleep (which he never did before), drinking a lot more water, and urinating more often. Since he generally sleeps in the house, he would wake me up to go outside at around 4am. I told the doctor about the hunger issues, (snack at night & wiping his bowl clean and begging for more during the day), and he said "it shouldn't be an issue caused by the prednisone, so just watch what you give him." So we started feeding him a bit earlier in the day, spacing out the food (we give him food at around 5pm), and started to really watch how many snacks we gave him throughout the day. His snacks are the Pedigree dog bone cookies. After noticing that the prednisone really wasn't helping, he still refilled the prescription another time. So that's 2 months on prednisone. After the 2 months were up, Max was still limping on his front leg, so we took him to the vet and he gave Rimadyl 100mg once a day. (he took blood from his liver & an x-ray of his leg to make sure everything was okay first). After a week of giving him Rimadyl, we started to notice that Max was losing his stability in his back legs - he was shaking and couldn't stand still for long periods of time. We also noticed that he was having difficulty urinating - he would stand for 2-4 minutes trying to urinate and only trickles would come out. He would try to urinate more often, maybe 4-5 times in a row trying to empty his bladder. during this time, he was also drinking a lot more water than usual. So we took him to the vet (and off Rimadyl) and he used a catheter to check for a blockage - and there wasn't. He suspected he had a UTI and gave a week's worth of Cephalexin. During this time on Cephalexin, Max started to urinate in his sleep (both at night, and when he napped during the day). It was only yesterday, when the week's worth of Cephalexin finished that i noticed he started to urinate a little easier. However, he is still having some problems urinating at night (but not as bad as it used to be). He seems happier off Cephalexin, appetite is back, and not sleeping all the time. After doing some research online, i'm thinking it could be Cushings - but he doesn't have the cysts/tumors on his body. He's also not losing hair. I'm thinking the prednisone could have led to Cushings? But I have no idea why he would have started urinating in his sleep. Is it the Cephalexin? Just old age? Any help would be greatly appreciated. (we have also been feeding him high quality dog food , and no change in diet at all in the past 6-8 years).

calliecritturs

Posted : 3/21/2008 6:32:46 PM

First question - did the vet WEAN OFF the pred ... after 2 months on you can *not* just stop pred. It will rebound (even at a 5 mg dose).

Cephalexyn isn't often used for a uti -- I wonder why the vet used it. Often you would have to be on ceph for a *while* to have it help a UTI (and Billy has been on a scad of drugs for uti's over the last 2 years -- I can nearly quote you verbatim which drugs, what dose, and in what order they'd give them). Ceph might have been used simply because it's NOT a broad spectrum drug ... but it's not typical for a UTI. But I'd bet the vet probably had a reason -- and I'd ask (Me being the non-shy type that I am).

In complete honesty, it's pretty pointless to speculate about Cushings. You'd need to test for it. Cushings can occur because of "long term" pred use -- and taking him off it suddenly? I dunno -- that could impact it ... or not. I'm not that smart.

Cushings can be 'mimicked' in the body simply as a reaction to steroids. Steroids and the steroid-like drugs (like cyclosporine/Atopica) can create a cushing-oid (like Cushings) atmosphere in the body -- but that doesn't mean there IS Cushings.

If you have faith in this vet ... it's time for a LONG talk. (asking the above at least). But it's also time for blood tests at the very least.

See Cushings itself isn't easy to diagnose. There are a couple of tests for it -- you have to fast the dog according to a strict schedule and then they draw blood several times in the day and they 'test' it (there are other tests for Cushings as well) and then later after the test is complete they can eat. (Billy had this done about 2 months ago -- been there, done that, THREE TIMES in the last 2 years).

But if you have the blood tested FIRST (just a senior blood panel or a super chem panel) you'll have a better idea of what you're dealing with It may not be kidney at all -- and don't borrow that trouble if it's not.

However -- has the vet done a real urinalysis? I would think at this point you probably should have a culture and sensitivity done or something fairly specific to know if it's gone. Because frankly what you're describing is just one of the many myriad symptoms a uti can take.

If Max is drinking a lot then that alone can make them not be able to 'hold it' in their sleep. Rimadyl, in particular, can have some bad reactions as far as loss of muscle control (it's rare but it occasionally happens).

My next question is are you using milk thistle? ALL of the things you are doing are hard on the liver (particularly the pred and the Rimadyl -- and some dogs seem less tolerant of it than others). That will help mitigate your damages and it will help protect the liver. The liver is probably more apt to take the sudden hit from the pred and the Rimadyl than the adrenals are (altho you probably don't know how good shape they were in before?)

Often with a uti they can fluctuate -- going from drinking tons to not drinking at all (water will dilute the burning urine -- but then you get reluctant to drink because you know how bad it will hurt TO pee) -- so you can get a swing from one to the other and if the urine is really dark and stinky that alone is a heck of a good indicator that there is infection.

You honestly must get some tests run and you really won't know what 'big' tests (and Cushings is kind of a big test) or what is even logical until you have some blood run and a urinalysis done (and I wouldn't just want a "strip" test done -- I'd want to see if there were crystals or the like in there as well as infection). I'd be at the vet when they open tomorrow if it were me ... if you want my opinon that is.