Incontinent, pu/pd Dobermann

Re: Incontinent, pu/pd Dobermann

Alet Engelbrecht — Wed, 20 Jun 2012 14:23:09 GMT

[quote user="Jo Jones"]We were thinking about a water deprivation, but are saving that as a last resort.[/quote]

I am very glad to hear that. Everyone always jump to water deprivation test, but it is a potentially harmful test if not done AFTER everything is ruled out. Has the antibiotics made any difference? Have you rescanned to see if there is any change in the cervical stump? It is very young for Cushings, although I would still consider an ACTH stim test.

A stump pyo is also something to consider in light of the enlarged cervix. A small focus of inflammation can cause PU/PD. I recently spayed a dog that had an unusually large cervix, I actually noted this down. I was quite enthusiastic in the ligation and oversown the stump for good measure - a few weeks later the dog presented with vomiting. The cervix was still palpable - at the time we thought it could be a foreign body. On ex lap just massive suture reaction which we resected and all fine. Very embarrassing for me, but just saying that it could be something like this. (At least I did not leave a swab, but it felt similar...)

Re: Incontinent, pu/pd Dobermann

Jo Cobbett — Wed, 20 Jun 2012 13:40:58 GMT

[quote user="Martin Atkinson"]

You mentioned blood results were normal but didn't specify haematology - was that also normal if performed?

[/quote]

Yes, haematology was all WNL

Re: Incontinent, pu/pd Dobermann

Martin Atkinson — Wed, 20 Jun 2012 13:28:26 GMT

You mentioned blood results were normal but didn't specify haematology - was that also normal if performed?

Re: Incontinent, pu/pd Dobermann

Jo Cobbett — Wed, 20 Jun 2012 12:17:11 GMT

[quote user="Hannah Bose"]

[quote user="Thomas Johnson"]Urine cortisol:creatinine WNL.[/quote]

I'm not familiar with how sensitive this test is. Why not just go for the ACTH stim test?

[/quote]

It has very poor specificity, but very sensitive. Useful for ruling OUT HAC (which is what we wanted to do in this case), but no good for ruling it in.

[quote user="Thomas Johnson"]

I assume normal bloods includes a normal calcium? Have you considered doing a water deprivation test for diabetes insipidus?

[/quote]

Yes, calcium is normal. We were thinking about a water deprivation, but are saving that as a last resort. And were thinking USG probably isn't low enough for DI.

Re: Incontinent, pu/pd Dobermann

Busybee — Wed, 20 Jun 2012 10:27:38 GMT

Last dog of a similar size I had that was drinking 6L a day turned out to have hyperadrenocorticism AND diabetes insipidus......it wasn't leaking but was wetting around the house - not surprised if drinking so much!

Re: Incontinent, pu/pd Dobermann

HMC — Wed, 20 Jun 2012 10:16:16 GMT

[quote user="Thomas Johnson"]Urine cortisol:creatinine WNL.[/quote]

I'm not familiar with how sensitive this test is. Why not just go for the ACTH stim test?

Re: Incontinent, pu/pd Dobermann

Thomas Johnson — Wed, 20 Jun 2012 08:30:31 GMT

[quote user="Jo Jones"]

Posting on behalf of a colleague, so I hope I get all the info right!

2 year old Fn Dobermann, neutered 12 months ago, presented approx 1 month ago with urine leakage when recumbent. Sounds straightforward... BUT!! Urinalysis shows USG 1.017, and dog drinking 6 litres of water daily (weighs 36kg) Most treatments for USMI contraindicated if dog is pu/pd, so cue investigation. Urine culture negative, bloods normal including electrolytes. Urine cortisol:creatinine WNL. Abdominal scan (mostly in search of focus of inflamation) largely NAD except possibly enlarged cervical stump. Dog was started on course of antibiotics 5 days ago, not sure if any change since then.

Do we just start Propalin/incurin, or is there something else going on?

[/quote]

I assume normal bloods includes a normal calcium? Have you considered doing a water deprivation test for diabetes insipidus?