Ugh. It's one thing after another. I apologize for the barage of questions. I'm a worrier but this is weird.
Ginger is going to the bathroom at LEAST every two hours when she's awake. It seems like she's going small amounts at a time. Both #1 and a bit less frequently #2. She had stomach upset from the Meloxicam (she was on it for just a few days and went off it on the 26th due to intolerance) and her stool is soft, not liquidy though, so I understand if she's still having residual stomach problems but I don't understand her also having to urinate at least every 2 hours. Sometimes she'll even urinate multiple times during one potty break. Up to three times, I think.
We had a sterile urine draw and it came back negative for a UTI. She does have central diabetes insipidis but she's taking .1mg Desmopressin three times a day.
She has a knee injury that she's recovering from (possible partial cruciate ligament tear they said, although it doesn't seem so bad. X-rays and palpating couldn't confirm anything. She was limping.) and that's why they put her on the Meloxicam. Like I said, I stopped giving it on the 26th. She was only on it for a handful of days. It's now the 3rd of the new month.
Could the frequent urinination be due to the Meloxicam being in her system? Could it be due to her having trouble maintaining a crouch so maybe she's not finishing her urine stream? Or is it likely that it's something else altogether? She's about due for her geriatric blood panel (very comprehensive) so I think we'll push it up by a month. I don't know what else to do. It's worrying me. I'm scared to death of organ failure or something serious. She was tested last year for thyroid disorders and also cushings and they came back negative.
I forgot to mention that she's not drinking an unusual amount, her appetite seems fine and she's not going potty simply because I let her out often. She's asking to go out this frequently. Our vet said the urine looked normal, not over dilute or overly concentrated.
Does she also have to go out that frequently during overnight? Shermie has a bladder the size of a thimble during the day and want out seemingly every hour, but sleeps through the night with no such activity. I am not attempting to help with her problem, just curious.
Maybe some famotidine for the upset stomach from the meloxicam?
This post was modified from its original form on 03 Nov, 22:47
The first thing that comes to mind... urinary tract infection. Get some urine and bring it down to your vet for them to check it. A course of antibiotics and I have a feeling she'll be sorted.
Urinary tract infections, urinary crystals and bladder inflammation can all look very similar outwardly. Animals are often urinating more often and smaller amounts more often. Cats often urinate outside the box and dogs have accidents in the house. Basically you look for more frequent smaller urinations, straining to urinate and sometimes vocalizing then they're peeing. You need to look at a urine sample under the microscope in order to figure out which one is affecting your animals.
Side effects of Meloxicam wouldn't look like what you describe Ginger doing. You'd see her drinking a lot more and urinating more frequently but they'd be large amounts of urine and no straining. You're not always going to catch a urinary tract infection on a culture and sensitivity or even a urinalysis. I'd still consider a course of antibiotics just in case. Maybe an xray to rule out bladder stones.
Also, if it was due to meloxicam you'd be seeing signs of kidney damage or failure and her urine would be dilute, the middle of the range of concentration. If it's really dilute or normally concentrated then you know the kidneys are working. If it's in the middle you know there's something wrong.
So, in short, less likely due to the Meloxicam. I'd try a course of antibiotics as precaution and consider an xray of the bladder. Good luck!!
Her stomach upset is improving. She doesn't seem to have discomfort anymore. Her stools are firming up also.
She sometimes has to go potty in the middle of the night, but not usually. (Thank God!)
We'll talk to the vet about the antibiotics for the possible UTI. I hope they'll comply. I don't see how it could possibly hurt things to err on the safe side. Especially if I give it with a probiotic.
We went back to the vet. It turns out that they never cultured the first sterile urine draw so we had to get another... We didn't see our favorite vet and now we're planning on just seeing him from now on, due to some other things but that's kind of off topic...
Anyways, the culture didn't grow anything and they said that they don't do courses of antibiotics just in case, when I asked. Instead, she wants me to give a pill and a half three times a day (instead of just one pill 3x a day) from now on for her Central Diabetes Insipidis.
Is it likely that the frequent urinination could be due to that? The increase in urination was very sudden. I thought worsening of the CDI would make it progressively worse, not suddenly worse.
She was taking .1 mg TID and now .15 TID.
Her creatine and something else (three letter abbreviation I can't recall) were elevated on her blood chem. Could be due to her recent knee injury. We were told to get it rechecked in a bit.
Do you think the next thing I should do is ask for an xray for stones? There's kind of a cavalier attitude about this urination but she's getting me up like 2-3 times a night, even if we go to bed late and wake up early. Not to mention going all day long. Whenever we're in an appt or a store, I can't stop worrying that she might have to go.
Did they look at a sediment for the urine as well as a culture and sensitivity? I would have thought that if it was progression of the DI that she would have had overly dilute urine and be drinking more. I don't know if I would worry too much about stones unless she had some blood on her urinalysis. Usually when there's stones, they're kind of knocking around the bladder causing damage and inflammation. This causes blood in the urine. Of course, other disease processes can also cause blood, but that's what I'd look for.
On the blood work... the other value that was increased, was it BUN? Both the BUN (urea) and creatinine are break down products of proteins in the body. They should be removed from the blood by the kidney. So, an increase in these values can point to something going on in the kidneys. Of course, other conditions can sometimes alter these values as well. That's why you always try to look at the blood values with a urinalysis. You'd be surprised how much information a little bit of urine can give you.
It could be progression of the DI. Gradually progressive can sometimes appear as sudden changes just because animals can cope with things a long time before they can't anymore. So, things can sometimes grumble along for a while and all of a sudden change. I'd see how the increase in the meds work and keep an eye on those blood values. If you can find a little more information about what her urine concentration is or if there was anything else on the urinalysis and that might help me be able to give a little more advise on what you should push for next.
Ohh, before I go, the creatinine is unlikely to go up with the knee injury. It's generally pretty kidney specific.
Hmmm. Her urinination frequently hasn't decreased much. It's still in and outside all day. I watch her and the trips are productive. We have an Adequin appt coming up and I'll change it to a consulation so we can get the answers from our favorite vet who tells it like it is and I'll update. He puts up with my neurotic worrying. :/
He said there wasn't sediment and it was creatinine and a three letter abbreviation. It has an H and an L, I think. Ugh. I forgot it, I had it in mind yesterday. I knew I should have written it down. Something to do with the liver. It was a 9, he said that a 7 is normal but that 9 isn't exciting for a 12 year old dog.
He said bring in an early morning urine sample so he can check the concentration. He didn't even charge me for the office visit, just Ginger's Adequin! Love this guy!