Tuesday, February 8, 2011

Puppies Pee, Huh? Koda's Story

by Julie Nutter

I have a working relationship with my vet. It just so happens that mostly, that relationship is torn between his exasperation with me and my wanting to smack him.

Throw in that I fancy myself a professional dog trainer and that he fancies himself a behaviorist as well as a vet, and you have more than just a slight possibility that some toes will be stepped on. 

Also, my vet has an ego. 

He’s very smart, and - despite some peoples’ opinions to the contrary when it comes to the case of me and my dog - very good at his job. 

And as an information-gatherer of a more sneaky sort, I am very good at mine. 

Every vet visit, I ask questions that he answers with a little more abandon than he might if he stopped to remember that I am a professional concerned about her dog and not the sixteen-year-old with a puppy that he sees.
Hi, I’m JJ. I’m a 23-year-old dog trainer with more jobs than you want me to count if you intend that I stay awake by the time I finish. 

I look like a teenager, no matter how professionally I dress, and could probably stand to gain a pound or two. All of this means that, with certain people, it doesn’t matter how I dress or how I conduct myself.
It means that when they look at me, they will see a teenager. 

Meet the vet. I won’t give you his name. Can you guess what he sees when he looks at me?

It’s a good thing that I have a flexible ego… 

And the dog?
That’s Koda. She’s a going-on-eight-months old Australian Shepherd puppy with a pee problem.
When I brought her home, she peed a lot. 

She peed outside every ten or fifteen minutes when I took her out. Twice. Sometimes thrice.
She peed inside every so often, too; sometimes right after she’d just peed twice outside. Mostly, when she peed inside, she did it while she was running, walking, playing, lying down, or trying to get to the door. Once in a while she peed while I was trying to put on her leash. 

I took to putting her leash on outside, and carrying her to the door.
Once or twice, she peed in my arms.
Those times, I didn’t love her so much.

Here’s the rule: If you’re having trouble with training - potty training or even behavioral problems - the first thing you do is rule out medical causes.

Who do you see for potential-doggy-medical-problems?
The vet, of course!

Unfortunately, the vet first answered my - well, the dog’s - problem with “puppies pee.” 

(In his defense, this was before she leaked all over me while I carried her to the door.) 

Equally unfortunate, and quite frustrating for the vet, was my refusal to accept that as an answer for her problem.

We did a pee test. 
One. Pee. Test. 

Did I mention there are two types of pee tests?

Well, there are. And beware, because no one thought to mention that to me. (And by no one, I mean the vet. The host of this here blog was how I found out!)

We ran one that checks for kidney function - tests for protein in the urine and makes sure the gravity and all that is good for go - and everything checked out.

I expected that he’d check for white blood cells. You know…because when there are a lot of those, there tends to be an infection of some sort at the root….and a lot of puppies come with worms and a lot of girl puppies come with vaginal infections. 

He also didn’t tell me that he didn’t test for that.

So, when I found out, I had him test for that.
…That was after I’d already made him rerun the test. 

Her kidneys checked out both times. 

Or all three times. I can’t even remember how many pee samples I brought. For the sake of argument, we’ll say three. Two for kidney, one for infection. 

My frustration must have been apparent in a very bullheaded fashion, because after the second test, he sent me home with antibiotics.

Low. Level. Antibiotics.

I was on the receiving end of some speech about how he didn’t think it was a vaginal infection, but if it was, the antibiotic would be more than enough for that. If it was a bladder infection - and I gave them a third sample to see - we’d have to adjust the dosage. 

Couple days later?

Well, I got a frantic call telling me to cut the antibiotics and get my dog to the vet. A sterile sample was to be taken and analyzed. 

Did I mention that I can be a tricky information-gatherer?

When picking her up, I had the vet come out and explain what was going on. Turns out that when he ran the sample, one slide would be free of infection while the other had more white blood cells than he could count. 

I got the sneaking suspicion he thought I’d somehow contaminated the sample…. 

And that I got to pay an extra $250 for it.

The sample came back clean.

From the bladder. Which didn’t rule out infection in the urinary tract, but nothing was mentioned about that.
Of course nothing was mentioned about that.
It was decided that when she was spayed, another sample would be taken and the vet would check everything to make sure nothing was wrong. (Blood work, EKG, another urine sample, a look to make sure everything on the inside was where it was supposed to be, and a scope to make sure no foreign objects were hiding out.) 

Something was hiding out.

Are you surprised?
I wasn’t. 

(Although, I need to note here that when a vet tells you that nothing is wrong, there is a very good chance that nothing is. Yes, we know our dogs because we live with them everyday and see their behavior everyday, but that doesn’t make us medical professionals. The problem could very well have been in my head. It just wasn’t, and even if it was, I was making damn sure that everything else was ruled out before I accepted that as an answer.)

Meanwhile Koda wasn't getting any better and started being lethargic.

Finally, the day of the spay operation arrived. And guess what?

It's turned out that she has ectopic ureters, allowing for the incontinence that she was experiencing, and explaining the potty problems that we were having. 

Apparently, this is not a common thing.

But when questioned, the vet couldn’t exactly answer whether the uncommon ectopic ureters was due to it actually being uncommon, or due to it not being commonly checked for.

Puppies pee, huh? 

My question is, would this be found if I didn't keep pestering my vet...


Julie is a Certified Professional Dog Trainer, a member of the Association of Professional Dog Trainers, and is working on her case studies to become a member of the International Association of Animal Behvaior Consultants. She coaches parents to train their fur-children in Confidence Building for fearful dogs, Agility, Rally, FlyBall, and Obedience. In her free time, she volunteers at local shelters and reads up on the newest dog-world information. You can visit her website at www.northeastdogtraining.org.

Koda has her own blog The Koda Diaries.

Related articles:
Common Misdiagnoses (Part 1)
Common Misdiagnoses (Part 2)
A Word on Second Opinions
It's Your Dog's Health!
Veterinary Drive-Thru: Coming Soon To A Veterinary Hospital Near You!
Does Your Vet Listen To You?
Help! My Dog Is Purple!
A Praise To Our Dog House DVM
A Word On Pain


  1. Hi,

    Great post! Having spent a couple of years trying to solve a problem with my dog, as I read your post I found myself thinking...I wouldn't have had her patience...I'd have been changing vets and changing again!

    BrownDog's Momma

  2. An unbelievable story :( Why is it necessary with some vets to almost have them at gun point to perform the proper tests. I guess he ows you a HUGE apologie!

  3. The vet-client relationship MUST be a two-way street. While the responsibility is on the vet to recommend diagnostics and treatments, many vets will not offer every possible option because then they are accused of being money hungry. I can't even begin to tell you how many times our vets would get reamed out by a client because they recommended an ultrasound or echocardiogram. Our philosophy was this: we will recommend the very best and it is up to the owner to say yes or no. But most vets don't operate that way. It's a no-win situation in many ways. Recommend the best; get accused of wanting money. Don't recommend everything; miss a diagnosis.

    Great blog by the way! :)

  4. Hi BrownDog's Momma. I agree with you. If my vet wasn't taking my dog's symptoms seriously, I'm outta there.

  5. Kenzo, my solution would have been changing vets. Not taking symptoms seriously is a big sin in my books.

  6. Jennifer, I appreciate the conundrum, and I appreciate the fact that many clients are not willing to invest in their dog's treatment. But when the client clearly WANTS to pursue the issue, I don't see the reason to underplay and shrug off described symptoms.

    I believe that at least the options should be laid out for the client.

  7. @BrownDog's Momma - Welcome to North Eastern Ohio, where all vets have a God Complex and you'll be lucky to find one willing to work with you, not against you. LoL. He is the "other" vet. In fact, he's the other, other, other vet.

    Here's what I think: Dear Vet, you may believe I'm full of it or that you can just write me and my dog off. (He didn't, though he didn't believe us.)
    But. Too bad for you, because I'm going to force you to do it my way. You're going to see this through to the end, and when I turn out to be right, you will be told that I sincerely hope you don't treat the next client who comes in the way you treated me.

    (And, when a different dog came in with a very similar problem, it took him much less time for him to connect the dots and find out what was wrong. ...Like about ten minutes, even though this is not commonly checked for.

    See, I think it pays to make them see, because I'm hoping that he'll take a lesson from it. And see that I'm not going to give up, and while finding a vet who will pamper me is great...
    This guy is a really good vet, but realizing you don't know it all and that there is still room to grow would be a boon to his other clients, who have had similar problems.

    Taking over the world...one vet at a time?

  8. @Kenzo. It is pretty darned stupid. I think at one point, he was afraid I was going to sue him. I said, without being prompted, that that would be a stupid thing to do, because what I want is to find out what's wrong with my dog, not be right and able to rub it in someone's face.

    I told him that he owes the next client who comes in with a problem an easier time.

    The next client who came in with symptoms close to Koda's was given both pee tests, and checked for what she had. Surprise. She had it, too.

    That's enough apology for me, I think. I hope that the tissue messing with the urethra was all that was wrong though, and she doesn't have an ectopic ureter, cause I don't think he'd ever figure that one out....

  9. @Jennifer While I totally agree with that, I told him money would not be a problem, and I would find a way to pay him.
    As it stands, I've just gotten myself down to 500$ from a 1000$+ bill.
    If anything, I think it would be more that he feared an inability to pay than an unwillingness to do so. (And he is very nice about it. You pay when you have the money, you can post-date checks, mail in payments, etc. Some check-ups, he won't charge for - even though his office visit...along with everything else, is rather expensive.)

    I think, personally, they should tell you every option there is along with the probability that it will turn out to be this or that.
    Here's what we should do, and here are some other things we can do...
    (I'm used to that from the hollistic vet. We joke that he is our house, because with as much as we have paid him... Well.)

    I guess I agree with jana, lay out the options.
    (Also, I think that if someone is stressed about their animal, they look for reasons to explode and people to blame. Add cost to that, and you're very likely to get an otherwise rational person to scream at a vet.)

  10. Well, I'm glad you finally found out what the problem was. But I'm not sure I wouldn't have changed vets right after the "puppies pee" comment. That sounds a bit condescending.

  11. Hello there. Great post. Here on the Saturday Blog Hop (yes I know it is Wednesday but there are so many to check out!). I am also a tricky customer at the vets - I like to know what is going on and I educate myself. So far my vet(s) have been great and very forthcoming - answered questions, debated courses of action etc.
    So, as I am a little bit of an investigator, I'll keep an eye on your blog, some good work there!

  12. Hi, E.A. thank you for stopping by!

    I came to believe it is very important to educate oneself and keep on top of what's going on. It is also important to keep the vets on their toes :-)

    I would love to hear about your experiences and what you learned too.