Tuesday, September 2, 2014

Cookie's Leaks Are Back: Garden Variety Incontinence Or Not?

So Cookie's leaks are back. Well, they aren't really leaks, rather that squirts.

It started last Wednesday.


She was leaking a bit in the evening. We took her to pee, she did, but leaked some more after. Stayed dry for the night, though.

The next day she was actually at the vets for her rabies shot. They checked her out thoroughly and check her pee region as well. She did squirt the vet a little. But nothing unusual was found and we thought it was going to be like before; it would come and go away.

It did seem to have gone away again.

There were no leaks we know of until Friday morning. This time it's been quite a lot. That was unexpected and unwelcome. Particularly right now as we have no amenities to speak of to keep things clean. And it was raining the whole day so no chance of putting things out to dry.

Fortunately, I still do have a stash of puppy pee pads which we got when it all started.

Since then it's been off an on. Not like in the past when she'd leak for a bit and than remain dry for a long time. In fact, it's been quite a while since it last happened before this.

So what has changed?

Of course, as it typically happens for us, it was a long weekend and the vet office was closed. Since this isn't an emergency, we had to wait.

Cookie has an appointment for another exam, urinalysis and culture tomorrow morning.

Last time, only couple weeks ago, during our initial appointment with the new vet, we did discuss this as part of history. She did feel that it is likely a result of Cookie being spayed very early (we don't really know when but I can imagine it would have been quite early)

That part does check out for this being hormone-responsive incontinence.

This is, sadly, quite common in girl dogs.

Things that can cause urinary incontinence are
  • Hormonal imbalance
  • Weak bladder sphincter
  • Urinary tract infection
  •  Urinary stones
  • Spinal injury or degeneration
  • Protruding intervertebral disc
  • Presence of other diseases that cause excessive water consumption, such as diabetes, kidney disease, hyperadrenocorticism
  • Congenital abnormalities
  • Anatomic disorders
  • Certain medications
Checking out the urine and overall health is a starting point.

Cookie does not have any other symptoms of a problem.

She drinks, pees, eats and acts normally and happy.

Some of the things about this do make me feel that there is something else to it than garden variety incontinence.

It doesn't happen when she sleeps soundly; it doesn't happen unless she moves. The urine doesn't dribble but squirts out with movement. Last night Cookie remained perfectly dry. When she was getting up to face a new day of adventures, she dribbled some.

Going to pee doesn't seem to have any effect on this.

If she's going to leak, she's going to leak before or after going to pee. No difference whatsoever.

I actually happened to catch the event on film (sorry, Cookie).



Cookie was in the office, awake, watching stuff outside the window. Then JD had found something and she was getting up to see what he's got. As she moved, that's when it squirted.

After seeing the video, our primary vet from Kitchener feels that the video does better fit vaginal pooling rather than incontinence.

Based on my description of events, Dr. Kay also says she'd wonder about some sort of structural anomaly that is retaining a small puddle of urine; perhaps in vaginal vault. Particularly since there were several times when Cookie was also leaking mucus during a walk.

The timing also doesn't quite fit to her.

It is also possible that there is a component of infection involved.

Hence the urinalysis and culture and all that to start with.

To Dr. Dan it also looks like a structural problem with a pocket of urine pooling. To Dr. Patrick it looks like typical hormone related incontinence. It makes sense to him that muscular control of the sphincters nor being as strong as they should due to her lack of exposure to female hormones like estrogen. Dr. Roxane feels that Cookie might have tweaked her lower back/pelvis. Wouldn't be surprising the way Cookie is flying through the tall grass.

Whatever it is, we need to get to the bottom of it.

If the initial work-up doesn't reveal anything, we need to look into ultrasound or vaginoscopy or both.

When and how it happens does confuse me. To me it doesn't fit with typical incontinence. To some of my veterinary friends it does, though.
  • it does not necessarily happen during the night or when she's sleeping (she might be awake and try to lick herself clean so clearly not sleeping
  • it does not seem to happen because of a full bladder because taking her out to pee does not put a stop to it
  • it does seem to happen primarily when she moves (e.g. I was sitting there, watching with flashlight; everything was nice and dry and then she moved and urine squirted out) though sometimes it might dribble a bit on its own. Generally, though, it's squirts out with movement.
It almost seems to me the urine might be pooling some place. That's why going to pee doesn't make much difference and that's why it squirts out with movement ... ?

Did you ever have a problem like this with your dog?

Related articles:
Incontinence? Cookie's Mysterious Leaks
From The End Of A Lead Line To Casa Jasmine: Meet Cookie, Our New Adoptee
And So It Begins Again(?) Our First Health-Related Heart Attack With Cookie 
I Didn't Know I Could Fly: Why Cookie Wears A Harness Instead Of A Collar
C.E.T. Oral Hygiene Chews For Dogs CAN Be A Choking Hazzard 
Our First Health-Related Heart Attack With Cookie: The Knee Or The Foot? 
Creative Solutions And An Incidental Product Review
Too Young For Pot: Cookie's Snack With A Side Of Hydrogen Peroxide  
Taming Of The Wild Beast: Cookie's Transition To Civilization  
Staying On Top Of The Ears: Cookie Is Not Impressed  
Putting The Easy Back Into Walking
Cookie's Ears Are Still Not Happy 
The Threat Of The Bulge Is Always Lurking 
Today Is Cookie's Three-Months Adoptoversary  
Cookie Meets The Electric Horse Fence And Her First Chiropractic Adjustment  
Why Examine Your Dog's Vomit? 
Why Is That Leg Still Not Happy? Cookie's Leg Keeps Getting Sore 
Cookie Too Is Insured With Trupanion
Does Being Insured Mean Being Covered? Our First Claim With Trupanion
Is Cookie's Leg Finally Getting Better?
Is Cookie Going To Be Another Medical Challenge Or Are We Looking To Closely? 
The Project That Is Cookie: Pancreatitis Up Close And Personal  
Pancreatitis: Cookie’s Blood Work   
Another Belly Upset: Pancreatitis Again Or Not?  
Happy Birthday, Cookie 
Who's Training Whom? Stick And Treat 
Don't Just Stand There, Do Something? Cookie's Mysterious Bumps 
Cookie's Mysterious Bumps Update
One Vomit, No Vomit 
Happy One-Year Adoptoversary, Cookie!



Do you have a story to share?

Your story can help others, maybe even save a life!

What were the first signs you noticed? How did you dog get diagnosed? What treatment did/didn't work for you? What was your experience with your vet(s)? How did you cope with the challenges?

 

7 comments

  1. I've had two dogs with incontinence Becca and Jack. Becca's was mild, but constant. The vet thought it was age and nerve damage related to her spinal issues. She was on Pronin the entire time we had her and that kept it pretty well in check. Jack's just started recently - age related hormonal issue. He's been on low dose Pronin and it's in check. I could see it happen to him too - with movement, but it didn't squirt like Cookie...more of a dribble. I hope I don't have to keep him on the Pronin, but we may. Good luck getting to the bottom of it.

    ReplyDelete
    Replies
    1. Sorry you're having the same problem.

      I'd very much like to find a solution that doesn't involve drugs. A friend of mine had a dog on Proin and she [the dog] went completely psycho while on it. I'm not a fan of drugs.

      I'm glad that Becca hasn't had any issues with the medication.

      I really want to know for sure what I'm treating first. And then, I'm hoping some more natural solution can be found.

      Delete
    2. The fact that it squirts, rather than dribbles is one of the reasons that make me think something else than incontinence is in play. As well as the timing.

      Last night, again, she remained perfectly dry. Squirted a bit only when she got up to go out.

      It seems it is more likely to happen during the day than during the night. When she sleeps soundly and doesn't move, nothing comes out.

      That morning when she made the biggest puddle, I found a bur in her skirt. So I'm wondering whether she was squirting more as she was trying to get the bur out (bending over to lick it)

      Delete
  2. I've never had a dog with this problem. I sure hope Cookie is feeling OK and that you get to the bottom of it. Poor girl. I'm glad to hear she's playing and eating and sleeping like normal.

    ReplyDelete
    Replies
    1. She seems to be feeling just fine, apart from the leakage. She doesn't like it happening but it's certainly not slowing her down.

      Saw the vet today; urine is clean and no sign of infection of any kind. Vet wants to try estrogen and see whether it changes anything. Reluctantly I think it might be a good next step.

      Delete
  3. Hmm, it almost looks like she's farting, the way the urine squirts out. I've heard of the hormonal incontinence from spaying to early (the number one reason I won't get a puppy from a rescue group) but I've never heard of it squirting out like that. I sure hope you can get to the bottom of it.

    ReplyDelete
    Replies
    1. I know, right? Sometimes it can do quite a distance ... Urine looks clean, though, and vet still convinced it's estrogen related so put her on estrogen to see what happens.

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