Health ? Idiopathic Renal Hematuria (after e.coli) - Page 3

not for  UTI, coccidia needs to be for sure cleaned up it could be compromising everything else and is really easier on the whole dog;  and if he has any more tests he needs to be off med's for some time before you can really get an accurate read on any cultures or sensitivities.  Nan

PS:  boy talking about doing things bass ackwards?  And at the puppies expense.  I don't like it at all.  Seems to be the way these days.  Try to save money and bites you in the behind.  Not good.  Poor little guy.

Ah, gotcha. 

The coccidia was back when he was just a tiny guy, 8-9 weeks. I only mentioned it because my choice would've been toltrazuril, not a long course of albon, since he was asymptomatic (a couple littermates had it). I was just stating he'd been on way too many antibiotics in his very short life. He was already fighting something and absolutely should've been on a probiotic and should not, during that time of stress, on antibiotics, been switched cold turkey to raw. Albon is the first abx he was on, then he was on amoxy, then cephalexin (I think)...the coccidia, other than being a stressor and the cause of the first antibiotic, was not really a big issue- just part of the big picture. 

Yes way way too many drugs for a young dog to be on and with a food change, new home, coccidia, UTI;  poor little guy, If he were mine I would take him off everything except probiotics w/cranberry give him some Kefir in his whatever food, make sure he is drinking plenty of water yet not excessive amounts though and wait and watch.  Recheck urine culture and do sensitivity at same time in about 4 weeks.  No stress just play and good food/water and let him mature a bit.  JMHO.  good luck  Nan

All of this could be the outcome of TOO much medication..................

PS:  definitely NOT a high protein diet though, something mild yet nutritious...  Again honest kitchen comes to mind for this little guy;  they have diets for special problems like this, call them and get info.  BOL  Nan  NOT f- - - - - - science diet or royal canin kidney/urine crap diets.  N

Do not throw more meds at this dog for ANYTHING esp undiagnosed.  Get the culture and sensitivity test done.  You do NOT have to wait.  If the bacteria is still there, culture it and find out what it's sensitive to. 

 That's the 1st and only step. 

The rest with probiotics and such is fine as supportive care but treat the problem aggressively and correctly. 

This is not the result of too much medication.  It's the result of the wrong medication because everyone is WAGging it (Wild Assed Guess).

Get the test done. 

MK

Just a little blurb about ecoli utis.

http://monicasegal.com/newsletter-september-2014.html

Jenni, just got a chance to check in on this.  I'll pull some reference info for you.  This could be a chicken versus egg sort of affair, as the condition is not unknown in the working breeds but usually is NOT something that occurs secondary to an infection, but rather predicates the development of an infection.

The short answer though, is yes, a lower UTI that isn't sufficiently treated to the point of full clearance can travel up the UT to the ureters and into the kidneys. 

Thanks, Hexe.I just got off the phone with the owners, and it unfortunately sounds like maybe a C&S was never done, just a quickie culture and they tossed some cephalexin at him. Hopefully I'll know tomorrow. 

IF in fact, a C&S was done and ceph IS the proper drug for this strain, and he still has the blood issue, he's going to demand a lepto test, as he asked for one 2 months ago when this first started, as he lives in an area with a lot of wildlife in his immediate yard. 

Thanks for the tidbit about predicating the development of an infection. I know it can travel upwards into kidneys but didn't know whether those changes would show on an ultrasound or if the "off" coloration was possibly caused by something else. "Off" doesn't really give us much info. 

Thanks for everyone's help and concern. I'll definitely keep you posted. 

The problem is that the term 'idiopathic renal hematuria' really just means that it's not going to be an easy diagnosis, and will most likely require contrast imaging and endoscopic examination of the ureters and kidneys to determine the specific location in those organs where the bleeding is occurring.  The reason I mention the chicken versus egg conundrum is because a pre-existing, congenital defect in a ureter or kidney which is producing small blood clots that can produce some degree of obstruction in the upper urinary tract, and predispose the pup to acquired infection by providing a petri-dish-like environment for ubiquitous and opportunistic agents such as the E. coli species to colonize and multiply. 

That said, E. coli is the most common bacteria isolated on cultures from animals with UTIs, and antimicrobial-resistant strains are being seen more frequently in dogs. So even with a C&S, it's a real possibility that the infection could be hard to completely clear, and may require repeating treatment with an alternate antimicrobial.

www.ivis.org/proceedings/aavpt/2013/abstracts/13.pdf

I likely would have pushed for a lepto screening initially, but at two months out from the onset of this problem that's a much less likely cause-- both the penicillin derivatives and cephalosporins he's already been on would have addressed the condition at this point. The thought of a bleeding disorder can't be entirely ruled out without investigation--though it's not as common as it once was, the breed does still have the risks of von Willebrand's disease and factor VIII deficiency [Hemophilia A] to consider on the hereditary, congenital points, and the rickettsial diseases have been found far afield of where they once were thought to be isolated, so RMSF and ehrlichiosis should be considered if the pup has other symptoms in addition to the hematuria. Were this not a 5 month old pup, a Lyme-associated nephritis could be added to the differentials list, but at this age it would be most unlikely.  www.ivis.org/proceedings/wsava/2010/c7.pdf 

One thing is for sure--this isn't something to play with, and the dog's owners need to be persistent to whatever degree necessary in order to get a true diagnosis and ultimately a full resolution. This shouldn't be permitted to become something so serious as to endanger the pup's life; unchecked, this could result in permanent damage to the dog's kidneys.

I pushed for lepto test on day 1. Guess what?

I pushed for proper culture and accurately dosed abx on day 1. Guess what? 

Before the UTI, I said don't expose a tiny pup whose been on abx to raw chicken immediately upon bringing him home, and whatever you do, put him on probiotics for the first course of abx, and long before you switch him to raw. Puppies eat chicken messily, then lick their privates. Puppies can be prone to UTIs anyway, and a puppy under stress is going to be less resistant to infection...but again, guess what?

After spending a ton of time on this between long-winded phone calls and constant texts,  and being pretty much ignored every step of the way, I'm getting quite frustrated, as there's only so much I can do, especially when you don't do what I say. Don't ask me and waste my time if you're going to ignore it! I even said early on to just bring me the puppy and I'll take care of it and give him back when it's fixed. This truly ought not to be rocket science. They're kind of friends of mine but I care a lot more about puppies than I do people so this really irks me for the dog's sake that someone who doesn't know enough to push the vet is also ignoring advice from people who do, and also not doing their own research. I cannot stand when people don't do their own research. Stop texting me stupid questions you can find the answer to in any online medical publication. Don't be lazy. He's YOUR PUPPY- YOUR RESPONSIBILITY TO FIGHT FOR HIS WELL-BEING. Unless you're going to start paying me hourly, go away until you are going to listen; otherwise, I really don't want to be involved in this asinine charade that will ultimately lead to the destruction of a gorgeous, sweet puppy's kidneys. I will certainly get no satisfaction saying "I told you so" in this case.   

Yes, I'm a bit pissy about the whole thing. I hate when puppies suffer for human incompetence. Sorry for the rant.

Back to the topic...apparently a C&S was done, cultured for a week (is that long enough? I haven't kept up on protocols for that stuff in several years) and ceph was the drug of choice and was prescribed for etiher 10 days or 14 days, need to check which. For a long-lasting UTI, that struck me as a rather short course, as I remember my cat w/urinary troubles was on them for 21 days to finally knock out an infection. Is that considered adequate now w/ceph? 

Puppy has never had any symptoms of anything. He was an absolute breeze to housebreak, never drank excessively like pups w/bad kidneys do, or any other symptom of anything but UTI (blood-tinged urine). Specialist was called back for clarification on ultrasound and has nothing to add to his statements that everything appears as it should, no suspicion of congenital defect in structure of anything in excretory system. 

MKlevin...if you can shed any light on this as it parallels to your daughter's experience, I'd be interested. 

Thanks to all!!!