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Cystocentesis a.k.a. A STERILE Urine Sample

July 26, 2016 By Jodi

Four weeks ago, Delilah had a Urinary Tract infection. She had a two-week course of antibiotics and my instructions were for a urine recheck a week after she finished them.

Delilah finished her last full day of antibiotic on a Sunday. Wednesday night she was going outside more than she normally would.  Thursday morning I called our vet and asked if maybe we should check her urine sooner than the recommended week.

My vet said she’d like a STERILE urine sample.  The STERILE urine sample is also known as Cystocentesis.

Cystocentesis is a fancy name for a needle inserted through the belly into the bladder, for the purpose of withdrawing a small amount of STERILE urine.

I hate putting my dogs through these types of procedures without exhausting all other options. And since Delilah had only been outside a bit more than normal, with no other symptoms, I felt certain she didn’t have an infection. So I asked my vet if we could check her urine the normal way first.

I was advised to get some wet ones and wipe Delilah’s va-jay-jay BEFORE she peed. SO bright and early the next morning, I found myself with my face down in my dog’s ass, wiping her Hoo-Hah with a wet one.

Either the wipe stung, or the wet one felt good, because right after I finished, Delilah took off doing zoomies around the house. When she settled down, we went outside and using my handy urine sample collection kit, I secured a sample.

We dropped it off Friday afternoon and I was shocked when the vet called me Friday night and said Delilah still had an infection.

WHY A STERILE URINE SAMPLE IS CRUCIAL

My vet was very concerned because either Delilah got another infection while on an antibiotic, OR the antibiotic didn’t work on that particular infection.

It’s also important to find out what type of infection it is as well as where the infection is. For instance, a urine sample can be contaminated in the Urethra (the tube that carries the urine from the bladder out of the body) and not be in the bladder. Without having a clear idea of where the infection is, you can be spinning your wheels trying to treat it.

In Delilah’s case, it’s also important because some antibiotics can really mess with the liver and Delilah’s ALT is already elevated, so we need to tread carefully with antibiotics, not to mention she’d just come off a two week course of them.

My Dr. wasn’t available until later in the day on Saturday, but Dr. Allen was, so I reluctantly made the appointment for 10:20 Saturday morning.

The key to Cystocentesis is having a full bladder, so Delilah had breakfast, went outside and then I couldn’t let her pee again.

I called the vet on my way in and said, “As soon as her feet hit the ground, this dog is going to have to pee. Can you have a room ready for us?”

I have the best vet and the best vet staff on this planet, so they assured my they would be set and if I called when I got there, they’d get her right in.

Sure enough, as soon as I called, they opened the back door and I pulled right up and unloaded Delilah. At first Delilah was excited, because we were hustling her along and talking to her. But when we hit the exam room door, she put the brakes on.

It broke my heart because I knew SHE knew something was going on, because her tail was tucked, and she was hesitant. But like I said, the peeps who work at my clinic are amazing and by the time I’d parked the car, Delilah was back to her happy self.

Dr. Allen came in almost immediately and started talking me through it. Delilah would be placed on her back on padded material. One of the vet techs would be holding her head, talking to her and another would be giving her some belly rubs. If Delilah fussed at all, or seemed the least bit uncomfortable, Dr. Allen wouldn’t do the procedure.

Chocolate Lab

Belly rubs are good, I can’t say I like the needles much though.

While we were talking, Dr. Allen was feeling Delilah’s bladder to make sure it was full.

It was.

At first she was going to do it in the exam room, and I asked if I could hold Delilah and Dr. Allen said, “Only if you can be perfectly Zen, otherwise it will upset her.”

I suggested maybe she should take her out of the room.

So I watched my dog leave the room with Dr. Allen.

I picked up my phone and was going to text Hubby, but changed my mind. Then I was going to text Sue and changed my mind again. So I pulled up a game. I was about a minute in when Dr. Allen came back in the room with Delilah.

“Couldn’t you get a sample?” I asked.

“I got a sample, we’re done, she did amazing.”

Wow, all that worry and Delilah wasn’t even bothered by it.

I thought that was the hard part. No, the hard part was waiting for test results. According to Dr. Allen, it could take up to a week to get the results, as the lab would be checking the bacteria against antibiotics to see which one would work best.

When I got home (less than an hour after I’d left) and was telling Hubby how it went down, I said, “Dr. Allen gets me. She knows exactly how to explain things to me, to make me feel better.” We had a good laugh about that. “She gets me.”

Thankfully we didn’t have to wait the full week.  Dr. Allen called on Tuesday evening and said Delilah has an E-Coli infection in her bladder.

E-Coli? Freaked me out. I mean, we’ve all heard of E-Coli outbreaks, and since she was eliminating it in her urine, I was concerned that Sampson could catch it.

It turns out that he can’t. The way Dr. Allen explained it to me is E-Coli naturally lives in the intestines and sometimes, such as in an E-Coli outbreak, some of that fecal matter gets on your food.

Say it with me. EW GROSS.

In female dogs, because of where the pee-shooter rests, directly below the poop shooter (her words, not mine, I told you she ‘got’ me) some of that E-Coli can get into the urinary tract. E-Coli is very receptive to some antibiotics, and resistant to others, which is why the STERILE URINE SAMPLE was key.

So Delilah is now on a three week course of antibiotics (Cefpodoxime) and we will check her urine at about the ten day mark.

When Dr. Allen and I were discussing the antibiotic on the phone, I made sure to thank her for her care on Saturday. I told her how speaking with her made me feel better (and shared the “she gets me” comment with her). After we laughed about that and she joked the next time I was in we should do a drum circle, I told her I wouldn’t hesitate to have that procedure done on my dog again.  At that point she told me that even a dog that does well with it one time, may not do well a second time. She also said, if we’d done that the first time I brought Delilah in (when she was peeing blood) she may not have done well, because her bladder was so angry.

Sometimes a STERILE URINE SAMPLE is a necessity, especially if a course of antibiotics hasn’t worked.

 

 

 

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Filed Under: Health Related Tagged With: Health

Ding Dong the Walk is Done

July 5, 2016 By Jodi

Since Sampson did a partial tear on his right knee back in January, I’ve been having to walk the dogs separately.

At first it was no big deal, because Sampson really couldn’t go that far at all. We would walk down two houses, then turn around and walk back.

Two houses is barely enough time for a guy to do his business.

Two houses is barely enough time for a guy to do his business.

After resting, anti-inflammatories, acupuncture and hydrotherapy, his walks slowly increased in time and length. For the longest time he’s been at seven minutes. Seven minutes in whichever direction we are walking, then turn around and head home. I decided it’s now time to bump the walks up to eight minutes, when time and weather permit.

Morning walks can be a bit rushed, as I have to get ready for work. Afternoons are a bit easier because back in January, my hours at work got cut. I arranged my schedule so I leave work at 2:00 pm and I’m done for the day.

With the separation anxiety that Sampson has been having, it’s just easier for him if I come home and stay home.

Honestly, I am really enjoying the individual time with my dogs. Not just because I am spending one of one bonding time with them, but because I can work on them with their individual issues (Sampson’s need to greet everyone and Delilah’s sometimes snarkiness with other dogs.) Still, it would be nice, if their morning walks could be together.

So that is my new goal. Get Sampson’s strength up so he can make it around the block. This means he probably has to get his walk time up to around 11 minutes.

I’ve mentioned this before, when Sampson and I head out for our walk, I set the timer on my phone and when it goes off, I coax him around and head back home. Some of you may recall Sampson’s been having some issues with noises lately, so I changed the notification on my phone to chimes, which doesn’t seem to bother him.

When Sampson and I walk, we always head down hill in the morning and up hill in the afternoon. Sampson has made a friend on the street that loops behind our house, so I try and make sure we head her way in the afternoons, when the probability is better that she will be outside.

Yesterday I set my phone for eight minutes and Sampson and I headed up the hill. As we reached a point we hadn’t been to in quite a while, I pulled my phone out to check our time and we still had about 25 seconds to go.

I always try and encourage and praise him, so I said, “Good job Buddy, you really went far today.”

At that point the phone, (which I’d left in my hand) went Ding, ding, ding, ding and Sampson, with no coaching from  me, turned around and headed home.

It reminded me of Pavlov’s dogs (minus the food of course) and made me realize that even when I don’t think he’s paying attention, he really is.

I wonder what other things he might be learning without me knowing? I wish he’d learn to pay the bills. 🙂

 

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Filed Under: Health Related Tagged With: Health, Life With Sampson And Delilah, Sampson

Tidbit Thursday

June 30, 2016 By Jodi

Tidbit Thursday…just because I couldn’t think of a better title and because the post has little tidbits of this and that.

First things first, there will be no Follow-Up Friday tomorrow, instead I have a special post planned for Lost Pet Prevention month. When working on tomorrow’s post I realized I had a number of things to share about lost pets, so I will have two or three more posts about lost pets throughout the month.

Then on Saturday, I’ll have a post about something blogging related that I’m really excited to share with you.

Because there will be no follow-up tomorrow, I wanted to give a brief update about Delilah and how she’s doing.

Siriusly, did she just compare me to Cujo?

It’s all good, the Mama just tends to over react sometimes.

Delilah got her first dose of antibiotics and Gabapentin around 12:30 Monday afternoon. The instructions said every 12 hours for both, but I wasn’t going to get up right after midnight to administer her second dose of antibiotics so I checked with the vet’s office and they said I could give them to her around 10:30 with a little bit of food.

The dosage for the Gaba was three every 12 hours and I really felt three were one too many for her. Then around 9:30 that night, she started going to the door every few minutes and squatting with no results. I decided to give her two Gaba’s when I gave her the antibiotic. The good thing about the Gaba was it worked almost instantaneously for her, so she was able to get a good night’s sleep.

My thought was why not reduce the Gaba from three to two, and give them to her every eight hours vs every 12? She’d still be getting the same amount in a 24-hour period, but it wouldn’t knock her out. Besides the Gaba seemed to wear off between the nine and ten hour mark, so why have her be uncomfortable for those in-between hours.

The next morning she got her ‘meatball’ with the Gaba in it around 6:30 am. My original plan was to leave the back door open for her to be able to get outside in case she had to potty, but Tuesday turned out to be super humid, so I turned on the air and took my chances. I figured she made it through the night okay, and I get out of work at 2:00 pm, so why not roll the dice? As it turned out, she did fine.

Meanwhile I’d heard from Jan K at Wag ‘N Woof pets and found out that her Sheba had pretty much the same situation the day before. Jan said, “It looks like we’ll be having similar posts tomorrow.” ‘-)

It’s always great for me to read about someone else’s experience because even though Jan and Sheba’s experience was similar, there was a slight difference because Sheba has a cancer diagnosis and I know how excruciating waiting for that vet appointment was for Jan.

I won’t lie and tell you that the minute I saw the blood in Delilah’s urine that my brain didn’t go there. Because it did. I was terrified that I’d be leaving the vet without her that day, and I can only imagine how terrified Jan felt on Sunday as well.

One of the things I learned from Jan’s post was that her vet CHECKED the urine for cancer cells and thankfully found NONE. I didn’t have a clue that the vet could check for that.

Well you know what happened next…I got right on the phone with my vet’s office and asked them if MY vet had checked for cancer cells. My vet wasn’t scheduled to come in until around 1:00 pm, but the tech took a message and said she’d get back to me. I also shared my thoughts on switching up the dosage of the Gabapentin.

When the vet’s office called back, they said they didn’t see any cancer cells in Delilah’s urine and it was okay to modify the Gabapentin dosage to two every eight hours. Which is what we’ve done and it seems to help immensely.

Delilah is on a 21-day course of antibiotics but I plan on trying to cut her Gabapentin down to one every eight hours beginning on Sunday. A week after that I hope to cut the Gaba out all together.

She is handling everything very well. I’m keeping her walks on the shorter side, partly due to the heat and humidity we’ve been having and partly because of the sedation aspect of the Gabapentin. She still stops to tinkle a lot on our walks, but both the dogs have always done that.

The key is that after Tuesday night, I haven’t seen any more blood in her urine and she seems like her old self again.

Phew, I guess that wasn’t as brief as I thought it was going to be. 😀 Thank you again to everyone who commented, texted and messaged me on Monday, this community is really the best!

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Filed Under: Health Related Tagged With: Delilah, Health, Life With Sampson And Delilah

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About Jodi

jodiHi, my name is Jodi. Thanks for stopping by and checking out my blog! I have all kinds of fun writing about my two crazy pups, Sampson and Delilah. Find out more!

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