"Incontinence" that keeps getting better with anti

[spamgirl]

I called my vet and she thinks I'm going to be wasting my time seeing a specialist because of the heavy calcification of the kidneys, but she did the referral.

[Traci]

Infection, inflammation, bladder wall thickening, kidney stones, nephritis, yeah, he needs a specialist. Unless your vet were willing to consult one on your behalf (which she could have been doing all this time), then I think it's worth a consult with a veterinary urologist (or internal med), but preferably, since his pressing issues seem to be urinary tract/kidneys, a veterinary urologist would be my advice.

[spamgirl]

Infection, inflammation, bladder wall thickening, kidney stones, nephritis, yeah, he needs a specialist. Unless your vet were willing to consult one on your behalf (which she could have been doing all this time), then I think it's worth a consult with a veterinary urologist (or internal med), but preferably, since his pressing issues seem to be urinary tract/kidneys, a veterinary urologist would be my advice.

We went in yesterday and she completed a full blood test (results will come today) and another ultrasound. All looks the same as before (although she also noted the adrenals look normal, and did not mention any issues with lymph nodes), but the thickened bladder wall has gone from 4mm in November to 5mm now. It's at the part of the bladder that exits into the urethra.

The options she suggested to me are:
1. Cystoscopy to see if it's a lodged urolith which could then be treated with debriding.

My opinion is that a) I'm not too happy to put him under full anaesthesia with his heart issues, and b) his bladder is already so sensitive and so delicate that I'm not sure debriding is safe, especially with all the infections he has all over. He has so many other problems, including the fact that he's still producing stones even though he is on a the lowest oxalate diet I can possibly give him, that I'm not sure this expensive, intrusive surgery would give him enough benefit to be worth it.

2. Removal of cells near the thickening with a catheter and then sent to pathology to determine if it's cancer. If it is, treat with a pill that started with "M" (not piroxicam, definitely an "M").

This test I'm more inclined towards, but still, if either the cystoscopy or the cell pathology showed nothing definite, that would be a few thousand dollars down the drain. We're as broke as broke can be - the $1,000 we spent yesterday literally emptied our bank account - but I don't want to say my dog suffered and died because we were poor.

My questions for the vet today will be:
(caveat: I know she's not psychic, but I'd like her expert opinion)
- based on what you saw in the kidneys and the bladder, which do you think will kill him first?
- based on other cases you've seen and his test results, if we don't move forward with any diagnostic tests and just treat symptoms, how long do you think he'll have?
- if we do the cystoscope and find debridement is indicated, how much longer do you think it might add to his life?
- if we instead do the cell pathology and find cancer, then treat with pills, how much longer do you think it might add to his life?

If she says she thinks his kidneys are the prescient threat, I don't think we'll do anything more.

Let me know what you think, I appreciate your opinion!

[Traci]

He's already had so many issues, not many of them were ever cured. Wouldn't you want him out of pain every time he pees? Crystals are painful too! I'd do the cystoscopy, then you'll know where you're at.

What food are you feeding? (name and brand)

[spamgirl]

He's already had so many issues, not many of them were ever cured. Wouldn't you want him out of pain every time he pees? Crystals are painful too! I'd do the cystoscopy, then you'll know where you're at.

What food are you feeding? (name and brand)

Because of the delicate nature of his bladder, they said the scope isn't going to be possible. Instead we'll do the urine test where you look for cancer cells. We make him "people" food because of his allergy issues. It's ground turkey, apple, cucumber, basmati rice, coconut oil and then supplements.

[Traci]

Did you or your vet work with a certified board nutritionist to get this diet? It seems...well, weird. Did anyone ever comment if he is low on certain vitamins, minerals?

What were her comments to your questions yesterday?

[spamgirl]

Did you or your vet work with a certified board nutritionist to get this diet? It seems...well, weird. Did anyone ever comment if he is low on certain vitamins, minerals?

What were her comments to your questions yesterday?

No, we didn't, we just tried different low oxalate foods until we had the recommended fat/protein/carb balance and his skin issues went (mostly) away. We also chose lower sugar fruits/veg to help get rid of his yeast infections. The coconut oil is for his coat and to get more fat into diet. His vitamin levels all check out, we've been monitoring him since he went onto this diet.

I ended up not asking those questions as the vet didn't have time to talk to me beyond giving me the info on the scope and his blood test results, I'd have to make another appointment to talk to her further. My original vet said we should hold off and wait a few weeks to do the urine cell test, and that if he has cancer he'll go on Piroxicam. She says she's had other dogs in that situation who have lived up to a year. She said surgery is out of the question as the tumour is located in the neck of the bladder, if that's what it is.

[Traci]

Confusing, so neither vet is a specialist?

I don't understand the conflicting opinions between the two vets.

Why the wait on the catheter procedure? (to obtain the cells for pathology)

[spamgirl]

Confusing, so neither vet is a specialist?

I don't understand the conflicting opinions between the two vets.

Why the wait on the catheter procedure? (to obtain the cells for pathology)

The one I spoke to about scoping/etc. is an internal specialist. We're waiting because he just got off the antibiotics, and when on them the spot doesn't bleed and she thought we'd be more likely to find free cells if it was bleeding.

[Traci]

Ok, so you're more comfortable with taking your first vet's advice, waiting for the catheter procedure only. If that's the case, go with your gut feeling, but just make sure you have all the available information before you to make an informed decision. Ask the questions of her that you had planned. I would just hate to see this as something that could be treated, but not treated, and his suffering needlessly.