Monday, August 16, 2010

166. Shih Tzu with urinary tract infection

"How he gets this UTI?" the mum asked. "Yesterday, I thought he was going to die." The dog just was lethargic for the past 3 days. He ate a lot after going home from neuter 7 days ago. The 8-year-old Shih Tzu had a right perineal hernia repaired by me just around 4 weeks ago.

I palpated a full bladder. There was no pain in his pre-scrotal lump which was the site of the neuter. Got a urine and blood sample taken and sent to the lab this morning.

The mum and daughter came to visit him at 5 pm. I explained to them that the dog had a severe UTI. Blood results - Total WCC was above normal, neutrophils was 97%, lymphocytes 3%. Abs neutrophils were 17 x10^9/L while lymphocytes were 0.5 x 10^9/L. "The results indicated a bacterial infection of the blood," I explained to the mum and daughter. "Luckily it is not a viral infection."

Urine results were very interesting:
pH 6.5, SG 1.039 considered normal

Nitrite +, Protein 3+, Glucose +, Bilirubin +, Blood 4+, White blood cells >2250/uL and Red blood cells >2250/uL. Bacteria 3+. No crystals or cats or epithelial cells.

"How did the dog get UTI?" the mum asked.

"One reason could be the stress of surgery for perineal hernia and the neuter soon after" I said. "Is he the type of alpha dog who would urine mark every spot even when he has no urine?"

"Yes," the mum said. "I thought all male dogs do that."

"Not all male dogs," I said. "Usually only the dominant ones wanting to mark his territory."

"When a friend's female dog comes to the apartment, he will urinate over her peed area," the daughter commented.

"So, he might be withholding urine for the past 8 years to urine-mark. Urine that is kept for a long time inside the bladder would get bacterial growth," I said. The dog had an alkaline pH and this would encourage bacterial growth and possibly struvite stone formation in the theory of struvite stone formation in the dog. However, this dog ate mainly chicken, rice and carrots and therefore should not be getting struvite urinary stone formation.

After 500 ml 5% glucose saline, baytril antibiotics and spasmogesic, the dog looked active in the evening when the mum and daughter came. He would be given another treatment tomorrow and go home.

"For the past 7 years, he had never seen a vet," the mum said that the dog's veterinary cost was high.

"If you had neutered this dog at one year of age," I advised belatedly. "He would unlikely to develop perineal hernia which occurs mostly in non-neutered male dogs and therefore you need not spend money to cure him.

"In your case, it was lucky he developed only the right sided perineal hernia and so far, with all this jumping up to the daughter's bed and running around so soon after perineal repair, he had no swelling. Otherwise, he would need another repair job. The dog is to confine at home in one place for at least 4 weeks, not jumping about like a Jack Russell."

"My sister's Shih Tzu are so laid back," the mum said. "This dog even bites me." My assistant Mr Saw also warned me about his biting habit.

"After neutering, there will be less aggression and urine-marking over time," I said.
"Will his personality change?" the daughter asked.
"Yes, he will be quieter and not so obsessed with urine-marking like some men who are thinking of making money all day long. Much depends on whether your daughter will spend time playing with him.

"Let him eat more so that he would have the resistance to fight against diseases"
I said as this dog lost 1 kg after perineal hernia, neuter surgery. I could feel the spinal processes. He was now 6.5 kg.

Aug 17, 2010 4 pm
Dog reviewed for going home. No fever. Had a good appetite. Tongue was pink.
Took him out. First thing was to urine-mark a vertical surface.

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