2969. INTERN The 7-year-old Silkie passes strong smelly urine

Saturday, August 15, 2015

An unusual feast of cases this Saturday morning and morning at Toa Payoh Vets.
Outstanding cases include:



A 7-year-old female Silkie X passes very smelly urine, blood and pus for many times and had been treated by vets. The lady had consulted 3 vets in a practice but the dog passes smelly urine after a course of antibiotics. Blood tests and X-rays were done.

So, she brought the urine sample in a bottle to consult me for a 2nd opinion. The ammonia smell was overpowering.
"Was urine test done?" I asked.

I palpated a "fish ball " sized bladder. It could be a thick-walled bladder which had been inflamed for many months or there could be bladder tumours and small stones.There was pain in the kidney area (video).

I got a urine test done.
  pH 9, SG 1.03, Nitrite +, protein 4+, blood trace, bacteria nil, crystals  triple phosphate +,  amorphous phosphate 3+. 
There was no bacteria as the owner had given a course of antibiotics from the other vet.

Blood test
Kidneys were OK. No abnormal blood cell count or numbers.

Treatment
IV drip with antibiotics and painkiller. Trimax tablets at 1/4 twice per day for 14 days.


Follow up on Aug 18, 2015
No smelly urine as the dog was on trimax.
The dog is advised to go on C/D
Ultrasound advised to check for bladder tumours
X-rays from the other vet needed although the vets said no stones.
A blood test 2 months later.

Advised spay as the vulval area and ventral skin area in the groin were hyperpigmented black since the dog had been licking it for many years. Possibly the dog had open pyometra leading to licking and bacteria entering the bladder causing infection. I explained to the lady that in female dogs, the urethral opening can be easily infected from the pus passed out from the uterus.

"I do not want my dog to suffer from pain (involving spay surgery)", the lady said. So this advice that could save the dog's life in later years was given but not accepted.  Pyometra could worsen leading to septicaemia and death  2 years later.