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Post by Curtis & Moet on Aug 10, 2023 14:31:02 GMT -7
Yet another bacteria... ugh. Enterococcus. Starting her on 3 weeks of ✙ doxycycline suspension liquid tonight (0.6ml every 12hr) and then will do another culture after this. I am going to inquire if we can just have the next culture done through our primary vet since I believe it's over $150 cheap. We've noticed her diaper having urine in it a bit the past 4-5 days again, even as she was finishing the Zeniquin, so not horribly surprised at yet another infection. At least we've still been able to express her, and urine is clear and has no mucus in it (except for one time possibly). Also, I'm pretty sure that she also has developed endothelial corneal dystrophy. We've noticed silvery deposits in her corneas on both eyes, though much more on the left. We treated her for an eye infection in June (I think) and not sure if related, but this has shown up relatively recently (the past 6 weeks maybe). Her left eye she is not opening as much and has extra tears. Reading into it, this is common for dachshunds, and is another inherited genetic trait. Not much can be done about it, but we are going to take her back to our primary vet to see if there is anything we can do to stop it from progressing further. She clearly has no issue seeing because she still tries to attack anything with 4 legs that comes on the TV (even elephants and lions, haha).  
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Post by Romy & Frankie on Aug 10, 2023 14:46:37 GMT -7
Oh, no! Not another bacteria. You all have been through so much. I hope the doxycycline will work for her.
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Post by Curtis & Moet on Aug 14, 2023 17:51:46 GMT -7
Hopefully not the start of another rollercoaster, but a few days into Doxycycline and it looks like signs of UTI are mostly gone again. 3 weeks on this one is quite a while. Will be monitoring closely.
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Post by Curtis & Moet on Aug 21, 2023 11:23:53 GMT -7
Well we are still on a rollercoaster. As of yesterday morning signs of UTI showing up again. Diaper full of urine, and slight streams of mucus again in the little bit we can express from her. Trying to find out cost of urine culture from our primary vet and then see if Dr. Rolfe will let us have them do it and send results to them since I think they are 2-3x's the cost.
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PaulaM
Moderator. 
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Aug 21, 2023 15:36:44 GMT -7
Curtis, I feel your pain in trying to resolve this UTI issue for dear little Moet. Hope Dr. R. will consider your lab idea as a doable option for a culture.
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Post by Curtis & Moet on Aug 21, 2023 18:14:46 GMT -7
Got confirmation that it's ok for us to have our primary vet do the culture and send Dr. Rolfe the results. Trying to get one scheduled again now.
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Post by Romy & Frankie on Aug 22, 2023 14:13:54 GMT -7
I am glad that you will be able to use your primary vet for this. It will make things much easier for you.
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Post by Curtis & Moet on Sept 15, 2023 7:44:14 GMT -7
I was out of town for a bit, but we got the culture results 2 weeks ago and are back on Zeniquin for 2 weeks due to Proteus Mirabilis again. My wife saw results quickly again and so far so good. 1 week left and we'll see what happens.
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Post by Curtis & Moet on Oct 2, 2023 21:22:47 GMT -7
It has been almost 2 weeks since Moet had her last Zeniquin. Talked to Dr. B today who said we will do another culture at 4-6 weeks after, so have another 3 weeks until we do the next one. So far her bladder seems decent. Finding urine in diaper often, but it's not full and we're still able to express her. Her getting excited or moving around much seems to cause it. If she isn't just sleeping or laying around, the diaper is either totally dry or has just a bit (maybe from getting her ready to change).
She's on Proin to try and help with leakage, but she doesn't like the taste so not getting her enough of it probably.
We have definitely seen cloudy urine sometimes still, and when she has a bowl movement there is a bit of urine that comes out and that is usually the cloudiest we see it. Most of the time it seems very clear though, which is a good sign. Overall it seems like there is a bit of bacteria growth but it's somewhat in balance for now. Hopefully supplements are helping to keep at growth at bay a bit. Very curious to see what the next culture says.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Oct 3, 2023 9:44:18 GMT -7
Curtis, it does seem as though her bladder environment may be more in balance. We, too, will be very curious about the next culture in three weeks.
I can't remember, but have you tried any of the tricks for dosing bad tasting meds?
If you are splitting the pill especially wash your hands to avoid transferring bad tasting dust to outside of "treats."
Put the pill into the well of a small mashed banana ball, a cream cheese ball, liverwurst ball, Gerber Lil' meat sticks, or inside of a sticky small marshmallow and sealed completely so no taste is on the exterior.
Use the three treat method. Prepare 2 treats with no meds inside PLUS the med ball. Give plain treat while holding med ball in front of eyes. The idea is your dog will be greedy after the first treat to get the 2nd. Immediately hold the 3rd plain treat so she will hurry to swallow the med ball to get to treat #3.
Dawn & Ollie <https://dodgerslist.boards.net/thread/7402/dawns-ollie-relapse-conservative-pancreatitis>highly recommend this pill paste (Vetoquinol Care Pill Wrap). Ollie now has no problem taking his meds. Shop on-line for best price- about $15.
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Post by Curtis & Moet on Oct 9, 2023 15:31:11 GMT -7
Thanks, Paula. Yes, the 3 treat method works well, haha. We've done that too. Pumpkin for powdered meds seems to work well with Moet, we just need to get her back into that schedule. She's just a picky eater sometimes and doesn't even eat breakfast/dinner at all sometimes.
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Post by Curtis & Moet on Oct 17, 2023 21:16:31 GMT -7
We are once again having the normal signs of a UTI. Diaper full of urine before express time, and some mucus in the urine we express periodically. We've moved up the next culture to this Thurs to see which bacteria this time. No obvious blood in urine or bad smells at least, so I bet we are going back on Zeniquin yet again. I've read about prophylactical taking antibiotics with recurrent UTIs, so we may be at that point IF we can have a consistent bacteria that is causing the problems. If it changes around like it has been, then I don't think that would work. I'll report back early next week when we have the results and the next antibiotic plan.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Oct 18, 2023 8:39:38 GMT -7
Curtis, Iadmire you for the excellent care you give Moet. I'm aware, from personal experience, of emotions accompanying long term situations. So I say to you what a good job you are doing and also being open to other techniques.
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Post by Curtis & Moet on Oct 31, 2023 9:11:04 GMT -7
We got the latest culture results back mid last week, and it is Proteus Mirabilis yet again. This time the culture said it was more susceptible to ✙Ciprofloxacin, so got her started on it for 2 weeks. We noticed a big difference after only ONE pill. Actually the first pill caused her to vomit within an hour, but the vet said to giver her another later with more food and she kept it down. She may have absorbed some of the first, but that's ok. Then the next day she vomited a little again, but we did not give another. We're having better luck now without the need for anti-nausea meds.
After reading more into this bacteria, it seems like a naturally occurring one in both the GI tract and water/soil, so we aren't going to get rid of it completely, but hopefully Cipro will reduce it's numbers to a more normal range better than Zeniquin. It's common for UTIs with catherization, but in her case due to wearing a diaper. I'm going to talk to our main vet about potentially going on a prophylactic dosage of zeniquin possibly to try and prevent future UTIs. I had read NIH studies about that as a possibility with other dogs.
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Post by Romy & Frankie on Oct 31, 2023 13:59:53 GMT -7
I sincerely hope that Ciprofloxacin will take care of Moet's UTI.
I know that some dogs use a prophylactic dosage of an antibiotic to help control recurrent infections. Let us know what your vet says about this.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Oct 31, 2023 17:35:22 GMT -7
Curtis, good to hear Cipro is having a good effect on Proteus Mirabilis.
Just throwing out some ideas.
--- prevent re-transmission of this tough to kill bacteria. The diapers are disposable so they get trashed. But is there a diaper cover that needs to be disinfected? What about contaminated sheets, bedding and floors she travels on? I read P. mirabilis "is susceptible to most common disinfectants used in animal facilities." You might check with your vet what the name of one of those disinfectants is.
--- I can't remember if you said she was free of stones which can be the cause of reinfecting the urinary tract.
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Post by Curtis & Moet on Oct 31, 2023 17:56:26 GMT -7
Good idea, Paula, thanks. I will do some reading about possible reinfection. We use baby diapers that are indeed thrown away, and then outer dog diapers as well. The outer dog diapers we replace every time and then wash with laundry disinfectant and dry on high heat, so I would hope that is enough to kill the bacteria, but I will read to confirm.
Yes, we had an ultrasound done with Dr. Rolfe who confirmed no stones.
My hope is that Cipro, being a stronger and more systemic type of antibiotic, will be able to reduce the amount of the bacteria that might have been hiding in other places of her body previously. I even read that bacteria can hide in the lower layers of the bladder wall and evade some milder antibiotics, so it seems like it might be plausible at least. I don't know that we can get rid of it completely if it's somewhat natural to have it in the GI tract.
We are also trying to do a better job expressing poop because it sitting in the diaper for long could be contributing to reinfection as well if the bacteria is in her GI tract. Also, we bought some antibiotic wipes that we are using on her if we find a poopy diaper as well.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Nov 2, 2023 9:10:55 GMT -7
Curtis, agree the good and the bad bacteria naturally exist in the environment and inside the body. It is not until the bad bugs in the body begin to out number the good bugs that infection erupts. I like the way you are addressing bad bugs on the many fronts. It sure is an art in getting the right balance of killing bacteria (the gut requires the good ones and the bad are heinous when too numerous.)
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Post by Curtis & Moet on Nov 27, 2023 13:57:22 GMT -7
I forgot to update you that after we stopped Cipro within a few days we started seeing signs yet again. Dr. B, our main vet, said to try one more round of Cipro for 2 more weeks, and she has 2 more days of that left. If it comes back again we will go back to Dr. Rolfe, the specialist, to see what to do next.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Nov 27, 2023 15:31:06 GMT -7
This unrelenting UTI is something. Your keeping on top of things, makes sure Moet feels a good as possible to keep on enjoying her life. I know she loves you, but just doesn't know how much you both love her.
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Post by Curtis & Moet on Nov 28, 2023 10:17:20 GMT -7
Agree, this has been so frustrating, but at least we can say for sure that she has never even noticed that there is a problem and is living the great dog life. Enjoying warm electric blankets now that is has gotten colder, constantly wants to play (especially while wife and I are on calls for work, haha), and has a big appetite, making it well known when we are a few minutes late with a meal, haha.
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Post by Curtis & Moet on Dec 11, 2023 21:29:19 GMT -7
Another update on Moet. We suddenly had some GI issues with her a few days after stopping Cipro. Had to switch to chicken/rice/pumpkin diet and primary vet put her on amoxicillin. 1.5 days of that left. The GI issue is resolved and urine is clear without any signs of UTI, so a bit of good news for now.
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Post by Romy & Frankie on Dec 12, 2023 14:29:50 GMT -7
I am glad that Moet is showing no signs of a UTI now.
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Post by Curtis & Moet on Dec 19, 2023 20:57:56 GMT -7
Well, it didn't last long. The past 3ish days we start noticing urine in her diaper again. Now there is quite a bit of dark urine in diaper and this morning had greenish mucus with blood again, ugh. Waiting on the vet to find out what to do now. At this point it's clear we are basically never going to get rid of this, which is what the vet hinted at earlier this year. I've asked about what longer term antibiotic treatments we could consider, but there are obviously risks doing that, such as breeding another resistant/dangerous bacteria again.
Edit: Our vet called. We're going to put her on Cipro again, every other day as long term treatment for now. Unfortunately this is almost guaranteed to end up with the bacteria gaining resistance to the Cipro eventually, then we are down to just 3 other antibiotics according to the culture from Oct. At this point we're basically just fighting time (Moet's) and bacteria resistance for the rest of her life it seems. After Cipro resistance builds up, then we will have to go back to Zeniquin (Marbofloxacin), then we are left with only Gentamicin and Amikacin (both of which she has never had). At 12.5yrs old, there is no telling how long she will be able to keep fighting this before a more serious issue like kidney infection comes up, or antibiotics cause problems with liver/kidneys. So frustrating...
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Dec 20, 2023 11:29:42 GMT -7
Curtis, can only hope that the EOD Cipro will be effective for a long time period.
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Post by Romy & Frankie on Dec 20, 2023 14:44:38 GMT -7
Extremely frustrating ! Hopefully, the Cipro every other day will be effective for a long time.
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Post by Curtis & Moet on Dec 21, 2023 8:19:52 GMT -7
Well a bit of good news, the bacteria definitely seems like it's susceptible to Cipro still. After just the one pill yesterday at lunch time I already noticed improvement expressing her this morning. So now we see how long it continues to work like this.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Dec 21, 2023 8:26:09 GMT -7
Every piece of good news is precious. Finger crossed.
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Post by Curtis & Moet on Jan 10, 2024 19:27:15 GMT -7
Happy new year! Just an update since it's been a few weeks. We are still on every-other-day Cipro and so far doing ok. We are finding a bit of urine in her diaper most of the time still when changing her, but we're able to express her quite a bit every 5-6hrs still though. A few times we have noticed some cloudy urine the morning on the day her antibiotic is due, which is obviously the most likely time to have bacteria build up since it's the longest period between expressing her overnight, and the antibiotic probably only lasts around 24hr.
We are also pretty sure Cipro is causing GI issues like we had before because we had to go on chicken/rice/pumpkin for a few days last week when she began having loose stool again. I believe she's only vomited once since we started this schedule. It's definitely important that she has a full stomach when taking the Cipro to reduce nausea.
Urinalysis strips are showing everything looks good except leukocytes are present. pH is around 6 something (she's on Hill's urine health food to acidify her urine a bit).
Her lower belly, thighs, and a spot on her lower back have started having signs of pyoderma again, but after a couple Chlorhexidine 4% shampoo baths it is improving. We have also started using a Chlorhexidine 2% and Ketoconazole 1% spray on these areas a couple times a day, and on the bottom of her front feet since she has been trying to lick them nonstop again (so also having to wear the cone of shame to let them dry out).
So overall she seems pretty stable for now. I have no idea how long we'll be able to continue with Cipro before the bacteria builds up resistance, but I think it will be pretty obvious as more signs show up like in the past.
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PaulaM
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Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Jan 11, 2024 11:35:25 GMT -7
Curtis, much compassion for you on all the issues surrounding this difficult UTI situation. Glad to hear there are stretches of stability to appreciate. May their duration continue for your sweet girl.
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