Well, I'm currently sleeping in the guest room because it has a door opening directly to the garden... so have an empathetic cyber hug.
Hooligan has a tendency to UTIs, so we are hoping that this is 'just' another round.
One rather unusual thing, though: This time the first urine sample tested, taken by me collecting it, showed nothing unusual. Because of her history we then took a urine sample directly out of her bladder (guided by ultra sound) so we knew it was 'clean'. The urine was green, usually a sign of infection. However, the analysis came back clear - no infection, nada.
Yet H was clearly in distress, needing to urinate every 20 minutes.
Sometimes you treat for clinical signs regardless of what the analysis says. Especially in an elderly pooch with a history. Which is what the vet decided to do.
H started ABs today, and already I am seeing improvement. (The lab analysis is important to pinpoint which AB, however. In this case, though, we don't have that so we went with the same AB used last time.)
So... if you haven't done a sample taken direct from the bladder, ask your vet if there is any merit in doing that.
Direct collection requires the dog to remain still on her side or upside down while an ultrasound wand is used and a needle inserted. If you thought that might be too much for Lizzie, her tolerance/discomfort needs to be taken into consideration. (H is something of a Stammgast at the clinic, so aaccustomed to 'the table'. Not all dogs are.)
I know vets are reluctant to use ABs unnecessarily - as they should be - but nonetheless ask if clinical signs merit a trial.
For Hooligan, clinical signs are desperation to get outside in a normally laconic dog. The urge comes on suddenly, and she clearly is distressed. It takes her several squats to empty the bladder, and often she continues to try even after there couldn't possibly be anything left. For me, that's a clear sign of another round of UTI.
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During one particularly difficult round, when H was not responding to treatment as I would have expected, the vets screened her for bladder and other cancers. She was clear, thank doG.
Again, something to ask about.
Also, ask about Cushings. Does Lizzy show any coat problems, any sign of developing a 'pot belly'?
Has Lizzie had any spinal injuries, even in the past? If so, ask the vet if that could be an underlying factor.
There are several conditions that might lead to urinary incontinence, or a perceived need to urinate.
You might ask your vet for a full 'senior' check up. Ask what other conditions might make sense to test for.
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Another possibility might be CCD, age-related canine cognitive decline. This can lead to house training reversion in some dogs. CCD is much like senility in people.
There are drugs used to help cognitive function. Some of mine have used Karsivan in the past, and I believe there is a newer, more effective drug out there now.
Does Lizzie show any other signs of cognitive decline? Any 'sundowning' aside from the need to urinate, such as not being able to settle at night, getting stuck in corners, atypical barking at nothing?
If so, ask your vet about the possibility of CCD, as well as possible treatments.
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As to management:
Aldi washable (human) incontinence pads are a godsend. 60x90, perfect for covering many dog beds. CHF 9.99, often on sale for half of that. I buy them whenever they happen to have them, just in case. They are covered in a soft cotton so comfy for the dog to sleep on. Far less expensive than anything else I have found.
Does Lizzie enjoy being in a crate? For dogs who see their crate as a den, line the crate with incontinence pad and have Lizzie sleep in there. Some of my colleagues have found that dogs who are not used to crates inside but are used to their car crate will accept sleeping in a crate if the car crate is brought inside.
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Incontinence pads will protect the bedding or furniture, but it's actually far simpler to protect - that is, diaper - the dog.
Doggie diapers are a right royal pain for a female dog - but if you are not sleeping you might want to consider them.
None of the brands out there are absorbent enough for a full bladder leak, so what I have done in the past is to buy the washable diaper (Waschbarwindel or Schutzhosen) in a size or two larger than recommended and add baby diapers. Cut a hole in the baby diaper for the tail .
Now - most female dogs hate hate hate diapers, so you have to train her to accept wearing them. They are a fiddle to get on and off, especially when the dog needs to go urgently. And you have to be vigilant about change them asap - you don't want a dog 'learning' to use the diaper rather than go outside. You especially need to be vigilant against urine scald. You would probably need to bathe Lizzie frequently. And then watch for dry skin.
(Male dogs are easy-peasy to diaper, you simply put a human diaper turned sideways so that the elastic leg bit goes around the waist, pleat and tape. My Puddle and Belltie didn't mind these in the least.)
I hope that a treatable cause can be found and that management is only a temporary step.
But do speak to your vet again, ask about all the other possibilities.
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Fingers crossed, thumbs pressed for Lizzie - and for you.