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Snook

Update added: Urinary/fecal incontinence

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Snook   

I'm writing this out, partly to get my thoughts in order before Justice sees the vet on Tuesday (the earliest available appointment), and partly to seek advice/opinions before then about what might be going on with my boy. 

 

Justice is turning approx. 15 this year (based on a vet's guesstimate when I got him at around 3 years of age) and I took him to see the vet on Saturday afternoon, after he'd spent a solid couple of hours or so shivering/shaking and whining/moaning and looking like he couldn't get comfortable early Friday night, before relaxing and falling asleep. He was fine on Saturday morning but started doing it again around 1pm, so I called the vet and was able to get him in before 2pm. The vet gave him a physical exam but couldn't find any cause or indicators of pain. She said to bring him back if he deteriorated, or if he stayed the same doing this on and off to bring him back towards the end of this coming week for blood tests, and if that didn't show anything he may have to go back to his vet behaviourist to see if it's his anxiety issues escalating (he's on paroxetine and gabapentin for anxiety.) I don't know if this is connected to the shivering and panic attack issues that I posted about recently in relation to a formula change with his gabapentin medication, or coincidence, or there was never any issue with the gabapentin and it was coincidence that he improved for a few days when I switched him from tablets to capsules. Either way, during that period when he was having uncontrolled shivering/shaking, he wasn't moaning or looking physically uncomfortable or in pain like what started on Friday night. 

 

Tonight about an hour after Justice ate his dinner, he was heading through the kitchen and laundry for his dog door, but let a full bladder go on the floor before he made it to the door. I was in another room so didn't see it and don't know if he did it knowingly or whether it was completely uncontrolled but he did go through the dog door afterwards. For a couple of hours earlier today, from around 4pm to 6pm, he was shivering (not cold to touch and had his onesie on) and moaning and being extremely needy and attention seeking while I had a friend here. I fed him as soon as she left (half an hour after his dinner time) and he seemed okay but then the urinating happened. I'm now wondering whether his shivering and moaning is connected to the incontinence/lack of control..

 

Prior to this, there have been individual incidents that I didn't connect until tonight. On 4th May, Justice was eating some dinner from his Bob-a-Lot toy while I was in another room and when I came back out, he'd released a full bladder on to the lounge room carpet and finished it off on a piece of furniture, the wall and the dining room carpet (open plan space). He seemed quite distressed but I don't know if that's because he saw me tense up when I saw it, even though I didn't raise my voice or tell him off, since there's no point after the fact. 

 

Somewhere around approx 20-24th April, I woke up in the morning to find that Justice had released a small amount of urine in my bed while he was sleeping next to me (not enough to soak through to the mattress.) 

 

In mid to late March, Justice had been sleeping on his bed in the lounge room when he stood up and crouched his back legs and started to pee. He looked a bit surprised when I yelled no and stopped peeing immediately, then held his bladder for well over an hour before going outside to pee. It was almost like he had forgotten where he was rather than a deliberate pee, if that makes sense, and obviously wasn't a control issue since he crouched first and was able to stop immediately and then hold it for ages. 

 

Over the last approx 6 months, there have been two incidents of his doing small poos in my bed during the night. I'm an incredibly light sleeper and wake up every time he moves, so I know he didn't stand up to poo in the bed and am assuming they popped out while he was lying down/sleeping and that he was unaware of them. 

 

Over the past 12 to 18 months, there have been two or three incidents of Justice popping out a small poo while he's standing in the kitchen eating breakfast and he showed no awareness of having done it on any of the occasions. 

 

I had put the earlier and more minor incidents down to just him getting old and not having the same awareness/control any more. He had a blood panel done in January when he had bone shards lodged in his intestines and was in and out of the vet over the course of a week, including a couple of overnight stays, and they came back normal. Is it possible he was in the early stages of kidney problems, so it didn’t show up as an issue on the tests? Could kidney issues be responsible for the shaking/shivering and moaning? Perhaps from pain?

 

Justice doesn't seem to be drinking any more water than normal each day, which is pretty easy to keep an eye on since I'm the only one who fills his water bowl, but his drinking pattern has changed over maybe the past 6 to 12 months. He tends to go long periods during the day not drinking, then drinks a heap in one go (as in a litre or more.. his bowl holds 2 litres and he's always consumed approx 2 litres total per day.) Lately when he's done that straight after eating, he's been bringing a little bit of the water back up again, but it's very inconsistent and certainly not daily. 

 

My other train of thought was maybe a UTI? He actually had a UTI when I got him and I had to take him to the vet for it within a day or two of bringing him home but that presented as urine leaking out without him realising, while he was lying down, not emptying a full bladder at once and there was no shaking or moaning at any point. 

 

Lastly, I was thinking perhaps the beginnings of canine dementia, based on the lack of awareness when he did the poos I mentioned and his behaviour when he crouched and started peeing on his bed but when I yelled, seemed startled and like he hadn't realised he was peeing where he shouldn't (although that may be me anthropomorphising to some degree.) 

 

If anyone has any information or advice to share, I'd love to hear it. Is there anything I haven't covered that might be helpful information to give the vet on Tuesday? I was thinking I might print out the timeline and info I've posted here to give to her, as covid19 restrictions mean that I can't actually go inside the building and be present for the consult, so having a clear break down of everything in writing might save a lot of time and confusion with her going back and forth to ask questions while she's checking him out or looking at which tests to run. Thanks in advance. 

 

Edited by Snook
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tdierikx   

Shaking/moaning, urinary/faecal incontinence... I'd be looking at a spinal/nerve impingement maybe? The Gabapentin has analgesic properties too, so may be masking some of the pain indicators on palpation?

 

Has he had spinal x-rays? I'd be looking from mid-spine down to the sacrum for degeneration of the discs, etc...

 

T.

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Oh dear Snook :grouphug: they do worry us as they get older. 

 

I've had several kidney dogs but none have exhibited pain or distress, they have all begun drinking a lot, eating fussier and losing weight. I guess I've never had any with bladder/kidney stones which would be painful and effect their ability to pass urine when they need to. 

 

Dementia; well they do do odd things as they age. :)  But if they are actually doing distressing things like getting stuck outside or behind furniture, barking/wandering at night or forgetting to eat, you have a problem.    ....Likely it's a placebo for me but I supplement my oldies with McDowells Maritime Pine Bark (antioxidant). 

 

Another idea I was thinking is simple constipation. Their bodies change as they age.  Benefibre is safe and tasteless, and works really well.  

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Oh, Snook,what a worry.

You have written it out so well...the vet will indeed be able to use all that information.I can add nothing useful.

Sending thoughts and best wishes.

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I had a cat who, when he had dementia, would walk into his covered litter tray and once his front two feet were in would pee (with his back end still out of the tray), proceed to scratch around the litter as if he were covering his eliminations, then turn around and walk out. It was a genuine disconnect for him. So maybe the pees near the door are similar?

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Snook   
1 hour ago, tdierikx said:

Shaking/moaning, urinary/faecal incontinence... I'd be looking at a spinal/nerve impingement maybe? The Gabapentin has analgesic properties too, so may be masking some of the pain indicators on palpation?

 

Has he had spinal x-rays? I'd be looking from mid-spine down to the sacrum for degeneration of the discs, etc...

 

T.

Nothing has been done so far besides the physical exam on Saturday, which I wasn't present for under current covid19 restrictions. It sounded like she was thorough though and said his range of movement is fabulous for his age, so I'm assuming she was testing all of his limbs when she was looking for a source of pain. I did mention to her that he has a very small lump that has come up in the middle of his spine over the past couple of weeks and whether that could be causing pain or pinching nerves, but I forgot to ask again when she brought him back out. I didn't rush him off to the vet when I first noticed the lump because he has so many lumps and bumps, and when I told his old vet that I wasn't willing to put him through more surgery when he got another mast cell tumour within a couple of weeks of having one removed (the surgery took a terrible toll on him and he ended up having to have two surgeries, a trip to the emergency vet to be stapled back up, plus having fluid syringed from the site every two days because the drain wasn't working properly and he was completely distressed by it all and became terrified of going to the vet), so she said there was no point in having future lumps tested if I wasn't getting them removed. 

 

It hadn't occurred to me that the Gabapentin might be masking pain on examination, even though I know it's used for nerve pain, but I did tell the vet he's on it and they have his records from the old vet. It's so much harder when you can't be in there talking to the vet while they're doing the assessment. That's why I wanted to put everything down in a time line that I'll print out and give her before she takes him in, as there's no way she'd be able to remember it all just from me saying it at the door. 

 

I'm happy to get xrays etc done. I just want to know what the problem is and whether we can fix it, so that he's not suffering. 

 

1 hour ago, Powerlegs said:

Oh dear Snook :grouphug: they do worry us as they get older. 

 

I've had several kidney dogs but none have exhibited pain or distress, they have all begun drinking a lot, eating fussier and losing weight. I guess I've never had any with bladder/kidney stones which would be painful and effect their ability to pass urine when they need to. 

 

Dementia; well they do do odd things as they age. :)  But if they are actually doing distressing things like getting stuck outside or behind furniture, barking/wandering at night or forgetting to eat, you have a problem.    ....Likely it's a placebo for me but I supplement my oldies with McDowells Maritime Pine Bark (antioxidant). 

 

Another idea I was thinking is simple constipation. Their bodies change as they age.  Benefibre is safe and tasteless, and works really well.  

His appetite is great and he's definitely not losing weight. I've actually had to cut back his treats because he was putting on weight from all of the peanut butter he scored over the weeks where I was trying to do his nails with a sanding block and getting nowhere fast. 

 

He's not getting confused or lost or stuck etc. He does usually go outside a couple of times during the night but he's always done that and it isn't anything new. 

 

I did wonder if it might be constipation on the Friday night but he's going pretty consistently twice a day and although I'm not observing him poo at home, he doesn't seem to be having any trouble when he does them at the park. 

 

 

1 hour ago, persephone said:

Oh, Snook,what a worry.

You have written it out so well...the vet will indeed be able to use all that information.I can add nothing useful.

Sending thoughts and best wishes.

Thank you

 

1 hour ago, mackiemad said:

I had a cat who, when he had dementia, would walk into his covered litter tray and once his front two feet were in would pee (with his back end still out of the tray), proceed to scratch around the litter as if he were covering his eliminations, then turn around and walk out. It was a genuine disconnect for him. So maybe the pees near the door are similar?

Only the pee last night in the kitchen/laundry was near the door. The other full bladder one was mostly in the lounge and then trailed off in to the dining room, and his dog bed that he stood up and started peeing on is in the lounge room. 

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tdierikx   

Looks like you have a few things to list for the vet to check out tomorrow... fingers crossed they can get to the bottom of it all and Justice can get back to his normal self soon.

 

T.

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Deeds   

I have googled the side effects of gabapentin because I was considering it as an option to treat my dog's seizures as an add on drug.

 

I decided against it but some of the side effects included tremors, ataxia , constipation, diarrhea, tiredness, clumsiness & unsteadiness.etc.

 

Could be the gabapentin.  Justice might be better off with tramadol for his pain.

 

All the best Snook.  I know how worrying these situations are.  

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Snook   
11 minutes ago, Deeds said:

I have googled the side effects of gabapentin because I was considering it as an option to treat my dog's seizures as an add on drug.

 

I decided against it but some of the side effects included tremors, ataxia , constipation, diarrhea, tiredness, clumsiness & unsteadiness.etc.

 

Could be the gabapentin.  Justice might be better off with tramadol for his pain.

 

All the best Snook.  I know how worrying these situations are.  

Justice has been on the Gabapentin for at least two years without those side effects and he's on it for anxiety on the advice from a vet behaviourist, not for pain. When he was put on the Gabapentin it was essentially either that or euthanasia, as his anxiety had hit an incredibly extreme point and his quality of life was very poor, with multiple panic attacks per day over things as minor as someone wheeling a bin past the unit, the neighbouring unit closing a cupboard door too loudly, my phone beeping with a message etc etc. He doesn't respond well to most anti anxiety meds and the vet behaviourist said we didn't really have anywhere to go if he didn't do well on the Gabapentin. I can't see that that's causing the issues but even if it is, I can't see how he could come off of it and still have a good quality of life mentally. :(

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Tassie   

Sorry you and Justice are having a tough time @Snook,    The new vet seems to be more able to respond to his special needs, so I think she would appreciate your account of what's been happening.   (Maybe even send it to her ahead of time as well.)   It's always hard to remember everything in a normal consult, let alone in a carpark consult.   I would certainly be thinking along the terms of some sort of nerve issue interfering with messages about need to eliminate.   Wishing you and the lad all the best.

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Snook   
19 minutes ago, Tassie said:

Sorry you and Justice are having a tough time @Snook,    The new vet seems to be more able to respond to his special needs, so I think she would appreciate your account of what's been happening.   (Maybe even send it to her ahead of time as well.)   It's always hard to remember everything in a normal consult, let alone in a carpark consult.   I would certainly be thinking along the terms of some sort of nerve issue interfering with messages about need to eliminate.   Wishing you and the lad all the best.

Thanks so much. Yeah, I might give them a call this afternoon and ask if they'd like me to email through what I'm going to take with me to the appointment, so the vet has a chance to read it properly prior to seeing Justice. I'll note on there about the small lump on his spine that I mentioned to her on Saturday as well as whether we need to look at a nerve issue or do xrays. I'll try to make it clear that I'm not attempting to diagnose him or tell her how to do get job, but they're things I'd raise during an appointment as we go along, and I won't have that opportunity since I can't go in with him. 

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Dogsfevr   

Okay im going to write this from another perspective keeping his severe anxiety & distress issues in mind.
If you took him to the vet & the x rayed him & said for example he has a tumor  what is your plan .are you planning to take action with anything diagnosed or would you work on the enjoy each day conservative approach.

You could collect a pee sample for them to test for UTI ,it can certainly make them do weird things ,hes also 15 and chances are just like us all when we get old the body just isn't functioning the same ,the head & the body with peeing having its moments or his prostrate having moments .Making hes hung on from peeing to long .

If hes in pain his meds are helping that & most likely what would get prescribed .
Problem is with all the meds they come with risks & at 15 the risks are minimal .
I have a dog on the same meds for pain ,he can't tolerate some of the others tramadol sends in him loopy ,previcox he can tolerate .Meloxicom is too little for his needs now .

I would be speaking with the vet & seeing when they plan to lift not having you in the room during consults ,our vets made us mask up & unless my dogs where at death door i wouldn't do a here's my dog consult especially with an oldie that struggles afterwards .

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Snook   
1 hour ago, Dogsfevr said:

Okay im going to write this from another perspective keeping his severe anxiety & distress issues in mind.
If you took him to the vet & the x rayed him & said for example he has a tumor  what is your plan .are you planning to take action with anything diagnosed or would you work on the enjoy each day conservative approach.

You could collect a pee sample for them to test for UTI ,it can certainly make them do weird things ,hes also 15 and chances are just like us all when we get old the body just isn't functioning the same ,the head & the body with peeing having its moments or his prostrate having moments .Making hes hung on from peeing to long .

If hes in pain his meds are helping that & most likely what would get prescribed .
Problem is with all the meds they come with risks & at 15 the risks are minimal .
I have a dog on the same meds for pain ,he can't tolerate some of the others tramadol sends in him loopy ,previcox he can tolerate .Meloxicom is too little for his needs now .

I would be speaking with the vet & seeing when they plan to lift not having you in the room during consults ,our vets made us mask up & unless my dogs where at death door i wouldn't do a here's my dog consult especially with an oldie that struggles afterwards .

I decided after he had the first mast cell tumour and some other lumps removed that I wouldn't put him through that again because it was so incredibly distressing for him, which is why I haven't had any new lumps removed. I decided I'd give him the best quality of life that I could for as long as he had and wouldn't do any invasive procedures unless it was needed for immediate pain relief. He has had surgery once since then when he had a dodgy tooth that made half his face swell up, as that's obviously not something that can just be managed with pain relief and the recovery wasn't going to be traumatic for him. If he has a tumour in his spine I think it's unlikely that I would agree to having it removed, assuming they even could remove it. My preference for Justice, taking in to account that he's heading for 15 and how easily he's traumatised and can go backwards mentally from an anxiety perspective, is for conservative management provided he's not suffering. If pain relief and some way to control his bladder were viable options, then that would be the most likely course of action over surgery. I have even been considering since Saturday what I will do if no cause can be found for his shivering/moaning and we're referred back to the vet behaviourist to start the medication merry go round again. I don't think I could put him through that again, especially since he doesn't do well on most of the medications we've tried. I was told last time that adding the gabapentin to his paroxetine was pretty much the end of the road medication wise, and from there all we could really do is wean him off of the paroxetine, that's his baseline medication, and see if any other antidepressants have a slightly better result. It took us a year of trial and error to get to a good place with him before he deteriorated and we had to add the gabapentin in. If he had years of life left, I'd do it, but realistically he's not likely to make it to 16 and I don't want whatever time he has left to be like that year of trying to get things right was. It was horrendous for both of us and although I don't regret doing it, he was much younger then and had more to get out of persisting with it. 

I think they'd probably be able to get a urine sample from his easily as he'll pee to mark bushes etc and won't have been for a walk to empty his bladder before hand. I had been just putting it down to old age until now and figuring that's what happens and I just clean up and move on. It's the shivering and moaning that has me particularly concerned, plus losing two full bladders inside in less than a week is an awfully big increase on what was happening before then. 

With pain meds, I'm not concerned about putting him on them for the rest of his life if they're needed. I know they can cause significant health issues long term but at his age, whatever makes him comfortable is all that matters and he's unlikely to be here long enough to experience those longer term issues, as awful as that is to think about. I would rather put him on pain meds than put him through an invasive or significant operation.

I spoke to the vet clinic this afternoon and have since emailed them the history I posted here plus raising the lump on his spine again and whether there could be a pressure/nerve problem causing pain and incontinence. They still have the covid19 restrictions in place at this stage but I know from previous contact, that they're willing to set up a video conference between my phone and their exam room if I want it or can talk to me on the phone. I feel like I have very little choice but to hand him over. I was really happy with the clinic and how Justice responded to the vet on Saturday, especially considering it was the first time he'd ever been there, and I've booked him in with the same vet tomorrow. I'm not willing to ring around and try to find another vet, who may not come as highly recommended as this one, but will let me be in the room. I don't really know what else I can do.

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Dogsfevr   

You can get a sample yourself and take it in that’s what we do .

 

Is the colour of his wee different is ,more like a syrup  does it stain when he goes That will be helpful for the vet .

 

For example we had a girl pee inside last year ,Thankgod she did it was orange colour .Had to figure which dog but she had a terminal spleen issue for examp,e 

 

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Snook   

His urine is the same as normal.. Quite dilute and the normal water-like consistency. The full bladder that he released on to cream carpet didn't leave any stains at all and you couldn't even see where he'd been after I'd soaked it up with paper towel. I went over it with white vinegar afterwards to try and eliminate any odour he might have picked up on but it didn't smell like more more concentrated urine does. The lot he released on the hard floors in the kitchen and laundry last night just looked like there was water all over the floor. 

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Snook   

The vet did a urine test this morning and was able to rule out a UTI but said the urine was extremely dilute, particularly given he hadn't had much to drink since around 7pm last night, so possibly a kidney issue. I'll have results from a full blood panel tomorrow and find out more then. If everything comes back clear, she's thinking increased anxiety plus dementia causing him to pee or poo because he knows he needs to, forgetting he needs to go outside first. She checked him thoroughly and can't find any indicators of pain anywhere and had a good feel of the lump on his spine and said it feels like a fatty lump that isn't attached to anything and is too small to be pushing down on any nerves. 

 

I told the vet that if everything comes back clear, I'm not willing to go back to the vet behaviourist and put him through the process of withdrawing from meds and trying different ones that may be no better for him, or potentially even worse given his history of not doing well on a lot of them. She said she'd be happy to write a script to put him back on valium and agrees with giving it to him daily if needed, rather than restrict it because of the issues long term use can cause. I've forwarded an email chain to her between me and the vet behaviourist from when we were doing valium trials, to work out his new valium dose after gabapentin had been added in, so that she can see that it was being prescribed and at what dose. 

 

I'll update again once I know the blood test results. 

 

 

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Tassie   

I think you've made a good find there .. she seems to be understanding and listening to you and Justice well.   That's a real bonus for you both.  Best wishes...

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Snook   
1 hour ago, Tassie said:

I think you've made a good find there .. she seems to be understanding and listening to you and Justice well.   That's a real bonus for you both.  Best wishes...

I agree. I'm really happy so far and feel like the vet and staff really care and are listening to my concerns and what I think is best for Justice's quality of life. I'm also beyond thrilled that Justice looked happy and relaxed when the vet brought him back out to me, despite having just been poked and prodded and having had blood taken. He happily trotted up to her for pats when she came out with the urine test results a bit later and went to follow her back in when we parted ways, instead of following me. Given how easily he gets distressed and frightened, and that he wasn't trying to drag me back to the car at every opportunity, that says an awful lot about how comfortable he is with the vet, especially considering I wasn't in there with him. 

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Dogsfevr   

I would look at being his alarm clock for toilet breaks when required .

 

Sometimes that extreme deep sleep can Alonso catch them short ,some of our old seniors would get move along notices especially in winter .

It does help 

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