there is no hurry to reply to this, as the client knows that you are not available until July 13th. I am just sending the info in before I forget to do so. :)
Chewy is aprrox 5-6 year old FS Pitbull mix.
The owners have only had her for about 3 years and this problem has been going on the whole time. They have money problems and haven't been able to do much in the way of testing.
History: She was spayed as a 3 year old and was urinary incontinent while sleeping PRIOR to that. During her spay, a gross evaluation of abdominal contents didn't reveal any explanation. Post spay, the incontinence stayed completely the same, did not get better or worse. She not only has urinary accidents while sleeping but urinates frequently throughout the day and obsesses about water.
On physical exam, she has a pale lavender tounge, swollen vulva, and urine staining down her back legs. She is slightly under weight. The owners feed her Nature's Variety dog food.
Feburary 2009, the urine color changed from the normal dilute yellow to having small amount of blood in it. Her urine sample did show bacteria white blood cells, wbc, and a ph of 7.5. SG = 1.013. She was started on Sulpha antibiotics, and next urine sample was normal.
Recently, her urinary incontinence has worsened while sleeping. She will empty her whole bladder. Owners gave permission for bloodwork and urine. Urine SG = 1.020, Ph = 6.5. Rest of UA negative and urine culture negative. On bloodwork, TCO2 = 25 (17-24) HGB = 18.8 (12-18) T4 = 1.8, all else is normal.
TCM Questions: She only vomits if she drinks too much water in one setting. She seeks out the cold. Two bowel movements a day normal. Urinates five or six times a day. Appetite and attitude are good. The only supplements she is on is apple cider vinegar, 1 tbsp, twice a day for three days in a row. Owners read this on the internet and feel it does help her symptoms for about a month and then they have to give it again.
She is a healthy, very active (slightly hyper active) dog in general. At this last visit, owners also mentioned that when she gets very stressed she has head tremors and has started grinding her teeth while sleeping. Also, the urine has a bad smell, again, dispite the urinalysis not showing infection this time around.
Thoughts?
THANKS!