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post #1 of 10 (permalink) Old 04-07-2018, 06:29 PM Thread Starter
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Problem with leaking - tried Proin/DES

I have a female (spayed) doberman who is having some problems with leaking. She will be 2 in July. She is a rescue and has had kidney problems since I got her (at 10 months old).

She has abnormal kidneys (confirmed by ultrasound) which are not due to cancer/genetics/disease. Our best guess is that she had a UTI which was not properly treated and the infection was able to travel up to her kidneys or she could have a stump pyometra. She was on Proin which worked for awhile, but lately was not working anymore. She switched to DES and has stopped the Proin. When she was on Proin (and if she wasn't on any meds) she would have a couple of small leaks throughout the night or if she was sleeping during the day. She started DES last Saturday and got it once a day for 5 days. Since starting DES, she will either be completely dry or will have massive leaks. She last had DES on Wednesday (it is now given once a week). Thursday night and Friday day she was completely dry; Friday night she had a massive leak around 4am and has been leaking heavily all day every time she sleeps. She peed Fri night right before we went to bed (around 10pm) and has been outside multiple times today to urinate but still has been leaking constantly. She got cranberry supplements for a month and is currently getting VetriScience bladder strength twice a day (neither of these seem to be doing much of anything, but also don't seem to be making anything worse). Also since starting DES, she seems to leak every other day (dry Mon, leak Tues, dry Wed, leak Thur, dry Fri, leak Sat). She is not on K/D as she won't eat it (she will force my male to trade food with her) and at her age, she still needs more protein than K/D provides, but she is on lower protein food and gets plenty of water.

I'm wondering:
if this problem could be due to her recent switch of medication and if this will soon go away?
if it could be a learned behavior due to her her having had this problem for so long?
if it could be due to something else (will probably bring a urine sample in to vet early next week to test for UTI)?
Does anyone have any experience with this type of problem or have any insight as to what else can be done?

I have done 4 loads of laundry today due to her leaking and now have to start another, I'm really going to dread this month's electric bill if this keeps up.
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post #2 of 10 (permalink) Old 04-07-2018, 07:11 PM
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ssc- Boy this is not a good problem to have - Our Kasia Girl had problems with a leak - but that didn't happen till she was 13 or so - She was also on Proin - we did have to raise the amount after some time - I don't know anything about DES -

My best advice would be to take her to the Vet - first thing Monday and take in a urine sample - I would not be surprised if she don't have a UTI -

When she go's out - do's she pee many , many times - once out and she still thinks she needs to go ?

When she lays down for the night - do's she lick her self ? Or wake you up licking ? If so , that is a sign of a UTI .

It may be - past time for you take her to a More advanced Vet - Like at a hospital

I would be more worried about her health - than the electric bill at this time - I'm not trying to be a - A-hole here - but there is a problem - After going threw this with our girl - I can tell you that it really bothers them as much as it do's us .

Best of Luck !!!!!!

...Ken
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post #3 of 10 (permalink) Old 04-07-2018, 07:46 PM
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I agree that I would probably see if you can get better answers from a specialist - do you have access to a university specialty veterinary center?

I'm not exactly clear if the dosage of Proin was maxxed out, or if they decided to try DES instead for other reasons? I think you need a specialist given her potential complicating background, and probably a full work-up to check kidney function, etc.

In the meantime, can you put down some waterproof pads so that you aren't so stressed about her leaking? What about some pants for her that are lined with absorbant pads for incontinence?
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post #4 of 10 (permalink) Old 04-07-2018, 09:17 PM Thread Starter
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Quote:
Originally Posted by ECIN View Post
ssc- Boy this is not a good problem to have - Our Kasia Girl had problems with a leak - but that didn't happen till she was 13 or so - She was also on Proin - we did have to raise the amount after some time - I don't know anything about DES -

My best advice would be to take her to the Vet - first thing Monday and take in a urine sample - I would not be surprised if she don't have a UTI -

When she go's out - do's she pee many , many times - once out and she still thinks she needs to go ?

When she lays down for the night - do's she lick her self ? Or wake you up licking ? If so , that is a sign of a UTI .

It may be - past time for you take her to a More advanced Vet - Like at a hospital

I would be more worried about her health - than the electric bill at this time - I'm not trying to be a - A-hole here - but there is a problem - After going threw this with our girl - I can tell you that it really bothers them as much as it do's us .

Best of Luck !!!!!!

...Ken
I have already spent thousands on her vet bills in the short time I've had her (rescued 5/14/17), I'm not as concerned about that part

She was licking herself extensively this morning after her second leak, but that's the first time I've noticed it this week. She does not pee frequently outside, but when she does, she empties her bladder completely - strong stream and good duration (my male, on the other hand, pees a little bit every time he goes outside). Urine tends to be clear with no unusual smell or visible blood. She has had UTIs in the past without the normal symptoms, so I wouldn't be surprised if she did have a UTI again (would be the second time this year).

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I agree that I would probably see if you can get better answers from a specialist - do you have access to a university specialty veterinary center?

I'm not exactly clear if the dosage of Proin was maxxed out, or if they decided to try DES instead for other reasons? I think you need a specialist given her potential complicating background, and probably a full work-up to check kidney function, etc.

In the meantime, can you put down some waterproof pads so that you aren't so stressed about her leaking? What about some pants for her that are lined with absorbant pads for incontinence?
I think the Proin was max dose for her age - 50mg morning & 50 mg evening. I have washable waterproof mattress pads (multiple, the kind that cover the entire mattress) which was two of the loads of laundry I did today. As far as the disposable ones, she chews them up. My vet said not to use any type of diaper for her specifically as it increases her chances of getting a UTI and will make it much harder to get rid of any UTIs as it will keep all that bacteria in the wrong place (she is already becoming antibiotic resistant).

As far as kidney numbers (and some others):

BUN - 35 (12/2/17), 39 (5/24/17), 47 (1/4/17)
Creatinine - 1.8 (12/2/17), 1.7 (5/24/17), 1.2 (1/4/17)
BUN/UREA - 32 (1/17/17)
BUN/Creatinine - 19 (12/2/17), 22.9 (5/24/17), 39 (1/4/17)
PHOS - 8 (1/17/17), 8 (1/4/17)
GLOB - 3.2 (5/24/17), 2.2 (1/17/17)
SDMA - 21 (5/24/17)

Urine specific gravity - 1.014 (12/2/17), 1.011 (5/22/17), 1.008 (3/6/17), 1.002 (1/17/17), 1.012 (1/4/17), 1.078 (12/29/16)
Urine protein - 2+ (12/2/17), 0 (5/22/17), trace (3/6/17), 0 (1/17/17), 0 (1/4/17), trace (12/29/16)
Bacteria - rods (12/30/17), 51-100 (12/2/17), 0 (5/22/17), 0 (3/6/17), 0 (1/4/17), rods (12/29/16)

2/10/18 - UTI cleared up, all bacteria gone, specific gravity was within normal range (for the first time).

Ultrasound conclusion (6/1/17) - bilateral non-specific renal changes; no evidence of renal dysplasia, obstructive disease or neoplasia. Lepto test (6/3/17) was negative.
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post #5 of 10 (permalink) Old 04-08-2018, 07:36 AM
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ssc : I have already spent thousands on her vet bills in the short time I've had her (rescued 5/14/17), I'm not as concerned about that part

She was licking herself extensively this morning after her second leak, but that's the first time I've noticed it this week. She does not pee frequently outside, but when she does, she empties her bladder completely - strong stream and good duration (my male, on the other hand, pees a little bit every time he goes outside). Urine tends to be clear with no unusual smell or visible blood. She has had UTIs in the past without the normal symptoms, so I wouldn't be surprised if she did have a UTI again (would be the second time this year).


Sorry - I didn't mean to insinuate that money was a deal - I was just thinking that this problem is - may be getting worse than better : )

I did pull up and reread about UTI - And forgot some of the reasons - which there are many - So there are many area's that need to be checked - like Kidney stones - cancer - prostate

I just wonder if there is another underlining problem : that is why the Proin is not working - Boy my memory must be getting bad - I can remember back to when Kasia was put on it and I do remember they talked about the DES - but there was a reason he didn't want to use it , well maybe I will remember : ))

I do have one question - I think you said she is already becoming resistance to Antibiotic's - Is this from earlier treatments for UTI ?

Best of luck !!!!!

...Ken
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post #6 of 10 (permalink) Old 04-08-2018, 03:15 PM
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My girl has been on Proin since age of 5. She is 75 lbs and 50 mg. Proin 1 1/2 tabs twice a day. So I am not sure she would be maxxed out with dosage, but maybe her weight is less. I believe that is what they go by.
Good luck with this. I wish I could offer better words of wisdom.

"Lots of people talk to animals...Not very many listen, though...That's the problem. " ~ The Tao of Pooh
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post #7 of 10 (permalink) Old 04-08-2018, 03:58 PM
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With the various problems I'd be inclined to see if I could get her in to see a specialist--but if your vet is knowlegeble about kidney/uti/leaking problems and you are satisfied I'd at least do an immediate check for a uti.

You should probably also talk to your vet about the possibility of using BOTH Proin and DES. Some leaky bitches will respond to Proin for awhile and may reach maximum dosage and it still isn't stopping the leaking. Other bitches may do fine on DES but start leaking again. But some bitches can be put on both drugs and that will stop the leaking entirely.

Also not all bitches on DES (which is actually a hormone treatment) will respond to the one week loading dose and then be able to remain dry with a one pill a week routine. I know of several bitches who got medicated twice a week and that did result in a complete control.

Just some stuff to talk to your vet about. Good luck--that one is so frustrating-especially when you are trying to find a protocol that works every time, all the time.
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post #8 of 10 (permalink) Old 04-08-2018, 05:33 PM Thread Starter
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@ECIN - her kidneys are stable (for now), so the game is just keeping them that way (Proin/DES don't do a damn thing for that though). She has had quite a few UTIs and apparently someone who had her prior to me getting her did not finish her antibiotics for a UTI so it kept "coming back" (because it never went away). We're thinking that this is what caused her kidney damage.

@Cressrb - She is 68 pounds and still growing, 100mg/day (split up 50mg morning/50mg evening) is all my vet believes to be safe for her to be on long term at this point. Maybe more would be safe, I know accounting, not medicine

@dobebug - specialist is next on the list, but right now her kidneys are stable, its just the leaking that's a problem, which is more irritating for both of us than it is harmful. My vet had actually wanted to keep her on both Proin and DES (with the DES starting at 1 pill/day for 5 days then 1 pill every other day until we figure out if it works. When I tried to get the Proin refilled, my vet was off that day and her boss said no more Proin and DES only once per week (he is a vet and I have heard really good things about him but has never seen or treated my dog...). Maybe since the DES is just not working I can get her back on both, otherwise I'm going to have to drop the DES (in which case I'll just give her both since I still have 25 pills left of the DES, @ 1/wk would last me long enough to see if it works).
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post #9 of 10 (permalink) Old 04-09-2018, 07:19 PM
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@dobebug - specialist is next on the list, but right now her kidneys are stable, its just the leaking that's a problem, which is more irritating for both of us than it is harmful. My vet had actually wanted to keep her on both Proin and DES (with the DES starting at 1 pill/day for 5 days then 1 pill every other day until we figure out if it works. When I tried to get the Proin refilled, my vet was off that day and her boss said no more Proin and DES only once per week (he is a vet and I have heard really good things about him but has never seen or treated my dog...). Maybe since the DES is just not working I can get her back on both, otherwise I'm going to have to drop the DES (in which case I'll just give her both since I still have 25 pills left of the DES, @ 1/wk would last me long enough to see if it works).
I'd talk to your vet (the one who wanted to try both Proin and DES) again about dosage. Any vet will their own opinions about treatment protocol for a variety of things. Thyroid treatment is a good example. Because it has been pretty firmly established that Dobes should probably be medicated for hypothyroidism if they are in the low normal range but having symptoms of hypothyroidism. (For most breeds this isn't done--as long as they are in range many vets don't want to medicate even if they are fat as pigs and bald--two common symptoms of hypothyroidism.

Many vets don't want to medicate with DES for leaky bitches an equal number don't want to give Proin. I'm not any kind of expert on treating leaky bitches (mostly since I haven't owned one since the mid '60's) but I have friends who have them and I know that the repro vets have treated with high dosage and with combo's that most general practice vets don't even want to consider--successfully.

(And it's interesting who tells a vet to try something and who doesn't) the vet who handles my dogs since their vet retired a couple of years ago is the clinic owner and a graduate of Texas A & M--he is more inclined to listen to me about treatment in Dobes for this and that than some of our other vets. So when the litter sister of one of my dogs was looking less than wonderful and her owner had her thyroid run--it showed up low normal and her vet didn't want to put her on thyroid meds--her vet is a really competent vet and I actually take all my cats to her but she hasn't had much experience with Dobes. I finally told her to have her vet talk to my vet (the clinic owner) specifically about thyroid dosage and treatment. They did put the bitch on thyroid meds and adjusted it and her coat came back and she lost weight but it just wasn't the protocol that she'd learned in vet school and was really reluctant to try something that different.)
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post #10 of 10 (permalink) Old 04-09-2018, 10:13 PM Thread Starter
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Well I at least got the Proin refilled today. Now to wait for it to kick in (while my washer and dryer churn away).
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