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Hello!
I am sure everyone is sick of me, by now, but I am so worried and not sure what to do next. In the past I have posted a few times regarding my puppies urogenital issues and some people had some very helpful suggestions. Well we have explored all of those suggestions and are not stuck with no clue what is going on. I am hoping maybe someone may have another awesome idea or test that we should try or anything.

So here is the deal:

7 month old puppy has been experiencing persistent microscopic hematuria (blood in the urine) for several months now. She has increased urine frequency, dribbling when she lays down or gets up from laying down, and obviously urgency since she is having so many accidents in the house. Also, her urine has a bit of a strong odor similar to anal glands and very strong ammonia.

UA: is completely normal with an above normal specific gravity, despite her ravenous desire to drink water. upon microscopic examination of sediment a large quantity of RBC are present.

Initially she was on 14 days of Cephalexin with no improvement. Then tried 14 days of Clavamox with no improvement. After 1 month on Cranberry supplement there is still no improvement.

Ultrasound came back negative for stones or other abdominal abnormalities.

Urine culture came back clean and free of any sign of infection.

Blood work shows a slightly elevated BUN and MCHC, but everything else is in normal range. The vet said these elevations are not enough to cause any red flags.

She is a VWD carrier, by parentage, so I highly doubt the possibility of clotting disorder.

Vaginal exam showed no obvious signs of infection or abnormality.

She has not displayed any sign of fever or illness, besides urinary symptoms.

She is clearly becoming more uncomfortable and frequently whips around in almost a panicked state to lick her vulva. Her appetite is very strong, and she has tons of energy.

I am not sure what to try next. The vet is going to consult a specialist, next week. Obviously her condition is not dire, but it is getting progressively worse and I worry about what will happen if we don't get to the bottom of it.

Has anyone ever heard of anything like this? Any tests I should request be done that haven't already? I cant stand the uncertainty and not knowing what to do. I am just sick over this.

thanks for your comments
 

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Still a Pup
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Crystals or small stones in her urine? That can cause a lot of pain and even teeny stones can cut the lining of her bladder.
My first Doberman, Mercury, had oxalate crystals and stones his entire life. We could never seem to get it under control with diet. Being a male he had difficulty passing little stones and got obstructed twice. He also had 2 surgeries to remove bladder stones. He also had chronic UTI's from the stones cutting his bladder.
The stones were very small at first, and were diagnosed with X-rays. Good luck. Edited to add, they would have to be teeny-tiny for ultrasound to miss them.
 

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Nub Enthusiast
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It may just take a much longer run of antibiotics to kick the infection.

Kaiser fought what we though was UTI for a couple months. He dribbled all over our house, had accidents everywhere, and was really irritated by his penis. He would reach back, tug, lick, and pull on it. After a few doses of Clavemox, Cephalexin, and Amoxycilin, nothing changed. I'm not sure if it's possible for a female dog to experience this with her vulva or anything, but it turned out that Kaiser's infection was local to the penis/sheath. We began doing Betadine and water flushes, and the dribbling and everything quickly cleared up. Then we got him neutered, and recently we haven't been doing the flushes and there's been no recurrent issues.

One of our vets (we took him to three when our regular vet wasn't giving us much help) was starting to think it may have been a neurological issue. That he didn't get the sensation of "Oh, I have to pee!" and instead would just start going. I don't know exactly how likely that is, but it may be worth bringing up.

Never hurts to get a second opinion, either. Maybe take her to another vet?

Oh, and I forgot to mention that Kaiser consistently had blood in his urine, but only one of probably 15 urine tests showed bacteria.
 
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