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Discussion on Bladder infection?

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Melissa Boschwitz
Member
Username: amara

Post Number: 422
Registered: 7-2000
Posted on Saturday, Dec 1, 2007 - 6:46 pm:   Edit PostPrint Post

Hello Dr.O

A few days ago I noticed that my pony was urinating abnormally. He was only able to urinate a very small amount (a few cups worth, if that), and was doing it very frequently, about every 10 minutes or so. He did not appear to be straining. His appetite was COMPLETELY undiminished, and TPR, gut sounds, etc were normal. He was lifting and holding his tail up just a bit. He is EXTREMELY stoic (i've seen bomb shelters with a lower pain threshold than he has). I called the vet, and we thought maybe just a very mild colic. As I have just moved, my vet was over 100 miles away and I havent yet had a chance to find any new vets in the area. Even tho I didnt have any bute or banamine on hand we decided to wait and see. The pony certainly wasnt in any distress, and was eating and drinking normally, and had passed manure without any problem.

The next day the problem wasnt any better, and my vet suggested I find a clinic nearby. I have no facilities and he suggested a catheter, and probably an ultrasound would probably be necessary. I took my pony to a clinic the next day.

The pony has very large tumours at the head of his penis, and a few smaller ones along the side. They are not ulcerated in any way, and dont cause him any pain. He has had these tumours for as long as I've known him (11 years), and havent changed any, and dont cause him any pain. At the time I got him the vet and I decided not to do anything about the tumours, as sometimes once you start to mess with them, they can come back with a vengeance. I've kept an eye on them and they havent changed in 11 years. He does tend to have a foul discharge, but no other signs.

The vet had no problem passing a catheter through. We collected some urine, which upon a dipstick test had a high WBC. It was a dark yellow. (his is usually a pale yellow). There was some blood in it, but I had not seen any blood previously (I had checked the areas where he had urinated), and wonder if that was from irritation from the catheter, or?...

An ultrasound was done and it showed an extremely thick bladder wall. The vet is not sure if this is a result of transitional cell carcinomal from the tumours, or something else. Because of the high WBC count we are treating him for a bladder infection. He is getting 30 cc's of penicillan IM 2x/day and 5cc's of dexamethasone IV 1x/day for five days.

DO you think a bladder infection the likely cause of the thick appearing bladder walls? What is the incidence of bladder cancer? We saw no stones in his bladder, but did not check his kidneys. Blood work to check his kidneys came back normal
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Robert N. Oglesby DVM
Moderator
Username: dro

Post Number: 19645
Registered: 1-1997
Posted on Saturday, Dec 1, 2007 - 10:04 pm:   Edit PostPrint Post

Hello Melissa,
A uniformally thickened wall is more likely infection. Are you running a culture on the urine, penicillins limited efficacy against gram negatives concerns me and would consider TMP-SMZ a better choice in most circumstances. Bladder cancer is not common in horses but does occur.
DrO
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Melissa Boschwitz
Member
Username: amara

Post Number: 423
Registered: 7-2000
Posted on Sunday, Dec 2, 2007 - 2:44 pm:   Edit PostPrint Post

Thank you Dr.O
A urine sample was sent off to Texas A&M, but we wont have the results till mid week. We discussed Tribrissin given orally, but in my situation it is actually easier for me to give medication through injections. The vet seemed to feel that penicillan was absorbed well in the bladder and should work if infection was the problem. I will say that as of this morning he seems to be urinating less frequently, and if anything has become even more "annoying" in his insistence in getting into things...he certainly wasnt lethargic for those few days, but he does seem a bit more "spunky"

What would cause a bladder infection? We have recently moved. He's out on 3 acres of overgrown coastal bermuda grass and heavily wooded areas/various brush... Previously he was getting free choice coastal hay and access to very well maintained pasture for several hours a day. He has access to a TM salt block and gets a few handfuls of alfalfa pellets AM and PM so its easier for me to check on them. My work schedule has been so crazy he rarely gets worked, aside from what the dogs and the goofy arab make him do (*LOL*).

He was heavily dosed with anabolic steroids as a youngster, and has had some trouble with lyme disease in the past, but generally speaking he is an extremely healthy pony. The only thing "unhealthy" about him are those aforementioned tumours on his penis, but even those dont look unhealthy. They are the same color as the surrounding area (pink), and generally smooth. They do have some striations, which have an appearance similar to the striations on a brain (which brought about some very bad jokes *LOL*). They dont cause him any discomfort at all. He has no problem keeping weight on (in fact tends a bit towards "portly"), and has a bright eye and healthy coat. The occasional bout with rain rot will always clear up on its own within a day or two, whether or not i do anything to the area. Wouldnt a horse with cancer have some other symptoms?...

Thanks for your input. I've been lucky that I havent had to use this site for medical advice overtly much in the years I've been a member, but it sure is a blessing to have this site on those occasions I do need it. This pony is a valued friend and has seen me thru some truly tough times, and having this information on hand makes me rest a little easier for his care.
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Robert N. Oglesby DVM
Moderator
Username: dro

Post Number: 19651
Registered: 1-1997
Posted on Sunday, Dec 2, 2007 - 6:50 pm:   Edit PostPrint Post

It is not that the pen is absorbed but it is excreted through the kidneys into the urine so reaches very high concentration in the bladder. This is true also of TMP/SMZ and its wider spectrum makes it the drug of choice pending culture and sensitivity. But if you are seeing a response and your horse does not mind the injections and muscle soreness not problematic by all means continue.

As to predisposing factors you don't describe any except possibly the tumors: are they promoting pathogen growth around the urethera than then ascend to the bladder? The lack of other symptoms does not rule out cancer, it may just be early.
DrO
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Melissa Boschwitz
Member
Username: amara

Post Number: 447
Registered: 7-2000
Posted on Thursday, Jul 24, 2008 - 11:49 am:   Edit PostPrint Post

I wanted to post an update to this as last week my pony started having similar symptoms. I started noticing that he was urinating very small amounts. HOWEVER, unlike last time where he was urinating small amounts every 10 minutes, this time he would urinate a small amount and then not urinate again for quite awhile. This went on for a few days, and because money is so very tight right now I decided to take a wait and see attitude. Now he's urinating normally. The color has appeared normal at all times. The only thing I noticed was that he would itch his belly on the ground quite vigorously just before he would urinate the small amount. He is normally an itchy pony, and loves to have any body part itched. He especially loves when I use a rough curry on his belly and near his sheath. (his skin is very healthy and he has always been like this, no matter what environment he is in and what he has been eating, so I am very sure that he just loves a good scritch, not that it is allergies)

The tumours on his penis have not changed at all. We did move again a few months ago (this time to a permanent place, finally!!). He is on good coastal pasture or good coastal hay 24/7, with a handful of grain AM/PM to change them from pasture to dry lot. He is on well water that is a bit sulfuric, but well within drinkable levels. (I add a little bleach to the well once a month to neutralize the smell (about 1 cup a month)... When I finally got the results of the urine test after his last problem it did show that pencillan would be ineffective, but he recovered within a few days anyways and has been urinating normally ever since, except for this brief bout.

What could cause him to have this brief bout of urination problems? He has not seen a vet since the incident last year, and with lack of symptoms right now am reluctant to take him to the vet now. Is it possible for him to get brief bladder infections because of possible pathogen growth around the tumours as you mentioned before, but have him recover from it on his own? I know you mentioned that there may be early cancer problems that havent had a chance to show symptopms yet, and aside from this brief problem, I dont see any other symptopms. At this point several months later would any cancer symptoms be showing up?
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Robert N. Oglesby DVM
Moderator
Username: dro

Post Number: 21082
Registered: 1-1997
Posted on Friday, Jul 25, 2008 - 7:56 am:   Edit PostPrint Post

Melissa, there is no way to construct a useful rule out list, including worrying about cancer, from a brief bout of smaller than normal amounts of urine as it is normal for the quantity at any one urination to vary.
DrO
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