Age at onset: 4 years and 11 months
Signs: Urinary incontinence and blood in urine
Breed: Sheltie mother and short haired father
Medical history: No other health problems
Freya got sick suddenly on Monday 1st of December 2014. She had urinary incontinence and bloody urine. I took her to the vet straight away. The vet took urine samples through abdominal pressure and did an ultrasound that showed sediment but no stones. The vet diagnosed UTI and I started her on Baytril 0.5% 1 ml twice a day (concentration 5mg/1 ml). Appetite and poop was normal but she was feeling a bit down.
A few days later there was no improvement, she was still leaking urine and spotting occasionally. I called the vet, who told me to continue with Baytril for 2-3 weeks as the UTI seemed serious. The urine culture came out negative but I was told to continue with Baytril anyway.
I called again on 11th January (11th day of treatment), the vet told me that it seemed Baytril was not working and that she probably had some infection that was resistant to Baytril. His plan was to stop Baytril for 5 days then get another urine sample.
16th December the vet took another urine sample through pressure.
20th December the results of the culture came out. They showed an infection caused by E. Coli and Proteus Mirabilis which are both susceptible to Baytril. The vet told me to start her on Baytril again.
At this point Freya was eating very little and she deteriorated quickly over a few hours to not eating at all on her own. Also she lost weight (around 200g), she was leaking blood and got bloated. I was trying to force feed her pellets with a syringe unsuccessfully as I couldn't find Critical Care anywhere.
Out of pure luck, I found an animal clinic that had Critical Care and I wrote them an email to which they answered in an hour although it wasn't working hours for them. I talked to the vet from the animal clinic (who is Canadian and is the only vet with an exotics specialty in Greece) and she provided me with Critical Care and metacam the same night. Her suspicions were that it was not a UTI but probably something abnormal in her uterus. Also, the previous urine culture was unreliable.
21st December the exotics vet from the clinic examined Freya (physical, x rays). Her abdomen was bloated and her bowels were all pushed up. Getting the critical care in time managed to save her from stasis. The vet suspected that her uterus was pushing her intestines up. I asked the vet for an ultrasound but she said that she would not be able to clearly see the uterus given the state of her abdomen. In order to determine whether it was the bladder or uterus, she suggested putting a catheter in Freya's bladder to clean her up and if the bladder wasn't the problem she was going to perform a hysterectomy.
Monday 22nd December Freya went under anesthesia, the vet inserted a catheter in her bladder. Blood came out together with sand and epithelium which made the vet think that it was the bladder indeed that was causing the problems. She decided not to open her up yet to see if the infection cleared after she cleaned Freya's urinary tract and if there was no improvement in 2-3 days then she would operate on her. She switched to injections of Marbofloxacin 0.25ml daily instead of Baytril. I was also giving her injections of Metoclopramide, a motility drug to help with the bloat, metacam and Butarphanol to ease her discomfort. I kept feeding her the Critical care (30g a day). She also gave me some digestive enzymes and instructed me to give Freya megadoses of vit C (over 100mg).
Freya started to get constipated because of the Butarphanol which is an opiod drug and was eating very little on her own although I was offering her food all the time. It looked as if sometimes she had appetite but was reluctant to move. After I stopped the Butarphanol she started pooping again and the bloat was getting better (the metoclopramide injections, hand feedind and abdominal massage were key to making her intestines work).
25th December small improvement. I started feeding her 50g+ of dry Critical Care a day (feeding every 4 hours) with vit C supplements (over 100mg), digestive enzymes and giving her metacam. She was still uncomfortable, unwilling to move or eat on her own except some times when she had appetite and ate vegetables or some hay. She was still bleeding but on the bright side, the bloat got better and she was pooping a lot since her digestion was improving. Her weight had previously dropped to 1080g from 1250g but was now stable and she was not losing more weight.
On that day the vet told me it was probably cancer in the uterus or bladder and thought that surgery was inevitable but she wanted to give a shot of amoxicillin to completely rule out infection.
26th December I managed to find Bactrim 480mg/5ml (400mg sulfamethoxazol and 80 mg trimethoprim) and started her on it 0.6 ml every 12 hours. Her weight was stable at 1080g. The vet didn't give her the amoxicillin shot in the end.
27th December I gave Freya probiotics plus poop soup for two days. Her appetite increased but I kept feeding her 40-50g critical care, in an effort to make her gain weight. Also, her Bactrim dosage was 0.6ml and she was taking megadoses of Vit C (as instructed by the vet). She was eating her poop, which although normal, changed a bit to bigger softer lighter coloured pellets that were really smelly.
By the 29th of January Freya became better and was eating by herself. I stopped giving her marbocyl and she was only on Bactrim.
In the following week (from December 29th to January 5th she was almost completely well. She was more active and seemed healthier. I stopped the critical care since she was eating completely by herself. Also, the bloody urine and incontinence had stopped. She even gained a bit of weight (1100g). It seemed like she was almost cured and that Bactrim worked.
Then on the 5th and 6th of January she started showing small signs of relapse mainly a decrease in appetite and feeling down.
On the 7th of January she became sick again, not eating and feeling lethargic. I called the vet and booked an appointment for that day. In the meantime, until I went to the vet, I started feeding her critical care but this time she wouldn't swallow. Freya started having some muscle spasms and her breathing was labored so I called the vet again and asked if I could come right away and then grabbed a taxi and went straight to the vet's office.
Freya passed away in my hands, on the way to the vet on Wednesday January 7th 2015, 15 min before reaching the office, around 3:15pm. She was 13 days short of her 5th birthday.
The vet did an autopsy and it showed bladder cancer which the vet had suspected because of the blood and because Freya wasn't responding to a combination of antibiotics (overall she was 11 days on Baytril, 7 on marbocyl and 12 days on Bactrim). The last ten days she was getting better and we thought she was responding to Bactrim. So it threw us off from what the vet had correctly suspected was the cause of Freya's problems.
The autopsy findings were hyperemia, calcification and thickening of the bladder (with minimum sand and no stones) and an overall bad condition of her bladder. She had 2 or 3 infarcts in her heart and 2 in the kidneys which most likely is the cause of death (heart attack or DIC causing multiple organ failure caused by the cancer).Additionally, it looked like the cancer metastasized to her lungs because they were also hyperemic and looked hepatisised. She also had 2 small cysts in her ovaries (which were irrelevant to her condition). Her uterus looked normal and her liver and intestines were in perfect condition (because of the successful hand feeding). According to the vet if we had operated on her chances were she would have died on the operating table.
Thread advising not giving penicillin to Freya: