Hi Jill Great summary and nice work up so far. It definitely sounds consistent with reflex dyssynergia. Even if he is also polydipsic, that would not account for the owner’s description of the urination. I would love to see a full abdominal ultrasound (but good job on checking the bladder and prostate, so unlikely to see much more) and a retrograde urethrogram. Make sure you have a good feel of his back (especially lumbosacral) and check his reflexes. Absent that, I don’t see you doing any harm by trying some tamsulosin/Flomax. Peter Peter S Chapman BVetMed DECVIM-CA DACVIM MRCVS ..read more

I saw a 13 week old, M Miniature Dachsund for his first puppy visit today.  The owners noted that when he yawns, they hear a clicking sound.  I can repeat this on physical exam:  when opening the mouth, there is “popping” in the region of the TMJ.  Teddy is non-painful, his dental occlusion and jaw conformation appear normal, and the owners have not reported any jaw locking or difficulty chewing/eating. I’ve never seen this concern in a puppy.  What (if anything) do we need to do to further characterize or treat ..read more

Sorry, one edit:  I spoke with the owner today and she DOES feel like Remington drinks an excessive amount of water.  This has been going on for a few years and seems to be getting worse.  I’ve advised measuring 24 hr water intake and she’s going to bring in a first morning urine sample for us to measure a USG. If USG remains low, I’ll definitely recommend doing some more investigation.  But if Remington is able to concentrate, my question regarding the dysuria remains the same ..read more

Hi Jill, Interesting case. It would be extremely unlikely for this pup to have MG based on the time in between episodes and the fact that she responded without any treatment. I agree that if she was weak with ME 100% MG until proven otherwise, however, with this case I would have to imagine that the two episodes are not related. Megaesophagus from MG is hard to control with treatment so spontaneous remission without treatment is unlikely. If she had been put on prednisone (even without pyridostigmine) and recovered both times then I would have it as a possibility for MG since the underlying pa ..read more

My associate saw a 3 yo FS Pittie, Molly, for acute onset hind limb weakness in October.  The gait began as just stiffness, quickly progressing to bunny hopping, short choppy gait, and then limb trembling and inability to walk. Unfortunately, the owner did not have funds for BW and rads let alone AChR Ab titers.  Fortunately, Molly just randomly recovered. I saw Molly again in May for excessive drooling, frequent regurgitation, lethargy and changes in breathing.  Rads confirmed megaesophagus and aspiration pneumonia.  Gait was pretty normal at this visit.  Molly was de ..read more

Remington is an 8 yo MN Lab who presented for his first wellness visit with us.  His owner mentioned that about 80% of the time when he urinates, it takes him a long time and he has a dribbling stream.  When he saw the vet a year ago, she was told that he had a bladder infection, but a course of antibiotics made no difference in his signs.  He has no incontinence or dribbling in the house.  But he will occasionally have an accident.  The owner noticed him once recently stand up and seem urgent, then urinate a large amount on the floor.  There is no reported PU/PD ..read more

An answer:  While Mya seems to have urinary accidents +/- pollakiuria all the time, she tends to develop gross hematuria only when bacteria are present Plan:  so nitrofurantoin can used long term?  That would be amazing!  I’ll plan to repeat a culture with her next suspected cystitis episode ..read more

Hi Jill A question and a plan for you… Question – are her clinical signs changing when she has the bacteriuria? I realize that she has frequent inappropriate urination, but is that worse or is there hematuria/stranguria when she is perceived to have a UTI. And do those additional signs resolve when she is on antibiotics. Because if this is just subclinical bacteriuria then I would ignore it – even if secondary to neoplasia. Plan – if we do think that we need antibiotics then I would think about nitrofurantoin if the bacteria are sensitive. Most Staph and E.coli are. Proteus are inherently resi ..read more

Not really a topic request, but all the webinars seem to cater to people on the west coast (I’ve noticed most other CE platforms do this as well). A lot of us live on the east coast! It’s really hard to get value out live webinar offerings when they are always at like 9/10 PM. Maybe it would be possible to alternate times for live webinars so people on the east coast could also attend without having to stay up all night ..read more

Dr. Reinstein,   I just wanted to thank you for all the webinars on Ophthalmology that you have posted. I am an American Vet working in Australia.  And although I am not a specialist, I do have my midlevel certification in Emergency and Critical care (MANZCVS). Tonight at my emergency clinic one of my colleagues saw a 3 yo FS Sphynx that ended up having unilateral uveitis (AQ Flare, decreased IOP conjuctivitis).  It turned out that I saw the same cat one year ago for the exact same thing, and now thanks to your webinars I was very confident writing a script for Famciclovir to th ..read more