[Dailydrool] Any experience with cystoscopy and/or episioplasty

[sylviemcgee at comcast.net]

Hi, Patti and Bob, 



Yes, I have experience, both with an older bitch (Luna) with recurrent and antibiotic resistant UTIs, and with cystoscopy and episioplasty surgery on that bitch. Been there, done it. 



A few thoughts: 



- On the cysto, have you done an extended panel culture and sensitivity? When my Luna (now 12, she was 10 ½ at the time of her surgery) developed antibiotic resistant UTIs, the first panels were extremely scary, because they came back with NO options left for which the ecoli infection was susceptible. We did an extended panel, and there were a few drugs left. We are talking REALLY BIG GUNS. She ended up on Merrem, which is usually given to humans IV, while hospitalized, for MRSA infections. Luna had to be injected 2X/day for 8 weeks intra-muscular. And it was a taxing treatment on her. This was after repeated bouts of all the “usual” antibiotics – clavamox, cipro, etc… and a trial of Nitrofurantoin, which completely flattened her within 3 days – she simply could not tolerate it, as apparently half of dogs cannot. If your vet has not ordered an “extended” panel, ask if it would be a good idea to do one, to understand what options you have left for antibiotics. 

- 


Also, always do a cysto, not a free catch. There’s really no such thing as a “clean catch” in dogs, because of their structure. Because of this, the labs have to expect some level of e-coli. So they basically ignore some level of e-coli as normal. Which may be fine if you have a dog without a UTI, but can be really deceptive and delay diagnosis and treatment in a dog with recurrent UTIs. The cysto gets a sterile catch, so that they can see what’s really going on. 



Because Luna’s infection was recurring so quickly (within 3 days or so) after antibiotic treatment, our first priority was getting the infection she had going at the time under control before it spread to the kidneys. So I started with the 8 weeks of Merrem 2X/day. We both hated it, especially Luna, who really got sore in the thighs where I was injecting her, despite moving around a lot. Eight weeks 2X day is 112 injections, and after about 6 weeks, it just hurt her every time. However, at this point we were out of options. 



I then gave her a rest for about a month, and during that time, we did cystos twice to ensure that the infection was gone, and everytime she eliminated, I wiped her vulva with an antiseptic towelette. Once she had recuperated from the Merrem and was doing well, I did have the episioplasty surgery done. It went very well. At this point, she was 10 ½ years old and had already been ill and then through the wringer of treatment for several months. I would say that the first three days post-surgery were fairly hard on her. She slept a LOT, and was heavily pain-medicated. Then her pain meds started stepping down, and she came out of the haze a bit. By a week post-surgical, she was mostly REALLY annoyed by the collar to keep her from licking herself. I did put her in a Bite Not collar. (for reference, you can see them here: http://www.bitenot.com/ ) rather than a “regular” Elizabethan collar. That worked for about 10 days, and then she got itchy enough at the surgical site that she needed about a week of a traditional collar because at that point she was feeling good enough to reach around back and try to mess with her incision a bit. Overall, beyond those first few days, during which she was so heavily medicated and out of it, her recuperation went extremely well. 



Knock on wood, it’s been about 1 ½ years, and NO signs of infection recurrence. I miss her lovely full-covered vulva – Luna in her day was a beautiful show bitch, and I liked her going was well as coming towards me ;). But I've gotten used to the "new shape", and in her case, it's a new HEALTHY shape, and she does not know the difference at all. But every day with her is a gift to me, and I believe that the surgery has given us the past 1 ½ years without threat to her health. In her case, had the UTIs continued, I know I would probably have lost her to kidney disease, as we were really at the tail end of what drugs were available to help her and kill off the e-coli. 



I do NOT recommend waiting until you get into the really big guns of antibiotics if you can avoid it. Luna’s Merrem was about $435/week at Costco for 8 weeks. In addition, the lab work required to check that it was working, and that her system was tolerating the treatment, was about another $750 over the course of the treatment. So I was at over $4K just for that part of her treatment in a two month period. I was very, very fortunate that I could afford to treat her. There have certainly been times in my life when I might not have been able to do that and keep a roof over both our heads and the heads of my other dogs. The worst, though, was waiting to see if it would work, knowing that if it didn’t, we were out of options and would soon be out of time. 




Bottom line, if I had a bitch who was experiencing repeated UTIs, I would do the surgery a lot earlier knowing what I know now, and seeing how effective it has been, rather than put her through the repeated infections and the possibility of having to use drugs that are really quite hard on them. I did see in your email that your girl has a history of some other health problems, and obviously I cannot speak to your situation with that, so I am just sharing here my own experience with my girl and her surgery. 




I am happy to answer any questions you might have about the cysto and the surgery. Just drop me a line privately, as I do not usually read the DD on a regular basis - I just dropped in tonight randomly, but won't see a response on the list. 





You have my best wishes and good thoughts in making this difficult decision. 





Sylvie McGee 

HeavenScent Bassets 

sylviemcgee at comcast.net
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