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#190737 - 12/24/06 11:09 AM Curious diagnosis/update on Marcus's UTI

So... In the beginning, (mid September) Marcus had a UTI. Well, rather, I thought he had a UTI since he was hissing while urinating and beginning to go slightly bald in odd places on his head which I presumed to be signs of overgrooming. So I took him to the vet I'd gotten a recommendation from in Baldwinsville, NY. After hearing about the symptoms, I received a prescription for a cherry flavored suspension of sulfametho(something)...trimethoprim to be taken for 10 days. No tests were run. For a while, things seemed to get better. His bald patches slowly began to grow back, he stopped hissing, etc. Then, over the next few weeks, Marcus started to get a little worse: he went patchy again behind his eyes and ears, and the hissing started anew. Frustrated, I took him back to the vet, only to come back with yet another prescription of the same cherry flavored stuff. Any entreaties for a urinalysis were deemed unnecessary, and I, in my foolishness, acquiesced and took the bottle of stuff home, this time to be taken for 21 days. Nothing changed. Then, in late November, Marcus climbed up the drapes, hunched over, and started hissing. He wouldn't stop. He seemed to be straining, and urine was only coming out slowly in droplets which he'd lap up immediately. He penis came out and he began grooming and licking at it. I had not seen him do this in all the five months since he'd been neutered. Disconcertingly, stayed out for a minute or two (i think) and after a brief application of KY jelly and numerous panic ridden posts on GC and calls to emergency vet clinics in the area (none of whom would/could see him) and finally a call to Cornell, he quietly climbed down into my shirt and went to sleep. I was terrified. It was finals week. I made several phone calls to Cornell, and was told that they were booked up for the holiday season and that their lab was closed whenever I could bring him in. After much exasperation and the end of my final projects, I drove down to NJ on the way home and took him to Dr. Hackock in NJ, who'd done an absolutely wonderful job with Marcus and his neutering back in June. A full urinalysis and dip stick test was run (finally) and oddly enough, everything was fine. Down to the concentration of his urine (which was, oddly enough, higher than that of the vet's own assistant), to the way he looked/acted/smelled/felt/ate/expelled/etc. He was fine. Any issue with his kidneys, liver, bladder, etc would have shown up on the gamut of tests involved with the urinalysis, and despite everything I'd observed, he was fine. According to the doctor, (who's had much experience with the fur-kids), the hissing was probably behavioral: due to stress, loneliness, boredom, etc. It's very odd that he'd exhibit all the signs of a UTI so vividly and still have all the tests come out clean. Up till this point, he's been housed alone, so I guess that could be a big issue with him being lonely/bored. I'm still a little lost though, in terms of the oddity of it all. If anyone has any thoughts or ideas as to these past events please let me know.

Confused, Alice

#190783 - 12/24/06 12:57 PM Re: Curious diagnosis/update on Marcus's UTI [Re: ]
BeckiT Offline
Glideritis Anonymous

Registered: 09/29/06
Posts: 16083
Loc: Manitowoc, WI
Alice, I wish I knew what to tell you... Perhaps as you said, it is just loneliness/boredom. I know Wiggles will cry and bark for me if he's not on me (which is only for about 5-6 hours a night while I sleep), so maybe Marcus was just calling out to you... The droplets of pee could be marking behavior...
~Becki & Crew~
Glidin' High Sugar Gliders
So You Want to Own a Sugar Glider? Read and Share wink

#190840 - 12/24/06 06:05 PM Re: Curious diagnosis/update on Marcus's UTI [Re: BeckiT]
SugarBlossoms Offline
Serious Glideritis

Registered: 02/23/06
Posts: 5830
Loc: USA
Wow. I don't know what to think. I have a couple of lone boys and one of them, Oscar, suddenly was missing fur behind his neck. He has 2 round circles of fur missing. Not scabby or nothing..looks like it was cut down short. He has always done the shhhhhhirp thing to call me. It's not a glider hiss but a call sound he makes. I panicked and got him a little female friend 15 months old last Sunday. They were together by the second night and are IN LOVE! lol It looks like the fur is getting longer but now he makes that sound to her. (kinda broke my heart cause that's MY

Those two are having a ball in the Stealth together and playing and cuddling up sleeping!

I would get him a friend. I think that's what was going on with our boy. Now we need to find another girl for Poss. smile
Keeper of Handprints on my Heart, You left your Footprints on my soul.
My precious loves that left to quickly, Peanut, Katie
Isabella, Kiwi, Bonnie and Monroe.

Spread your wings and glide free of pain,
Until the day I see you again.

God speed my precious angels. I love you. Mama.

#190927 - 12/24/06 10:42 PM Re: Curious diagnosis/update on Marcus's UTI [Re: SugarBlossoms]

it's all so very confusing.. i've been trying to get marcus a friend and I had a prospective baby lined up in upstate NY but timing and circumstances thwarted any chance of getting her to me safely. She was a young little thing too. Who knows... maybe a friend'll fix things up.

#190970 - 12/25/06 05:04 AM Re: Curious diagnosis/update on Marcus's UTI [Re: ]
Xfilefan Offline
Serious Glideritis

Registered: 02/22/03
Posts: 8899
Loc: Jacksonville, FL
UTI symptoms don't always show up on tests, particularly if recently on antibiotics. It could also be reproductive, bowel, or anal glands. My suggestion would be to insist on a 3 week course of Clavamox (amoxicillin clavulanate) and Flagyl (metronidazole) to cover a broader spectrum, and to check out his anal glands. My Chronos we thought had a UTI for a year....turns out it was anal gland abscesses. Those glands should be about the size of a grain of rice (or so)...if they're enlarged (size of a pea or bigger), they could be infected, but you won't know unless the abscess ruptures and starts draining (like with us). The danger here is that the kidneys can become involved if the infection isn't stopped. That happened with Chronos as well, before we discovered the problem. And a glider can overgroom if in discomfort due to stress. If nothing else it's worth a try. Keep us updated, and I hope your little guy starts feeling better!
Jen/Colin :bb: Commander Riker 12 16 02-10 04 12 you will be FOREVER missed :wfb: Sinbad, :wfb: Gabby, :grey: Baby, and :grey: Alley

#191221 - 12/26/06 02:37 AM Re: Curious diagnosis/update on Marcus's UTI [Re: Xfilefan]

There are many liver, kidney or bladder issues that do NOT show up on a urinalysis, so a normal UA does not exclude too many things. The UA is nice when it directs one somewhere, but a normal UA often leaves us annoyingly without an answer. Your comment suggested a UA yielded evidence about the liver, but it is not at all good at detecting liver issues.

I would hazard a suggestion that a normal UA does tend to make a UTI very unlikely. As Jen points out, treating with antibiotics before testing can make evaluation harder. But a bona fide kidney or bladder infection usually makes the urine dirty enough to show some evidence suggesting infection. So no microscopic findings of pus or bacteria, nitrites, leukocyte esterase or any markers of infection would certainly be strong evidence that a UTI is statistically remote. The reverse is the problem situation, or at least the more difficult call. Dirty looking urine is NOT always a UTI. Many other things can cause that, but it is suspicious and warrants looking to clear the urinary tract. Cultures still provide the best evidence, but unfortunately gliders don't easily yield urine cultures collected in a manner that excludes stool and thus stool bacteria. Mis-interpreting urine cultures can lead many to erroneous conclusions, and worse the wrong treatment.

It appears to me that UTI's are way over-diagnosed here.

Jen's point about abscessed anal glands is also a good thought. That will cause pain and hissing, and can be present with totally normal urine. The treatment for that is mechanical, draining the glands. A veterinarian check should help evaluate for that.

One other thought on antibiotic selection- Most of the meds commonly employed in urinary tract infections get concentrated in the urine and reach great levels there. Reaching the concentrations to kill bacteria is easy. UTI's are not hard to kill (if you really have a UTI.) As mentioned above, if over-diagnosed and mis-diagnosed, there will be many "treatment failures" since the real problem wasn't identified or treated. If one is mistaken and there isn't really a UTI, treating with two meds or treating a week or a month or a year won't help.

Abscesses usually need to be drained unless they spontaneously come to a head and drain on their own. Meds play little role, or a small role as an adjunct.

Constipation issues can also create the same presentation. So can colitis (inflamed intestine wall), proctitis (inflammation at the anal verge), urethritis (inflammation of the tube from the bladder to cloaca) or inflammation of the cloaca itself.

#191295 - 12/26/06 11:58 AM Re: Curious diagnosis/update on Marcus's UTI [Re: ]

Hi all, thanks for getting back to me so fast. It's great to get such wonderfully straight forward advice. Here are a few questions/thoughts/observations:

When he'd visited the vet, he'd been off of antibiotic treatment for about two-three weeks. Shouldn't this be enough time for them to have gotten out of his system? Not sure, just asking. Also, his UA turned out clean: down to the very concentration of the urine, and apparently (according to the vet i went to) any issues correlating to the liver/kidneys would have turned up in the dip-stick test which was run alongside the UA. Whether/not if this was actually a part of the UA, i'm not quite sure.

Also, not to dispute anything: but the doctor felt around his cloacal area and belly and said everything felt ok: no swelling or irregularities or anything. During the exam, Marcus exhibited no evidence of pain. If these abscesses cause pain and hissing, wouldn't he have exhibited some reaction to the poking/prodding?

In terms of putting him on another course of antibiotics, I am a little aprehensive as to put him back on another course as the previous two runs yielded little, if any noticeable results. The hissing has lessened in the past couple of weeks since he's returned home but he has not been on any meds since I stopped administering the Sulfametho (something) -Trimethoprim suspension back in november, so I honestly don't think the meds helped in any way.

To clarify, he tends to hiss when he first wakes up and goes for his main "long pee." He has done this less and less since he has gotten home, and his bald patches have almost grown back completely. I am inclined to think of this as a stress reaction, but any thoughts/advice would be welcomed and appreciated.

#191516 - 12/26/06 09:00 PM Re: Curious diagnosis/update on Marcus's UTI [Re: ]

2-3 weeks off antibiotics is enough to allow growth of bacteria and not inhibit evidence of infection - all of it will be out of his system by now.

The dipstick will note protein and red blood cells(kidney injury), white blood cells, red blood cells and leukocyte esterase (urinary tract infection), urobilinogen (bile products of liver origin in the urine), ketones (starvation or insufficient insulin), glucose, but a dipstick of urine is really not any kind of test of liver inflammation, injury or infection. Urine dipstick is mostly about kidney issues. Bloodwork will be needed to really study the liver.

I'm glad your veterinarian took a good look at his poop shoot. An exam should have helped rule out anal gland infection or abscess.

I guess my point was that not all hissing is a UTI. I suspect mostly it is not. It is appropriate to think of UTI and look for it if hissing during peeing is noted. I frequently see people get tests that yield pretty strong evidence showing no UTI, but assume it was there and not picked up on the tests and treat for it anyway.

Your plan to want to stop antibiotics is understandable. I'm glad the bald spots are better.


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