Case solved: Hemorrhagic cystitis
As the saying goes, life can change in an instant. For Priscilla Doel that moment came in July 2012 when she noticed that her 6-year-old Wheaten Terrier, Kirby, had blood in his urine.
What followed was months of trying to pinpoint the cause and find a course of action that would solve the problem. Working with Kirby’s local doctor in Maine, Doel tried medications for a urinary tract infection but that didn’t resolve the symptoms. A few months later, Kirby underwent an exploratory surgery at a specialty veterinary hospital in her area and doctors found that Doel’s mischievous and spirited dog had ingested a chunk of a pliable tub drain which had hardened in his stomach.
Removing the obstruction was good news but it wasn’t necessarily the cause of his bladder issues. Post-surgery, the mix of prescribed medications left Kirby vomiting, constipated and with more blood clots in his urine. One medication, prednisone, increased his frequency of urination and this compounded the difficulties.
“I had to take up all the rugs in the house and we were up several times at night because he needed to go to the bathroom so often,” recalled Doel. “He couldn’t sleep, he was so uncomfortable.”
Doel’s concerns grew by the day as Kirby’s condition worsened. Her mild-mannered, fun-loving companion was typically an on-the-go guy. A certified Canine Good Citizen, therapy dog and lover of agility courses and nose work, Kirby was sidelined from all the activities he enjoyed and life got increasingly more challenging for him and Doel.
In November, she called the Foster Hospital for Small Animals at Cummings Veterinary Medicinal Center for an appointment and saw Drs. Mary Labato and Daniel Jardes.
“Now looking back, it was such an intense and scary time that I ask myself ‘why didn’t I make that call sooner?’” said Doel. “Our veterinarian had mentioned Tufts early on and I knew coming to North Grafton was an option but when Kirby first got sick, traveling there seemed overwhelming. But that appointment changed our lives for the better and I am so pleased that I made the decision to go to Tufts.”
Foster Hospital veterinarians diagnosed Kirby with sterile hemorrhagic cystitis, which is an inflammation of the bladder without the presence of an infection. Patients have symptoms similar to a urinary tract infection and have difficulty and increased frequency of urination, as well as the presence of blood.
“The absence of infection makes this condition rare and taking certain medications can actually cause more irritation to the bladder,” said Dr. Jardes.
Foster Hospital is equipped with an endoscope, a small, flexible tube with a light and tiny video camera on the end used to look into the esophagus, stomach, colon, rectum, or in Kirby’s case, the urinary tract. This aided in making a diagnosis, as did Tufts urology specialists’ familiarity with rare disorders of the urinary tract.
Kirby was prescribed Methylsulfonylmethane (MSM) and Meloxicam. MSM is a joint supplement that has anti-inflammatory properties and can help to decrease inflammation in the bladder at high doses. The medication is not commonly used and provided a great benefit to Kirby, explained Dr. Jardes.
“I saw an improvement right away,” said Doel. “It was a magic formula of medications for Kirby. His discomfort and other symptoms went away almost immediately. I feel so committed to the services and expertise at Tufts.”
Doel has decided to bring Kirby back annually for a wellness exam and the trip to North Grafton has become a mini-vacation. Doel visits her sister who lives in Massachusetts and together they bring Kirby to the Foster Hospital.
“We grab some coffee, drive down and we are seen right away,” she said. “The doctors we work with are wonderful. Even now, I feel like I could call them with questions.”
It’s been more than a year since Doel and Kirby first visited Foster Hospital and they have resumed their busy schedule. Kirby is back to his mischievous ways (Doel reports that he recently stole half a chicken sandwich off the kitchen counter) and is seeking his advanced certification through the Canine Good Citizen program.
And just like that, life is back to normal again.