Foster’s Problem

D. E. Larsen, DVM

Jim was waiting for the exam when I came through the door. He wasn’t smiling today, and Foster, his old black Lab, was standing with his head down.

“What going on with Foster today?” I asked.

“That’s what we are here to find out,” Jim answered. “We were over at Joseph this weekend, and I noticed that he had some blood in his pee. It has been getting worse every day. We got home last night, and it took him forever to get done peeing before he came in the house, and that’s not him at all, Doc. He can usually mark every post with no problem. Last night he was just standing out there dribbling blood.”

“That doesn’t sound very good for an old dog,” I said. “Let me get him up on the table and look things over.”

“You be careful, Doc,” Jim said. “You know he’s over a hundred pounds.”

Foster was an older black Lab and a constant companion for Jim. He was an old-time Lab, with a large dog with a large head that was almost square. Foster was getting older now, approaching ten years of age. And like many of the older Labs, he had some arthritis in his knees and back. But his heart was still strong. And he was still an intact male.

I took a deep breath, bent over, and with my left arm across his chest and my right arm under his abdomen, I swooped Foster up and placed him on the exam table.

“Keeps me in shape,” I said to Jim with a smile.

Jim was a timber faller and was used to hard work and working with men who worked hard and used their muscles. He finally cracked a smile.

I looked Foster over, checking everything before getting to his urinary tract. When I finally palpated his abdomen, Foster registered his discomfort. I could feel his bladder was pretty full, which would help get a urine sample. Then I could feel his prostate immediately behind his bladder, and I should not have been able to feel his prostate. This prostate gland was the size of a large grapefruit, and Foster groaned when I palpated it.

“Jim, his prostate is the size of a large grapefruit,” I said.

“That’s what my sister-in-law suspected,” Jim said. “She a vet over by Madras, you know. Do you think it is cancer?”

“I have only seen one case of prostate cancer in the dog,” I said. “Most of the time in an older intact male, it is a benign hypertrophy, along with an infection.”

“How do confirm that, and what do you do to treat it?” Jim asked.

“We play the odds a bit,” I said. “If it were to be cancer, he is probably a dead dog. We need to get a urine sample to look at and do a culture. We need to get an x-ray to make sure there aren’t any bladder stones involved and do some blood work to ensure his kidneys are okay. Then with some medication and neutering him, most of these guys clear up in a few days. Getting those testicles out of the picture is the important thing. I had one old dog about Foster’s age that belonged to an old man who couldn’t afford much. We neutered that dog and put him on some antibiotics, and he was well in a few days. His prostate was almost back to normal when I took the sutures out. When I neutered him, the infection in the prostate was extending down the spermatic cords all the way to the testicles.”

“Doc, you know I don’t want to neuter this dog,” Jim said. “Can it be done without neutering him?”

“It can be done,” I said. “But it won’t be as fast, and you will be back in here with the same problem sometime in the future.”

We did the diagnostics on Foster and sent a urine culture off to the laboratory. The x-rays show a massive prostate hanging over the brim of the pelvis. It was so large it was interfering with the colon even though it was mostly out of the pelvis.

I sent Foster home on medication and checked him back in a few days when we would have the culture results.

***

Foster bounced through the door for his recheck, and Jim followed with a smile on his face.

“He is feeling like his old self, Doc,” Jim said.

“That’s a good thing,” I said. “We cultured an E. coli out of his urine. Sometimes that can be serious, but our antibiotic we started him on was the correct one.”

I palpated his abdomen with Foster on the floor and did a rectal exam. 

“It’s not back to normal quite yet, but much smaller today,” I said to Jim.

“What do we do now?” Jim asked.

“Now we finish the antibiotics and then recheck a urine sample in a couple of weeks after they are through,” I said. “Then, if the urine is okay, it is just a matter of watchful waiting. It will happen again, maybe next month or next year, and you just have to be watchful and catch things early.”

***

Over the next year and a half, Foster was in for his prostate problem several times. It was always the same. Jim had learned to notice as soon as Foster’s urinary habits changed a bit. His prostate was always large, but never the size it was on his initial visit.

“Jim, you know, Foster isn’t getting any younger,” I said. “One of these episodes will run into some major issues with kidneys or something. We could bring this all to an end by neutering him.”

“Okay, Doc, let’s go ahead and neuter the old guy,” Jim said. “He has slowed down in his old age, and I would guess he won’t get much use out those things at this stage in his life.”

We scheduled Foster’s surgery for the following morning. I wanted to get it done before Jim had second thoughts.

Veterinarians do neuter surgeries on dogs often, maybe not every day, but certainly, every week. They are always cautioned against calling a surgery routine, but a neuter is almost a routine surgery for most veterinarians. But they rarely neuter an eleven-year-old large dog.

The procedure is the same, but the tissues are different. Squeezing the testicle and its tunic out of the scrotum in a young dog is no problem and takes little effort. That same testicular tunic in an old dog is solidly attached to the inside of the scrotum. It is a real struggle to free from its attachment. But I got it done.

Foster went home a new man, and when we checked him back for suture removal, his prostate gland palpated normally. And he lived out his life without another issue with that gland.

Photo by Matthis from Pexels.

Bill Sieg’s Celebration of Life

D. E. Larsen, DVM

Today we will be attending the celebration of life for Bill Sieg.

Bill was my second client when we moved to Sweet Home, calling for help with his poisoned dog before we had completed moving into our well stuffed two-bedroom apartment. He became a friend and a lifelong client.

Below find a link to his obituary in The New Era, Sweet Home’s weekly newspaper and links to a couple of my stories about Bill.

https://www.sweethomenews.com/story/2022/02/16/obituaries/charles-w-bill-sieg-sr/25409.html?fbclid=IwAR2sU1Ji0udBYKfOB3BDfa8WQwZyg-RWZx-l8vsRyZbfDZ056DmvyDEp0Gc

https://docsmemoirs.com/2020/05/06/a-strychnines-summer-evening/

https://docsmemoirs.com/2021/04/23/a-rush-to-judgement/

That Difficult Sample Collection 

D. E. Larsen, DVM

Gigi was resting on Betty’s lap when I entered the exam room. Gigi was probably a Chihuahua mix, and she was getting a little older, and she was now really overweight.

“Hi, Betty! How is Gigi doing this afternoon?” I asked. 

“She hasn’t been feeling very well the last couple of weeks,” Betty said. “And now she is starting to leave puddles on the floor. I noticed today, when I wiped up one of her puddles, that there was not a lot of color to her urine.”

“That sounds like there might be some problems,” I said. “Are these puddles small or large?”

“They are big puddles, and they seem to be occurring more frequently,” Betty said. “But you can see by looking at her, she hasn’t missed too many meals.”

“We are going to have to do some blood work to see what’s going on with Gigi,” I said.

“I am on a pretty strict budget for her,” Betty said. “Ralph is getting tired of putting up with her anyway, and then this morning, when he got up, he stepped in one of her puddles and almost fell. Needless to say, that didn’t do anything to endear her to him.”

“We are possibly looking at some kidney failure or diabetes,” I said. “At least, that is where we need to start looking.”

“Can you do that with just a urine sample?” Betty asked.

“Well, that would give a good glimpse at what is going on with her,” I said. “But Betty, I will be honest with you, collecting urine from an overweight female Chihuahua is probably one of the hardest sample collections we do. It is almost impossible to collect it with a needle without sedation. The minute we try that, when she is awake, she will become nothing but a snapping turtle with teeth. And any other method is just as difficult.”

“Can we collect it off the floor?” Debbie, my high school assistant, asked.

“That will work for this sample,” I said. “We can get a better sample later if we need it.”

“I think I can get your sample,” Debbie said as she scooped up Gigi from the exam table. “I’ll take her in the back. I’ll just be a minute.”

Debbie grabbed a syringe from the drawer and headed out the door.

“This might be interesting,” I said to Betty, who had a wry smile on her face.

Just as she said, Debbie returned after only a brief moment. She handed me a syringe of urine and set Gigi back on the exam table.

Betty smiled, “I see, one of the hardest collections you do,” she said.

We looked at Gigi’s urine. There was no glucose in the urine. The specific gravity was high enough that kidney failure was probably not the issue.

“Gigi’s urine looks like there might not be a major problem,” I said. “Have you changed her diet recently?” 

“As a matter of a fact, Ralph picked up a cheap bag of food at the store the other day,” Betty said. “Do you think that could do it?”

“I have seen that before,” I said. “If you’re on a limited budget, let’s change out the food to a prescription diet and watch her close for a few days. I will have Sandy give you an appointment for Friday, just to recheck her urine.”

“Will Debbie be here Friday?” Betty asked.

“You think I couldn’t get urine out of Gigi?” I asked with a smile.

“You said it would be hard, and she seemed to do it so easily,” Betty said. “Maybe you should be paying her more.”

“Maybe, I should watch her and learn how she accomplished the chore so fast,” I said. “But yes, we will make the appointment in the afternoon, and Debbie will be here.”

Betty went out the door with a small bag of Hill’s Prescription Diet W/D and instructions to put the cheap food in the garbage.

“Ralph won’t be happy with the price of this food,” Betty said.

“Have him add the office call fee to the cost of the cheap food, and he will think it is quite a bargain,” I said.

***

Betty came through the door on Friday afternoon carrying Gigi and with a broad smile on her face.

“I hope that smile means that Gigi is better,” Sandy said.

“The change in food solved the problem almost immediately,” Betty said. “But I thought I should still have her urine rechecked anyway.”

“I think that is all that Doctor wanted today,” Sandy said. “Let me see if Debbie can is available to get a sample.”

“That will be great,” Betty said. “I think she embarrassed Doctor Larsen on the last visit. Debbie got the urine sample in a few seconds, and Doctor Larsen had just told me how difficult it was going be to get urine out of my little fat dog.”

“Yes, I heard about it,” Sandy said. “And, you know, it takes quite a bit to embarrass the Doctor. Just a moment, and I’ll grab Debbie.”

I noticed as Debbie was carrying Gigi into the back of the clinic. I gave her a brief moment, then followed her back to the kennel room. The door was open, and I watched from as she set Gigi down in the middle of the room. 

She took a quick step toward Gigi, stomped her foot and clapped her hands, and said, “Gigi,” in a sharp voice. Gigi was startled, and she immediately squatted and peed on the floor. Debbie picked up Gigi and soothed her as she bent down and drew the urine into a syringe. 

She jumped a little when she turned around and saw me watching.

“It works almost every time,” Debbie said. “Is it okay to do it that way?”

“That is pretty inventive,” I said. “I think we will be alright as long as we do it back here in private.”

Gigi’s urine was back to normal. I suspect that cheap dog food has a lot of added salt to enhance the flavor. And Gigi loved the W/D food.

Over the next couple of years, Ralph would grumble about the price, and Betty would always remind him about the expense of his cheap food. Gigi even lost a few pounds on the new diet food. So much so that I no longer called her a little fat dog.

Photo by Lucas Pezeta from Pexels.