Advice Please - Has anyone come across a condition called Detrusor-Sphincter Reflex Dyssynergia

[julie madin]

My 13 month old Teddy has been diagnosed with the above by a process of ruling out everything else which is known to cause his issues by The Willows veterinary referral centre, Solihull.

His problems were urination related and he was seemingly getting infections one after another (infection symptoms but not proven infections but nevertheless he responded to antibiotics). This has been ongoing since March when he was 10 months. Another piece of information about Teddy which may or may not be related here is that he has one undescented testicle.

At times when he was likely to have a full bladder (first thing or after he had been left a while (once just 2 hours)) he has difficulty urinating. he starts with a good stream then has a stop/start pattern. then when he comes into the house and he is relaxed he passes urine walking around or just lying on his bed. When he leaks he licks himself which I am told can cause the infections. On Monday/Tuesday this week he had blood tests , urine cultures etc. scans and xrays of the bladder, kidneys, prostrate and urethra and everything appears normal. He stayed with them overnight and the vet took him out for his first we at 08.00 and saw the problem for herself. She says after 10 minutes outside and having cocked his leg numerous times when he returned to his kennel and lay down he flooded it. He also saw a neurologist to rule out trapped nerves etc.

Based on the above the diagnosed condition is basically poor coordination between the bladder muscles contracting to empty the bladder and the urethral muscles relaxing to allow urine to pass freely, which can be aggravated when the bladder becomes stretched (full). Although proving this problem is almost impossible. They have said he is not in pain but will feel uncomfortable when his flow of urine stops. We have been advised that the cause could be hormonal particularly as it only started when he reached 10 months.

Our options are to put him no a human drug called Phenoxybenzamine, whereby the known side effects are low blood pressure or have him castrated.

http://www.petplace.com/drug-library/phenoxybenzamine-dibenzyline/p...

 

We know we have to tackle the retained testicle sometime soon and The Willows think it unethical to leave one testicle remaining and would always castrate in these circumstances (i think they mean ongoing breeding issues). If he is going to have this op at least the Willows have recent xrays to show where the missing testicle is at this moment (im not sure if it moves around) and I think he would be in the right place for the operation should they find anything else.

Plus I dont really want to put him on meds maybe for life but it is hard to live with this urination problem as Teddy lives inside and has the run of the place and he is at risk of infections.

Should we remove the retained testicle and castrate now and only go to try the meds if this doesnt work.

If we do does anyone know of any supplements which would help his coat.

[Chantal McIlveen-Wright]

Julie I am so very sorry to hear that about your little man, poor him and poor you!!!

[colette tuite]

Sorry i have not come across this condition before. However , castration is not the only option re the retained testicle. I would ask the vets to just remove it . So he does not need to be castrated. Perhaps if you have the risk of him mating other animals have him castrated but it is not necessary. Some vets can now do keyhole surgery for this operation.This is less invasive than before.

[Philip Hall]

I do agree with Colette about just removing the retained testicle. Humphrey started life with a retained testical and did pass water on occasions, nothing like you describe. We were informed by our vet that they would not remove just the retained one but would only do a full castration. This was not acceptable to us so we took him to our old vet 40 miles away....we had just moved and needed to register with a local vet, he spent time explaining all the pro's and con's and then he left the decision to us. The removal of the retained testical was a great success and the urination stopped after about 3 weeks. We do check on the remaining testical just to make sure there is no abnormalities. Humphrey does seem to clean himself more than our Irish have but over the past 6 years plus he has had no infections since the op and mating is a definite NO NO.

To say that the removal of one retained testical is UNETHICAL is the biggest load of baloney I have ever heard.

I do hope all turns out well for the little man.

 

[eva ciechonska]

I agree with Phillip..........don't let your vet bully you into a full castration.  If he refuses to remove just the retained testicle then find a vet who will.  That should take care of your problem.......good luck

[Dawn Riddell]

Hi Julie, reading between the lines, it sounds possible that the retained testicle could be causing an obstruction around the area of the urethra. I'd be inclined to have the retained testicle removed and leave the decended one alone, therefor the coat issues wouldn't be aggravated.

 

 

Dawn R.

[julie madin]

I spoke on the phone to the vets yesterday. They say the retained testicle is in no way causing an obstruction so they feel has no bearing on teddys problems. They cannot say whether it is hormone related or not. It is unlikely but not impossibe particularly as the issue only started at 10 months old. They say the hormone levels will not be reduced by just removing the retained one. So whilst he needs thisremoved it wont help the urination problem. I didnt ask about their stance on removal of retained and then a trial chemical castration, I just didnt think of this. They seem to want to try the phenoxybenzamine but it scares me, he seems an immature dog in many ways not skinny, good bone and muscle but small (like a mini version) and weighs just 25kg. I have his litter brother (Jesse) and they weigh and look the same in terms of size. However both dogs started cocking their leg at just 10 weeks which was a shock

If you dont think me crazy (cos I think im going that way) im going to throw a side ball here and say....... the other dog seems to be showing signs of the same problems and the vets are aware of this but for now are just treating one dog (their decision). It happened just the once 2 weeks ago (coming back in house and immeditely wetting when relaxed). Took him to vets who did urine culture (nothing there) but gave antibiotics anyway. Since then I have been getting up with them both at 05;00 making sure they empty their bladder (which can take 30 mins of walking around garden). However what I am noticing now is that Jesse seems afraid to step on to the grass staying firmly on the patio by the house. I have to go to the other end of the garden and coax him to come for a cuddle then walk around looking at plants, basically ignoring him, hoping he will sniff and have a wee. Which he does but just a 2 sec wee which overnight I know is not emptyng his bladder, then he hop foots back to house as quick as he can. Of course im worried he will wet himself so this morning I had to get dressed and take him for a walk on the immediate farmers field - where he then acted normal (lots of wees and a poo) . Its almost like hes scared to go on the garden. Its definetly not a relationship issue between the boys they get on so well (see pics). It seems psycological  but could it be hormones. Unless something is coming onto the garden but then I would have thought the back field would have held more threatening smells.

One major thing is that the rest of the day they are fine.

Teddy is booked to have the retained testicle removed on Monday by the willows who want a decision on castration as well. Im really tired cant keep it up at my age . All I know is they were two happy boys and I dont understand what is happening here there have been no other changes in their life.

Please has anyone had issues like this? Could they be puberty related?

 

[Fran Griffin]

I agree with Sue. Go for the Suprelorin and see what happens.  Also look at his diet. Get him off dry food if  he is on it, and look at the BARF diet/RMB diet as dry food puts enormous pressure on the entire system.  It is dehydrated therefore I wouldn't consider dry food an option for a dog with urinary problems.

[Rosie Dudley]

Hello Julie, I think you need to take a step back and look at the big picture. Firstly the retained testicle has been declared unrelated to the urination issue and there is no urgency to have it removed, to allow the procedure go forward on Monday, will only give you more worry and is not going to resolve the real problem.

This article on retained testicles was In the 2003 ISAE Annual Review, You could ask your vet to read the original paper, most vets keep their BVA Journals or they can get a copy of the paper from the BVA the issue reference is in the article. This is a decision you can make at some time in the future, if your vet puts pressure on you they are not good vets.

I will however tell you of my own experience, I had a dog with one retained testicle and one descended. I was told it had to be removed but could be done when he was adult. I had it done when he was about 4, opting only to have the retained testicle removed. He went in at 8am and I was told he should be ready to go home at lunch time. At about 11am I rang to check when I could come to collect him, they said he was still a bit groggy and to ring back in a couple of hours, I rang back at regular intervals that afternoon with the same response, and at 6pm I just went to the surgery feeling concerned. They let me take him home but he could not stand, still with the effects of the anaesthetic. It took 3 days for this to wear off and for him to be normal again. I think I could have lost him and dreaded to think what might have happened had I had him operated on as a youngster. He lived a normal trouble free life with his good ball.

To return to the real issue, I think dogs do go through stages, I know of many show dogs who will not eat, drink or wee when they go to a show. I had a bitch once who did this, when we got home and in her own garden she would just be bursting and so relieved to be able to go.

Your boy may be going through a stage and you need to observe and try different things to overcome the problem. when you exersize dose he wee normally then? where do you notice he likes best to wee, perhaps a tree or maybe he's a lamp post boy. I would put a few logs or some tree clippings in a heap close to the path in your garden and let him see if it is suitable for him, just leave him in the garden on his own and don't let him see you watching, it could be inhibiting him.

I hope things get back to normal soon !

[julie madin]

Sue,

Thanks so much for taking the time and trouble to find this. Ive read it and I feel sick and numb. I know it doesnt mean its the end but its a big worry and maybe both brothers are affected. Ive had a bad time with losing setters over the last 2 years and these boys are my joy and were hopefully my happy future. Now........

[julie madin]

No Sue you havent upset me, sorry if my response gave that impression. But I am upset its recent news and I need to get my head around it. I guess in one way I was hoping it was hormones and he was just saving his wee to scent mark and after puberty he would be sorted. I just wanted at least their young life to be well as do we all. Do you know at what age a dog (setter) reaches sexual maturity?

Really Im very grateful for the document at least now I can read about it rather than just a brief conversation with a vet. Its like anything I have a raft of questions now I have come away. I did try to get in touch with her Friday but she was away. Questions like I know the urine sample was extracted by needle directly from the bladder but I spoke to a doctor this morning and he said its rare but what if he has Prostitis which is an infection after the bladder going down to the exit apparantly rare. This urine sample would not show this. He had a raging temp one day and that must have been something.  You see before going to the willows the antibiotics had scewed the urine tests. (he has been off them 10 days now). I will mention it on Monday but its tricky as some vets dont like you to come up with ideas once they have their mind set. It just seems strange to me that it could be both dogs whereas an infection would fit. Anyway no use in keep guessing I will now ask the question. Many thanks again 

[Howard Glansfield]

Julie,you must be worried sick.

Just to wish you and your dogs well and please let us know how things develop.

 

[Catherine Carter]

Hi Julie,
I am really sorry to read the above.....have you been in touch with the breeder of your boys? And if yes, what does he or she recommend?