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  1. #1
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    Default Help? Diabetes insipidus in dogs

    Well, crap. I'm hoping the COTH community can help me.

    Just got a call from one of my clients. Her 9 1/2 y o Vizsla has been drinking more H2O so she had bloodwork and urinalysis done. He had a urine specific gravity of 6 - normal is 16, she was told. Vet is running another test with results back tomorrow to help with diagnosis but suspects DI.

    Can anyone point me toward specialists, the latest treatments, or reliable info on this? Personal experiences, good and bad? We are in northern NJ, close to NYC, so Aminal Medical Center is a top option.

    Quincy is a spectacularly great dog. Loves kids, dogs, cats, everything but rain. Has had UTI issues in the last year. Not an easy keeper- always had trouble keeping weight on - he now eats homecooked proteins and sweet and regular potatoes plus premium canned food.

    I've known Q since he was a wee pup, and I've trained/exercised him 5 days a week since. He is a truly special boy, and I would like to point his owner to the latest info and hopefully towards some hope.

    Any info on diabetes in dogs appreciated for my Baa Baa Q.Thanks in advance.
    Last edited by lovey1121; Nov. 18, 2012 at 01:23 AM. Reason: spelling Vizsla
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  2. #2
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    Quote Originally Posted by lovey1121 View Post
    Well, crap. I'm hoping the COTH community can help me.

    Just got a call from one of my clients. Her 9 1/2 y o Visla has been drinking more H2O so she had bloodwork and urinalysis done. He had a urine specific gravity of 6 - normal is 16, she was told. Vet is running another test with results back tomorrow to help with diagnosis but suspects DI.

    Can anyone point me toward specialists, the latest treatments, or reliable info on this? Personal experiences, good and bad? We are in northern NJ, close to NYC, so Aminal Medical Center is a top option.

    Quincy is a spectacularly great dog. Loves kids, dogs, cats, everything but rain. Has had UTI issues in the last year. Not an easy keeper- always had trouble keeping weight on - he now eats homecooked proteins and sweet and regular potatoes plus premium canned food.

    I've known Q since he was a wee pup, and I've trained/exercised him 5 days a week since. He is a truly special boy, and I would like to point his owner to the latest info and hopefully towards some hope.

    Any info on diabetes in dogs appreciated for my Baa Baa Q.Thanks in advance.

    Jingles for Quincy.

    AMC is great. Diabetes Insipidus is frequently misdiagnosed (meaning diagnosed when its really not the active disease) by vets. Other more common diseases can mimik it. However, saying that I have known several dogs diagnosed with DI. A trip to AMC for a consult is warranted, and dont panic...they will be able to help Quincy

    Has your vet run any other tests to support the diagnosis? ADH levels? What about an ACTH stimulation test? How are his renal values?



  3. #3
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    Thanks so much for the quick response, Squish.

    MotherQ didn't know which test is being run today w/results tomorrow. I just got a text that she has an appt at AMC on Tuesday. So glad. We are lucky they are so close.

    I will pass what you wrote on to MotherQ.
    Last edited by lovey1121; Nov. 17, 2012 at 11:01 PM.
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  4. #4
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    I have a D.I. dog.

    What Squish said is spot on. There are SO many other things that can cause the excessive drinking of a dog that may not be diabetes insipidus. There's really no 'official' way to diagnose D.I., you simply have to rule out everything else first and then do a trial with desmopressin acetate which is the synthetic form of the hormone, which is an anti-diuretic, that D.I. dogs don't produce or the kidneys can't use..

    With my dog, we had to rule out diabetes mellitus, kidney disease, urinary tract infection, Cushing's disease, cancer, etc. The only thing that really was a red flag in all of his bloodwork and urinalysis was his urine specific gravity was 1.001. We ruled all of those out, did a water deprivation test (which came back with the exact same specific gravity of 1.001) did a 30 trial with the desmopressin and had great results for about 3 weeks, then the drug no longer worked. Did more testing, went to an internist for an ultrasound, and found that my dog, T.C., actually had Cushing's disease (though earlier tests ruled it out). We thought we'd found the problem.

    Did 6 months of playing around with Cushing's meds, got the Cushing's under control (cortisol finally within low normal limits), but water intake was still excessive. Specific gravity only improved to 1.010 on a good day. Once again, had to rule out urinary tract infection first...ruled that out, tried twice daily dosing of Cushing's meds, and concurred there was something else going on in addition to the Cushing's. Started another 30 days on the desmopressin and this time, with the Cushing's controlled, we've finally been able to control his water intake (and have controlled it since early August).

    Prior to diagnosing both the Cushing's and the D.I., T.C. was consuming approximately 150-180 oz of water each day (he weighs 55 pounds, so his water consumption should be in the 60-80 oz range). With the addition of the Cushing's meds, his water intake dropped to about 120 oz per day, and with the addition of the desmopressin, he now holds stead between 70-80 oz per day. He's on the smallest dose of the desmopressin (one drop once per day, though when he seems to be hanging at the water bowl a lot in the late afternoons, I often will give him a 2nd drop in the evenings)

    The desmopressin is EXPENSIVE. One tiny bottle costs me $125. I can get two months out of it on a tiny dose, but most dogs require 4-6 drops per day. I'm happy that I'm able to control him on the minimal dose, as his Cushing's meds aren't cheap either! He's lucky his mom loves him dearly.

    Many people choose not to treat the D.I. It's definitely not a death sentence. You simply MUST be sure that the dog has water 24/7 and limit their activity outdoors when it is especially hot and humid. A D.I. dog can dehydrate incredibly quickly. The issue with not treating, if you dog does have D.I., is that with the excessive water intake comes lots of urination...sometimes in the house if they can't hold it while the owner is out.

    There is some very good, user friendly, information at the website (though the individual who originally posted it all had a cat with D.I.):

    http://www.surroundedbycats.com/di-whatisit.html

    My dog has the Central D.I. type. Because he has pituitary based Cushing's disease, it sort of makes sense that with a pituitary tumor, his pituitary either isn't storing or isn't releasing the anti-diuretic hormone produced by his hypothalamus.

    All of that said, Diabetes Insipidus is pretty rare. It is often misdiagnosed because so many other diseases/conditions cause the exact same symptoms.
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  5. #5
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    Thanks, glfprncs. I copied your story in an email to MotherQ. It will help her prepare for what she's facing.

    Will update with a Q photo I'll take Monday when he runs with his peeps. He is one of the good ones, you know? He has this routine I call the Slide Flap & Scratch - when I come through the door and call him, he runs towards me, slides a few feet, flaps his ears LOUDLY, and scratches his collar. Every day like clockwork for 9+ years. A 9 year old puppy, that's "my" Q.
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  6. #6
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    t It is quite possible that Quincy is still dealing with a UTI. We checked his urine once for uti, but his internist wanted to.be certain and got a sterile sample by placing a needle.directly into his bladder and pulling the urine. His bladder was so distended at that time (as he wasn't treated for either the cushing's or the d.I. that you couldn't miss it). I would definitely rule that out before suspecting D.I. It just isn't that common. Also, Q is at that age when other senior issues tend to arise. If it hasn't been done already, I would bloodwork drawn and do a basic senior panel.
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  7. #7
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    Glfprncs, I know he has had numerous urinalyses done in the past year. We weren't seeing a noticeable increase in water consumption, just polyuria, until recently. I'll tell MotherQ about the sterile sampling. The good thing is she wasted no time getting him a Tuesday appt at the Animal Medical Center in Manhattan. They got me through a cancerous lower mandible and gave me my dog back, tongue always hanging out on that side due to removal of most of lower jaw, but he came home. Good vets are such a blessing.
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  8. #8
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    I don't know what exactly I'm dealing with in my 9.5mo male. He has increased water consumption/increased urination. Occasionally he'll soak the crate when he's left crated during the day for 2-3 hours. But he can go all night in his crate. Heck I can sleep in 11pm to 8am and he's ok in his crate. However he has soaked his crate at night 2x.

    We've run CBC's, tested cortisol levels (all normal) Normal ultrasound. Tested specific gravity on many diff urine samples. Did a 7 day drug trial with desmopressin. But honestly he has an accident about 2x a month maybe... if that. by accident I mean usually pees in the crate or in the house. So I don't see how a 7 day drug trial would show me any difference... unless it would have decreased his water consumption... But I have an extremely difficult time measuring his water due to the fact that there is another dog in the house and other humans who don't follow the protocol. My best guess is that he has 34 oz a day and he weighs 36lbs.... it isn't excessive but it is far more than the other dog, same breed 33lbs.

    He has free access to water in the house when out of the crate (and never crated more than 3 hrs at a time) he is crated at night. There is no water in his crates.....

    Stumped.


    glfprncs did you find the cushings from the u/s and not bloodwork?? Didn't understand that part of your post.



  9. #9
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    NRB...we ran his original senior bloodwork, and the main screeing for Cushing's is to look and see if their Alkaline Phosphotase is high. T.C.'s was only in the upper 300 range (above normal, but not in the usual 800-1200 range that vets usually see in Cushing's dogs). So, we assumed not Cushing's.

    After we ran the 4 week trial with the desmopressin (and got solid results for 3 weeks, but then the water intake increased dramatically), we ran another senior panel (with the same results) and the internist that my local vet was consulting suggested an Low dose dexamethazone test (to actually test for Cushing's). It actually came back positive for pituitary based Cushing's.

    The problem was that while we got his cortisol under control, the main symptom that I was seeing (the water intake and urination) wasn't changing at all. I was wondering at that point if he really did have Cushing's or if there was something else going on (i.e. cancer, etc.) that could be causing his cortisol levels to be high.

    We then went to the internist for the ultrasound and she was able to confirm that both of his adrenal glands were enlarged, but still peanut shaped, that all other internal organs looked good, and that he had a bit of 'sludge' in his pancreas (normal for a dog his age, but might need meds in the future). So, we had diagnosed the Cushing's, but the internist truly confirmed that was what we were dealing with. Since she had far more experience with Cushing's than my local vet, she worked with us for the next 6 months changing up dosages, going to twice per day dosing, and offering her thoughts/expertise on how to manage T.C.

    After 6 months of playing with his Cushing's meds, she felt we needed to do another trial with the desmopressin. Fortunately, that's what was needed and his symptoms have been successfully managed since August.
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  10. #10
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    Quote Originally Posted by NRB View Post

    So I don't see how a 7 day drug trial would show me any difference... unless it would have decreased his water consumption... But I have an extremely difficult time measuring his water due to the fact that there is another dog in the house and other humans who don't follow the protocol. My best guess is that he has 34 oz a day and he weighs 36lbs.... it isn't excessive but it is far more than the other dog, same breed 33lbs.

    He has free access to water in the house when out of the crate (and never crated more than 3 hrs at a time) he is crated at night. There is no water in his crates.....
    NRB...I have 3 dogs in my house, so my water measuring had to be as scientific as I could make it. One of my dogs does most of his drinking out of the guest bathroom commode (I guess he prefers his water to be cooler than the bowls in the kitchen), so he can skew the results a bit. However, I have two water bowls that sit in the kitchen. Each holds 8 cups of water or 64 oz, so 128 oz. combined. I measure my water during a 24 hour period.

    So, first thing in the morning, I fill both bowls to the top. As the day progressed, if the bowls ended up dry, I would add a specific amount of measured water into one of the bowls. I would then write down on a chart that I had taped to the kichen cabinet above the water bowls that I had added X oz. of water. The next morning, I would measure how much water was in the bowl.

    So, if I had started with 128 oz. in both bowls, but had to add 80oz. during the day, but there was 8 oz. left, I would say 128+80-8=200 oz.

    Both of the dogs that drink out of those bowls (remember, dog #3 prefers the toilet, so I don't count him in) weigh about the same weight, so they should drink approximately the same amount of water. So, 200 oz/2 dogs=100 oz. per water per dog. However, I knew that one of those dogs was drinking more than the other because of his medical issues.

    After I had a pretty good idea how much water the dogs drank on a daily basis, I began my desmopressin trial. I measured water every day over a 24 hour period. My husband knew that if he added water, he HAD to write it on the sheet above the water bowls.

    I saw an immediate response to the desompressin (like within 24 hours) that was seen in the measured intake of his water as well as how long he would stand there and pee outside. When T.C. was medicated (for both), he literally could urinate for 2 minutes straight without stopping. It was a deluge!

    I don't have the sheet in front of me anymore (I've been measuring water now since July and haven't kept the sheets from July-August--I now track it on my calendar since I don't have to add the water to the bowls anymore), but I noticed during the 2nd desmopressin trial (after we were able to control his cortisol), that we almost immediately went from 200 oz. of water per day to right around 120-150 oz. of water per day. I could then concur that the reason for the dramatic drop was that the D.I. dog was not drinking as much since the only thing that changed in my 'water experiment' was that T.C. was getting the anti-diuretic hormone.

    My dogs have free access of their water bowls during the day, but they sleep in the bedroom at night where there is no water. T.C. can make it through the night without having to go out to pee, but he can get pretty demanding in the late afternoons/evenings (which is when his Cushing's meds would be wearing off and his desmopressin would be out of his system). If he impersonates a camel at the water bowl excessively, or I find I have to add water to the bowl in the late afternoon, I give him a 2nd drop of the desmopressin.

    Today, my dogs (55 pounds each) drink right around 12-15 cups of water most days or 96-120 oz. of water depending on how warm it is and how active they've been.

    34 oz. of water for a 30ish pound dog doesn't sound abnormally high to me. From what I've read anything over about 1.35 oz. per pound of body weight would be considered excessive.
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  11. #11
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    NRB...were his urine specific gravities low? Also, have you checked for a urinary tract infection?
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  12. #12
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    Quote Originally Posted by NRB View Post
    I don't know what exactly I'm dealing with in my 9.5mo male. He has increased water consumption/increased urination. Occasionally he'll soak the crate when he's left crated during the day for 2-3 hours. But he can go all night in his crate. Heck I can sleep in 11pm to 8am and he's ok in his crate. However he has soaked his crate at night 2x.

    We've run CBC's, tested cortisol levels (all normal) Normal ultrasound. Tested specific gravity on many diff urine samples. Did a 7 day drug trial with desmopressin. But honestly he has an accident about 2x a month maybe... if that. by accident I mean usually pees in the crate or in the house. So I don't see how a 7 day drug trial would show me any difference... unless it would have decreased his water consumption... But I have an extremely difficult time measuring his water due to the fact that there is another dog in the house and other humans who don't follow the protocol. My best guess is that he has 34 oz a day and he weighs 36lbs.... it isn't excessive but it is far more than the other dog, same breed 33lbs.

    He has free access to water in the house when out of the crate (and never crated more than 3 hrs at a time) he is crated at night. There is no water in his crates.....

    Stumped.


    glfprncs did you find the cushings from the u/s and not bloodwork?? Didn't understand that part of your post.

    Hey NRB - just wondering what type of vet did your pups ultrasound? Had a dog come in last week with a very similar signalment/symptoms. Ended up having renal dysplasia (regular vet who ultrasounded didnt pick up on it). Just something to think about.

    Cushings can also be diagnosed through ultrasound if ACHT stimulation tests and low dose dex tests come back inconclusive. Sometimes tumors on the adrenal glands or adrenal hyperplasia causes cushings syndrome.



  13. #13
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    His drinking/peeing isn't excessive..... but it is higher and puzzling. I had originally approached this as a house-training issue.

    The specific gravity of the urine is low, I don't know the measurement. The vet would have told me over the phone but I don't remember anything unless it's written down and I can find the notes.

    The vet gave me a 2 page document on the top 25 things that cause excessive drinking/urination. And she's noted what we have tested for and what we have not. I can email it to anyone. But I'm clueless as to how to attach it to this post.

    The vet I've used so far is my local vet. There is a local specialist, in a new clinic. (year old clinic) My next step is obviously to go to them.

    I keep notes on the dogs behavior and have a 6 page word doc with all that info. Lol.

    For measuring water intake I spent one day crating and picking up/ putting down designated water bowls. So first thing in am, young dog comes out of his crate and I offer water from the white bowl I measure 24 oz and put into his bowl and start a log. (take up all water bowls in house and close toilet lids) the older dog is SOL for water for this 10 min start of the day. I then potty both dogs, crate the older dog with water and her food. Crate the young dog with food. 15 min later let both out and crate older dog with water. Leave young dog out with white bowl down. Then when I have to leave the house I let old dog out of crate, take up the crate water. Take up the white water bowl and put down a silver bowl. Young dog is crated without water. Come home let young dog out, let him drink from white bowl. Potty both dogs. Crate older dog with water in the crate. Take up her silver bowl and put down the young dogs white bowl. I add measured water to bowl when it's empty and log that in my notes.

    All this works well until my dd comes home from Kindergarten and then hubby comes home from work. I got to make dinner,feed dogs and inevitably the water bowls get mixed up. The old dog drinks from white bowl, the young dog drinks from silver bowl.

    At the end of the day I pour water left in bowl out and measure it. Do the subtraction and try to guestimate how much the young dog has drank from the older dogs bowl and get a totally wild guess at 34 oz.

    The reason I've been working at this angle is b/c the pup will occasionally pee all over itself in the crate, during the day. He's never been crated more than age appropriate.... or so I think. At age 9.5 mo he's only in there a MAX of 3 hrs. Sometimes he soaks the crate after 2 hrs. It's damn odd. Last pee occurrence was few weeks ago when hubby came home, let him out (dog did 2 small pees) then comes inside to get dog food, dog runs around kitchen peeing by the kitchen door , in front of stove, then on rug and in the crate. Hubby cleans up mess and feeds dog. I enter about 10 min later and take pup outside to pee and he does 2 very long pees......

    One day (Sept 4th) at the groomers he pee'd 7 times. Sometimes on her. During his grooming session.... it was the first time he got a full strip, but she said he was happy and comfortable with the hand stripping and that his coat came out very easily. She said he drank ALOT of water.

    My dog sitter has made same comments, (sept 1st weekend) that he drinks a ton of water to the point that she was concerned that my female wasn't drinking enough, lol.

    At this point his last crate soaking was on Sept 30th and the last accident in the house (mentioned above) was Oct 31st.

    Part of me wants to blame this on housetraining gone awry or his nerves (at the groomers) or excitement about getting fed (husband episode) But I've gone over all this with my vet and she feels it's not 100% normal. But it's not 100% a health crisis either.



  14. #14
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    I completely read 9.5 months as 9.5 years. Highly doubt at that age that you're dealing with Cushing's, as that is typically diagnosed in senior dogs.

    If you have the resources, I would systematically rule out those other items that can cause increased water intake. Alas, the water intake doesn't seek excessive to me. It is quite possible that it's an excitement/housetraining issue, but I honestly don't know what else to suggest.
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  15. #15
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    Actually...one more thought. Are you 100% certain that when the dog goes outside that he actually urinates? He may be so distracted by scents & sights outside that he may not be emptying his bladder, hence the accidents. I have one that I have to make sure he 'does his business' every morning because he's so excited about breakfast that he runs down the deck stairs and runs right back up without peeing. I have to send him back down to finish the job.
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  16. #16
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    Quote Originally Posted by glfprncs View Post
    Actually...one more thought. Are you 100% certain that when the dog goes outside that he actually urinates?
    Dog is always leashed when we go out for potty.

    doubt Cushings as well. Tested for Addisons, nope there.

    the u/s was of his kidneys..... confess I've no clue where adrenals are located....

    Agreed that 34 oz isn't excessive, but I really should measure every day. Second trip to groomer was today and no pee accidents with her. was there 6 hrs.

    Lovey1121 I hope to hear back from you, sorry I didn't mean to derail this thread... Just find out more info on DI. Fingers crossed for your clients dog.



  17. #17
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    A regular vet may not be able to determine subtle renal changes with ultrasound, best to go to a specialist for this if thats a real concern.
    Psychogenic polydipsia is certainly possible!! Frusterating for an owner, but the best diagnosis for the pet!



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