written by brindle
Tigger has always seemed like he needed to drink and pee a lot. I was worried about this right from "Day One" when we brought him home from the SPCA and noticed how much he drank. I mentioned to the vet on his very first vet visit about 3 days after we got him - but the vet said not to worry, it was just because of the hot weather. I was still uneasy though. It made him very hard to housetrain and really tried our patience during those first few weeks. He needed to go out almost every 15 minutes or so!! And he just guzzled water. But we learned to sort of manage it so that was that. It was definitely a whole change of lifestyle because no matter what I was doing, I was thinking, "When was Tigger out last? Did I just see him head towards the door? Did I hear him drink any water lately?"
However, I got really worried when he starting having "accidents" IN HIS SLEEP. ie, he would not get up, whimper or anything at all, just leave a wet puddle behind afterwards. This worried me since I had read about other dogs having Urinary Tract Infections and having similar symptoms. After it happened about 3 times, we took him to the vet. He said there was no infection. So he got us to do "water deprivation tests" where we didn't give Tig any water for 10 hours or so and then get a urine sample. (We did it over night so it wasn't so hard on him, it just meant I would cut off his water earlier in the evening). Anyway, after doing these tests it seemed that no matter how little water Tigger drank, his urine was still about the same concentration (quite dilute). That meant that Tigger might have Diabetes Insipidus (DI). What this disease means, is that due to a lack of some hormone in his system (either because he can't produce it, central DI, or because his kidneys can't use it, renal DI) he is unable to concentrate his urine. The vet said that treatment for this could be given as eyedrops, BUT, it's really expensive at about $60/month, and it also only works if it's central DI. He also said that there were no real health risks so if we could live with occasional accidents, lots of water-drinking, and lots of peeing - things would be fine. So we talked about it, decided that we didn't want to spend $60/month if we could help it, and decided to manage the disease the way it was.
Now being the internet information junkie that I am, I started researching DI all over the place. I found out all sorts of stuff about it and also talked to other owners whose dogs have it, and other vets who have treated it. (our vet had only seen one other case ever, it's apparently quite rare). In my research I decided that Tigger must not really have it. The dogs I read about were much worse (ie, they couldn't even be let in the house because they dribbled constantly), the numbers for the urine concentration were much lower (about 1.002 or something instead of Tigger's 1.025 - that's a big difference for urine), and best of all, Tigger seemed to be better! He starting being able to hold it for the whole day while we were at work, he seemed a little less obsessed with drinking water, and he stopped having accidents all together. He hadn't had an accident in the house for about a month or more at the beginning of November (1998)!
HOWEVER.... the story isn't over. First of all, in my research I found out that the vet was partially wrong about related health risks. I read that a dog with DI is very prone to dehydration, since they must dilute their urine they will use up water that their cells need to do this. So even though I thought Tigger probably didn't have it, I was thinking of getting a 2nd opinion in case since I wanted to do the healthiest thing possible. And THEN, at the beginning of November, he started "dribbling". This never really happened before, I've seen it a few times when he was really excited and his bladder was really full, like when we get home after a long day at work. But it seemed like he was doing this for no apparent reason - like he was just out 1/2 hour ago, he's running around acting normal - but - he's leaving a trail of pee behind! It was very strange, annoying, and more along the lines of what you'd expect from a DI dog I think. So now I was starting to rethink my opinion that he didn't have the disease. And also rethink our strategy of just dealing with it instead of treating it! It was really a nuisance. So I decided to take him to a new vet, for a 2nd opinion, and to talk about the new dribbling problem.
The new vet agreed with my opinion that Tigger's case did not sound like DI. So she took him in for two full day tests, where she would not give him water, and measure his urine specific gravity once an hour. She had some surprising results, such as Tigger's specific gravity wavered around, getting more dilute and then more concentrated for no apparent reason (ie, with no water intake in between!). However, she did find that even after his body had become clinicly dehydrated his urine was still too dilute. This meant that he truly was having trouble concentrating his urine, and so therefore he did have Diabetes Insipidus. On the second day of tests, she wanted to determine if it was central (caused by a lack of the concentrating hormone) or renal (caused by a kidney problem) so she gave him an injection of desmopressin (DDAVP), the missing hormone. Then he finally produced concentrated urine. This meant that his kidneys were working fine and they could use the hormone, but his body wasn't producing enough. Therefore Tigger's diagnosis was central diabetes insipidus. We were happy about this since it meant that it could be treated.
There were still some wierd details: like the fact that Tigger CAN hold for all day (usually DI dogs can't) and that the concentration of his urine was much higher than usual for DI. And the strange wavering the vet saw in his specific gravity measurements. Therefore she modified his diagnosis to partial central diabetes insipidus - which really just means: "it's a strange case" and his symptoms are not as severe as usual with Diabetes Insipidus.
We got Tigger's prescription for DDAVP filled. It is a "person drug" so we got it from a normal drug store. It came in a spray format because in humans it is sprayed up the nose. The vet told us to spray it in Tigger's eye though, since dogs will sometimes sneeze it out if you put it up their nose. So, that's what we did for the first few days, and it seemed to work fine. However, around that time I got an e-mail from a woman I had talked to before, whose 9-year-old Malamute has DI. She told me that since giving him DDAVP drops in his eyes, his eyesight has deteriorated rapidly! Although he is pretty old, that is still quite a scary coincidence. For that reason, we really cut back on Tigger's medication (only giving it to him for special occasions, like going to visit other people's houses and not wanting him to dribble). We also started spraying it in his nose like it was meant to be in humans. We did not find that he sneezed it out, so that worked fine.
So... that's where we are as of December 1998.
UPDATE: February 16, 1999. - Tigger's medicine ran out in January. We got a new prescription... but we have not yet gotten it filled. I don't think we need to! Tigger has been doing great and has not had any accidents in the house since January 11. He still drinks and pees more than any "normal" dog I know, but since I am used to taking him outside often and always refilling the water bowl, it doesn't seem like a big deal. He sleeps through the night, holds it all day while we are at work, and has even started to whine sometimes when he needs to go out (as opposed to just peeing on the floor). So things are going really really well. My fingers are crossed that this continues!
UPDATE: June 21, 1999. - Tigger has not had a DI-related accident since the beginning of March! He is doing extremely well. For a while it seemed like he was on a one-month cycle where he would have a few "bad days" about once a month. Now it's been almost 4 months! We are still not using his medicine at all. We just pay extra attention to keeping water available at all times, and make sure to let him outside frequently. He is doing great!