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Polydipsia and Polyuria (excessive drinking and urinating) in Dogs

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  • "Nephrogenic" diabetes insipidus

    This disorder is a result of the kidney's inability to respond properly to anti-diuretic hormone, which normally facilitates water reabsorption in the kidney tubules. Usually this disorder is secondary to other problems (e.g. hypokalemia, hypercalcemia), but very rarely it can represent a congenital kidney defect (a problem present at birth). Treatment depends on the initiating cause or symptomatic treatment may be necessary when no underlying disorder can be identified.

  • Central diabetes insipidus

    This disorder is result of a deficiency of anti-diuretic hormone secretion from the pituitary gland at the base of the brain. It can be "idiopathic" (that is, of unknown cause), due to head trauma or due to a tumor in the pituitary gland. Water deprivation testing and response to anti-diuretic hormone administration confirm the diagnosis. A drug called DDAVP (a synthetic form of anti-diuretic hormone) is administered intra-nasally in drop form to treat central diabetes insipidus.

  • Hypoadrenocorticism

    This disorder is diagnosed by the adrenocorticotropin response tests (failure to respond). Treatment consists of intravenous fluids and replacement of missing steroid hormones.

  • Pyelonephritis

    This disorder can be difficult to diagnose because identification of urinary tract infection by urine culture and sensitivity does not localize the infection to the kidneys. Diagnosis requires integration of complete blood count results, urine culture and sensitivity results, contrast dye study of the kidney ("intravenous pyelogram" or "excretory urogram"), ultrasound of the kidney, and possibly kidney biopsy. Treatment requires long-term administration of antibiotics.

  • Psychogenic polydipsia (compulsive water drinking)

    This behavioral disorder is diagnosed on the basis of water deprivation testing after excluding other causes of polyuria and polydipsia. Most veterinarians perform gradual water deprivation to avoid confusion that can arise from loss of normal kidney concentrating ability that can arise simply as a result of longstanding polyuria ("renal medullary washout"). Treatment includes behavioral modification, gradual water restriction and occasionally drugs to counteract obsessive-compulsive behavior.

  • Iatrogenic ("caused by treatment")

    This cause of polyuria and polydipsia is managed by discontinuing the offending medical treatment.

  • Pyometra (uterine infection)

    This disorder is diagnosed based on history (i.e. older intact female dog), complete blood count, and abdominal X-rays or ultrasound. Treatment involves surgery to remove the infected uterus or occasionally prostaglandin type drugs to evacuate the uterus if it is open and draining.

  • Liver disease

    Diagnosed by serum biochemistry tests (including bile acids), abdominal ultrasound, and liver biopsy if necessary.

    Definitive therapy of polyuria and polyuria depends on the underlying cause.

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