Diabetes insipidus in dogs is a rare condition which may cause excessive thirst and urination. Integrative veterinarian Dr. Julie Buzby explains what it is, signs to watch for, diagnosis, and treatment so you will know how to help and support your beloved pup.
You’ve probably heard of the term diabetes before. When diabetes is mentioned in conversation or in a television commercial, it often conjures thoughts about blood sugar, A1C, or a kindly mustachioed gentleman telling you where you can get your diabetes testing supplies.
However, not all cases of diabetes are the same. Everything listed above relates to diabetes mellitus, which leads to increased blood sugar. However, there is also another form of diabetes called diabetes insipidus. It affects both dogs and people but has very little to do with blood sugar.
What is diabetes insipidus in dogs?
Diabetes insipidus is a rare disorder involving antidiuretic hormone (ADH). Affected dogs will either stop producing sufficient ADH or their body will stop responding to ADH. This is a hormone that helps maintain water balance in the body by controlling how much water is lost in the urine. When ADH is released, the body conserves water, producing more concentrated urine.
However, because dogs with diabetes insipidus don’t make or can’t respond to ADH, they lose too much water in their urine. And they cannot conserve water or concentrate their urine appropriately.
Types of diabetes insipidus in dogs
There are two types of diabetes insipidus in dogs.
Central diabetes insipidus (CDI) is when the body is partially or completely deficient in the production and release of ADH. CDI tends to be an acquired disorder.
In nephrogenic diabetes insipidus (NDI), the kidneys do not respond to ADH, no matter how much is present in the body. NDI may be either an acquired or congenital (i.e. present from birth) problem. (As a side note, breeders should not breed dogs with congenital NDI because they could pass it on to the offspring.)
How does ADH affect the body?
Before we can discuss diabetes insipidus in more detail, let’s take a closer look at ADH. As mentioned, ADH helps to regulate water balance in the body. In short, ADH decreases the total amount of water lost through the kidneys, resulting in more concentrated urine. Its function is actually right in its name—anti-diuretic hormone. A diuretic is something that increases water loss, creating large amounts of dilute urine. So a hormone that is “antidiuretic” would have the opposite effect.
ADH comes from the pituitary gland
ADH is a product of the endocrine system. This network of multiple internal organs regulates the body’s metabolism, reproductive system, growth, and other biological processes. The pituitary gland is one of the most important elements of the endocrine system. It is a tiny, bean-shaped gland in the center of the brain that releases various hormones. These hormones are chemical messengers for different parts of the body.
The pituitary gland will release ADH when the water content of the blood is low. It does the same if the concentration of substances, such as salt or glucose, in the blood is too high. These are both situations where the body needs to hold onto water to restore fluid balance in the blood. Additionally, the pituitary may excrete ADH in response to anxiety, pain, or when certain drugs such as phenobarbital are present in the body.
ADH works on the kidneys
ADH binds to cell receptors in the tubules of the kidney. The job of those cells is to filter blood and reabsorb water. The kidneys do need to lose some amount of water to produce urine since it is a liquid. However, the presence of ADH causes special proteins called aquaporins to act like channels that transport water back into the kidney tissues. A healthy kidney cell receptor always responds to ADH in this manner.
What are the causes of diabetes insipidus?
When dogs have nephrogenic diabetes insipidus (NDI), they have normal levels of ADH in their body. However, the portion of the kidneys that concentrates urine cannot respond to ADH. As a result, the urine is dilute. Congenital NDI, where a dog is born with poorly functioning or absent ADH receptors, is extremely rare. Instead, the acquired version of NDI is the more likely culprit. Any of the following can cause NDI:
- Use of steroid (i.e. prednisone for dogs) or diuretic medications
- Infections (e.g. pyelonephritis in dogs or pyometra in dogs) or sepsis (injures the receptors that bind ADH in kidney tissue)
- Cushing’s disease in dogs (may also affect the release or function of ADH)
- Addison’s disease in dogs (causes low sodium in blood which decreases ability to concentrate urine)
- Diets that are deficient in protein
- Electrolyte disturbances—low potassium or hypercalcemia in dogs (elevated calcium) interfere with ADH receptors
- Kidney failure in dogs or liver disease in dogs
Dogs with central diabetes insipidus (CDI) have insufficient amounts of ADH. This results in dilute urine because the kidneys cannot reabsorb water. Since ADH is made and produced at the base of the brain, dogs with head trauma can develop diabetes insipidus. Similarly, dogs with blood clots in the brain and brain tumors in dogs (especially pituitary tumors) can eventually show signs of CDI.
And even though congenital CDI is rare, it is likely that puppies with poor brain development may be born with a malfunctioning pituitary gland.
What are the symptoms of diabetes insipidus in dogs?
As you can imagine based on the function of ADH, increased thirst in dogs and excessive urination are the most common signs of diabetes insipidus. We will look at those two symptoms in more detail soon, but first, it is important to understand the list of symptoms as a whole.
Overall, the symptoms of diabetes insipidus in dogs include:
- Significant increase in water consumption—It may feel like you are filling the water bowl every time you turn around or your dog is constantly drinking water. His or her thirst may seem insatiable.
- Significant increase in urine volume—Your dog may be asking to go outside more frequently and then will urinate for a much longer time than normal.
- Dilute urine—The stream of urine may look almost clear rather than yellowish.
- Accidents in the house or urinary incontinence in dogs—Due to the massive amount of urine he or she is producing, your dog may have accidents in the house if he or she can’t hold it anymore. Or your dog may dribble urine when resting or sleeping because the bladder is so full.
- Lack of appetite—Your dog may not be eating as well as usual.
- Weight loss—Sometimes you may notice your dog getting a bit thinner.
- Being a lethargic dog—Your dog may want to lay around or sleep rather than participating in his or her normal activities.
- Dehydrated appearance—Despite drinking a lot, your dog’s gums may be a bit dry or sticky or his or her eyes may appear slightly sunken. These are signs of dehydration.
Increased thirst and urination
Since increased thirst and urination are the primary signs of diabetes insipidus, let’s take a closer look at what this really means.
Dogs may vary a bit in how much they drink and urinate on any given day. In general, a dog who is consistently drinking more than 90 to 100 milliliters per kilogram of body weight per day is drinking too much. Similarly, a dog whose urination output is more than 50 milliliters per kilogram of body weight is urinating too much.
So as an example, if your dog weighs about 50 pounds, and he or she drinks more than two liters in a day or urinates more than one liter in a day, this may be cause for concern.
It doesn’t automatically mean your dog has diabetes insipidus, though. Many conditions can cause polyuria (i.e. increased urination) and polydipsia (i.e. increased drinking).
Safety note: If your dog does have polyuria and polydipsia, it is important to avoid limiting access to water. If water is only provided in small amounts, it can lead to elevated sodium levels in the blood (i.e. hypernatremia in dogs). This salt toxicity can cause neurologic signs such as depression, stumbling when walking, or may even lead to a coma.
How is diabetes insipidus diagnosed?
To reach a diagnosis of diabetes insipidus, your veterinarian may recommend several tests. Some of them can help rule out other conditions with similar symptoms. Others are useful for confirming the dog has diabetes insipidus.
Blood tests and urinalysis
Often, the vet will start with blood tests for dogs such as a complete blood cell count, blood chemistry, and electrolyte measurement. Plus, he or she may recommend a urinalysis.
Your vet may also want to submit a urine culture if he or she suspects a UTI in dogs. Or sometimes your dog may need specialized blood tests to confirm a diagnosis of Cushing’s disease or Addison’s disease.
Urine specific gravity
Your vet will also look at your dog’s urine specific gravity, which is part of a complete urinalysis. Also known as “spec grav” or USG, urine specific gravity measures the concentration of particles in urine.
Water has a specific gravity of 1.000. The higher the number, the more concentrated the urine ( i.e. 1.040 is more concentrated than 1.025). Normal urine concentrations are usually around 1.035 or higher while USGs below 1.012 are pretty dilute. Any USG below 1.008 is highly suggestive of diabetes insipidus.
Since concentrations can vary throughout the day, it is always best to use the first urine sample of the day when evaluating USG. Samples collected in the middle or end of the day are almost always more dilute. Your vet may recommend repeating a USG with first morning urine to make sure that the reading is accurate.
Modified water deprivation test
Veterinarians used to perform the modified water deprivation test to help diagnose diabetes insipidus. The test involves a gradual reduction of water intake over a four day time period. Then water is withheld and the veterinary team carefully monitors USG, hydration status, body weight, and other parameters.
If the dog demonstrates he or she can concentrate the urine to a USG of 1.030 or higher, this rules out diabetes insipidus. If not, diabetes insipidus is likely.
However, this test has fallen out of favor with some vets. Limiting the water intake of a dog with CDI or NDI can cause terrible neurologic signs due to rising levels of sodium in the blood.
Desmopressin trial
Some veterinarians will skip the water deprivation test and go straight to treating with a medication called desmopressin, which mimics the actions of ADH.
With a desmopressin trial, the dog parent measures water intake for three days to establish a baseline. The dog parent will also collect urine at the same time every day. Then the dog will start receiving desmopressin. The dog parents will continue to measure water intake and collect urine samples. The veterinarian will analyze the USG, and sodium, glucose, and urea concentrations in the urine.
Patients with CDI usually show dramatic improvement in water consumption and urine concentration. However, since NDI patients have problems with the ADH receptor function, desmopressin won’t help.
What is the treatment for diabetes insipidus?
After reaching a diagnosis, your vet will develop a treatment plan based on the type of diabetes insipidus your dog has and your dog’s symptom severeity.
Treatment for nephrogenic diabetes insipidus (NDI)
There is no definitive treatment for congenital NDI. Treatment for acquired NDI focuses on addressing the underlying cause. For example, if the vet treats a kidney infection quickly and aggressively, the kidney tissue can become healthy again and may start responding to ADH.
Most NDI patients may not respond to therapy. But thiazide diuretic medications such as hydrochlorothiazide or chlorothiazide may help decrease urine amounts. It sounds counterintuitive to treat diabetes insipidus with a diuretic. However, it is effective in some cases because it helps the kidneys retain more water independent of the action of ADH.
Treatment for central diabetes insipidus (CDI)
Dogs with partial CDI (i.e. lower ADH production than normal) may make enough ADH that they do not need specific treatment. Having some ADH may make their clinical symptoms more manageable compared to dogs with complete CDI.
Otherwise, the main treatment of CDI is desmopressin acetate, a synthetic version of ADH. It is available in a liquid form which you can put into your dog’s nostrils or under his or her eyelids. Oral tablets are also available if these methods prove difficult to pursue long term. Most dogs respond well to this therapy.
Note: It is not required you treat CDI. Some dogs can do fine without treatment as long as they always have free access to water and can get outside to urinate (or use a pee pad or litter box) whenever they need to.
Low sodium diet and unrestricted water access
Additionally, as part of the treatment of diabetes insipidus (NDI or CDI), it is important to feed a low-sodium diet and to avoid treats that provide excess salt like rawhide treats.
It is also extremely important that no one withholds water from your dog. This could be very dangerous for your canine companion.
What is the life expectancy for dogs with diabetes insipidus?
If your dog’s NDI is the reversible type, it should not significantly impact your dog’s life expectancy. However, dogs with irreversible NDI often have a worse outlook than dogs with CDI. This is because NDI is more difficult to treat since these dogs don’t respond to desmopressin. The underlying cause of the NDI can also impact life expectancy. Some of the conditions on the list are more treatable than others.
While CDI is typically not reversible, these dogs may still have a good prognosis with desmopressin therapy and other management options. The exception to this is dogs who have CDI due to a pituitary tumor.
No matter whether your dog has NDI or CDI, you can help him or her by always providing access to fresh water. You should also give him or her lots of chances to go outside to urinate. Monitor your pup closely, paying special attention to water intake, and ensure that you report any changes to your vet promptly.
Sometimes dog parents may wonder about the connection between diabetes mellitus and other conditions like Cushing’s disease or diabetes mellitus. If this sounds like you, keep reading to find out the answers.
Diabetes insipidus and Cushing’s disease in dogs
Dogs with Cushing’s disease (i.e. an over production of steroid hormones) can present with symptoms that are very similar to diabetes insipidus. This includes an increase in thirst and an increase in urination. Some dogs with these symptoms just have Cushing’s disease.
However, it is possible for diabetes insipidus to occur secondary to Cushing’s disease. The elevated levels of steroids can interfere with the release of ADH from the pituitary gland. Also, excess steroids in the blood can interfere with how ADH binds at the receptors in the kidneys.
The good news is that getting a dog’s Cushing’s disease under control may help improve the signs associated with diabetes insipidus.
Diabetes insipidus vs. diabetes mellitus
On the other hand, diabetes insipidus and diabetes mellitus are two unrelated conditions that are unlikely to happen at the same time. They primarily share the first name “diabetes” and the common clinical signs of increased thirst and urination.
Diabetes mellitus (diabetes in dogs) occurs when the dog’s body either doesn’t make enough insulin or doesn’t respond correctly to insulin. This causes abnormally high levels of glucose (i.e. sugar) in the dog’s blood because insulin’s job is to cause the cells to take up glucose from the blood. It is still an endocrine disease, but the deficiency is in a different hormone with a different function.
Interestingly, the names for the two types of diabetes came from how the urine tastes (not that I am advocating you taste your dog’s urine). The term mellitus comes from the Latin word for “sweet.” This makes sense since dogs with diabetes mellitus typically have elevated levels of glucose (i.e. sugar) in their blood or urine.
The term insipidus is the Latin word for “tasteless” or insipid. Because the urine of dogs with ADH is very dilute, it is practically like water, which doesn’t have much of a taste.
Final thoughts on diabetes insipidus in dogs
Diabetes insipidus can be an incredibly frustrating illness for everyone. It is hard to watch your furry friend do nothing but drink and drink! If you notice these signs, ensure you get your pup to his or her vet. If you have time before the appointment, try to determine how much your dog is drinking. And consider bringing a first morning urine sample in to the appointment so your vet can check the USG.
Finally, and I can’t stress this enough, ensure your dog has free access to water all the time.
Together, you and your vet can get to the bottom of the increased thirst and urination. If the answer is diabetes insipidus, hopefully some medications and/or management changes can help get your dog’s face out of the water dish and back into enjoying time with you! But even if your dog doesn’t respond well to treatment, you can still make some good memories together.
Do you have a dog with diabetes insipidus?
Please comment below.
My golden retriever was diagnosed with diabetes insipidious at the age of 5 after drinking out of the toilet bowls constantly and having some indoor accidents. She passed at 16 years old last year. She just had to take desmopressin twice a day, every day.
Hi Janet,
I am so glad your girl was able to live a long and happy life despite having DI. Thank you for sharing your experience with us. This will definitely offer hope to others as they face this difficult diagnosis in their own dogs. ♥
I have an American Eskimo female, approximately 9 years old, whom I adopted after she had been used as a puppy mill breeder mom for the first 6 years of her life. She is very active and can be very excitable and anxious when I’m not around. I noticed her having accidents in the house when she was anticipating my arrival, and even though I make sure she urinates every couple of hours, she still sometimes has accidents. I took her to my vet because I was concerned that she might have DM (as my last American Eskimo did), but her bloodwork/urinalysis were perfect, with the exception of a USG of 1.005 (urine obtained by cystocentesis). We have been having pretty hot weather, and I’d say she is drinking more than in the past, but it doesn’t seem excessive. I have 2 other dogs and a cat with kidney failure, so measuring the amount of water she drinks is impossible.
In your experience, is CDI something that worsens with time? Or is it fairly stable? My vet brought up the possibility of DI, and wants to do the water deprivation test, but especially at this time of year, it sounds cruel to me! I’m a former vet tech, so I bought my own refractometer and have been measuring her morning urine. It has been 1.025 after at least 8 hours of sleep (and she doesn’t ask to go out in the middle of the night). I know that the desired level of concentration is > 1.030, but at least the 1.025 is showing that she IS concentrating to some extent, right? How worried should I be? Can you think of any other reason she might have low USG? And do you think a desmopressin trial is warranted (if I can get my vet to approve)?
She is spayed (at age 6), and I also considered bladder sphincter insufficiency, but she doesn’t leak – just pees when excited and running around waiting for me.
Thanks for any insights!
Dear Rebecca,
I am sorry your girl is having these ongoing issues with inappropriate urination/leaking. Without examining her myself, it is hard to make specific conclusions, but this definitely does not sound like DI to me. Maybe it would be worth a trial course of medication for incontinence (bladder sphincter insufficiency)? I know it is best to rule out medical causes first, but I wonder if this is truly behavioral. Anxiety could be contributing to this situation. Have you thought about using any calming supplements or products? If nothing else works, you can always request a consultation with a specialist. Hoping for clear answers and an easy solution. Best wishes to you and your sweet girl.
Thank you, Dr. Buzby. I’m happy to say that the situation has pretty much resolved since the weather cooled off and she’s not drinking as much. And I agree with you that it’s probably behavioral. Rescued mill mommas are special creatures – who knows what they had to put up with for years!
Hi Rebecca,
So glad to hear things have improved! Your girl is lucky to have you taking such good care of her and advocating for her well-being. Wishing you both continued success and many happy days ahead!
Our 1-year old English Setter, Colby has well managed CDI with desmopressin. This week, he had a major emergency, where he had a large amount of sudden diarrhea followed by collapse and stupor. We rushed him to the vet and they were able to revive him very quickly. We moved forward with bloodwork to test for Addison’s as he presented like a dog in Addisonian Crisis. The bloodwork came back negative for Addison’s and he is recovering well from the incident. Any thoughts about what may have happened? Could this event be related to his D.I.? Did he dehydrate quickly and shock his poor body? We’re baffled.
Dear Shannon,
I am so sorry Colby endured this scary episode a few weeks ago. What a blessing the ER vet was able to act quickly and revive him! I honestly have no idea what could have caused this event. I know it is hard to be left with more questions than answers. Hoping you will never have to experience this again and wishing Colby all the best for many happy years to come.
Hello. My grandog who is 16 years old has diabetes insipitis, and Idk which kind. I am watching him for my daughter right now but when she had him. she limited his water because of his incontinence. I’m not limiting it and he our dog looks much better. However of course this means he is urinating like crazy, which my daughter doesn’t want to deal with and talks of having him euthanized because of it. I don’t think that’s right. Our dog is on desmopressin. Does the fact that he’s on ADH, if that’s correct, mean that you can give less water or does that not matter? I assume it does not, but I wanted to make sure. Do you have ANY tips for feeding or for dealing with all the urine. Lex, our dog, often can’t make it out the door without urinating. But I love my dear boy a lot, who is technically my daughters dog, so I will keep fighting for him, to the extent that I can. Where I rent I can’t have dogs. I think his quality of life is good and I give him lots of attention, but my daughter and her husband ignore him. After 16 years! This certainly contributes to his quality of life. And he has to live in a hallway that is fenced off. He is on a wet mat under his blanket. The blankets of course get soaked. Is there ANYTHING that will cut down his urinating, so my daughter may decide to keep him? Or ANY ways to make cleaning easier. where we are now there are three sets of concrete stairs to outside. My daughter’s new house has 0 to few. Anyway, I digress. Thank you very much for any advice you may be able to give. Oh I forgot to mention that I tried him on Proin but it didn’t seem to make a difference, and he started panting in the air conditioning so I just took him off of it. One more question would steroids or anything else help him. Thank you so much.
Kate Davis
Dear Kate,
I am sorry you are facing this difficult situation with your daughter and her dog. Even with taking desmopressin, I would not recommend limiting water intake. If the symptoms are still severe even with treatment, it is possible his DI is nephrogenic and not central and therefore would not respond to the medication. Have you tried using diapers or male wraps to keep the cleaning to a minimum? Other than that, I am not sure I have any great additional advice. You could discuss the use of a diuretic with your vet, but it may not be as helpful as we would hope. Hoping you can find a way to offer your grandpup a better quality of life. Praying for strength and clarity as you navigate this tough path.
About a year ago my miniature poodle, Dewey, was diagnosed with Cushings and was put on Veterol. His original symptoms were weight loss, hair loss, calcified skin and lesions, excessive thirst and urination. The Veterol, as far as lab tests go, has his Cushings under control. However, none of his symptoms have gone away, in fact are worse. He is now down to seven pounds (he was at 10 to begin with). His appetite has diminished even more, his thirst is much worse to the point that all he does is drink and pee. I am wondering if he has diabetes insipidous? He has had so many tests and I can no longer pay for more. Is it possible for my vet to try the medication for DI without more tests? I am at my wits end and yes he is fifteen but I think would be happy and active if we could get this condition under control. My vet at this point says he can’t think of any thing else it could be,.And also reminds me of Deweys age. I have been rescuing senior dogs for many years and understand when it is just old age, but I don’t think it is in Deweys case. I feel bad that these expensive drugs are not doing anything to make him feel any better after all this time.. But now that I have read about Cushings and DI related problems I am going to ask him about it. Any suggestions would be appreciated. I am desperate!
Hi Molly,
I understand your concern for Dewey as he is dealing with these worrisome symptoms. He is a lucky boy to have you advocating for his health and well-being and searching for answers. If his quality of life is being diminished and you are facing the decision to say goodbye, then I would definitely give desmopressin a trial run. I don’t think the risks outweigh the possible benefits in this situation. You can also ask for a consultation with an internal medicine specialist if needed. Hoping you can find a way to offer him more quality time. Wishing you both the best and feel free to keep us updated on how things are going.
I have a beagle boxer mix, Piper, that is now 13 years old and within the last 2 years she has begun to drink excessively, to the point she has frequent accidents in the house daily and many times urinating while asleep and staining her fur. She would rather drink than eat or go out in the morning and actually figured out how to lift the toilet lid in desperation to get to water while we were away at work (she already drank all the water provided for herself and 3 other dogs). She has muscle wasting and increased shedding (she’s quite furry) we did gain a bit of weight back in the last few months. I’ve had her tested for Cushings 3 separate times. My vet finally came to the conclusion that she has Diabetes Insipidus and we tried Proin ER and Hydrochlorothiazide and neither seems to help her at all. Still constantly thirsty and she has become withdrawn and anxious. Always checking her bowl for more and more water. My question is am I being selfish by making her go through all this? Am I prolonging her suffering? I’m beginning to feel it’s time to just let her go and rest.
Dear Debra,
I am sorry you are facing this difficult situation with your senior girl. I understand your concern for Piper’s health and well-being and think it is good you are searching for answers. I would strongly recommend you talk to your vet about a trial of desmopressin. This is truly the best treatment for diabetes insipidus if the problem lies within the brain. It does sound like her quality of life has been diminished due to this terrible disease. If her symptoms cannot be controlled and Piper can’t get some relief, then saying goodbye may be the most loving option. Praying for strength to face each new day and for clarity in your decision making. Bless you and your sweet girl.
Hello there from the UK. I found your page whilst researching DI as my vet has diagnosed this. My Border Terrier, Stanley, who is 13 has been drinking huge amounts of water for two years now. It seemed to have been brought on by stress when I was having a new kitchen fitted. 2 years ago he underwent a lot of testing (including Cushings which came back negative) and at the time, they suspected DI but advised me to manage the symptoms. He did actually calm down a little when the kitchen was finished and we have been doing okay, always with water available and frequent opportunities to pee, up to about 2 months ago when I noticed he had bald patches appearing (where is collar/harness would be, and other pressure points, like his joints, it seems to be thinning too) the drinking and urinating started to get too difficult to live with so we went back to the vets. He’s been tested again, this time around they were thinking thyroid issues but these came back normal too. They have landed on DI and prescribed desmopressin as a trial. Currently having issues giving him his meds so I’m unsure if it’s working or not, I think it may be, I’ve been given a nasal spray and after a couple of doses he’s got wise to me and now I have to enlist help of friends and neighbours to administer it! I don’t think he quite gets the full dose. I feel the little amount he’s had may work but wears off a bit too quickly so he’s not getting enough. My question is this. I think he has other symptoms that, to me, sound like Cushings. He’s gained weight, from 8kg to 8.75kg since he was last weight in Nov 23. He pants a lot has the hair loss, he’s not pot-bellied but looks like it could be starting, he’s hungry all the time – looking for breakfast the second he stirs – sometimes it’s his priority before even going out for a wee when he’s desperate to. Can these symptoms be anything related to DI? I haven’t read that these as common symptoms for DI. Should I be pushing for another cushings test? He only had a basic test for standard Cushings, and not A-typical Cushings, two years ago. Thanks in advance for any help.
Hi Suzanne,
I understand your concern for Stanley and think he is lucky to have you advocating for his health and well-being. From what you describe, I too am suspicious of Cushing’s disease. Sometimes the test can be negative if done too early in the disease process. I do think it would be worth repeating the testing and see if anything has changed. Hoping for answers and a clear path forward with treatment. Wishing you and Stanley all the best for many happy days ahead.
Thank you for your speedy response. I will make a firm request when I see the vet Thursday. I’ll let you know how I get on.
My 13-yo shorty jack Russell terrier was diagnosed with DI a couple months ago. The treatment plan was 0.2 mg of desmopressin, 1/2 tablet every 8 hours to help concentrate his urine. The dosage made him sick for the first couple days (nausea/vomiting) so I reduced the dosage to 1/4 tablet 2x daily. This seemed to control the excessive thirst and urination for almost 2 months but now Milo seems to be drinking more water again and having peeing accidents. My question is this: is desmopressin a med that dogs can learn to tolerate so that I can slowly increase the dosage, so as not to make him nauseous but better control his symptoms?
Hi Tami,
I am sorry Milo is battling this difficult disease. What a blessing your vet was able to get a definitive diagnosis and start treatment. I am not aware of desmopressin becoming less effective with prolonged use, but it is definitely a possibility! My recommendation would be to discuss your concerns with your vet. Every drug has a maximum dosage limit, and your vet can let you know what the maximum dose is for Milo. This way you will know how much wiggle room you have with adjusting his medication. Also, I would make sure to keep your vet in the loop and let them make the call when deciding to increase the dose so they can monitor for any negative side effects and stay on top of the case details. Wishing you continued success and many happy days ahead. Keep up the good work!
Hi Dr. Buzby,
I have a 12 or 13 year old Cattle Dog. I adopted her years ago and they were unsure how old she was. She was diagnosed with CDI almost a year ago. Other than this she is healthy, happy and active. We walk a mile daily and she eats raw food. I’ve had her on Desmopressin and started her on one tablet 2x a day. I find that every 3 months I have to increase her dosage. One day she’ll be thirsty and start having accidents in the house. I’m up to 2 tablets 2x a day and it looks like I have to increase again. I normally increase by a 1/2 tablet at a time. I’m curious if you have ever experienced this.
Sincerely,
Nicky
Hi Nicky,
I am sorry your girl is living with this difficult diagnosis, but it sounds like you are doing a great job taking care of her. I have not personally had a patient that consistently needed their dosage to be adjusted like this, but I suspect this is more common than we realize. My only word of caution is to make sure your vet is kept up to date about these medication changes. I am not aware of what the maximum allowed dosage is for Desmopressin, but you would need to ensure you keep it below this level. Wishing you all the best for continued success and happiness. Bless you and your sweet girl.
Thank you so much for your response Dr. Buzby. I appreciate it. I’ll definitely get her back in to see him.
I think I speak for everyone, it is nice to have another opinion and sounding board and someone who cares. I think that this is a rare condition.
With much appreciation,
Nicky
Hi Nicky,
Thank you for the kind words! I hope this blog is a space where we can encourage each other and offer support. How is your girl doing? Is her current desmopressin dosage still working well? Feel free to leave an update anytime you like. I’ll be keeping you both in my thoughts. ♥
Hi! My 10 year old Dogo Argentino has been recently diagnosed with DI and is responding to Desmopressin treatment very well. She also has a lot of symptoms of Cushing’s disease, dry skin, hair loss down the sides/belly/tail. Increase appetite, pot belly, panting a lot, lethargic most of the time. She had an abdominal ultrasound which was normal, blood test showed high ALP, high GGT, high cholesterol, high bilirubin and high creatine kinase. All of the tests were done before the DI diagnosis, my question is can she have DI and also Cushing’s disease at the same time or could the DI been misdiagnosed? Thank you!
Hi Daniel,
I am sorry it seems as though your senior girl is battling both of these difficult diseases at the same time. While Cushing’s can sometimes contribute to the development of DI, this type of DI is usually not responsive to desmopressin therapy. The fact that your pup has shown improvement with desmopressin is confirmation that the DI diagnosis is not a mistake. It may be a good idea to ask for a referral to an internal medicine specialist. They have tons of experience with complicated cases and may be able to offer guidance and advice on how to navigate this unknown path. Hoping you can get the answers you need to find a clear way forward. Wishing you and your sweet girl all the best.
Hi,
Our 5 year old dog has always drunk and peed so much. After tests vet suspects DI.
We don’t mind taking him out to pee and giving him water. What if we weren’t to give him medication? Would our dog’s health worsen or lead to complications? Dog doesn’t seem to suffer at all ATM. Also wondering about life expectancy with DI if left untreated.
Thanks so much!
Hi Carla,
I honestly wasn’t sure how to answer these questions, so I did a bit of research. It seems as though dogs with DI can do fairly well without treatment as long as they have unlimited access to water. The biggest risk is that they drink so much water they start to suppress their appetite and then end up losing weight. So as long as your boy can keep up with his food intake, he should be ok. I did not see any information on how this would affect life expectancy. Hopefully that means your pup has many happy years ahead. Thank you for bringing up these great questions. Best wishes and good luck!
i have a 3.5yr old labrador who until 4 months ago was healthy, fit and athletic. However in the autumn his appetite suddenly increased, he put on weight and became very lethargic. Our vet carried out a full blood test and upon receipt of results stated he had hypothyroidism. He was prescribed thyforon.
A few days after starting on the thyforon his thirst and need to pee suddenly increased. Our vet said this was normal ie thyforon can increase thirst. Unfortunately this continued for a number of days and a number of phone calls from me to my vet before another vet at the clinic asked to see him. He said to stop the thyforon as he believed the hypothyroidism was a secondary condition. He suspected diabetes insipidus. Further blood tests were carried out – plus urine culture tests, adrenal/kidney scan, water deprivation test and desmopressin test. Both Cushings and Addison’s were ruled out. The scan was normal and there were no indicators of other conditions. It was concluded he has central DI and has been on desmopressin tablets since. This instantly resolved the thirst and need to pee symptoms. However he is not the same dog out on a walk. His energy levels although improved from what they were from when he first became poorly are nowhere near what they used to be. He’s no longer interested in playing with other dogs and will only occasionally chase after his ball. Could he still have secondary hypothyroidism or is this how dogs diagnosed with central DI are? Thank you for any advice you may have.
Hi Anita,
I understand your concern for your young Lab. I am sorry he is having these ongoing issues with lethargy despite treatment for the DI. I would suspect this is still related to his diagnosis but without playing a personal role in his medical care, I can’t make specific conclusions. To be honest I do not have much personal experience with DI as it is somewhat rare. It is common for some endocrine diseases (such as DI) to cause the thyroid level to appear abnormal on lab work even though there is not an issue with the thyroid itself. Some medications can cause this as well. If the DI is causing your dog’s thyroid to appear decreased, then I would suspect it to remain this way. Decreases in thyroid levels secondary to a disease or medication do not need to be treated with thyroid supplementation. It sounds like your vet is on the right track, especially since you have seen an improvement in your boy’s symptoms since starting the desmopressin. Hoping he will continue to improve and praying for a full happy life for your sweet boy. Best wishes and take care!
My 11 year old golden was diagnosed with CDI in April of 2023 (when he was 10). The Desmopressin worked amazingly on him. Two months after we started the Desmopressin though, I started seeing signs of depression and lethargy but exams were normal. Fast forward to Feb 2024 he has progressively gotten more and more lethargic and depressed, and is now showing cognitive issues such as neurological tremors and disorientation, walking close to the wall. His physical exams, X-rays and US are all normal. We are wondering if it could be the Desmopressin that has caused this in him, as the timing matches up. Our other concern is that we misdiagnosed him and the Desmopressin is just masking the symptoms while some other condition is continuing to affect him without treatment. Can Desmopressin cause these symptoms? And does Desmopressin only work for dogs with CDI or is it possible that it would work well on the PU/PD symptoms even if he did not actually have DI?
Hi Ellen,
I am sorry your senior guy is experiencing these worrisome symptoms. I have never seen Desmopressin cause these types of issues and I could not find any reference to a similar situation when doing some quick research after reading your comment. Since the Desmopressin initially worked so well, I am almost certain your vet made the correct diagnosis and would not be concerned about other causes for the PU/PD. I am suspicious that what you are describing may be symptoms of dementia or cognitive dysfunction and that the timing of onset was coincidentally close to when the CDI diagnosis was made, but not necessarily related. I will attach links to other articles with more information and great advice from other readers. Hoping you can find the answers you need to ensure your boy remains happy and comfortable for as long as possible. Best wishes to you both!
1. Signs of Dementia in Dogs: Stages, Symptoms & Treatment
2. Canine Cognitive Dysfunction in Dogs: Signs, Symptoms, Solutions
My 2yr old dog just finished with her 3rd uti in less than a year. She has a recessed vulva and vet recommended the area be cleaned daily. This last uti, her urine results came back with very low sug and her vulva area is clean. He says possible DI, but she has no symptoms of DI, would it still be possible? Also, before her 1st uti diagnosis, she absolutely stopped drinking water. I can get her to drink it, but she needs some other liquid in it in order to drink it, so it’s never plain. Vet is stumped, I’m confused and I don’t know how to get her to drink it alone. I have tried several water fountains, several water bowls, even placing them in different rooms of my house and she looks at water like it’s contaminated.
Hi Sherri,
I understand why this situation has you worried and confused. Without examining your dog, myself, it is hard to make specific conclusions, but this does not sound like diabetes insipidus to me. It is possible your dog could have DI as not all go by the textbook as far as their symptoms and how the disease manifests itself. This may be a good time to consider a referral to an internal medicine specialist. Hoping you can get some answers and find the best way to restore your sweet girl’s quality of life. Feel free to leave an update as things progress.
My dog has been diagnosis of Diabetes Insipdius. Now I need to find the right Dog Food for her and can’t find any solutions. Other than no more kibble use canned foods. My Vet has not gotten back to me yet for this issue, but I am wondering what everyone else found that was a good choice.
Hi CC,
I am not aware of any specific dietary requirements other than to limit sodium intake. The use of canned food is helpful due to the higher water content. It makes getting extra fluids into them a bit easier to help deal with the extreme loss with urinating so frequently.
Hello CC Seerup,
My dog was also diagnosed with Diabetes Insipidus, and our vet contacted Iams Proactive Health MiniChunks Small Kibble Adult Chicken & Whole Grain Dry Dog Food and confirmed it was low sodium. We were told to watch out for the treats, as those tend to be high in sodium.
My 6-8 year old rescue dog underwent anesthesia for a routine dental cleaning. No reported complications. She came out the same day and was desperate for water and peeing excessively. We’ve been monitoring her over the last month and went straight to desmo pills 3x a day. She is acting normal after only 1 day on the medication and her peeing and interest in water is also back to normal. Wondering if we should do a (costly) MRI to find out if it is a pituitary gland tumor/issue. She also had a very short seizure/fainting episode on a walk the same day we started the desmo. Curiously, this has happened twice in the past. All three of these episodes were linked to her getting worked up in reacting to another dog. She rouses quickly in all cases and is not visibly disoriented. She does not have coordination problems or other neurological signs. We’re unsure of what a sensible next step would be, and can’t figure out the best course of action for her.
Hi Lilly,
That does sound like a very puzzling situation. It is hard to know which direction you should go with diagnostics and treatment with so many strange issues happening at once. Have you thought about scheduling a consultation with an internal medicine specialist? Or maybe even a neurologist? I hope you can get some answers quickly and ensure your sweet girl remains happy and has a good quality of life. Wishing you the best of luck and praying for a positive outcome.
We are pretty sure our dog has DI, Urine specific gravity has been abnormal, she drinks constantly. It’s confusing to her vet since she is 10 years old, the vet wanted to do scans but it is very expensive. We finally talked her into the desmopressin trial. Is the normal dose 0.1mg BID? Thank you
Hi Amanda,
That is the dosage that is mentioned in the veterinary drug resources I have on hand. Here is a link to a trusted website that also mentions this exact amount (under the paragraph titled “Diagnosis of Diabetes Insipidus in Animals”): https://www.merckvetmanual.com/endocrine-system/the-pituitary-gland/diabetes-insipidus-in-animals
Hi, my 20 mo old male cockapoo was just diagnosed with CDI. We went trough all the various tests of blood and urine and tests for Cushings and other diseases before a desmopressin trial. The results were almost instantaneous. Within hours he became indifferent to water urination became normal in volume, frequency and specific gravity. The onset of the disease was very perplexing because the polyuria and polydipsia were his only symptoms. He is very active, happy and healthy otherwise with no signs of any issues in bloodwork.. We are very happy that the desmopressin works so well and that he is no longer struggling with the constant thirst and peeing but are wondering how far to go in trying to determine what may have caused the low or non production of vasopressin in the first place. Further testing for pituitary tumors,etc are very expensive and if that is the issue his prognosis would be quite poor anyway. Should we be happy with diagnosis and solution we have found or continue searching for the root cause? From what I understand a very high percentage of dogs with CDI are classified as idiopathic.
Any advice ?
Thanks
Hi Carl,
I am sorry your young dog has received this difficult diagnosis. But what a blessing he responded so well to the desmopressin! Honestly, I am not sure there is a right or wrong answer when it comes to investigating this further. There is a chance you could spend a lot of time and money on testing and end up at exactly this same point. It might be a good idea to talk to an internal medicine specialist just to get their expert opinion. I hope your pup will continue to thrive and live a long happy life. Wishing you both the best and keep up the good work!
My 6 yr old mixed breed male developed I assume cdi was treated with desmopressin drops slight bump in his urine specific gravity took him to an internist vet no improvement after months of treating him for cdi. He was a rescue and when he was a pup had many gi issues which lead to aspiration pneumonia. He drinks gallons of water and has to urinate volumes every couple of hrs . The internist told me basically it entails how much I am able to tolerate letting him out every 2 hrs every day. It is quite stressful to see him drink so much water then have to pee and the cycle repeats. Any suggestions his specific gravity 1.000 very low as you can see. He has been at the vet for 2 days. Thank you so much.
Hi Kathy,
I am sorry you are in this extreme situation with your dog. If there is nothing else your vet can do medically to treat these symptoms, then I am afraid it is up to you to decide what you can live with. Are there ways you can make life easier for you and your dog? Could you put in a doggie door so your pup can go out as often as needed without you having to do the work? Would diapers be a tool that could help reduce accidents in the house? You have tried medications but what about a consultation with a holistic vet? Maybe things like herbal therapy and acupuncture would be worth a try? I pray you can get the answers you need to make the best choices for you and your sweet boy. Wishing you strength and clarity. Bless you both.
Hello Dr.Buzby – we rescued a puppy at 8 weeks that had been hit by a car. He has now been diagnosed with diabetes insipidus and gets desmopressin eye drops twice daily at 8:00am and 6:00pm. There is definite improvement, however, beginning about 4:00pm daily the frequent urination returns every 15-30 minutes (but not excessive thirst). Any suggestions? I have discussed this with our vet and she thinks it’s behavioral. I disagree because it’s the only time he potties inside and once he gets the evening drop it stops.
Hi Lani,
That is so strange! Sometimes it can be very hard to distinguish medical issues from behavioral. But I agree, it makes me suspicious it could be related to the timing of the medication since it happens with such consistency. I recommend talking to your vet about playing around with the timing of the desmopressin drops a bit. Maybe do the morning drops at 9:00 for a few days and see if things change? As always, please get your vet’s approval before making adjustments to your dog’s treatment regimen. The last thing we would want to do is accidentally cause unnecessary negative side effects. It may also be a good idea to have a phone consultation with an internal medicine specialist. Hoping you can get to the bottom of this troublesome issue. Wishing you the best of luck!
My 6 year old dog was recently diagnosed with diabetes insipidus & placed on desmopressin after spending the night at the hospital for dehydration.. She appeared to be fine, although lethargic, the first day back. By the second day she was refusing to get up without us lifting her to a standing position, refusing to eat & drink water. Fearing dehydration again we returned to the ER. After having an MRI, a pituitary mass was confirmed. The neurologist recommends radiation which is in the range of $10-12K & cannot say if it will extend her life or increase her quality of life. If left untreated, without radiation, do u think steroids can help with her discomfort? I just do not want her to suffer and am taking her to a holistic/ herbal vet to explore alternative options. Just wondering what your opinion is. Thank u.
Hi Laura,
I am so sorry your pup is dealing with this tragic disease. Without examining her myself, I can’t say for sure if steroids would be of any help. I think it is wonderful you are taking your pup to a holistic vet. I am hopeful they will have some great ideas about how to best restore your sweet girl’s quality of life. Praying for a positive outcome. Feel free to leave an update if you have a chance.
We adopted a 10 yr old male chihuahua from a shelter 5 wks ago. Initial testing two days ago indicates diabetes insipidus. A water deprivation test is scheduled for next week. They will keep him from 8:00;am until their office closes. I can’t bear to think of his being in that much discomfort for that long. Why can’t we just try the Desmopressin instead? Note: We have four other rescues. Which makes measuring water intake and collecting urine output from one dog nearly impossible. . Thank you.
Mary Visco
Hi Mary,
I understand your concern for your sweet boy and his scheduled testing. Without having a personal role in your dog’s medical care, it is hard to say for sure why certain decisions are being made. You always have the choice to decline recommendations for treatments and testing. Sometimes getting a second opinion can be helpful as well. How did things go? Were your dog’s results conclusive? Hoping all is well and you have a clear path forward. Feel free to leave an update if you have a chance.
Our 11-year-old Chihuahua was diagnosed with Diabetes about 4 months ago. His blood sugar was over 500, probably for a while. In the previous months his liver was 3 times bigger than it should have been, for which he takes Denamarin daily. His liver shrank, but then the diabetes was discovered. He was doing okay other than developing cataracts which seemed to get worse overnight. He was on 4 units of insulin, but after a curve the amount was reduced to 3 units. He weighs 7.4 pounds now but was 2 pounds heavier at the time of diagnosis. A day and a half later his blood sugar was found to be low, 59 at the vet office. 2 doses later his glucose urine test remained low. I called the vet & was told to decrease his insulin to 2 units. A few hours after eating and his insulin dose last night his blood sugar was low again. Does it take time for the insulin dose to regulate for more stable readings? I gave him two mini milk bones & a drip of honey. This morning two hours after breakfast a urine strip test revealed approximately 350-375, If the low blood sugar continues to happen & I decide to lower his dose to 1 unit, am I jumping the gun? Does it take time or is it a clean slate with each dose. The learning curve is real!
Hi Lisa,
I understand your concern with these low blood sugar episodes in your senior boy. Diabetes is such a tough disease and getting it well-regulated can be tricky and take some time. Without examining your dog myself, I can’t make specific recommendations on how to adjust his insulin dosage. In general, it is much more dangerous for blood sugar to be too low rather than too high. It would be best to discuss these issues with your vet and have them guide you through the dosage change. If you are in a situation where you cannot talk to your vet, I think it is best to err on the side of caution and give less insulin. Giving less will prevent a hypoglycemic crisis. You can always give more insulin if needed, but if you give too much there is no way to take it back. I hope that makes sense. How is your little guy today? Hoping all is well and this will work itself out quickly. Wishing you both the best of luck!
I recently adopted a puppy that we now know has diabetes insipitus. He is not responding to the medication and his symptoms are the same. I’m heartbroken because he is an amazing dog but with two young children I just don’t think I can give him the care he needs. I’m struggling over here.
Hi Christina,
I am sorry your puppy has received such a difficult diagnosis. I understand the burden this must have placed on your shoulders, and it may be time to make some tough decisions. To find out if this pup has a chance to recover from his condition, he may need to see an internal medicine specialist. It would not be wrong to rehome him or find a rescue to take him if this is too much for your family to endure. Also, if he truly cannot respond to treatment, euthanasia may be the most loving option and the only way to prevent unnecessary suffering. My heart goes out to you during this difficult time. Bless you and your family.
Hi Dr. Buzby,
Our 10 year old Australian Cattle Dog was officially diagnosed with CNDI at 9 weeks of age and has been on hydrochlorothiazide ever since. We have been extremely lucky and every year when we take him for his annual vet appointment his lab results have been great. We are vigilant with his low sodium diet and access to water. Recently he has developed cataracts and subsequent visual impairment. A few days ago he stumbled and fell in our pool, which he has always spent a lot of time in and can easily navigate to the exits, however in the tumble he lifted a nail from the nail bed. We took him to his vet and he was put on antibiotics and tramadol for the pain. We had tramadol in the house as he has previously taken it for a leg injury, as in true cattle dog fashion not even injury has ever slowed him down, so the night prior to the appointment with his vet we gave him a dose at his previously prescribed dose. That evening he has 2 accidents in the house, which hasn’t happened in several years. He then also had an accident at the vets office, which I didn’t think much of at the time as he is a big nervous baby at the vets office, but since then the symptoms have worsened. His polyuria and polydipsia are the worst I have seen since before his diagnosis. I found on article online in humans that showed some correlation between tramadol and NDI. We have called the vet and he has an appointment Monday morning when they open and we are just watching him closely, ensuring his access to water, encouraging food despite his lack of interest, and have stopped the tramadol. Have you seen this kind of an interaction with NDI and tramadol before? If so could his current age be why he is having issues with it this time when he had previously taken it with no problems?
Hi Megan,
Wow, your boy is definitely a unique and complicated case. I have never personally seen an adverse interaction between tramadol and hydrochlorothiazide. Like you, I did some research and found it mentioned a couple times in human medicine but did not find any reference to it in veterinary medicine literature. With that being said, it makes me highly suspicious, and I am glad you have an appointment to have your dog evaluated by your vet. I hope your senior guy is feeling better and stable. Praying you received good news from your vet and are able to find a treatment that works well for your sweet boy. Feel free to leave an update if you have time. Best wishes!
Hi Dr Buzby, I just wanted to give you an update on Leo. After stopping the tramadol he returned to his normal self within 48 hours and his labs all are returning to his baseline as well.
Hi Megan,
Thank you so much for the update. I have had my eyes opened from your experience and will carry it with me as I continue to practice veterinary medicine! I am glad Leo is feeling better and his lab results are improving. I really appreciate you taking time to help us all learn something that could be very valuable for other dogs in the future.
Is there any chance that Optimmune could cause DI?
Hi Wendy,
I am not aware of any issues with Optimmune causing Diabetes Insipidus. Just to be sure I did some extra research, and I did not find any cases mentioned in the literature or research articles.
My 10 year old dog has recently developed excessive thirst and urination problems. All bloodwork was fine except for a slightly elevated Alkaline Phosphatase. Very low SG of about 1.004, I think. Vet did dexamethasone test which ruled out Cushings. We just started measuring water intake and it is alarming. He is drinking 20 cups of water in a 24 hour period. Vet thinks maybe he is reacting to the death of his sister 3 months ago since they were litter mates and always had been together but has mentioned desmopressin as a possible treatment. Any thoughts on what to do would be appreciated!
Hi Mary,
I am sorry you lost your girl pup 3 months ago and now your boy is struggling so much. Since I haven’t examined him personally, I can’t make specific recommendations. It does sound like he is a complicated case, and it could take some time and extra tests to get answers. It might be a good idea to get a referral to a veterinary internal medicine specialist. Many times, they have access to testing and treatments that could be cost prohibitive in a general practice setting. I hope you can find the help your sweet boy needs. Best wishes for happy days ahead to keep making memories together.
Hi Dr. Buzby,
I am fostering a dog (they think between 4-6 yrs old) who is blind and began the desmopressin drops today. His USG was 1.002 today before the drops and 2 hours later it is up to 1.012. Could he be blind because of DI or are the 2 unrelated? Could being blind have caused the DI (head trauma from walking into things)? Is there a way to rule out a tumor without a scan?
Thank you SO much for any info./advice 🙂
Tara
Hi Tara,
These are all good questions! To my knowledge, DI does not cause blindness. That being said, if there is a tumor or previous head trauma that caused the DI it may have caused the blindness as well. I wouldn’t think your dog would bump into things with enough force to cause the level of trauma needed to induce DI. Usually, the force needed to cause this level of head trauma would require a major event such as being hit by a car. The only way to definitely rule out a tumor is with advanced imaging techniques such as MRI, CT, or possibly x-rays. I hope your foster boy continues to respond to the desmopressin. Best wishes to you and keep us updated!
If my dog is on Desmopressin tablets for Diabetes Insipidus and has been taking tablets 2 times a day and now I just spotted light blood in her urine does that mean the UTI or whatever is over riding the Desmopressin tablets? She has been peeing a lot today even while taking the Desmopressin tablets.
Hi Vanessa,
I am glad you caught these changes early and recommend you call your vet and let them know about the blood. Without a urinalysis or some lab work, it is hard to say for certain what the cause of your dog’s increased urination could be. A UTI is possible! I hope you find the answers you are looking for. Good luck to you and your sweet girl.
Our lab is 8 years old and we have been treating him with desmopressin since about 4 months of age. He has always drank a lot of water and peed a LOT. Never killed the grass.
We were told last week that he has kidney failure even though he is acting the same as always.. The vet said his creatinine level was 4.4 . Trying to find out if dogs with NDI would have high creatinine levels. Wondering if the desmopressin has not been helping and he has always had NDI and not CDI. Maybe this kidney thing is new and I am just in denial?
Any suggestions for testing, treatment?
Hi Mary,
These are great questions. I am glad to hear your Lab has done so well with the desmopressin for the past 8 years! The fact that your dog responded to the desmopressin confirms CDI. NDI causes the kidneys to stop responding to anti-diuretic hormone (ADH) and desmopressin mimics ADH. Dogs with CDI do not produce enough ADH on their own, which is why supplementation with desmopressin corrects the problem. Unfortunately, NDI does not cause high creatinine levels. I am afraid it does sound like he may have a new kidney issue. The good news is there are medication options to help with kidney function depending on what stage of kidney failure your boy is experiencing. Since I haven’t personally examined your dog, I really can’t make specific recommendations. It sounds like your vet has done a great job staying on top of things. I think it would be a good idea to talk to your vet about your concerns and see what plan you can come up with together. I hope you can find a treatment option that is a perfect fit for you and your Lab. Best wishes as you navigate this new journey!
My dog was tentatively diagnosed with cmvi in mid 2019, after abdominal surgery which revealed 2 adrenal nasses, that were presumed to be benign adenomas after a year & 1/2. However, almost immediately following surgery to remove a ruptured liver tumor with hemoabdomen, where the gall bladder & spleen were also removed with approx. 3 liver lobes, in aboutv1 month, my dog began to show classic signs of Cushings Disease/syndrome-while still in the hospital after surgery, for that week, she was consuming huge amounts of water, with polyuria, and to avoid a feeding tube, I was allowed in to coax her to eat, and she gradually began eating a little can food. The polyphagia onset was about a month after surgery. Fast forward to her 6 month checkups, and the 3rd year residents & faculty/staff vets all postulated diabetes insipidus from cystocentesis, and after 1st urine in the a.m.’s, her urine was consistently dilute, and for just shy of three full years, she woke me every hour and 1/2 to 2 hours to go out. The Covid shut down in my area, caused all of the reachable teaching hospitals to shut down between March & September of 2020. She was due for 6 month checkup when everything shut down except for emergencies, andcso in the meantime, I discovered an endocrine department a little further away, and they chose to repeat a third test to rule out Cushings after a negative ACTH, and a negative Dezamethasone Suppression Test, by repeating another DST & a UCCR, which was apparently prompting the endocrinologist to repeat a UCCR, even though she knew & I understood that test was not meant to be a stand alone test to confirm Cushings.
The adrenal tumors were very visible, & being measured for any signs of a cancer spread.
In October of ’20, she was moved to stage III cmvi, and prescribed pimobendan (which she did not tolerate). I began to see what I now know was signs of belowcaverage oxygenation in April of ’21, and her chart said to return her for echo in April or sooner for another echo. They were overbooked, and did not put her on the schedule until April. Her stamina gradually began to plunge, and her heart had become more enlarged from 10/20 to 6/’21. We were awaiting insurance reimbursement to do another workup, she began to have many changes & was suffering – the private urgent care vet took all of my resources to put her in an oxygen tent, do abdominal u/s, and chest X-Rays for two overnights. The 1st overnight doc thought shecwas showing signs of chf, so he treated her with Lasix, and the second day, the cardiologist from the University called and said he agreed that there was no chf yet, but that her heart had enlarged per above, and that the IM doctor also ruled out chf the second day, same private facility. Since my dog did not tolerate pimobendan, and the Lasix RX was not given, nor the other RX drugs used in canine chf, and Ibwas continuing to see urine so clear that it had the appearance of tap H2O, from May ’19, until I lost my beloved pet at age 14, 3 months later. She never got treated, nor the PU/PD further investigated. I had been very diligent about trying to make up for the time we lost during Covid shutdowns, and scheduling delays, but needed to be reimbursed before we could further pursue the Cushings syndrome, & possible relationship to suspected diabetes insipidus at a different teaching hospital, and imagine that the Covid shutdown backed ne into a terrible time crunch, along with a difference of opinion between the endocrinology group. No one stopped saying that any neoplasm may be playing a role, as to why she continued to be mildly anemic her last 2 years, approx., but when she tragically passed, I felt to have closure, that I needed a Necropsy. No cancer, cause of death right ventricular failure, and notable, “punctate nodules” throughout the surface of the mucosal membranes of the bladder.
I had so nany questions about how they would put her on meds. for heart failure, which she slid right into in June ’21, and do a trial of desmopressin, or the other ways to test for
CDI/NDI, (since specific gravity varies) and why the endocrine dept. said if it was Cushings, it would be pituitary dependent when she had bilateral adrenal tumors (to which pathologist attributed in the affirmative, the probable increased cortisol and corticosteroid production). I have been absolutely devastated, and my head was in a frenzy trying to figure out her advanced chf &/or enlarged heart, signs I f hypoxia, and letdown of how all these variables could or would be addressed; whenever I look up the term “punctate nodules on the bladder, surface of mucosae”, bladder cancer & cystitis, chronic units, and reading about the urine cultures, possible cystoscopy, and other things that need to be pursued to prevent dehydration & loss of electrolyte balance. Another non-practicing vet/endocrinologist wrote a three part article to help vets confirm Cushings, which is very clear that itbis highly unlikely that dogs with adenomas or other adrenal nasses, will result in a positive LDDS test, and it is very, very frustrating to watch my dog decline without any treatment, for chest pain or discomfort, bladder pain or discomfort, and elevated BP with no med. to empirically treat her Cushings syndrome, andcall the $$$ I spent to try and help her get the right treatment & still she suffered, and Ibwas unable to even give her death with dignity and/or know when to say when, with a humane euthanasia. If you would be able to to speak hypothetically to this, and what type of thorough diagnostic & treatment approaches would be appropriate in say, another living dog, to try and accomplish some plan to relieve the dog’s suffering, I would so appreciate it. I need to find closure – my dogvlived to 14, an Aussie/BC mix, that was with me from 10 weeks to 14 years. Thank you kindly for any feedback. With a pharmacy background, I was wondering if these conditions could have even been treated with recommended meds., concomitantly, without inducing an untimely death. Please know I am not passing judgment in the big picture, just that I invested in humane treatment & diagnostics to provide relief for my beloved pet, and it continued to elude us. Thank You
Dear Aileen,
It sounds like you have been through a very difficult journey over the last couple of years. I am sorry you lost your sweet girl in such a tragic way. Her case sounds very complicated and involved. Since I never had the opportunity to examine your dog myself, it is difficult to make conclusions or recommendations and sort out all the variables. I feel it is safe to say you did everything you could, and I am sure your girl knew how much she was loved. Try not to carry around the burden of all the “what ifs”. I pray with time your heart will heal. May her memory be a blessing.