Sam's still sick. He's drinking so much water that he's very nearly peeing plain water. But there are some white blood cells in there and some bladder cells...way more funky cells than should be there in a boy that's drinking so much and peeing such diluted samples.
So--remote possibility: a stone or tumor that didn't show on last week's x-rays. Far more likely: an antibiotic-resistant infection. (An infection is especially likely since the excessive drinking started about 40 hours after the last dose of the Clavamox.) So, another antibiotic: 500 mg of Ciprofloxacin* once a day for 14 days. Then see how he's doing. If that doesn't clear things up, we'll have to wait for two weeks off antibiotics, then get a urine sample and try to grow a culture and see what antibiotic is effective on the culture. Or, maybe, an ultrasound to check for stones or tumors. If Sam hadn't just had a spectacularly uneventful set of x-rays last week, this latter possibility would be scaring me. But I'm pretty much crossing stones/tumors off the list of stuff I should worry about. Poor Sam is in for another two weeks of antibiotic-influenced poop. I can't tell you how thrilled I am about that...
(The vet tech was taking Sam out to pee. I told him they might need to give him more water first since I'd let Sam pee outside before we went into the office. They brought Sam back to me almost immediately. "Took about 30 seconds for him to decide to go," the tech said.)
The vet drew blood from Jacey to run a new T4 to check out her thyroid levels. He really doesn't want to go up on her dosage because of her physical symptoms; he thinks a dog her size shouldn't be taking more thyroxine than she is at present. If the blood work is significantly low, he'll reconsider. He should call me on Wednesday with the results.
But Jacey has acquired a new problem: a sort of crusty, scaly bit of skin on her butt--right where the hair loss I photographed last week is located. (So I have a photograph from a week ago that shows no problem.) She has a nice Gentocin Topical spray I get to spray on 2 or 3 times a day for 10 days. I'll be getting pictures to document the situation--so I can tell if it's getting better or worse or if my imagination is running the show. I won't be posting the pictures here, but I thought I'd warn you what sort of Jacey-porn you might stumble into on my Flickr account. (The photos aren't gross or anything, and the patch of bad skin doesn't seem to be bothering her.) Once we deal with the skin thing, if her T4 results weren't helpful, we'll talk about what else to check. Meanwhile, the poor baby's getting her food cut back just a bit...but not the full-on cutback I've done before when her weight was crazy. The vet agrees, though: she should be weighing about 55 pounds, not 60-plus.
*The vet said Clavamox and Ciprofloxacin are the #1 / #2 antibiotics for bladder infections.