Differential Diagnosis for the 10-year-old Chow Chow

• Single most likely diagnosis:
  • Urinary Tract Infection (UTI) or other urinary issues: The initial improvement with antibiotics suggests that a UTI or another urinary issue could be the primary cause of the symptoms. The recent accident could indicate a recurrence or persistence of the urinary problem.
• Other Likely diagnoses:
  • Canine Cognitive Dysfunction (CCD): The dog's age and the change in behavior, such as whining, pacing, and entering rooms she's not allowed in, could be indicative of CCD, which affects older dogs and can cause changes in spatial awareness and housebreaking.
  • Gastrointestinal issues: The dog's recent fecal accident in an unusual location could suggest gastrointestinal upset or a medical issue causing urgency or incontinence.
  • Sensory decline: As dogs age, their senses can decline, potentially leading to accidents due to an inability to detect or respond to the need to eliminate.
• Do Not Miss (ddxs that may not be likely, but would be deadly if missed.):
  • Cushing's disease: This endocrine disorder can cause a range of symptoms, including urinary incontinence and changes in behavior. It's crucial to rule out Cushing's disease due to its potential impact on the dog's quality of life and the need for specific treatment.
  • Diabetes mellitus: Uncontrolled diabetes can lead to urinary incontinence and accidents, along with other systemic symptoms. Early diagnosis and management are critical to prevent complications.
  • Neurological disorders: Conditions affecting the brain or spinal cord, such as tumors or strokes, can cause sudden changes in behavior and elimination habits. These conditions require prompt veterinary attention.
• Rare diagnoses:
  • Prion disease (as initially suggested by the vet): While prion diseases are rare and typically present with more severe neurological symptoms, they cannot be entirely ruled out without further testing. However, the dog's response to antibiotics and the nature of the recent accident make this a less likely diagnosis at this stage.
  • Other systemic diseases: Certain systemic diseases, such as kidney disease or liver disease, can cause changes in elimination habits. While these are less likely, they should be considered in the differential diagnosis, especially if other symptoms are present.