Excessive Urinating...

MillyP

Registered User
Jan 5, 2007
108
0
London
Just wondered if anyone else has the same problem with a Dementia sufferer and what the reason might be.
Dad is urine incontinent now but hardly drinks during the day...no water, very little tea etc...but at night he literally pees for England....three times during each night, my Mum is changing his pads as even the really thick ones can't cope with the amount of water he's passing....firstly, where is it all coming from if he's not drinking much during the day and has anyone been given tablets by their Doctor to slow it down? I am going to see his Doctor tomorrow to ask, as the CPN said it's unusual for anyone to pass such large amounts of urine without drinking...he's been checked for infections and is clear....Thanks for your input.:)
 
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BeckyJan

Registered User
Nov 28, 2005
18,971
0
Derbyshire
Yes we have had similar problems here. My husband was ultimately prescribed Flavoxate x 3 daily plus 1 Alfuzosin last thing. Now he only goes a couple of times per night. (At one time it was every 1.2 hr). He drinks plenty during the day but nothing after 8.30 pm - usually going to bed around 11.00 pm.

I think Skye will comment as she has posted on this problem herself.

Each person is different and I believe there are many medication out there to try.

Good luck Jan
 

Skye

Registered User
Aug 29, 2006
17,000
0
SW Scotland
Oh my goodness, Milly, I've hed this problem with John for over a year now, and it's so exhausting!

The first thing is to have the prostate checked. Out GP wouldn't prescribe anything without a complete cystoscopy.

If this is ruled out, then it's probably caused by his dementia. The neurotransmitters that normally cause the kidneys to shut down at night to give us an uninterrupted sleep are no longer functioning, hence urine continues to be formed at the daytime rate.

We've had three different medications:

First, amitriptylene. This has a calming effect, but doesn't reduce the quantity of urine.

Second, detrusitol, which is commonly given to children who wet the bed. This worked for a while, but not for long.

Third, desmopressin. This is again commonly used for children. It's a nasal spray, which is supposed to go directly to the neurotransmitters. This had no effect on John apart from giving him diarrhoea.

Then we went back to amitriptylene!

The alternative is an external catheter, but we've discussed that before.

Please be wary of your father not drinking enough. John also did this, I think he was very aware that his control was slipping, and he's now in hospital with a very severe infection.

By all means discuss these meds with your CPN, they may be worth trying, and I'd be interested to hear the results.

Good luck,
 

Skye

Registered User
Aug 29, 2006
17,000
0
SW Scotland
BeckyJan said:
My husband was ultimately prescribed Flavoxate x 3 daily plus 1 Alfuzosin last thing.

Hi Jan, I've just googled these meds, in case there was something we've missed. It appears that they are both prescribed for prostate problems.

John's prostate is OK, his problem is entirely neurological, so as you say, everyone's different.

But the prostate has to be checked first.

Love,
 

MillyP

Registered User
Jan 5, 2007
108
0
London
Many thanks to you both...so at least there is drugs to try...:) Dad did have an enlarged prostrate which was operated on some years ago and he's had it checked recently and everything was fine...he has no trouble peeing at all. He also had an operation a few months ago to widen his Urethra as he had a narrowing...but to be honest he pees the same amount now as he did before the op...he's very stubborn when it comes to drinking water...we try but usually fail...give him a large glass at tablet time:) will definitely go and see the Doctor tomorrow and get something for him...feel sorry for my Mum as she's up and down all night at the moment...will let you know what he says..thanks again.:)
 

noelphobic

Registered User
Feb 24, 2006
3,452
0
Liverpool
excessive urination can be a sign of diabetes but it is generally accompanied by excessive drinking also, as well as other symptoms, so probably not applicable. However, it is worth ruling out if nothing else.
 

MillyP

Registered User
Jan 5, 2007
108
0
London
Yes he does have Type 2 Diabetes and has done for many years...but this excessive urination has only started recently...as the Dementia has progressed...maybe a few months now...before he was ok...:confused:
 

noelphobic

Registered User
Feb 24, 2006
3,452
0
Liverpool
if it is related to the diabetes then I would only expect it to occur when his blood sugar levels were raised. If this is not the case then I wouldn't think it would be connected.
 

elaineo2

Registered User
Jul 6, 2007
945
0
leigh lancashire
Hi,i have read your post several times.is dad on diuretics?i have encountered this many times at work.reducing the diuretic tablet/suspension can help.you have to watch for the swelling of feet etc but encouraging mobility helps this.just a thought,love elainex
 

BeckyJan

Registered User
Nov 28, 2005
18,971
0
Derbyshire
Hello there. Interesting about your find, Skye. David has been known to have a slightly enlarge prostrate for many years without problems at night; that is not what they are treating him for presently - its just to reduce the night time urination problem ????!!!! (Have to say the present medication seems to work).

I failed to mention he is also on Amitryptilene - but that was prescribed for depression and general calming down (it was increased as he became more depressed some 12 mths ago).

I do think these GPs keep trying different medications until they find the one that suits. David was also put on a diuretic but that was stopped as his b/pressure dropped too much.

It seems very common for dementia sufferers to have this night time urination problem and interesting to hear of the different medications being prescribed.

Good night all Jan
 

MillyP

Registered User
Jan 5, 2007
108
0
London
elaineo2 said:
Hi,i have read your post several times.is dad on diuretics?i have encountered this many times at work.reducing the diuretic tablet/suspension can help.you have to watch for the swelling of feet etc but encouraging mobility helps this.just a thought,love elainex

No hun, he's not on any diuretics...wish it was that simple...:) thanks for your help though, much appreciated.:)
 

MillyP

Registered User
Jan 5, 2007
108
0
London
Went to see Dads Doctor this morning and he saw me straight away which was good...explained that the sleeping tablets were only keeping him asleep at night for an hour at the most, so he has increased then to two tablets...hope it works:)
As for the excessive urinating, he said there wasn't many tablets he felt would work but he was prepared to give something a try as my Mum was having such a bad time of late...so he has prescribed oxybutynin 2.5 mg tablets, two to be taken each evening...he said it may work for a while or not at all...so fingers crossed...here's what it says about them...

Oxybutynin hydrochloride blocks muscarinic receptors, which can be found on the muscle cells of the bladder wall. Stimulation of these receptors causes the bladder to contract and empty. Therefore, when these receptors are blocked the muscle of the bladder wall contracts less. The bladder can empty too often (urinary frequency) or unexpectedly (incontinence). This is thought to be due to the bladder wall contracting uncontrollably. This medication can dampen down these contractions and makes the bladder more stable.

Here's hoping:) he's having his first two tonight so I will let you know how it goes...at the moment, anything is worth a try...:)
 

Skye

Registered User
Aug 29, 2006
17,000
0
SW Scotland
Hi Milly

Sorry to be a wet blanket (ouch!:D ), but if the problem is the same as John's, ie excessive production of urine at night, anything that acts solely on the bladder is unlikely to work. He may pass water less often, but the quantity will still be the same.

Let us know if it works.
 

MillyP

Registered User
Jan 5, 2007
108
0
London
I did ask the Doctor this very question and he said that he would still produce the same amount of urine but as with people who are well, they are able to hold onto it in their bladder and go when needed.....with Dementia sufferers, their brain doesn't tell their bladder when to empty and when not to, so this would maybe help...if it doesn't then I reckon my Mum will tie a knot in it....:D
 

connie

Registered User
Mar 7, 2004
9,519
0
Frinton-on-Sea
Had the excessive urine problem when Lionel was at home.
detrusitol,
worked for quite a while.

When I got the care home to review Lionels medications I asked for him to be taken off the Detrusitol. Just one tablet less to take, and as he was doubly incontinent seemed pointless. Care home staff then said it never made any difference.

Easier for them to care at night, with shift patterns and regular time off. Me, like most of you out there, it was 24/7 - with no respite.

Hope that something works out for you soon.
 

MillyP

Registered User
Jan 5, 2007
108
0
London
Well Dads been on the Oxybutynin hydrochloride now for almost ten days and for the last two nights my Mum has had totally dry sheets and pyjamas from Dad...only a wet nappy, which is great for my Mum...seems to be working...:)
 

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