The B12 shot is harmless and good and usually relates to a malabsorption problem in the GI tract such as SIBO or problems w/enzyme secretion as in EPI, but that would normally present with poop problems.
Although with the incontinence that too could spell trouble w/the pancreas as that is responsible for regulating insulin.
Diabetes will present with weight loss, incontinence, excessive thirst.
There could be a UTI as well, and/or crystals.
I suspect the x-rays are to look for an enlarged pancreas...this could also be a sign of pancreatitis which is not the same as EPI...
High PH is related to diet and too many carbs (potatos, legumes, grains, fruits), so even if on a no grain diet, would still be high in carbs if on kibble diet.
Hopefully the pancreas is in check and this is a simple diet change...meat protien will acidify and bring the body back into balance, as well diet change will assist and can even reverse diabetes dx. if that is all that is wrong.
Dog Diabetes Symptoms, Treatments and Diet
Diabetes is a result of inadequate production of insulin by the islet cells in the pancreas. There may be a genetic predisposition for this in some dogs. Islet cell destruction also occurs in some cases of pancreatitis
. Insulin enables glucose
to pass into cells, where it is metabolized to produce energy for metabolism. Insulin deficiency results in hyperglycemia (high blood sugar) and glycosuria (high urine sugar). Glucose in the urine causes the diabetic animal to excrete large volumes of urine. In turn, this creates dehydration
and the urge to drink large amounts of water.
Initially, dogs who do not metabolize enough sugar have an increase in appetite and a desire to consume more food. Later, with the effects of malnourishment, the appetite drops.
In summary, the signs of early diabetes are frequent urination, drinking lots of water, a large appetite, and unexplained loss of weight. The laboratory findings are high glucose levels in the blood and urine.
In more advanced cases
there is lethargy, loss of appetite, vomiting
, dehydration, weakness, and coma
I would think it more prudent to seek a specialist and not waist funds on this vet, who may end up or should be (?) sending to a specialist...I think a ultrasound would be better then x-rays??? IDK...somebody else may have more knowledge were diagnostics are concerned