Question Details
Chronic Urinary Tract Infections In A Dog
by johnnalsmith - January 19, 2021    View Case Report
Earl is my own personal dog that I am struggling with. We found him in the woods two years ago. He was emaciated, missing several teeth, refused to eat and very depressed. After a lot of work and persistence, we got him eating a home cooked diet with some kibble. Since then he's been doing great aside from slow progression of his degenerative myelopathy, which was being managed well with Bupleurum and Kudzu and acupuncture.
November 30, 2020 he developed aspiration pneumonia and was prescribed doxycycline. December 7 later he ended up in the ICU for acute mixed hepatopathy with ALP and ALT in the 4000U/L and T.bili above 6.0mg/dL. After several days in ICU he came home on Clavamox and Denamarin. He did great until Dec 18, when the pneumonia came back. We suspect aspiration pneumonia. He was taken off of everything and switched to enrofloxacin, which has worked wonderful for the pneumonia. Radiographically his pneumonia is gone and his liver values are all within normal limits.
Unfortunately, now we are treating an extremely resistant e.coli urinary tract infection. He is not tolerating the antibiotics (nitrofuantoin) and the only other susceptible antibiotic is chloramphenicol, which we won't use due to his previous liver injury.
His tongue is full and hangs out of his mouth (he is missing several teeth too) and is usually pink, but can tend towards purple. It isn't usually wet. His pulses are very deep and weak. He has significant muscle loss in his back legs from his DM. He has always been an extremely picky eater, so I am assuming SP Qi deficiency. He has been off of his Bup&Kudzu; since Nov due to not eating well on his pharm meds.
Has anyone been able to keep a resistant UTI under control without the use of pharm meds? I can get herbs down him, but with him eating sporadically, I cannot get him to take the antibiotics.
Thanks so much!
Replies
by naturevet
January 22, 2021
Hi Dr. Jo

I would wonder about Bu Zhong Yi Qi Tang for this dog. It is well tolerated and often helpful in DM dogs and is my top pick for stubborn or recurrent UTIs. It is a top consideration in dogs that have previously benefited from Shao Yang formulas, and would be expected to help confer greater immunity in the airways, too. I think it's the first thing you should try.

If the pulse becomes stronger again, but mid-depth, think about introducing Xiao Chai Hu Tang simultaneously, to continue preventing DM progression while combating the tendency to lower burner Stasis (causing UTIs) and pneumonia

Hope that helps you out! Let us know how it goes!

Steve
by johnnalsmith
April 21, 2021
Earl is still hanging in with us. Unfortunately, the BZYQT was unable to be administered at the dose needed. Earl is currently on two antibiotics for his pneumonia and UTI. He will not eat his pills anymore, therefore we are pilling him. The BZYQT was just too much to give him. However, he seems to be doing ok with the antibiotics and his homecooked diet. Thank you!
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