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Greta, Long Haired Dachsund With Chronic UTIs

by landauvet@gmail.com - January 21, 2021

Saw her initially in April 2020 1 month post cystotomy for chronic bladder stones. She was obese with abdominal distention, pu/pd, panty. She was temporarily paralyzed in her hind legs post-surgery but was able to walk again on presentation. She was also on a prednisone taper on presentation as well. She was diagnosed with a possible stroke. Since first appointment, she was put on a raw diet, SMS, adrenal support.Over the first few visits, Greta seemed tp get more painful if prednisone was discontinued as far as neck pain went initially but able to get her off prednisone by June.

I think I am still confused about how to post. This was posted on 12/29 and I see it on "my cases" but not in the Forum. Please remind me of the process for posting (sorry).

Pulse was deep but slippery, dry nose, lavender tongue. Metabolic symptoms improved and weight loss started to happen as well as able to discontinue the prednisone. I added in Benefit hips and Knees to help manage the neck pain based on acupoint reactivity.
Starting in June, she started getting UTIs with ni crystals or stones, but increased urine pH with bacteria and wbcs. I added in Hydrangea and Eupatorium (1 ml 2x daily recently increased to 1.5 ml 2x daily) in July. Since July, she has been on antibiotics repeatedly for UTIs and can't seem to clear it. She was ultrasounded and all looked normal in September. I am at a loss at this point in how to help besides what she is already on. Hep pulse has been relatively strrong and slippery for the last visit in November. She is less pu/pd but still pretty fat. Primary care vet pushing hard for a prescription renal diet.
Help!
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by naturevet

January 22, 2021

Hi Kevin,

Some lingering questions: is it the same bacteria being cultured each time, suggesting a persistent locus of infection? Or does the dog experience reinfection?

Bu Zhong Yi Qi Tang is the first formula I think of for UTIs that a dog cannot shake, especially if there are reinfections. It's not an anti-Damp formula, though, but it does fit a lavender tongue, since it addresses lower burner Stasis. It also tends to work in animals that have had benefits from Shao Yang treatments in the past, such as Benefit Hips and Knees

Damp Heat approaches almost always fail if the diet is not changed from a processed diet to a real food diet. Is she still on raw? If so, is the diet high fat? That can prevent a dog from improving as much as they could on an anti-Damp diet. San Ren Tang fits the tongue and pulse and is an anti-Damp formula, if you want to continue in that vein

Stasis formulas like Shao Fu Zhu Yu Tang can fit persistent UTIs, but I would have expected at least a thickened bladder wall

I'm not clear what the specialist hopes to achieve with a renal diet in a bladder infection case. Is the dog azotemic as well? If so, given the episode of hind end weakness and then the cystitis, I'd look at Zhi Bai Di Huang Wan as the next step. Note that if the dog is truly Damp, a return to a processed diet is likely to make things worse and send the dog backwards.

Hopefully one of the suggestions make sense. Please let us know how things go or if you have additional questions

Steve

by landauvet@gmail.com

January 24, 2021

Hi Steve,

Thanks for the reply. I will try to clarify with answers to your questions here.

3/2020 Bacteria were positive. Cystotomy to remove 6 stones. Woke up from anesthesia paralyzed to one front leg. Saw me 4/2020 At that point I was addressing resolving paralysis and metabolic syndrome/obesity.
6/2020 E Coli on cystocentesis ( Blood, Bacteria, pH-6.0, protein +, no crystals)
7/2020 Urinalysis: S.G. 1.017, pH-7.0, protein 1+, WBCs>100, rods and cocci many- added in Hydrangea and Eupatorium
12/2020 Urinalysis USG 1.026, pH-8, trace protein, 15-20 WBC, marked rods >40 per HPP, non-crystalline debris present
I added in SRT and stopped the SMS, Continued the Hydrangea and Eupatorium.

Greta has actually been gaining weight all through the process so we are not winning on the metabolic front either.

Only the one culture and sensitivity performed but UA shows rods and cocci at different times suggesting different bacteria.

The dog was switched to a relatively low-fat raw diet at the first appointment (Darwins). Pulse has stayed deep and toned. The tongue was a bit redder at last appointment 1/2021.

No Azotemnia. No HL weakness but does have recurring anal gland issues and occasional constipation.

Based on your response, I am thinking the BZYQT would be a good option to roll into the mix. I would be inclined to stay on SRT and the hydrangea and eupatorium as well unless you thought otherwise.

Best,

Kevin

by naturevet

January 24, 2021

Sounds good. The formula is most likely to help and least likely to hinder an animal whose symptoms are now muted, even if the lab findings are pronounced. Also, if the pulse improves with sedation of LV 3/SP 4, then for sure you're on the right track. If not, then if you can identify which specific points the pulse does respond to, that will help me help you

Meanwhile, if SRT has delivered some benefits then continue it while starting the next formula

S

by landauvet@gmail.com

January 27, 2021

Just to clarify, Steve, are you suggesting BZYQWT based on your last reply or the ZBDH? I do love the mystery of it all!

Kevin

by naturevet

January 27, 2021

Hi Kevin,

If the dog is not very clinical and doesn't show symptoms of a raging cystitis, only laboratory findings, then I would try the BZYQT

If the dog does have raging symptoms, and not just laboratory signs, then I would not use BZYQT. Overall, it seems a good fit, so if this is a dog where you have to do urinalyses to know how things are going, then it qualifies as a deficient type of cystitis, more suited to a tonic

Steve

by landauvet@gmail.com

July 30, 2021

Hi Steve,

As a follow-up, I wanted to let you know that the BZYQT was a big hit! Finally, the pH dropped to normal and no bacteria after a few years of managing with diet and other herbs. She is staying on SRT as well.
Also, she is finally able to lose weight after a lot of being stuck with a lot of fat deposits and a big abdomen. Great advice!

Kevin

by naturevet

July 30, 2021

Nice! Thanks for the feedback!

S

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