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Dog With Otitis Media, Nerve Damage, Osteomyelitis And Meningitis

by sophiek - April 25, 2026

Hi Steve,

"Theo" is a 6 year old MN French Bulldog. I've seen him in the past for GERD and mild skin allergies.

He initially presented to his RV with unilateral submandibular LN enlargement which then progressed to a head tilt, facial nerve deficits and a corneal ulcer. He was diagnosed with otitis media and has been on antibiotics for this for 8 weeks with not much improvement. Prednisolone started 2 weeks ago which he had a really good response to (brighter, playing), but is PUPD. He is on a good quality fresh food with adequate prebiotic fibre levels.

I saw him 2 days ago - there was still a foul smell from the right affected ear and he was very painful on light pressure around the area. Right sided facial nerve deficits with reduced blink, drooping of eyelid and lip, and a head tilt to the right.
Pulse was mid depth, full, slightly thin, not obviously slippery. Pulse softened with GB 34.

I thought Shao Yang Disharmony with Wei Qi Deficiency, and Damp heat

I did some acupuncture and started him on QYT, with the plan to then add in Halscion when hopefully some of the inflammation / heat in the ear had reduced. And later down the track think about BZYQT.

That evening he started having discharge from his right nostril and he was admitted to emergency. An MRI showed otitis media, nerve damage, bone infection and meningitis.

I don't think he even would have had a dose of the herbs that day before he was admitted to emergency, so I don't think this caused the progression.

I am not sure where to go from here - plan now is for him to have a flush / install antibiotics and continue medical management.

Do you think QYT is still a good option? Should I be adding in Halscion now, or could the YGJ be too tonifying at this stage? I wondered about adding in LDEMS too, but he did have GI upset whereon this a couple of years ago - perhaps SMS?

Thanks for your help,
Sophie

by naturevet

April 29, 2026

Hi Sophie,

I agree with your assessment that this is a Shao Yang disharmony and would persist in that vein. All the red flags for a Shao Yang disharmony are there, including already being on a healthy diet, nerve damage, lymphadenopathy, chronic otitis, and now meningitis. Even deep bone inflammation is a Shao Yang disharmony issue.

In terms of what Shao Yang formula would help all the above, you're looking at some variant of Minor Bupleurum. Probably the place to start is Chai Ge Jie Ji Tang. You may be able to source a granular version of that, which would be better. Otherwise, if you can get Kan formulas, the Kan Essentials equivalent is Augmented Bupleurum and Kudzu Clearing Formula.

I hear you about needing probably later to follow with a Yin tonic, but right now, the preponderance of symptoms calls for a regulation of the Shao Yang. Damp Heat formulas are unlikely to help when the dog is on a real food diet. As for QYT, it doesn't have as much of the scope that is needed to resolve a lot of these issues. Eventually, if you can beat the problem back to just a chronic ear canal infection, then Halscion (with its Yin tonic component) may finish the case for you. I fully agree that QYT had nothing to do with the progression. It was to be expected after two months of ineffective treatment.

Lastly, consider using at the same time as CGJJT Hoxsey and Boneset from Natural Path. ANVC may have that in stock. It helps resolve deep-seated bone inflammation and infection, as well as lymphadenopathy.

Hopefully, this helps you out. I suspect that it might take a few weeks to get the problem to where you just have an otitis as the main issue, so the main thing to watch for in the days after implementation as that nothing is worse, signifying disease progression because we are targeting the wrong things. I doubt that will be the case, though.

Let us know how it goes, and don't forget acupuncture. GB 20 and points around the base of the ears are likely to help a lot - but if you were to just do one point, do GB 20

Steve

by sophiek

May 2, 2026

Thanks so much Steve, that all makes sense
I am trying to source the Chai Ge Jie Ji Tang as the Kan version won't be in Australia for a few weeks.
I can source a Koda brand version which lists the ingredients as Chai Hu, Ge Gen, Qiang Huo, Bai Zhi, Huang Qin, Bai Shao, Jie Geng, Gan Cao, Shi Gao, Sheng Jiang, Da Zao. But no amounts given in the ingredients. Or a colleague can make up the formula, but again I'm not sure of mg of each herb.
Do you think the above brand would be OK or do other brands ingredients differ from the Natural Path formula ?

Hopefully I'll be able to report some good progress soon!
Thanks
Sophie

by naturevet

May 4, 2026

Hi Sophie,

Those seem like the right ingredients. The Kan recipe is proprietary just like it is for Koda, but reference texts give you some sense of what the proportions should be if you want to make it yourself. I would guess you're okay to just try the pre-made version out first.

Good luck!

Steve

by sophiek

August 27, 2026

Hi Steve,

An update on Theo - he ended up having a TECA and bulla osteotomy to treat the middle ear infection about 2 months ago. The owner stopped herbs at that time (he had only been on them for a week or so before he had surgery.
I saw him again 3 weeks ago and the middle ear infection seemed to have resolved. There was residual nerve damage with neurogenic dry eye being the main issue, but also reduced blinking, head tilt and reduced nerve sensation to right lip. He was under the care of an eye specialist for the dry eye and being treated with pilocarpine (orally), tacrolimus, chlorsig antibiotic eye drops and lubricating eye drops.
Pulse at that time was toned at mid level but very fine and wiry at deep level. Improved with GB 34 and SP 10. So I thought Shao Yang Disharmony and Blood deficiency.
I started him on Halscion.

When I did a revisit today he has been up and down. Within a week of starting the Halscion, the owner noticed improved blinking in the right eye. However, the last few days he has been quite lethargic and on exam today there is lymphadopathy again (submandibular bilaterally and one at the base of the ear on the right), and heat around the head and especially right ear area. I couldn't find anything else on exam so assuming this may be a recurrence of the middle ear infection. Pulse today was not fine or wiry, but full at the mid-superficial level and empty at deep. Thinking Wind Invasion / Shao yang. I didn't get a pulse change with BL 40 but pulse slightly softer with GB 34, so seems like still Shao Yang pathology.

I have referred him back to the specialist to further investigate possible middle ear infection recurrence. In the meantime I've continued on a higher dose of Halscion and awaiting results of further imaging.

If there is middle ear infection, would you recommend CGJJT and possibly Hoxsey/Boneset as before? Switching that out for the Halscion, or continue Halscion as there was an improvement in the blinking?
Is Halscion still the right blend for neurogenic dry eye or anything else that could be helpful for that?

Thank you for your help - I'm finding Theo complicated!!
Sophie

by naturevet

August 30, 2026

Hi Sophie,

It's too bad they jumped into surgery so quickly without giving you a chance to help, since neurogenic post-op complications are hard to resolve.

I think now you have lymphadenopathy and a potential recurrence of the infection, you're looking for now at:
- Chai Hu Jia Long Gu Mu Li Tang (i.e., Halscion without the Blood and Yin tonics)
- Hoxsey and Boneset for any actual bone infection
It's possible that Xiao Chai Hu Tang will work in place of CHJLGMLT if you don't have the latter, but when there is lymphadenopathy, we are almost invariably needing some spin on Minor Bupleurum.

CGJJT is more focused on nerves and less on ear tissue, so I'd be inclined to try CHJLGMLT first unless inflammation and pain is severe. In that case, I would try the CGJJT.

Hopefully things settle down again. If you get the problem whittled down to just a superficial nerve injury (like neurogenic dry eye), then CGJJT could be very helpful.

Steve

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