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9 Mo. old pug - AMR UTI, Antibiotics, Very Lethargic + fever

KaminiJ

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  1. Chia
  2. 9.5 months
  3. Female
  4. Neutered
  5. 75% Pug, 25% Chihuaha Pekingese
  6. 15lbs - underweight
  7. Normal BEAM - playful, happy, cuddly, run for 20 mins then pass out, loves her cooked food and fruit. Current BEAM - extremely lethargic, interest in people & sniffing, but otherwise can't get up. Eating small amounts of food slowly with encouragement.
  8. First 7 months of life - Royal Canine kibble, then Open Farm Kibble. Last 2 months - homecooked organic turkey & beef or egg + raw or lightly cooked veggies + fruit. Sometimes added flax, hemp, zinc drop, or b12 drop.
  9. Vaccination history / exposure to toxins, other medication - Rabies, Bortdatella, DAPP, and Leptospirosis Vaccines in 2021. Simparica trio monthly from 3-9 months of age for flea & tick prevention. 5 rounds of antibiotics for folliculitis, sniffling/sneezing, spay at 6 mo, spay not healed well, and currently she is on on day 2 of Amikasin injectable antibiotics for AMR UTI.
  10. Primary problem - UTI, began around January 5th 2022. Was licking herself, some accidents, took to vet for urine culture. Came back with AMR UTI and we waited to see if it would improve. It did when we started cooking her food, threw out kibble, added barley grass powder + vitamin C + olive leave + pau d arco. Around March 11th suddenly symptoms resurfaced with licking/accidents diarrhea, blood in urine, so we did second urine culture and got same AMR UTI results. Within a few days she went from tons of energy to lethargy + 105 fever + shaking and we went to the ER 3/14. They administered fluids, kidney test, and she's currently undergoing 7 days of antibiotics. She is on day 2 today 3/16. Tested Negative for parvo.
    1. We could see on her pee pads that she had brown crystals for at least the last 4 months. Small brown dots, would range in frequency. Haven't been seeing them last few weeks.
  11. Is the condition better or worse from exercise, heat, cold, time of day, certain foods, emotional upset, being touched, excitement - Haven't noticed any difference. She loves to be outside, loves people, touching, and other dogs. Rarely upset - only when hungry. Currently she is very lethargic and a little bothered after meals.
  12. Has any diagnostic work been done? - Yes see attached, kidney blood work, urine culture
  13. Treatment - Different antibiotics in the past, pain medication. Currently taking Amikasin & anti-dhiarrhea nothing else. Anti-dhiarrhea medicine has caused constipation for the last 18 hours. Hasn't been eating much in that time, so not administering it.
  14. Other health concerns: 1. Antibiotic resistant UTI (MRSA) - lethargy, diarrhea, lessened appetite, fever, shaking. Currently receiving Amikacin shots planned for 7 days to treat.
    2. Skin infection on chin since we got her at 2mo old. After we switched to cooked food 2 months ago, skin infection nearly cleared up except 2 small bumps remaining and persistent. Think it could be related to chicken allergy as well, not feeding that currently.
    3. Spay healed very slowly, stitches were inflamed, this required extra round of antibiotics & pain medication before it healed fully.
    4. At 2 mo old received 2 rounds of antibiotics for sniffling/sneezing, sinus concerns. This problem does not seem to have returned. She still experiences lot of grey discharge from the eyes.
@Dr. Jeff @Dr. Christina @Dr. Sara
 
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Dr. Jeff

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Wow, Chia has way to much to be going on for such a young pup!o_O I'm super grateful to hear how much you've helped her. ?❤️We may be able to help you and your vets do something about the infection, diarrhea, fever, skin stuff, low energy, etc. Kamini.

Let's take a step back from Chia's plethora of symptoms. The reason is that all of her symptoms are secondary to just one thing so let's focus on that.

The one thing is that every cell in her body needs fuel/energy/information to do their jobs (making symptoms).

When there is enough energy, and if it is balanced through a species-appropriate lifestyle, symptom management, etc. then the signs (clues) that everything is OK are the ability to have a normal life full of the freedom and flexibility that she deserves.

Like the natural law of conservation of energy, that is a medical "law". Cells can not operate without fuel (like ATP, NAD+, etc.). The cells of all living beings die without energy.

What isn't a law though, and which may facilitate dis-eases (internal imbalances), is that it is the way we manage symptom clues directly effects development of dis-eases.

For Chia, my clinical curiosity would want to know the details of her first truly natural skin dis-ease. The reason being that the details of her initial symptoms are what guide energetically-oriented vets (like at HA!) to ways that she can recover in all ways.

This can be a very long discussion, but it's almost time for HMDM calls, so I gotta run and can't wait too hear what @Dr. Sara @Dr. Jean and @dr_ judy herman @Dr. Sue have to say about Chia's secondary urinary infection, fever and LOW energy. ?⚡



⚡
 

Dr. Christina

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Some of us are born naturally healthy, others with many problems initially yet either can DEFINITELY be healed and live a long life.

Because Chia has had so many problems, I would definitely be working with a veterinary homeopath starting now. You may need to try more than one as you learn to build natural vitality and immunity.

As a member you can become a virtual client of Dr. Jeff, or Dr. Judith Herman whom you can hear speak in the empower hours. Or check www.theavh.org for one who may be near you.

Dr. Christina
 

GinnyW

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Speaking as a lay person, I will still say that, yes, I can see resolution of all these issues in her future. Let's see if we can start working on her diet, towards simple, raw, and full of the factors she will need. This can - and should - be pretty simple, initially, and I would expect she'd eat a bit of raw or lightly cooked meat and eggs. Keep her immersed in happiness:) - all the things she loves to do and see: games, walks, rides, people, dogs, tricks...

My first dog was a bit like this: overdosed with vet stuff: drugs, shots, topicals, anesthesias, surgeries. We started turning him around at four years old, with homeopathy and raw food. EVERYTHING changed! Dr. Jeff was involved from then to the end of his life at 14. The outlook is bright for your little girl, too, and you are in the right place to get what is needed.
 

Dr. Jean Hofve

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You've gotten some great suggestions for treating her whole body, and constitutional homeopathy is definitely what she needs for overall healing. But let me suggest a couple of things that address her discomfort right now.

What stands out to me is the lack of calcium in her diet as you describe it. Calcium is essential for nerve, muscle, and heart function, so restoring that balance could be very important. Deficiency might help explain her lethargy and weakness. For homemade, I add one heaping tablespoon of calcium powder (I like Standard Process Calcium Lactate) per pound of meat.

I'd lay off the fruit, too--too much sugar/fructose that can jack up her energy temporarily, yet cause collapse once it's used up. It's like fruit juice for a 2-year old, they run in crazy circles for 10 minutes and then just tip over!

Brown dots in the urine could be crystals, but also could be just little clots of blood leaking out due to the inflammation in the bladder lining. My #1 things for UTI is fluid, the more the merrier. Make her food soupy, add warmed chicken broth or stock to increase its good smell. If you can get some extra antioxidants on board to help tamp down the inflammation, that would be great, but don't push stuff she really doesn't want right now. Subcutaneous fluids may be indicated at some point.

One of my favorite tricks for stubborn dog UTIs is canned cat food. It's high in protein and encourages a more acidic urine, which will dissolve struvite crystals (if that's what you're seeing; it's the most likely type in a puppy.)
 

KaminiJ

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Thank you all so much for your initial feedback! Wanted to provide an update of some changes:

Her overall health:
  • No longer seeing blood in urine, no diarrhea or excess licking, no fever. Still low energy, but very happy, tail wagging for us, but noticing some new fear of strangers & other dogs. Wonder if it's related to so many hospital visits + poking in the past few months.
  • Chia is now working with a holistic vet (Dr. Pasternak) based out of LA. The other 4-5 vets in LA on the list are not currently accepting patients! It's very busy out here :) Thank you @Dr. Christina for suggesting this.
Changes we've made:
  • Per @Dr. Jeff recommendation, have added in some soaked chia seed water for hydration. Now taking her on 1 or 2 30-minute sniff walks each day to boost BEAM - she loves these and has more energy afterwards.
  • Holistic Vet prescribed 5 herbal medicines: (Pure Cranberry with D-Mannose, BHCC Immune, Pro-14, Cyto-Ess, Epicor)
  • Holistic Vet performed a fecal transplant to boost immunity
  • Per @Dr. Jean recommendation will be getting the Calcium supplement & experimenting with cat food + chicken broth. Reducing fruit as well.
Next Steps:
  • The vet did an x-ray that showed some change in the kidney (kidney appears dark, picture attached). Recommended an ultrasound to check for stones or scarring. Her past blood work did not indicate kidney infection or toxicity.
  • Vet conducting fecal transplant once a week for several weeks to boost immunity.
  • Second urine culture recommended this week to see if antibiotics cleared the infection, and we'll continue holistic immunity boosting protocols.
Questions:
  • She currently eats cooked meat + raw veggie + some freeze dried raw. Are there any recipes you all recommend to follow when experimenting with cooked/raw feeding? Or brand recommended for canned cat food?
  • I noticed some recommendations in other posts about essential oils, or other immunity protocols. Is it too soon to bring something like that in?
  • We give her Simparica Trio each month for all pest prevention. For a puppy like this, might it make sense to consider more natural solutions? Or wait on these kinds of changes as well

ABDOMEN_LATERAL_6204.jpg
 
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Dr. Jeff

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Hey Kamini-

Great news that Chia is loving her Therapeutic Sniff Walks and is doing a bit better!

1. No matter which recipes you use Kamini (including ours), please vary them since most do not provide 100% of nutritional needs. Dr. Jean (who has written extensively about nutrition) tho may have other ideas including specific cat foods.

2. Good immunity balancing foods and supplements are always OK to start IMHO. However,it sounds like Dr. Pasternak has already prescribed some wonderful ones so start with these. You may not need to use any others.

3. Yes, it would make sense (to me) to look for non-chemical solutions to pests. Essential oil blends like Away or Evict from animaleo.com are great, especially when combined with daily manual inspection and flea combing.

There are lots of other suggestions depending on Chia's exposure to fleas/ticks/mosquitos/heartworm disease.
 

KaminiJ

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I spent the weekend visiting my parents about an hour away, and have noticed upon returning that Chia is very low energy. She usually loves visiting them but this trip seemed very anxious/scared (spine raised, dodging pets, running to me). Other changes include that she had Simparica trio last Thursday. And accidentally a double dose of cranberry d-mannose on Sunday which caused vomiting.

We think she had a fever/light shaking last night (Tuesday), little bit of incontinence or too tired to get up and pee. She has been lethargic for most of yesterday and today, although still eating some. No blood in urine, no licking.

Our original allopathic vet was scheduled for urine analysis today to check on the infection but I'm not sure about having her poked more when she's not feeling well. We're making sure she gets lots of fluids. She's supposed to visit the holistic vet on Friday for a fecal transplant/check-up. Any recommendations? Or what would constitute an emergency that she should be seen somewhere?
 

DanielleDL

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I'm not a vet, and I'm still pretty new to this forum, but my dog Bobby (1.5yo GSD mix) doesn't do well on Simparica Trio. He took it for four months and the last two months the side effects were enough to stop giving it to him (mostly diarrhea, lethargy. And I wonder if his inflamed outer ears [otitis externa] and heightened anxiety might have been side effects as well. The otitis externa is definitely on the side effect list, and I would think that just not feeling well would heighten his anxiety.). He also had leg surgery back in October, and he's a shelter dog full of vaccines (and antibiotics from the diarrhea), so we're just starting our balancing act with him. When the current dose of ST gets out of his system, which should be soon, I'm going to switch to putting Wondercide on him before walks, and they just came out with a flea/tick/mosquito collar that I'm going to try (especially since he likes to stick his face into tall grass). I'll also be trying Dr. Jeff's suggestions. I'm totally creeped out by bugs, and scared about what could happen if a pest ever caused disease in Bobby, but the flea/tick/hearworm meds scare me just as much. Not giving any advice here, cuz every dog is different and I'm no expert, but just wanted to share my personal experience with Simparica Trio. Took a couple weeks for his BEAM to improve after the last two doses. I hope your little baby girl feels better soon!!!
 

Dr. Jeff

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Sorry to hear about Chia's symptoms a few days after Simparica. I agree 100% with Danielle about avoiding it and unintended ill effects from using it.

In addition to Wondercide, essential oils, magnetic tags,etc. one conventional, but non-systemic and potentially less harmful, option is the occasional use of permethrin impregnated bandanas, shirts, etc from:


One other thing to consider Kamini is starting to work with a trained and experienced vet homeopath (in addition to the great holistic care from Dr. Pasternak).

Drs. Herman and Sagrera are both wonderful to work with (and can consult with you virtually):


 

KaminiJ

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Thank you so much for this feedback @DanielleDL and @Dr. Jeff . I will definitely reach out for consultations for vet homeopathy and discontinue ST after this current dose. It seems there are many other solutions that just take a little more time and research.
 

KaminiJ

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Chia's urine analysis today came back as still positive for the resistant Staph infection (MRSA). She has a fever around 103, they administered fluids. Allopathic vet is recommending 3 additional weeks of Amikacin which we will do anything to avoid. That dr. has also not worked with an infection like this before.

I'll speak with both Dr. Sagrera & Dr. Pasternak separately on Friday if anyone has advice of considerations to bring up. We will try to get an ultrasound this week to check on her kidneys, multiple doctors mentioned possible genetic problem or scarring.
 
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Dr. Jeff

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I'm sorry to hear that Chia still has resistant bacteria in her urine, and low grade fever (her body trying to mobilize it's defenses).

I'm super hopeful that a few doses from Dr. Sagrera helps Chia's BEAM and immunity.
 

Dr. Jeff

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Kamini, I was thinking about Chia this am and wonder if she might like little pieces of freeze-dried heart?

These are super yummy to most dogs and cats! If she likes them, they would be great to use in the snuffle mat.
 

KaminiJ

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Thank you so much, Dr. Jeff and others. We will definitely be getting a snuffle mat and some treats to keep her busy. Per everyone's suspicions, Dr. Segrera also felt that Simparica Trio was the cause of her anxiety/spine raising around her favorite grandparents last week. The last dose was the last. She got a second fecal transplant yesterday, the last one for now as well. No fever, or visible blood in urine. But we noticed shaking after meals (nausea/pain), and some folliculitis on her face, some lethargy but overall happy and more playful than before.

She'll begin taking the AE Sea Calcium supplement on Monday, and is loving her bone broth so far. If anyone is curious, Dr. Segrera recommended to continue with her cooked food, 70% meat + 30% carb (potato, quinoa, or veggie). She prescribed a remedy + supplements (Hepar Sulph Calc 6C, Aminovast, Folic Acid, B complex, D3, L-Glutamine). She suggested Vet Classic Urine Support was a better alternative to Pure Cranberry, and would like Chia to remain on the BHCC Immune, Pro-14, Cyto-Ess, and Epicor for now.
 

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