Ear Infections, Otitis Externa Otitis Interna

This is for Trinket, who recently developed an ear infection and a ruptured ear drum. We’ll cover ear infections, then in later blog, we’ll cover what’s safe to use in the ear if the drum is ruptured.

Ear Anatomy
Ear infections are also called otitis since "otic" means ear and "itis" means inflammation. If the infection involves the outer portion of the ear, it's called otitis externa. If the middle or inner ear are affected, it's otitis media or interna. The ear drum sits at the end of the ear canal and separates the external ear from the middle ear. There are 3 tiny bones in the middle ear. Just deep to the middle sits the inner ear with the nerves for hearing and balance. The middle ear is usually filled with air, but can become infected and filled with pus. The inner ear is bathed in fluid. Infections from the external ear can travel through the ear drum and involve the middle ear or inner ear if the infections are untreated.

Two Types of Infection: Bacteria & Yeast
Ear infections are usually caused by bacteria or yeast, or both bacteria and yeast. (Yeast is a type of fungus and the words are often used interchangeably so your vet might say your pet has a yeast infection or your pet has a fungal infection).

Vertical Ear Canal – Usually Yeast
To decide whether a pet has a bacterial infection or a fungal infection, your veterinarian will put material from the ear on a slide and examine it under a microscope. The ear has a long canal with a bend in it. The first part of the canal, is the part we see when we look in the ear, is called the vertical canal. The vertical canal usually has yeast organisms in it. If the number of yeast organisms if very high, if there is a strong odor or a discharge, the balance between the body’s immune system and yeast is out of whack. Your pet will need an antifungal medication to bring the yeast under control.

Horizontal Ear Canal – Usually Bacteria
The horizontal canal is the deeper extension of the vertical canal. It is difficult to visualize without pulling on the pet’s ear, but when the ear canals are examined thoroughly, veterinarians can see through them right to the ear drum.
Most pets with infected ears have yeast in the vertical canal and bacteria in the deeper horizontal canal. If a proper diagnosis is made, the swab must retrieve material from the horizontal canal as well as from the superficial vertical canal.

Treating Yeasty Ear Infections
Rinsing an ear with douche solution that is 2% acetic acid and water (vinegar) acidifies the ear canal and makes it inhospitable for yeast. Douche solution will clear up a very light yeast infection. Douche solution is also helpful prevention to rinse the ears weekly if your pet is inclined to occasionally have yeast infection. Do not get douche solution that is scented or contains anything other than acetic acid and perhaps 2% boric acid.

Douche solution is not effective if your pet has a yeast infection that is overwhelming. In this case, antifungal medications similar to those we use for athlete’s foot are put into the ear. These otic medications are modified so that they’re exactly right for treating ears, which means they will be runny and will go from the outer vertical canal all the way to the deeper horizontal canal.

Some pets with severe yeast infections also need oral antifungal antibiotics such as fluconazole or itraconazole in addition to the topical otic medications.

Treating Bacterial Ear Infections
If your pet has a bacterial ear infection, it needs an antibiotic medication. The antibiotic can be both a topical that goes into the ear and an oral that goes into the mouth and is absorbed through the gut and is carried by the blood to all parts of the body, including the ear.

Some pets have simple bacterial ear infections, but some have wicked bacterial infections caused by antibiotic-resistant pseudomonas. To fight bacteria, the antibiotic is put into the ear along with a solution that breaks down the bacterial cell wall. An example of this type of solution is TrisEDTA. For many pets it’s necessary to combine TrisEDTA and the antibiotic Baytril (enrofloxacin) to clear up pseudomonas and other gram negative infections. The pharmacist mixes 6ml of 100mg/ml enrofloxicin (large animal concentration) with 4 oz TrisEDTA.

TrisEDTA and Baytril is a liquid solution, rather like water. This is good because dogs can need up to 2 cc to fill their ear canals. We can call these liquid solutions, flushes. Usually we fill a pet’s ear with the flush, and this can take 2 cc each time. The flush is used twice a day for a week or so, then once a day for another week. Then, the vet examines the ears to ensure the infection has cleared. If it hasn’t, material from the ear can be sent to the laboratory to see whether it is resistant to the medication. Obtaining a good culture sample requires anesthesia for most pets. This is also a great time to vigorously flush the ears and to get a good look at the ear drum.

Why not use TrisEDTA and Baytril every time there’s an ear infection?TrisEDTA and Baytril ear flush are only used for bacterial infections. This flush is not a good medication for pets with yeasty ear infections because the Tris portion changes the ear pH to alkaline, and an alkaline pH contributes to yeast growth.

What's coming?
In a future Caring for Pet's blog, we'll cover otitis interna and what's safe to use when there's an infection in the inner ear and the drum is ruptured. And, we hope to let you know how Trinket is doing.

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Paralyzed Dogs Can Recover—What Helps The Most

Some paralyzed dogs recover and some don’t. We've just told Sadie's story. She was completely paralyzed and could not stand, move, urinate or defecate. With her family's care and holistic therapies, she recovered in 10 weeks to be able to run in the woods.

Not all paralyzed dogs recover as Sadie did. I've treated many post surgical dogs recovering from disc disease who remained at least partially paralyzed. I've also treated dogs with disc disease that have recovered completely. What I've seen has convinced me that which steps we take can make a significant difference in whether a paralyzed dog recovers.

What I’ve seen that makes the difference:
• Don’t use steroids—instead use antioxidants and Omega 3 fatty acids to naturally control inflammation
• Immediately begin treating with acupuncture and moxa
• Use electro acupuncture as well as dry needles
• Treat as often as possible—a minimum of three times a week to start
• Have the family reinforce acupuncture by using herb moxa between acupuncture sessions
• Prevent the skin from breaking down while the pet is immobilized
• Put all the joints through full range of motion at least twice a day
• Maintain an optimistic attitude around the pet and keep the vision of the dog as healthy & active.

If your pet becomes paralyzed, don't give up hope. Get holistic veterinary care and start your pet on its journey back to health.

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Paralyzed Dogs Can Recover—Homeopathy

Homeopathy helps paralyzed pets recover. It certainly contributed to Sadie's ability to go from completely paralyzed and unable to move, urinate or defecate to being able to run about in the woods in 10 weeks.

Holistic medicine has many aspects: nutrition, acupuncture, supplements, flower essences, and homeopathy. Each form of holistic medicine contributes to recovery of nerve and muscle function on paralyzed pets, but many families don’t ask for homeopathy because they don’t understand how it works.

Rather than try to explain how homeopathy works, I’m going list the homeopathic medications we used to help Sadie. Sadie was completely paralyzed and we’ve written about her recovery in detail in previous Caring for Pet blog entries. Now, here are the homeopathics I used for her:
• Traumeel oral and injectable
• Neuralgohreum injectable
• Discus injectable

Each of these medications is a combination of homeopathic ingredients. Together, the ingredients form a synergistic whole that benefits pets more than the individual homeopathic ingredients.

Traumeel
Traumeel contains Arnica montana, Belladonna, Calendula officinalis, Chamomilla Millefolium, Hepar sulphuris calcareum, Symphytum officinale, Aconitum napellus, Bellis perennis Mercurius solubilis, Hypericum perforatum Echinacea, Echinacea purpurea, and Hamamelis virginiana.

Traumeel helps control pain, swelling, infection, irritation, and stimulate bone union. Traumeel is best used at the outset of injury but it is also helpful if used during the recovery phase. In my experience, it is better to inject Traumeel than steroids at the outset of injury.

Of all homeopathics I’ve used, I believe Traumeel is the single most beneficial medication for injured pets. It is available as an injectable, oral med with an alcohol preservative, tablet, and cream.

Neuralgo-Rheum
Neuralgo-Rheum contains: Gnaphalium polycephalum, Gnaphalium polycephalum, Gnaphalium polycephalum, Causticum, Colchicum autumnale, Colocynthis, Ferrum metallicum, Lithium benzoicum, Rhus toxicodendron Spiraea ulmaria, Causticum, Colchicum autumnale, Colocynthis, Ferrum metallicum, Lithium benzoicum, Rhus toxicodendron, Spiraea ulmaria, Causticum, Colchicum autumnale.

In my experience, Neuralgo-Rheum helps ease nerve pain, stimulate nerve regeneration, and stop soft tissue swelling. If Traumeel is the first medication I chose for injury and acute paralysis, Neuralgo-Rheum is the second. In addition to helping pets paralyzed through traumatic event, it is helpful for pets that have been hit by car or have sports injuries that damage nerves.

Discus
Discus contains more almost three dozen homeopathic ingredients: Gnaphalium polycephalum, Berberis vulgaris, Cimicifuga racemosa, Cinchona officinalis, Colocynthis, Ledum palustre, Ranunculus bulbosus, Aesculus hippocastanum, Ascorbicum acidum, Cuprum aceticum, Kali carbonicum, Nadidum, Natrum oxalaceticum, Nicotinamidum, Picricum acidum, Pulsatilla, Pyridoxinum hydrochloricum, Riboflavinum, Secale cornutum, Silicea, Thiaminum hydrochloricum, alpha-Lipoicum acidum, Ammonium muriaticum, Cartilago suis, Discus invertebralis suis, Argentum metallicum, Calcarea phosphorica, Coenzyme A, Embryo suis, Funiculus umbilicalis suis, Glandula suprarenalis suis, Medulla ossis suis, Mercurius praecipitatus ruber, Sepia, Zincum metallicum, Sulphur

In my experience, Discus is invaluable in helping dogs paralyzed due to disc disease. It is most effective when started early and should be used intermittently after the pet has recovered mobility. In my experience, dogs paralyzed from ruptured discs that have been treated with steroids or surgical repair do not respond as well to homeopathy as those treated with holistic therapies from the outset.

I used Discus for Sadie because it helps with spinal injury regardless of the cause, but its use is not limited to disc disease. Pets with arthritis, spondylosis, and other joint problems, benefit from Discus, especially when it is injected at appropriate acupuncture points.

Summary
Homeopathic medications help paralyzed dogs. Unfortunately, they are not as easy to give as some other medications because they cannot be combined with food. Instead, they are given by injection or given when the mouth is empty, usually by crushing between two spoons and placing the powder inside the cheek to be absorbed through the mucous membranes. No paralyzed pet should go without them.

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Paralyzed Dogs Can Recover—Acupuncture

Nothing is more heartbreaking than a paralyzed pet, but don’t give up hope: acupuncture can help restore nerve and muscle function. In a previous blog, we told Sadie’s story. Sadie went from complete paralysis, including inability to move her legs and inability to urinate or defecate, to running in the woods in 10 weeks. Many pets, just like Sadie, can recover from apparently hopeless paralysis.

What we did for Sadie
Acupuncture that helped Sadie included dry needles, electro-acupuncture and homeopathic injections at acupuncture points. We started with more than 20 acupuncture points and used fewer and fewer points as the treatments progressed. We chose which points to use based on Sadie’s symptoms.

We started with needles in the webs between her toes, on the outside of her front paws and her back paws, and along her back. After inserting all the needles, I ran an alternating current between points above and below the spinal injury. For Sadie, I also injected homeopathic solutions from BHI-Heel into the four points that benefit the whole spine: SI 3 and BL 62. This medication lingered at the points, continuing to send its healing message along the meridians, rather like holding a finger on an elevator button continues to ask the elevator to come to your floor.

I’ll describe how to find SI 3 and BL 62 so that if your pet has a spinal problem, you can massage these points to bring energy to the spine. Massage at these points will also help pets with disc disease.

SI 3
SI 3 is the third point on the Small Intestine meridian. Usually, it’s easier to find SI 3 on yourself, then look for it on your pet. Feel alongside the edge of your hand away from your thumb just as the hand bones join the littlest finger. The hand bone is a metacarpal (MC), and the metacarpal on the outside is MC 5. As MC 5 forms a joint with the bones in the little finger, it widens. The dip just before MC 5 widens is where SI 3 is located. Most people have one or more tiny wrinkles here.

To find SI 3 on your dog, wiggle the toes (digits) of its front feet. A dog’s digits are shorter than our fingers are, but it’s easy to see where the digits flex as they form a joint with the metacarpals. Feel along the outside (lateral) of MC 5 for the dip just before MC 5 widens. This is in the right point to stimulate energy that helps the spine, especially the neck. Stimulate this point on both right & left front paws.

BL 62
BL 62 is the 62 of 67 points along the bladder meridian. The bladder meridian starts at the inner corner of the eye and runs along the spine all the way to the little toe. BL 1 is at the eye, and BL 67 at the outside of the nail on your smallest toe. BL 62 is the point along this meridian where you can feel the dip on the outside of your ankle bone. It’s easy to find if you grab your Achilles tendon. The ankle bone (lateral malleolus) is just in front of the web of skin in front of the Achilles tendon. Find the most prominent part of the ankle bone and slide down on the bone into a tiny dip. That’s BL 62. Massage here to help pull energy all along the spine.

Massage both SI 3 and BL 62 to benefit your pet’s entire spine.

What’s coming?
In the next few Caring for Pet blog, we’re going to cover the homeopathic meds that can help paralyzed dogs, focusing on those we used for Sadie. Never lose heart if your pet is paralyzed. Use homeopathy, acupuncture and holistic medicine. And pray: “May the best that can happen, happen. Amen.”

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Paralyzed Dogs Can Recover

Sadie's Story
Don't be heartbroken if you have a paralyzed dog. The future may look hopeless; you may be in tears, and your pet may be in pain; but there is hope. Let me share Sadie’s story because it’s a great example of what’s possible when a family doesn’t quit believing that their paralyzed pet can recover.

Sadie is a beautiful blonde 8-year old Akita-Lab mix that developed sudden paralysis May 18th. When I met her,Sadie was unable to move anything but her head. She was unable to urinate and unable to defecate. She couldn’t take a drink of water or eat a bite of food unless she was rolled onto her sternum and held so the bowl was directly under her mouth.

A few days earlier, a neurologist had told Stacy and Avi, Sadie’s guardians, that Sadie needed an MRI to establish what had happened to her spine. You can imagine the sinking feeling they had when told they needed several thousand dollars for tests. To make matters worse, Stacy and Avi had booked nonrefundable tickets for a trip out of the country. The flight was leaving in 5 days.

Making the decisions that helped Sadie
Stacy and Avi decided that rather than invest in an MRI, they would invest in acupuncture and homeopathic therapy. Stacy asked for my help and we created a treatment plan. Stacy had elicited a friend’s help for the period they would be away; and Abe, Stacy and I refined the plan so it would work in their absence. Then, Stacy set to work changing Sadie’s diet to home-cooked meats and vegetables rather than canned food or kibble.

Our plan included the best of allopathic and holistic medicine. Sadie would receive a house call every few days. During the house call, I would acupuncture Sadie and give her homeopathic medications. Between visits, the family would moxa specific acupuncture points. Sadie would be turned every few hours. Three times a day, she would be carried outside and her bladder would be manually emptied. Her bowls were manually emptied until she was able to defecate on her own. We added flax to her diet to increase the bulk in her feces and get her stimulated to defecate as soon as possible.

The challenges of wet bedding and shedding
Sadie had been an outdoor dog with the thick Akita coat but she couldn't be left outside where, paralyzed, she couldn't protect herself from flies, rain, wind, or sun. Sadie was moved indoors where she shed up a storm.

Loose hairs were not the only housekeeping challenge, because within days Sadie became incontinent and leaked urine. Her bedding need to be changed, washed & dried multiple times during the day. The family bought potty pads by the car load.

Handling the health problems
During her illness, Sadie lost muscle mass. Her weight went from 80 pounds to 70 pounds, and by the time she quit losing weight, she was probably nearer to 60 pounds. Her limbs stiffened. Her bony joints rubbed on the bedding and it looked as though she might develop bed sores. We handled these problems by feeding Sadie more often, frequently massaging and moving her limbs through full range of motion, and positioning her elbows and ankles to prevent skin breakdown. Sadie received bed baths to keep urine from scalding her skin. We continued with acupuncture. We used injectable and oral homeopathics. We added a Chinese herbal formula, Minor Invigorate the Collaterals.

Baby steps
By the first of June, about two weeks after she became paralyzed, Sadie was standing on her own. Stacy & Avi were in Israel and couldn't see Sadie's first steps to recovery. Abe wasn't sure Stacy & Avi believed what he was seeing when he discussed Sadie during their phone conversations. Abe had seen Sadie stumble outside to urinate and, indeed, her bed was no longer wet. Abe also believed Sadie had climbed down one flight of stairs and back up. Abe wisely blocked off the stairs because Sadie was neither strong nor coordinated, and she could easily hurt herself with a missed step.

More problems
Sadie developed diarrhea and we changed her diet. Abe fed her small frequent meals of broth, rice and chicken. We continued acupuncture, homeopathy, and the range of motion exercises. We kept the stairs blocked off but let Sadie spend more time outside. We made sure no flies had laid eggs on her coat as she slept and no maggots were able to penetrate her skin. Maggots are a living hell for many paralyzed animals.

Stacy & Avi return to a stiff, mobile, elated Sadie
Four weeks after having been too paralyzed to pee, poop, or move, Sadie had full control of her bodily functions and was able to walk reasonably well. Stacy & Avi returned to find a stiff, but mobile dog.

At that time, only one of Stacy's legs actually received messages from the brain that let her know where it was in space (proprioceptive placing), but Sadie was able to stand to urinate, defecate, and eat. Her skin was intact. She had not developed bladder infections or skin infections. Her appetite was great and she could begin rebuilding lost muscle mass.

The strength to climb 3 flights of stairs
We were all thrilled, but there was work to do because Sadie lived 3 flights up from street level and our goal was for Sadie to be able to run in the woods. Sadie would need to climb the stairs under her own power. Over the next few weeks, with her beloved family at home, Sadie grew increasingly stronger, and 10 weeks after Sadie became paralyzed, I got this note:

“I wanted to let you know that Sadie is doing very well. She is now able to go up and down the stairs to walk in the woods twice a day. She is loving it. She also is running a bit like a trot and she has a huge smile on her face. I have been giving her the herbs 2x a day - I think it is helping with her energy and vitality. Thank you for all your support. Avi's youngest son said the other day "Sadie's back!" that was a joy to hear. Love, Stacy"

Pray & don't lose hope
If you have a paralyzed dog, be like Stacy & Avi, don't lose hope. We do not have miracles for paralysis, but we do have the great traditions of Chinese & Western medicine. And, we have the prayer, “May the best that can happen, happen. Amen.”

What's coming?
Over the next few Caring for Pet blog entries, let's discuss the acupuncture techniques, homeopathy, herbs and attitudes that helped Sadie overcome paralysis.

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