Kaya, 7 1/2 Month old GSD, anxiety-related cystitis? Getting a clearer diagnosis and alternatives to standard-of-care

[AlysonR]

We've had Kaya, our 7 1/2 Month old (maybe older, probably not) GSD for about 3 1/2 weeks, now. We got her from a neighbor, who got her from a guy going through a divorce. According to the guy, Kaya was bought for $600 from a (backyard?) breeder and kept in a crate about 20 hours of every day since then. Also, the wife was the one who took the dog to the vet, so the guy didn't know much about her medical history. I have tried to get more information, to no avail. I was told she is housetrained, and I surmised from a comment my neighbor's wife made (they had her for under 2 weeks) that they had been controlling her water intake to avoid urinary accidents in the house.
First day -- it was warm, Kaya played non-stop with my other dog, Merlin, and she drank several gallons (no exaggeration) of water and would pee almost immediately following each drink. That was on a Monday. She was seen by the vet on Friday (earliest appt.) and it was determined she had a UTI (chronic) due to: Monocytes high (2.45 K/ul), MPV high (14.4 fL), WBC 5 /HPF, RBC < 1 /HPF, Non-squamous EPI <1 /HPF, nothing else detected (no bacteria detected!!), Catalyst Dx all normal, and LEU 100 Leu/uL (1.006 specific gravity -- but it was a midday catch, and pH of 7.0). So she went on antibiotics. Two weeks later, Monocytes are at 1.38 K/uL (improved!), MPV 14.8 fL (slightly worse), WBC 6 /HPF (but specific gravity at 1.033 -- much improved), RBC 1 /HPF (slightly worse), pH 6.0 (much improved), LEU 25 Leu/uL (much improved!).

So, overall, things have gotten better (with the exception of the WBC), but the situation hasn't completely resolved. And Kaya is still drinking more than what *I* would call normal, although I don't really know what is normal for her. And the vet wants to put her on Carprofen for the bladder inflammation, and Prozac for the stress she thinks is now the underlying cause of that inflammation. While I certainly agree that Kaya has been under a lot of stress -- her socialization skills with both people and other dogs outside of this family is basically nil, for instance -- if we had gotten her yesterday, based on what I see, I would not have taken her to the vet for a possible UTI.

So...here are the questions:
1) The only reason I can see for following through with the vet's plan is to make a definitive diagnosis through, hopefully, a relatively benign (hear me out!) treatment. Is there *any* possibility, given the numbers I've given above (and everything else in the UA and CBC were normal) that this could be something else that would develop rapidly (within the next 6 months) into a major problem? Having just gone through this with Magic, who was diagnosed in May with some inflammation of the bowel -- which turned out to be spleenic hemangiosarcoma with liver involvement -- I'm VERY gun shy. In Magic's case, the bleeding was off and on, so I didn't go back to have her re-evaluated. I dropped the ball, but my vet did, too!
2) If I don't go through with the vet's treatment, what can I use to bring the stress down? I currently have Kaya on Calming Care and Springtime, Inc's Calmplex, both of which were helpful for Magic. I can and will do TTouch on her, but what else would be 'relatively quick' to take down her stress? The vet is thinking follow-up in 1 month!
3) If I don't go through with the vet's treatment, what can I use to bring down the bladder inflammation (Kaya is slurping water just now )? Is it harmful to let it just reduce naturally as her stress decreases? She doesn't have near the problem with needing to go outside all of the time.
4) If I do go through with the Vet's treatment plan, what are things I can do to mitigate the probable side effects of the Prozac and/or Carprofen? *My* doctor works with patients that do both conventional and non-conventional treatments, as well as patients like me who just do non-conventional treatments. That's opened my eyes quite a bit. According to the testimonials on his website, he can reduce side effects of, say, chemo, to almost nil, as well as supplements to make those treatments far more effective. (Unfortunately, neither he nor I see the use in adding anything conventional to my own treatment plan.)

Any and all suggestions welcome. I've got the time, knowledge and situation to work with Kaya's fear of people, but I don't want the delay in stress reduction to harm her physically. And I don't want to have her present with the same UA and CBC in a month -- or even worse 'numbers', especially if I stand up and say I declined the treatment my vet prescribed.

 

[Dr. Jeff]

Hey Alyson! Congratulations on your new puppy, and thanks for sharing all those great details.

I want to address all of your questions as they are super helpful and important.

Time doesn't allow me to do so right now, but I did want to share 1 thing before I gotta run. And that is to get her out to sniff, connect and be as happy as possible (fun and easy for a well-socialized pup but for Kayla you may need to go slow).

The Happiness Protocol in Your Pet's Life

At HA! we are committed to much more than helping pets become dis-ease free. We promote restoring and maintaining vitality, balance, energy, & happiness.

www.holisticactions.com

 

[AlysonR]

Of course! 2 sniff walks a day -- about 30 minutes each, sometimes longer (all of my walks with the dogs are sniff walks, fyi). She plays all the time with Merlin and enjoys it thoroughly (she's currently sacked out under the table after a vigorous play session with Merlin). She gets chews as necessary (especially when she's starting to attack a toy with gusto). One marrow bone (small) a day. Two if she's especially hungry or anxious. She gets training after the second walk of the day (clicker training -- no force). She's always with me if I'm in the house, and I'm retired, so I'm in the house most of the time. She's always with Merlin unless I'm taking either of them out for individual training or to the vet (Merlin barks at people, especially if he's in the car, but he's quite friendly with them once they get within about 1 ft. of him -- don't need to give Kaya any ideas, though). She gets time to relax with me in the evening -- complete with TTouch if she's close by, and she usually is. I've avoided giving her access to too many soft toys, as she's still in the chew and destroy stage, but she's got some (and, amazingly, Merlin's not guardy about them!). Food: dinner fresh, breakfast canned, high quality kibble to supplement, and freeze-dried ground and mixed with cream cheese stuffed into old bones or trachea chews as a treat after our dinner. The yard is 1/2 acre, fenced in, and there's a dog door to it, so the dogs go in and out as often as they want. There are lots of choices the dogs get to make (including choice as to where to walk, what chew is preferred, where to sleep (we have 3 dog beds upstairs and 3 downstairs, and there's always the floor and rugs, which are often preferred). They say choice is important for happiness, and that's been something I've been interested in since I first adopted a dog back in 1988. As I often say, I don't want to come back (after death) as any dog, I want to come back as one of MY dogs! Have I missed anything?

We live on a 63 acre farm with permission to walk on the neighbor's 150 acre farm, and the roads are pretty empty, too. If anything, she's getting too little exposure to people and dogs at the moment, so I'm starting to train using a friend of mine as the 'scary person' sitting over 100 ft. away. We've done 2 sessions so far. I pushed it the second session and she barked (individually) a couple of times. We quickly walked back to the car after that. Lots of treats and clicker training (on easy cues she already knows) during each session. Next session, hopefully, will be a couple days from now, but it'll depend on the weather, as we're training outside. We really are trying to limit situations that would provoke her anxiety, but she's got FOMO (fear of missing out), so if I'm right outside the door, she goes a bit crazy, jumping up and whining (as does Merlin, sigh...). But once I'm out of ear shot, she calms down pretty quickly. We don't have a crate for her and we don't plan to get one.

Please understand (and Dr. Sara can attest to this), I've been reading Whole Dog Journal since it came out, around 1998. I've been working with holistic vets since a few years after that. My first dog saw an acupuncturist from 1999 until he died. I also took him to Carvel Tiekert, one of the first holistic vets and former head of the AHVMA. That was when I started feeding raw, too. He got to choose his walks, too. People would ask, "Who's walking who?", and I'd reply, "We take turns." And that's the truth. I was employing choice in my dogs' routines LONG before it became "a thing". My first dog learned "show me" via me holding out two different treats covered by my hands and him pointing at the one he wanted with his nose.
One night we came home from a walk in a heavy rain. We'd gone up to the maple sugaring to cover the boiling pan. He wouldn't settle when we got back. I asked him, "Show me." He pointed his nose to the kitchen towel. I toweled him off, and he settled right down. I actively work to understand what my dogs are asking me, giving them opportunities to show their preferences. If I'm really missing something in the "happiness protocol", please, "Show me!"

 

[AlysonR]

Well... I just picked up the Prozac (Fluoxitine) and Carprofen. The only instruction on dosing I got was on the bottles, and for the Prozac, it said "2 (20 mg) capsules TWICE DAILY 12 HOURS APART". Kaya is 60 lbs. That's triple the dosage she should be getting. I called in and got a response from the person who filled the prescription who said only the bottle label was wrong (I.e. the vet prescribed the right dose). It was supposed to be 2 capsules ONCE a day. I'm still ticked, and I've decided to try to find another vet. What if I hadn't looked up the proper dosage on the web? I know Prozac is *fairly* safe (in terms of long term side effects), but still. What if the medication had been something more "fussy"? Totally unacceptable. Any ideas on finding a vet near the Eastern Panhandle of WV (Levels, WV, to be precise)? I'm thinking I'm going to have to go with a conventional vet and just decline certain treatments. But...there's the issue of Kaya reacting (barking and a bit of lunging) to people, which is going to give any new vet pause, no? I still strongly believe Kaya is a barker, not a biter, but she's a GSD, and they do have a reputation.

I've also decided I don't want to go the route of Prozac and Carprofen, at least not yet. Both walks in our woods and pastures today included *NO* sightings of humans. She's not getting constantly exposed, so she's not in a constant state of agitation. I have dealt with reactive dogs before, albeit never one that barked and lunged at humans. My dog River was scared of humans, too, but he backed away from them (or acted goofy), rather than tried to scare them away. My dog Phoenix was so reactive to other dogs initially that she would get whiny and nervous if she so much as smelled another dog. When I took her to a Nosework class the first time, I had to feed her *constantly* just so that I could hear the instructor. Otherwise she would bark the entire time. She was better the second class, etc. By the time she died, she had successfully integrated with a new dog in the house! '

So, the questions remain:
1) What other 'alternative medicines' are there to help me in my quest for a calmer dog? I started CBD oil (because I have it) tonight. I've never found Rescue Remedy to be effective. She's on Purina's Calming Care (which will take a bit longer before I can tell if it's making a difference) and Springtime Inc's Calmplex. What else?
2) Should I worry about the slightly inflamed bladder? If so, any ideas how to help it? She's got free access to water, now. And I'm trying to minimize exposure to things that make Kaya anxious. Other ideas?
3) Do I need to worry that the inflamed bladder/off-normal blood work could be something else?

Thanks!!

 

[Dr. Jeff]

You're doing wonderful work with using the Happiness Protocol with Kaya!

Perhaps just do as much of what you're already doing and especially focusing on what she loves to do the most, and gradually socializing her. Has she tried agility or tracking? @beccak do you think Schutzhund training would help her? Persistence and patience are the keys.

My impression is that the key to most/all of her emotional and physical problems are in the months before you adopted her.

To answer your most recent questions:

1. There are many, many natural and holistic supplements that can help palliate anxiety. But I really think she can still be "cured" and don't think any supplement will be the answer.

IMHO, her dis-ease is energetic and the physical part is just the tip of the iceberg. Have you looked into the energetic tool from Assisi called CalmerK9? It's researched primarily in separation anxiety but I've seen it help many other physical and emotional challenges:

Calmer Canine® – Dog Anxiety Treatment | Assisi Animal Health

Discover a dog anxiety treatment that works with Calmer Canine from Assisi Animal Health. A drug free separation anxiety treatment for dogs.

assisianimalhealth.com

Regarding homeopathy (which I think may be the answer) you mentioned @Dr. Sara and I wonder if you worked with her or another trained and experienced vet homeopath, such as Judy Herman or Adriana Sagrera?

Animal Wellness Center

At Animal Wellness Center, our primary modality of treatment is homeopathy. We also use nutritional supplements, western and eastern herbs, Bach flower essences, and conventional medicines where deemed appropriate.

www.judithhermandvm.com

Natural Pet Care - Metairie / New Orleans, Louisiana - Dr. Adriana Sagrera, DVM

Dr. Sagrera is committed to alternative medicine as a way to improve the health of her patients by the most natural and non-invasive means possible.

drsagrera.com

2. Perhaps monitor her bladder inflammation but don't worry about it. Is she showing any urinary pain, crying before or after urination, visible blood in her urine...?

3. Same thing with her blood abnormalities. I think as her emotional state improves, so too will her blood parameters.

I think the most important thing right now is to add a vet homeopath to your vet care team. Do you have a nearby internist for monitoring and diagnostics?

 

[AlysonR]

Given where I live (Levels, WV), doing any kind of sports with Kaya would be pretty difficult. If you're thinking Schutzhund, you're thinking, I presume, lack of confidence might be part of the problem. That is something I can address through TTouch, so I'll think on that and do a bit more with it. I haven't dragged out the TTouch maze in ages . Also, general training will help with that, and that's something I'm already doing.

I do want to get her better socialized, and I'm thinking things like walks along the C&O towpath could be helpful, especially this time of year, when we're likely to see only one or two other walkers. Line of sight is long, there, so I can set her up to be quite far off to the side while the person or people walk by. The thing that's helped my other dogs fearful of people is just me being at a distance from the person and talking to them, while the dog is allowed to be at a much further distance and watch. Also, I just talked to the neighbor who gave her to me, and he said that to introduce her to people, he was straddling her (protective posture?) and petting her while the person approached. ACK!, you say (or I would, because it sounds like a recipe for disaster to me, and it's not something I'd recommend anyone do) -- except that's what we do now to keep her from lunging at cars, and it's working just fine, as well as apparently reducing her anxiety in watching cars go by. And my neighbor clearly had success with it because he introduced her to his family, including a couple young kids, with no problems!

I'm about to switch to the vet my neighbor took her to. That vet is a bit further (1 hr.), but a couple of people have told me she's good, and Kaya's already seen her once, which is a real plus. I was really nervous about trying to introduce her to a vet with her 'issues', but Kaya having already seen this vet should make the process a whole lot easier.

I can be quite persuasive when it comes to getting vets to help me with monitoring and diagnostics. We'll see. To answer your question about inflammation, no, Kaya's showing no signs of an active UTI, or even an intense cytitis. If I'd gotten her yesterday, I would not have taken her in for a UTI. The signs aren't there. The only outward sign of anxiety I see (aside from the barking at sounds and sights of people) is too-rapid breathing at night. If it were summer, I'd chalk that up to the heat and intense play she does with Merlin. But...it's not hot, and Merlin's not breathing anywhere near as rapidly.

I was a client of Dr. Sara's for 10+ years, back when I lived in Bowie. Unfortunately, as you know, she doesn't do phone consults. Dr. Sagrera helped me a bit with Magic, and I was really impressed both by her dedication and knowledge, so maybe I'll seek her out for Kaya. I've heard about the Assissi Loop (rebranded CalmerK9, apparently). At this point, again, I don't see her issues as being severe enough to investigate that, but I'm open to using it, certainly.

I am reassured that the symptoms, such as they are, don't warrant further investigation at this point. Of course, I'll discuss them with the new vet and get her opinion, too. I do agree Kaya's issues stem both from genetics and her dubious upbringing. Well-adjusted GSDs don't just pop out of the woodwork.

Thanks! I've got a plan of action, now. With any kind of luck, the new vet will be able to approach Kaya without setting her off, and Dr. Sagrera will have some ideas on how to reduce her anxiety (night terrors? apparently the first couple that had her put a blanket over her crate -- that she inhabited about 20 hrs. a day!!). As long as I've got a vet she can go to, I can handle the rest.

 

[AliceR]

Hi Alyson,
Having worked with fearful/reactive dogs and having a couple myself, I would suggest trying a thunder shirt or wrapping Kaya according to the t-touch techniques. If you decide to do it, put the thunder shirt on when everything is peaceful and calm. The manufacturer suggests only keeping it on for a short time, but I kept it on my dog, Reese, for about 2 weeks and saw a noticeable difference- he would bark during the night, lunged at cars, people etc. Then I used as needed, definitely kept him calmer at night- and then sounds like you are already keeping him under threshold, and then desensitize and C/C using high value reinforcers - she should be far enough to remain calm. She sounds like a great dog.
Alice

 

[AlysonR]

I've been using a weighted blanket -- similar idea to the thunder shirt. Oddly, I usually find the TTouch half-wrap to be more effective than the thunder shirt, but it definitely depends on the dog. I've also been going through the TACT program (touch assisted clicker training). I feel like there are so many programs out there -- BAT, CAT, TACT, Click to Calm, Look at that (and associated training), etc. They all have some basic elements in common. I like TACT in that it provides a way to progress beyond the 'first contact', but I'll be doing things a little differently. I'm going to start by trying to desensitize Kaya to me talking to other people at a distance. In the end it's about exposure under threshold, as you say. Slow and steady wins the race.