Antibiotics

Re: Antibiotics

Michael Woodhouse — Fri, 14 Mar 2014 11:54:29 GMT

This is one of those limitations with clinical audit and broad guidelines that don't take a local situation into account.

Re: Antibiotics

Bob Russell — Fri, 14 Mar 2014 11:25:51 GMT

Clearly there is a world of difference between the kennel coughs I see and those others are!

The dogs I see are well in themselves and my rule of thumb is if it is bothering the owners more than it is bothering the dog there is no place for antibiotics.

It seems others are seeing much more aggressive forms of KC. Antibiotics are indicated for these cases!

Re: Antibiotics

Hannah Wynne Richards — Fri, 14 Mar 2014 09:31:01 GMT

How sad.

Wynne

Re: Antibiotics

Richard Carter — Thu, 13 Mar 2014 18:23:24 GMT

we have a puppy farm near Lincoln and we routinely used to see pups with advanced respiratory disease - one was referred to RVC when the usual panacur/septrim then clav amox failed to make any difference and the experts put her onto a triple combination abs including a fluoroquin even though less than 6 months age so they certainly take pneumonia seriously.

A more recent case I saw was a fungal pneumonia post kennel cough. Unfortunately the owner gave up in this case and decided if her dog would run the risk of never being normal, length of rx, costs etc, she would rather pts much to everyone's dismay and disbelief.

Re: Antibiotics

Yantha Smyth — Thu, 13 Mar 2014 18:05:42 GMT

There was a talk at LVS last year titled emerging resp pathogens in dogs, and it seems there may be loads of bugs we haven't considered or knowingly seen before involved also....

Re: Antibiotics

mariette asselbergs — Thu, 13 Mar 2014 17:20:03 GMT

[quote user="ruths"]David- I might add another category to your list- 4) has the dog been in a rehoming kennels recently? I have seem some pretty horrific cases of KC in young dogs become pneumonia after a brief stay in a local rehoming centre and so I think I might get more aggressive with these dogs too.

[/quote]

Yes, same experience. I used to think of kennel cough as just a dog cold with an annoying cough for a while, but I have seen very serious cases with dogs dying from a shelter too. For them it is a horrible problem. At some point I wondered if there was some distemper involved, but I think there are just very bad strains of bordetella.

Mariette

Re: Antibiotics

karen jones — Wed, 12 Mar 2014 22:03:13 GMT

I usually give them antibiotics. I think that animals presented to us usually need antibiotics . The last outbreak we had was in gun dogs at the local shoot and we isolated pasteurella as some had had nobivac kc vaccine and msd asked us to swab them How effective do people think parainfluenza vaccine in injectable vaccine is compared to intranasal?

Re: Antibiotics

ruths — Wed, 12 Mar 2014 20:50:56 GMT

David- I might add another category to your list- 4) has the dog been in a rehoming kennels recently? I have seem some pretty horrific cases of KC in young dogs become pneumonia after a brief stay in a local rehoming centre and so I think I might get more aggressive with these dogs too.

Re: Antibiotics

David Mills — Tue, 11 Mar 2014 11:48:34 GMT

It's interesting the reasons given for pro/anti-antibiotics in these cases, and there isn't necessarily a good logic behind them or choices of other therapies. For instance: - there is no evidence that benilyn has a beneficial effect in dogs - a prospective study showed no reduction in cough duration of severity with nsaids in ITB - suppressing the cough may predispose to pulmonary spread - haemorrhagic diarrhoea and antibiotics. There is strong, dog-specific, evidence that bacterial translocation is the same whether antibiotics are used or not, and by using abx you are simply selecting for resistance with no difference in outcome (apart from metronidazole - but this is likely due to anti-inflammatory effects). Whilst viral cause may predominate - am not convinced by the 70% figure though - there is undoubtedly a predisposition in these patients to bacterial infection. Anecdote, but we have seen a far more virulent form of Bordetella in recent years with excessive mucoid productive coughing and devlopment of pneumonia in some cases, often in young, healthy dogs, and even seen some die from this. It's surely about risk assessment both in terms of local factors and the patient. Add to this that owners will not isolate (especially a young bouncy) dog for 2 weeks - kidding ourselves if we think they will - and you may be setting up a local spread of bacterial ITB. I think in areas of high population density, a dog with any co-morbidities, or a severe presentation, I would err of the side of caution and cover with abx.

Re: Antibiotics

Bob Russell — Tue, 11 Mar 2014 09:19:23 GMT

Absolutely not routine antibiotics for an otherwise well dog with KC. I prescribe metacam (or clone) to make the dog more comfortable. It works just as well (or better) than antis.

Very young puppies and compromised patients (airway disease etc) would get precautionary cover. KC is a combination of viral and relatively benign bugs in 99+% of cases and patients rarely need antibiotic cover. If in doubt try it with the next 'ordinary' KC!

I also advise as strict isolation as possible to minimise spread.

The cultures of bordetella we have done in the past have given quite alarming resistance patterns!

Diarrhoea cases get antibiotics only if there is a fever and or blood in the poo!

Most of our owners seem very aware of the risks of resistant bacteria (perhaps we look after a very well educated bunch) and I can only think of one case in the last decade where an owner went elsewhere to get antibiotics! I don't let clients or breeders dictate prescribing policy! That is why I am allowed the privilege of prescribing antibiotics and the local pet shop is not!

(Viral coughs tend to improve on NSAI's as well!)

Re: Antibiotics

Toby Birch — Tue, 11 Mar 2014 08:49:07 GMT

No. I believe 70% are viral anyway so antibiotics no use. Can always reassess and change plans if need be but be aware viral coughs can linger for a couple of weeks. Prescribing antibiotics just because the client gets 'umpty' is not a responsible way to prescribe - I find clients generally respond well to an informative chat.

Re: Antibiotics

James Laidlaw — Tue, 11 Mar 2014 07:38:47 GMT

No - unless pyrexic or purulent nasal discharge associated. Most get better with anti-inflammatories +/- pholcodine if coughing excessively (benilyn)

Re: Antibiotics

Lazy Bee — Tue, 11 Mar 2014 07:02:19 GMT

1) Try not to, unless client gets "umpty", suggest honey or possibly "off licence" benylin. Just try to keep the patient away from other dogs until asymptomatic and stress the need to vaccinate next time - a dose is HALF the cost of a consultation anyway. 2) & 3) Almost certainly.