Re: Antibiotic use in birds following cat attack

Marie Kubiak — Wed, 18 Jun 2014 08:13:22 GMT

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Baytril data sheet reads “The product may also be used in exotic animals (small mammals, reptiles and avian species) for the treatment of bacterial infections of the alimentary and respiratory tracts where clinical experience, supported where possible by sensitivity testing of the causal organism, indicates enrofloxacin as the drug of choice.” So no obligation to use it for cat bites and indeed it is being used off licence for this. . Enrofloxacin has reasonable efficacy from studies of farm animal P. multocida strains though treating small birds necessitates injecting into the pectoral muscles and I would be loathe to do this with the known potential for tissue necrosis as flight impairment invariably means a dead bird.

With cat bites we are looking to prevent fatal sepsis, usually associated with Pasteurella multocida. Human treatment of pasteurellosis tend to be penicillins with amoxy-clav effective. One bird study advocated doxycycline but injectable forms are only available on an STC here.

We use amoxy-clav as it is safe and effective for Pasteurella treatment, has a good evidence base in avian patients and covers a wide spectrum of other nasties from a cat’s mouth. Oxytetracycline may be another option.

Marie

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Smit T, Moraal LG, Bakhuizen T., Pasteurella multocida infections in birds following cat bites (author's transl), Tijdschr Diergeneeskd. 1980 Apr 15;105(8):327-9.

Abstract

Infection with Pasteurella multocida caused by bites has been known for several decades. Cats are an important factor in Pasteurella multocida infection. Considerable numbers of victims are 'rescued' from the mouths of cats and submitted to bird reception centres for treatment. A number of bird shelters sent birds in this condition to the present authors for closer examination. The majority of birds caught by cats die. The mortality rates in shelters were reported to be 30, 90, 99 and one hundred per cent. Of the birds rescued alive from the mouths of cats, approximately 40 per cent died from the direct effects of the bites, and approximately 60 per cent died from Pasteurella multocida infection.

Korbel R, Epizootiology, clinical aspects and therapy of Pasteurella multocida infection in bird patients after cat bite, Tierarztl Prax. 1990 Aug;18(4):365-76.

Abstract

Since early 1986, fatal cases of Pasteurella multocida infection following cat bites have been seen regularly among avian patients at our institute. The problems of the epizootiology of this infection are discussed on the basis of research during the last three and a half years. By evaluation of collected data from clinical examinations, autopsies, bacteriological and biochemical diagnosis of isolated strains from birds and cats the possibility of transmission via cat bite is discussed as well as the status of cats and birds in an epizootic chain. Even birds with trivial wounds caused by cats must be classified as emergency patients. The risk of an infection after a cat bite is about 56%. For treatment of a Pasteurella multocida infection Doxycycline should be used.

Donald P. Francis, MD; Monroe A. Holmes, DVM; Gatlin Brandon, MS, MPH, Pasteurella multocidaInfections After Domestic Animal Bites and Scratches, JAMA. 1975;233(1):42-45.

Pasteurella multocida is a common cause of infection following bites or scratches caused by dogs and cats. However, it is rarely reported and apparently often overlooked as a pathogen. It causes the typical clinical manifestations of a rapidly developing cellulitis at the site of injury. The infection is potentially dangerous and can cause a chronic local infection of deep tissues and septicemia. However, it responds well to several antimicrobials, with penicillin being the drug of choice.

E J Goldstein, D M Citron, G A Richwald, Lack of in vitro efficacy of oral forms of certain cephalosporins, erythromycin, and oxacillin against Pasteurella multocida.

ABSTRACT

The in vitro susceptibility of human isolates of Pasteurella multocida to oral antimicrobial agents from our current study and from a review of the literature suggests that dicloxacillin (oxacillin), erythromycin, clindamycin, cephalexin, cefaclor, and cefadroxil should not be used for empiric therapy of animal bite wounds. Agents that were consistently active against P. multocida were penicillin, ampicillin, amoxicillin-clavulanic acid, tetracycline, minocycline, chloramphenicol, trimethoprim-sulfamethoxazole, and cefuroxime. Possible reasons for the confusion regarding the activity of oral cephalosporins are addressed.

Re: Antibiotic use in birds following cat attack

Evelyn Barbour-Hill — Wed, 18 Jun 2014 01:25:42 GMT

[quote user="Michael Woodhouse"]

It doesn't matter. Baytril is licensed for use in birds. Unless I am very much mistaken amoxy/clav is not.

Many people take a lax view on the cascade but the rules are prescriptive:

The principle of the Cascade is that, if there is no suitable veterinary medicine
authorised in the UK to treat a condition, the veterinary surgeon responsible for the
animal may, in particular to avoid causing unacceptable suffering, treat the animal in
accordance with the following sequence, in descending order of priority

these medicines must not be used as a first choice treatment in
every situation.

http://www.vmd.defra.gov.uk/pdf/vmgn/VMGNote13.pdf

There is a licensed product, you have to use it. Doesn't matter what the published evidence says.

[/quote]

Yes, but:

[quote user="Michael Woodhouse"]if there is no suitable veterinary medicine
authorised in the UK to treat a condition,[/quote]

Enrofloxacin may not be suitable for treatment of cat-inflicted wounds on birds, being ineffective against anaerobes. So if the published evidence - or even your own considered opinion – says so, you need not use Baytril (indeed, arguably, should not.).

Re: Antibiotic use in birds following cat attack

Michael Woodhouse — Wed, 18 Jun 2014 00:44:35 GMT

It doesn't matter. Baytril is licensed for use in birds. Unless I am very much mistaken amoxy/clav is not.

Many people take a lax view on the cascade but the rules are prescriptive:

these medicines must not be used as a first choice treatment in
every situation.

http://www.vmd.defra.gov.uk/pdf/vmgn/VMGNote13.pdf

There is a licensed product, you have to use it. Doesn't matter what the published evidence says.