fluoroquinolone-resistant P. aeruginosa

Re: fluoroquinolone-resistant P. aeruginosa

HMC — Thu, 09 Sep 2010 16:13:33 GMT

[quote user="Michael Woodhouse"]Where are you in the country? I no longer even bother trying nasal radiographs, send them straight to Nigel Harcourt Brown at Harrogate - one of the pioneers of veterinary rhinoscopy in this country. [/quote]

I'm in London. But that's a useful comment as I had been debating whether to xray at the branch where I work then send to the main hospital or whether to refer in the first instance for rhinoscopy and rads at the same time (I know the latter makes sense, I just don't want to part with an interesting case!! )

Re: fluoroquinolone-resistant P. aeruginosa

sasho gjorgjievski — Thu, 09 Sep 2010 12:49:54 GMT

try with amoxicillin and gentamicin.
I think you will have the effect

Re: fluoroquinolone-resistant P. aeruginosa

Anonymous — Wed, 08 Sep 2010 22:00:02 GMT

just wondering, how about nebulised inhalation of one of those antibiotics. never done it dont know if it would work but could bypass the systemic side effects but might not work. of course would be completely off label. anyone else have any experience using nebulised antibiotics or is it a big no-no?

Re: fluoroquinolone-resistant P. aeruginosa

Michael Woodhouse — Wed, 08 Sep 2010 20:45:11 GMT

Where are you in the country? I no longer even bother trying nasal radiographs, send them straight to Nigel Harcourt Brown at Harrogate - one of the pioneers of veterinary rhinoscopy in this country. There are a series of old In Practice articles by him April/May 2006.

Re: fluoroquinolone-resistant P. aeruginosa

Hannah Wynne Richards — Wed, 08 Sep 2010 09:28:32 GMT

Gentamycin and amikacin both less toxic with large once daily dose rather than 2 smaller doses, but monitor renal function, and again think aspergillus, FB, or neoplasia May even have neoplasia AND aspergillus !!!!!!!!!!!!!!!!!!

Wynne

Re: fluoroquinolone-resistant P. aeruginosa

Evelyn Barbour-Hill — Wed, 08 Sep 2010 01:27:58 GMT

Yeah, what Mark says.

Radiographs (including intra-oral) are indicated sooner rather than later in a dog with persistent mucopurulent nasal discharge. Followed by rhinoscopy if there's anything suspicious.

Some people like forced flushing, some don't.

Are there any changes in the nasal planum?

Don't rely entirely on the serology in considering aspergillosis.

Re: fluoroquinolone-resistant P. aeruginosa

HMC — Tue, 07 Sep 2010 19:39:27 GMT

Thanks, that is interesting. Bloods have been taken for the aspergillosis antibody and I am awaiting the results. Foreign body is definitely a differential. Endoscopy is available. Having read the side effects of the aminoglycosides I am thinking I'd rather do the radiographs/endoscopy prior to starting the antibiotics. Tobramycin seems to be the best of the aminoglycosides according to the BSAVA formulary.

Re: fluoroquinolone-resistant P. aeruginosa

Mark Holmes — Tue, 07 Sep 2010 19:13:54 GMT

Other considerations would be nasal fb so you could try force flushing on the nasal passages as well or rhinoscopy if available

Re: fluoroquinolone-resistant P. aeruginosa

Mark Holmes — Tue, 07 Sep 2010 19:12:19 GMT

My experience of nasal infections is that they are always secondary infections so the most important consideration is what is the primary disease? The last one I saw had a fungal granuloma in the frontal sinus this did not once culture positive on nasal discharge. Try an aspergillus titre. With regards to antibiotics I have resorted to iv gentamycin with covering iv fluids in the past.