augmentin

Re: augmentin

Martin Atkinson — Mon, 18 Jun 2012 16:45:28 GMT

Could always try Maluka honey in rabbit abscesses, I have mixed success with this, how do other's find it?

Re: augmentin

Rajat — Mon, 18 Jun 2012 16:30:21 GMT

[quote user="Mark Holmes"]

I understand Antirobe is ok as long as the abscess does not communicate orally. If so ingestion leads to enterotoxaema and the Black Rabbit commeth. Although rabbits with abcesses are pretty high on the Black Rabbit's to-do list anyway.

[/quote]

Yeah, I always worry about this too! Makes me super cautious so I usually check by flushing some saline into the wound and see if there is some oral communication/saline leakage and thorough probing to make sure it isnt communicating. with the oral cavity. Putting a needle as deep as it will go and then radiographing sometimes helps. Packing the wound with some umbilical tape or gauze as othe paper described to 'keep' the powder in there also works well. Sort of a substitute for a PMMA bead. Prob with the beads as mentioned is you have to make them up before and if the bug isnt sensitive you have to start all over again.

Best

Raj

Re: augmentin

plantagenet — Mon, 18 Jun 2012 15:17:23 GMT

[quote user="Evelyn Barbour-Hill"]Anyone remember the days of emptying a "mastitis tube" into the abdomen before closing it?[/quote]

yep!

Re: augmentin

Mark Holmes — Mon, 18 Jun 2012 10:22:38 GMT

Re: augmentin

Martin Atkinson — Mon, 18 Jun 2012 08:58:28 GMT

[quote user="Lorna McHardy"]

Seriously, though... the idea of using 25mg antirobe capsules to treat rabbit abscesses came, ages ago, from a talk I went to. I did it for a while and provided the owners were able and willing to do it, it seemed to work for those really horrible ones you used to see a lot of that would otherwise lead to euthanasia. It really is years since I've seen one, now.

[/quote] AFAIA, the idea of stuffing an Antirobe capsule into a rabbit abscess was promoted by Upjohn (the manufacturers/ suppliers) many years ago and I have used the technique in the past. I was under the impression that this was now discouraged due to the untimely demise of some bunnies as a result and although antibiotic impregnated beads are faff their slower release over a long period of time works better anyway. In theory you should make the beads up in advance and test them to make sure they are efficacious but when time is short it doesn't take long to whack some up with a bit of Isopon and some Augmentin powder - works for me anyway. I'm sure the exotics experts, Mark include, may have some more to say on this.

Re: augmentin

Evelyn Barbour-Hill — Mon, 18 Jun 2012 02:12:57 GMT

[quote user="svn"]Does anyone else remember the days of opening and sprinkling an antirobe capsule or two into the surgical site before closing up?[/quote]

Anyone remember the days of emptying a "mastitis tube" into the abdomen before closing it?

Re: augmentin

svn — Mon, 18 Jun 2012 00:36:25 GMT

Does anyone else remember the days of opening and sprinkling an antirobe capsule or two into the surgical site before closing up?

Anyway, if doses are being missed or given significantly late, then you need to have a word with your nurses... assuming you have RVNs, then this needs to be a stern word!

Re: augmentin

Lorna McHardy — Sun, 17 Jun 2012 02:34:30 GMT

[quote user="Rajat"]

Funny how things go around in circles and techniques come back in vogue. I have used this for the last couple of years and find it invaluable in cases of osteomyelitis secondary to dental disease.

[/quote]

Yes, that's the kind of thing I used to use it on. Takes time and a dedicated owner; but it does work. Those horrible great abscesses under the jaw...

Re: augmentin

Rajat — Sat, 16 Jun 2012 21:43:09 GMT

[quote user="Lorna McHardy"]

[/quote]

Funny how things go around in circles and techniques come back in vogue. I have used this for the last couple of years and find it invaluable in cases of osteomyelitis secondary to dental disease. I found this paper encouraging reading (can send you full text if you want to have a read, pm me!)

http://avmajournals.avma.org/doi/abs/10.2460/javma.237.12.1444?journalCode=javma

Best

Raj

Re: augmentin

Lorna McHardy — Sat, 16 Jun 2012 18:42:54 GMT

Re: augmentin

Lorna McHardy — Sat, 16 Jun 2012 18:40:22 GMT

[quote user="Mark Holmes"][quote user="Lorna McHardy"]

[quote user="Martin Atkinson"]

The powder is also very useful for making up into instant antibiotic impregnated beads made from car body filler to stuff into rabbit abscess cavities.

[/quote]

That sounds like a lot of faff and hassle when you could just use antirobe capsules. Haven't seen one in years now (rabbit abscess cavity, I mean)

[/quote] Somebody ought to check on Mark Rowland and make sure he has not choked to death on his dinner reading this!

[/quote]

I did wonder about that

Re: augmentin

Mark Holmes — Sat, 16 Jun 2012 18:39:13 GMT

[quote user="Lorna McHardy"]

[quote user="Martin Atkinson"]

The powder is also very useful for making up into instant antibiotic impregnated beads made from car body filler to stuff into rabbit abscess cavities.

[/quote]

That sounds like a lot of faff and hassle when you could just use antirobe capsules. Haven't seen one in years now (rabbit abscess cavity, I mean)

[/quote] Somebody ought to check on Mark Rowland and make sure he has not choked to death on his dinner reading this!

Re: augmentin

Alet Engelbrecht — Sat, 16 Jun 2012 18:14:55 GMT

[quote user="bob lehner"]

[quote user="Alet Engelbrecht"]Ps: I think pilling a cat may be one of the best way to show of clinical skill in front of a client - they are always impressed..[/quote]

Except when the little bugger defeats you - very humiliating.

[/quote]

Very true, although that always lead to a bonding episode between myself and the client as I reach for the convenia, able to justify the expense completely.

Re: augmentin

bob lehner — Sat, 16 Jun 2012 17:53:57 GMT

[quote user="Alet Engelbrecht"]Ps: I think pilling a cat may be one of the best way to show of clinical skill in front of a client - they are always impressed..[/quote]

Except when the little bugger defeats you - very humiliating.

I do think hefty 'Injection fees' are a bit of a con - I've never been comfortable with them - but I do routinely give the first dose of an ab course by injection - at least I know the patient has had one full dose dose. I feel that often if the animal is unwell, by the next day when the first tablet is due, the animal may be feeling rather better (e.g. particularly with cba cases) and the owner may have more success in dosing, rather than dealing with a v. grumpy patient.

Re: augmentin

Lorna McHardy — Sat, 16 Jun 2012 17:46:38 GMT

[quote user="Martin Atkinson"]

The powder is also very useful for making up into instant antibiotic impregnated beads made from car body filler to stuff into rabbit abscess cavities.

[/quote]

That sounds like a lot of faff and hassle when you could just use antirobe capsules. Haven't seen one in years now (rabbit abscess cavity, I mean)

Re: augmentin

Alet Engelbrecht — Sat, 16 Jun 2012 16:59:47 GMT

[quote user="Clive Ansell"]tradition and fee generation[/quote]

Completely agree. Both pet peeves of mine. I don't want to be 'traditional' in the sense that I get set in my ways and if I am giving injections to generate money, I am not necessarily doing the best for my patients. I fully understand that the veterinary clinic is a business, but I prefer to have repeat custom because people trust me as a vet, rather than getting the absolute most from a monetary point from my unsuspecting clients. And, I am sure, clients will catch on one of these days...

Ps: I think pilling a cat may be one of the best way to show of clinical skill in front of a client - they are always impressed...

Re: augmentin

Clive Ansell — Sat, 16 Jun 2012 16:36:25 GMT

[quote user="Alet Engelbrecht"]

[quote user="Clive Ansell"] I contacted Pfizer, and they informed me that levels are reached in 1-2 hours.[/quote]

So does a synulox tablet. I also asked Pfizer.

Perhaps the question should be whether we are overdoing injections when tablets will do?

[/quote]

Very good point, and I guess we probably are? I think giving injections during consults as a "loading dose" has more to do with tradition and fee generation than it does with science perhaps? the nsaid Onsior for example reaches serum levels quicker following tablet dosing than it does from s/c injection.

From Onsior data sheet: shows that serum levels are reached twice as quick following oral dosing (1/2 hour) than from a s/c injection (1 hour)

(1) After oral administration of robenacoxib flavoured tablets at 1 mg/kg without food, peak blood concentrations are attained rapidly with a Tmax of 0.5 hour. Co-administration of robenacoxib non-flavoured tablets with food produced no delay in Tmax but slightly lower values for peak blood concentrations.

(2) Peak blood concentrations of robenacoxib are attained rapidly after subcutaneous injection in cats and dogs. After a dosage of 2 mg/kg a Tmax of 1 hour (cats and dogs).

Re: augmentin

Alet Engelbrecht — Sat, 16 Jun 2012 15:50:27 GMT

[quote user="Clive Ansell"] I contacted Pfizer, and they informed me that levels are reached in 1-2 hours.[/quote]

So does a synulox tablet. I also asked Pfizer.

Perhaps the question should be whether we are overdoing injections when tablets will do?

Re: augmentin

Evelyn Barbour-Hill — Sat, 16 Jun 2012 13:50:13 GMT

[quote user="Clive Ansell"]she replied "we were told at uni to use it for pyos"[/quote]

Ah, and therein lies the problem.

Re: augmentin

Evelyn Barbour-Hill — Sat, 16 Jun 2012 13:45:35 GMT

[quote user="Rajat"]So a 5ml dose costs £2.70 more than a 1ml dose.[/quote]

Probably true. But then a cat needs a dose of 0.25ml (OK, you might charge for 0.5ml because of wastage, ullage and so on), and it would be a very big dog (200kg?) that needed 5ml.

[quote user="Rajat"] I don't think 10 or 11 quid is excessive for an injection fee[/quote]

I do.

Re: augmentin

Clive Ansell — Sat, 16 Jun 2012 10:06:44 GMT

[quote user="Julian Earl"]

The cascade refers to like-for-like, and as there is no veterinary-licensed intravenous potentiated amoxycillin, Augmentin can be used under the cascade.

[/quote]

I am not sure it can, unless there is a good sound clinical argument or reliable documented evidence (is there any?) that it is more efficacious and offers a better result over and above the use of licenced s/c and i/m preparations such as synulox?

In very sick patients maybe (only maybe), but I cannot see how it can be justified for use with routine and elective surgeries, or healthy animals where effective serum levels are reached quickly from s/c or i/m injections. I contacted Pfizer, and they informed me that levels are reached in 1-2 hours.

Much of its use is due to habit maybe, I certainly used to use it far more than I do now, particularly for really bad infected neglected dentals. Now they get synulox on admission 2-3 prior to the procedure, and results seem to be the same.

I think it's use is taught as the norm in the schools too maybe? I recently had an open pyometra in an otherwise healthy dog that had received synulox and metacam the night before its op - at the start of the op a new grad colleague informed me that I ought to use Augmentin. When I questioned her and pointed out that it was not needed or indicated because synulox was given 15 hours ago, she replied "we were told at uni to use it for pyos"

Re: augmentin

Rajat — Sat, 16 Jun 2012 09:58:05 GMT

Just had a look. The majority of it is an injection fee. So a 5ml dose costs £2.70 more than a 1ml dose. I don't think 10 or 11 quid is excessive for an injection fee, and we are by no means the most expensive practice in our area (London/outer London).

Re: augmentin

Michael Woodhouse — Fri, 15 Jun 2012 22:57:22 GMT

[quote user="Evelyn Barbour-Hill"]Jeez I must be doing something wrong[/quote]

Snap. That is just crazy.

4p for a syringe, 10p of synulox cost.

We gave up with Synulox because despite best efforts you got the moisture in there.

They get Betamox from me at IIRC it comes to about £2 for a shot including an injection fee and the VAT.

Maybe this is why punters ask for prescriptions..................

Re: augmentin

Evelyn Barbour-Hill — Fri, 15 Jun 2012 22:49:23 GMT

[quote user="Rajat"]

Yes, for a 4 kg cat. For a 10kg dog about £15 (will have to dbl check that but pretty sure there or thereabouts)

Whats RTU BTW?

[/quote]

Jeez I must be doing something wrong

Re: augmentin

Clive Ansell — Fri, 15 Jun 2012 20:48:45 GMT

[quote user="Rajat"]

Yes, for a 4 kg cat. For a 10kg dog about £15 (will have to dbl check that but pretty sure there or thereabouts)

Whats RTU BTW?

[/quote]

Just had a quick look, cost price of synulox = about 12 pence for a 4 kg cat, plus injection fee and mark up of course. (£15.51 +VAT for a 40ml bottle)

ready to use by the way