[ SHOWGSD-L ] superbug bites dog, part 2
- From: "Peggy" <pmick12@xxxxxxxxxxx>
- To: <showgsd-l@xxxxxxxxxxxxx>
- Date: Sat, 30 Aug 2008 14:18:23 -0400
I decided to go with the second option, primarily to avoid the stress of
daily vet visits for Kyrie, and because the side effect risk, although far
from negligible, was less for chloramphenicol. And at first, I assumed we'd
gotten lucky, because the wound started healing immediately.
Unfortunately, it came back two days after a three-week course of
chloramphenicol was finished, just like before. But I'd spent those three
weeks researching MRSI and MRSA skin infections, and this time I tried
dressings of medical-grade honey, which is often effective when used in
combination with oral antibiotics. Within a few hours, the wound had started
healing, and within two days it was finally gone. Today, three months after
it all began, the infection seems to be eradicated, her coat has re-grown in
the affected area, and we're hoping her next skin culture will show her to
be free of the superbugs.
Meanwhile, down in San Diego, Angelina was fighting for her life. "She had
an episode of septicemia (blood infection), and the sores were all over her
body, and the hair just sloughed off, and they were oozing," said Rose. "I
have never seen a dog that sick that survived."
The Roses and their veterinarians persisted with Angelina's treatment, and
gradually she recovered. After just under a month, they tried to stop the
antibiotic, but her symptoms returned almost immediately.
In the end, Angelina was on the drug for more than 12 weeks before her
cultures came back negative for MRSI. "She's lost most of her hair," said
Rose. "My husband, who is an infectious disease doctor, says that in humans,
when you get these resistant staphylococcus infections, they will slough
skin for several months." In addition to the lingering skin and coat
problems, Angelina suffered damage that will probably be permanent to the
joints in one of her legs that had become infected.
I spoke with Angelina's veterinary dermatologist, Laura Stokking, and she
said that, while Angelina's case was a bad one, she's seen worse. "You know,
it was easy with Angelina's parents because they're physicians, so they know
a lot more," she said. "She responded pretty well. I have some cases where
there is a substantially higher amount of the body that's affected and a lot
more tissue necrosis, and the dogs are really systemically ill." She
attributed Angelina's recovery, slow though it's been, to aggressive
treatment.
I asked Stokking if it's just a coincidence that I heard of two cases at the
same time, or if MRSI in pets is really on the rise. She said that MRSI
infections were the hottest topic at the recent North American Veterinary
Dermatology Forum, and while there is some increased awareness leading to
more frequent diagnosis, there's no question the infections themselves are
becoming more widespread.
"Definitely in dogs it's an emerging problem," she told me. "Up until
recently, the bacteria that most commonly affected dogs didn't tend to trade
resistance information with other bacteria the same way that the staph in
humans did." Those days are gone, however, and she says both the incidence
and prevalence of drug resistant bacteria are spreading in companion
animals.
Given that MRSI infections are of increasing risk to dogs and cats, the most
useful information a pet owner could get would be how to prevent them. To do
that however, we'd need to know where the pets were getting the infections.
While humans frequently get the more severe strains of MRSA in hospitals,
Kyrie was perfectly healthy and hadn't even been to the vet's office
recently. And even though Angelina had recently undergone surgery and spent
time in a veterinary hospital, she actually had the infection, although it
was undiagnosed, prior to her accident and surgery, in the form of two lumps
on her legs â€" lumps that were initially mistaken for spider bites.
Stokking agreed that the origin of most MRSI infections in pets is unclear,
and wasn't surprised that Angelina most likely had acquired the bacteria
before her surgery. "We don't usually see a link between hospitalization or
veterinary visits and the acquisition of this strain of staphylococcus," she
said.
What about the canine or feline equivalents of the daycare center or gym,
such as dog parks, boarding kennels or groomers? "Contaminated water,
contaminated shampoo bottles," she agreed. "It's possible."
Pets living in the same household with an infected dog or cat will sometimes
get MRSI from the sick pet. (Humans virtually never get MRSI from animals,
although we can transmit MRSA to them.) But neither Rose's nor my other dogs
became infected, and that's not uncommon. Why did seemingly healthy dogs
like Kyrie and Angelina become ill, when other also seemingly healthy pets
in the same household didn't?
The truth is, we really don't know where dogs and cats are being exposed to
these bugs, which makes it almost impossible to prevent our pets from
getting them.
However, uncertainty about prevention doesn't mean there's nothing pet
owners can do to minimize their pets' risk of resistant infections. Because
rapid diagnosis and effective treatment are key to preventing the more
serious forms of the disease, pet owners and their veterinarians need to be
on the lookout for it.
They first need to be aware that many skin infections with MRSI or MRSA are
initially misdiagnosed as spider bites, as both Kyrie's and Angelina's were.
Stokking said that the Centers for Disease Control and Prevention have a
poster used in human medicine that says, "Looks like a spider bite but
isn't? MRSA." Since it's such a common misdiagnosis, she believes it's
probably a good idea to do a skin culture on any suspected spider bite and
any skin infection that doesn't immediately respond to the usual
antibiotics.
Even though it was not the case for Kyrie or Angelina, there is one other
factor that should make owners and veterinarians particularly alert for
signs of MRSI in pets. "We do frequently see a history (in infected pets) of
repeated use of antibiotics," Stokking told me.
Owners also need to be aware that trying to save money by delaying or
skipping diagnostic tests can cost them much more money in the long run. A
skin culture might cost over $100, but wasting time on an ineffective
antibiotic can cost much more. The first drug Kyrie went on was priced at
only around $40, but the second one was nearly 10 times that for a
three-week supply.
And if you think my dog's prescription was expensive, want to know how much
that course of amikacin â€" or, for that matter, vancomycin, the drug of
last resort for resistant staph in humans â€" would cost? Around $1,000.
Not to mention both have to be given intravenously and are highly toxic to
the kidneys. Worse, over-reliance on vancomycin in human as well as
veterinary medicine is leading to the further development of
vancomycin-resistant bacteria, which is leading directly to the loss of
human lives.
But the really bad news has nothing to do with your bank account. It has to
do with the development of resistant bugs itself. Bacteria have a dazzling
ability to trade genes and develop resistance, so strains that are
susceptible to one drug today could easily be resistant to it tomorrow.
Using an ineffective antibiotic, chosen without doing a skin culture first,
can accelerate the development of additional resistance in bacteria. And
that, again, threatens not only our pets but human health.
Given that risk and expense, as well as how painful and dangerous these
infections are, an ounce of detection in the form of a culture may well be
worth a pound of a very expensive cure.
"Don't be afraid to culture," Stokking said. "It's better to do a culture
and then find out that it would have responded to cephalexin than not
culture and let it go three weeks before realizing that you're dealing with
a methicillin-resistant strain."
Laura Stokking PhD., DVM, DACVD is a diplomate of the American College of
Veterinary Dermatology, and has published several book chapters and reviews
in veterinary dermatology and has lectured veterinarians at national and
local conferences. She is active in educating general practitioners in San
Diego County on recognizing and treating resistant staph infections in
companion animals. Christie Keith's full interview with Dr. Laura Stokking
can be found at Pet Connection.
Christie Keith is a contributing editor for Universal Press Syndicate's Pet
Connection and past director of the Pet Care Forum on America Online. She
lives in San Francisco
>
============================================================================
POST is Copyrighted 2007. All material remains the property of the original
author and of GSD Communication, Inc. NO REPRODUCTIONS or FORWARDS of any kind
are permitted without prior permission of the original author AND of the
Showgsd-l Management. ALL RIGHTS RESERVED.
ALL PERSONS ARE ON NOTICE THAT THE FORWARDING, REPRODUCTION OR USE IN ANY
MANNER OF ANY MATERIAL WHICH APPEARS ON SHOWGSD-L WITHOUT THE EXPRESS
PERMISSION OF ALL PARTIES TO THE POST AND THE LIST MANAGEMENT IS EXPRESSLY
FORBIDDEN, AND IS A VIOLATION OF LAW. VIOLATORS OF THIS PROHIBITION WILL BE
PROSECUTED.
For assistance, please contact the List Management at admin@xxxxxxxxxxxx
VISIT OUR WEBSITE - www.showgsd.org
============================================================================
Other related posts:
- » [ SHOWGSD-L ] superbug bites dog, part 2
