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I’m coming out of a draining 9-week health ordeal with my 45 lb, 10 year old dog. Her vet suggested a culture because the wounds on her neck were not healing after weeks and making her itch madly. The results revealed the presence of antibiotic-resistant staphylococcus pseudintermedius (I think that’s the same as MRSP?). The resistance stems from the Clavamox she was on for an initial infection on her paw at the time her neck became wounded from the cone placed on her at urgent care.
Without many drug options left (daily injections out of the question due to her temperament), she was prescribed a 10-day course of enrofloxacin (aka Baytril); 1.5 tabs of 68 mgs once per day. Her vet said that depending on when the wounds started to improve, we may need more so he approved a second 10-day course as well. Her wounds started to dramatically improve by about day 7/8; close enough to the 10th that I decided to continue to make absolutely sure the potentially deadly bug was dead.
Here’s my question: I know that ending a course of antibiotics early risks making the bug stronger, but since she’s already done 10 days, what’s the ideal place to stop now? On one hand, I want to make sure the bacteria is dead, but on the other, I don’t want to overdo it with a strong antibiotic - her appetite isn’t great, her signs of nausea at night are increasing, and I worry about side effects like liver damage, especially when the itch is 100% gone and the area has looked fine for about five days now with no further improvement (we’re on day 12). The embedded photos get totally chopped off but feel free to click on the link to view the full progression:
[url]https://imgur.com/9xnHtEt[/url]
And a photo of her:
[url]https://imgur.com/PxMF1b9[/url]
To pre-empt suggestions of asking my vet, I’m not going to get an answers from there until it’s too late because he's away this week. I left a message through the front desk person last week before getting the second 10-day round of the antibiotic. She's very kind but responded vaguely along the lines of, “Well, you can do the second 10 days if you want to?”.
I suppose the priority is for the superbug to not return but, having completed the initial 10 days and then some, I worry about harming my dog with overkill now that her skin looks normal (except for the tiny yellow crust you can see at the bottom) and she has zero itching.
I get that no one can give me a cut-and-dried answer or instructions, but I'd greatly appreciate any information or guidance that might help me gauge this. Thanks so much!!
Your vet knows your dog's case better than anyone here. No one here should be giving you this sort of specific medical advice. Did you send your photos to the practice and ask that they forward them on to the prescribing vet? They don't have anyone filling in while your vet's away? They could consult and get back to you.
There are ways to relieve nausea in the meantime. According to Baytril labeling instructions it is usually given on an empty stomach, but it also notes that giving it along with food (no dairy or antacids) can help ease GI symptoms. Give a bland diet of things she really likes (rice? Scrambled egg? Tidbits of meat?) and encourage drinking more fluids (flavor water with chicken or beef broth? If she has a sweet tooth maybe mix with fruit juice?). If she isn't eating as well, she may be dehydrated. Dehydration causes or makes nausea worse. That will help metabolize the Baytril and ease empty stomach nausea.
Courses of Baytril can be as long as 30 days, so 20 for a resistant infection isn't unreasonable. Again, every dog is an individual so deferring to the prescribing vet would probably be best.
Liver/kidney toxicity due to Baytril is one of its rarer potential side effects. Signs of toxicity would include jaundice, dark urine, excessive thirst.
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