EPISODE 3 | ANTIBIOTICS
EPISODE 4 | PAIN CONTROL
Antibiotics (antimicrobials) are medications we use to kill bacterial infections. Reasons why we choose a certain type of antibiotic • Expense of antibiotic • Where in the body is the disease Types of antibiotics The difference for the owner is how often they are dosing it. • Concentration dependent antibiotic you usually give once daily • Time dependent antibiotic usually give 2 to 3 times daily What bacteria are we trying to fight off? 4 Classifications of Bacteria • Gram + Aerobic • Gram + Anaerobic • Gram - Aerobic • Gram - Anaerobic When an owner asks, Can I stop a medication? Our general response is going to be no. You do not want to stop an antibiotic. If you stop too soon, you could have batted down part of the infection but not gotten rid of all of the infection. That is how you have resistant bugs that will be less responsive to antibiotics. Please tell the owners it is important to finish all the antibiotics We may not have them finish it if the pet is having GI issues, diarrhea, vomiting, or allergic reaction.
• Albon If we have a dog with Coccidia, which is a protozoa, not a bacteria, that is found on a fecal test, we will be giving the dog Albon. Coccidia is common in puppies and in our rescue patients. The dosage is very specific, we typically give a double dose for the first dose and thereafter 1/2 of that dose for 9 days. • Amoxicillin is a penicillin and is a first line antibiotic. It is relatively inexpensive. It can be used for many things such as a urinary infection, skin infections and various infections of that nature. • Clavamox is a potentiated penicillin. It has both amoxicillin and clavulanic acid. The acid makes this medicine more potent. It is the same medicine we use for people called Augmentin. Clavamox is used for bladder and skin infections, and is considered a broad-spectrum antibiotic. It will kill all four types of bacteria. • Cefpodoxime is an antibiotic that is commonly used to treat skin infections in dogs. This is given once daily. Is in the same category as Cephalexin. • Cephalexin is in the same family of antibiotics called cephalosporins. It is given 2 to 3 times a day. • Clindamycin is good against anaerobic bacteria. Used a lot for dental issues, and a very good bone antibiotic. It is dosed out as twice a day in capsule form. • Antirobe Aquadrops Liquid is the brand name for Clindamycin. In a liquid form so it is used more for small dogs and cats. • Doxycycline is first line for respiratory infections. It is very effective against mycoplasma that we see in respiratory infections. Also good against kennel cough, tick-borne diseases and Leptospirosis disease. • Marboquin and Orbax Given once a day. Second line antibiotic. Used to treat urinary tract, ear, and kidney infections. • Metronidazole is a very good GI antibiotic. It is an antibiotic to treat diarrhea in dogs and cats. Also has good anti-inflammatory affects. There is a liquid version for cats. • Sulfamethoxazole/Trimethoprim may be effective against resistant bacteria, urinary tract infections and it is not very expensive.
Non-Steroidal Anti Inflammatory Drugs (NSAID) These are not steroids. These have both pain and anti-inflammatory benefits. The number one side effect is an upset stomach. (Symptoms: stop eating, vomiting.) • Do not give to a pet that is dehydrated. • Do not give this medication if the pet has chronic kidney disease. It can make the kidney disease worse. • Liver reactions are very uncommon. Dr. Sam has never diagnosed liver cirrhosis from being on a longtime NSAID. Can I stop giving NSAIDs to my dog because he doesn’t seem in pain? There is still a benefit for the anti-inflammatory effect, especially after surgery or if they have arthritis. For arthritis, the pet should be on this long-term, so it treats the underlying condition and continues to reduce inflammation. Studies show that therapeutic benefits increase over time as they continue to give this medication daily. This medication is less effective if owners stop and start it, or only use it periodically. Cats traditionally do not metabolize NSAIDs as well as dogs do. They are more likely to have side effects if they are on it too long.
• Gabapentin is a very common pain medication, it is a generic version of a medication called Neurontin. Primary use is for pain in both dogs and cats and it can be added to a pain regimen if already on Carprofin, or we may use it alone. Used a lot for back pain. Very commonly used for anti-anxiety or sedation for cats. Comes in a liquid version or a capsule which can be crushed and sprinkled over food. If you have an anxious cat, we may suggest using Gabapentin before coming in for a visit or a home visit. • Side effects: Can cause sedation or make your cat seem a little drunk. • Dogs seem to tolerate it well. • This medication can be stopped cold turkey. • There is no benefit to continue using it if you feel your pet’s pain has gone away. • Galliprant (NSAID) is the newest medication in the NSAID category of drugs. We believe the side effect profile may be less than the other NSAIDs. It may have less side effects on the stomach, kidney and liver. It is more expensive. There is not a generic version of this medication. • Metacam (NSAID) used to relieve pain, inflammation, and fever in dogs and cats. It is also used to treat pain associated with surgery. Side effects are GI related. Dosage is in a liquid form given in a syringe. If a dog weighs 20 pounds, you give it up to the 20 pound mark. If a dog weighs 60 pounds you give it up to the 60 pound mark. Cats traditionally do not metabolize NSAIDs as well as dogs do. They are more likely to have side effects if they are on it too long. • Onsior (NSAID) in a pill form and in an injectable form for surgical procedures. It is a good anti-inflammatory for cats and has limited side effects. • Rimadyl (NSAID) This is the most commonly used NSAID. The branded form has flavored tablets. Carprofen is the generic version of this drug. It is less costly than Rimadyl so we use this a lot for dogs who need to be on it long term. It is important to carefully read the label the doctor prints up when scripting this medication so that you fill the proper form. • Methocarbamol is muscle relaxant used for back pain. Side effects are sedation or pet can seem a little drunk. You can stop this medication at any time. INJECTABLES • Solensia for cats, Librela for dogs are both month long pain medications. These are game changers as well. Since you give an injectable once a month, you do not need to give daily pills. Type of drug is Monoclonal antibodies, which are super targeted, goes right at pain mediator in the body and doesn’t have other effects on other organs. Side effect profile goes way down. Some reactions similar to a vaccine reaction. Owner must come in monthly or can be taught to administer at home. CONTROLLED DRUGS (Kept in safe) • Tramadol used to be used more often. It has unpredictable efficacy. This means that it will relieve pain well in some dogs and be ineffective in others. There is a large dose range for this drug. • Buprenorphine for cats, it is an Opioid medication. Some GI side effects (constipation) and sedation side effects. You can stop it if your cat is not in pain or you do not like the side effects. It is a controlled drug so it is in the safe and need a DEA license to distribute it. Very good pain medication, used a lot after surgeries.
Golden Paws Animal Hospital | Pharmacy Education
Golden Paws Animal Hospital | Pharmacy Education
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