Correction: There was a typographical error in last week’s column. Out of 27 flea and tick medications that I reviewed, I found nine that I considered acceptable, not just one as was stated in the article.
This is a good time to remind you about Baylisascaris procynotis and humans. B.procynotis is the common roundworm of raccoons and is most pathogenic for intermediate hosts like humans. Dogs also are susceptible to infection and can shed its eggs. One worm can shed more than 100,000 eggs per day so a raccoon with only 10 worms could shed 1,000,000 eggs into your yard daily and the eggs, which can withstand freezing, can remain infective in the soil for years. Infections in humans have four different presentations: Neurologic (when the worms are living in the brain), Ocular (when the worms migrate in the eye), Visceral (when the worms migrate through the liver and other organs, and Subclinical. (vague signs of illness). Clinical neural larval migrans has been diagnosed in the United States, mostly in toddlers or young children; some cases were fatal and the remaining cases had neurologic impairment. Ocular larval migrans usually affects just one eye and is considered the most common cause of diffuse unilateral subacute neuroretinitis syndrome. Prevention and control are focused on avoiding contact with raccoons and their feces. This is not a common disease but uncommon things do happen.
Dear Dr. Fleming,
I have had many dogs in my life and have treated many bladder infections. In my experience the vet always treated my dogs with 10 to 14 days worth of antibiotics. My husband took Daisy and a urine sample to the vet yesterday and found that she had a bad bladder infection. My husband came home with three days of antibiotics. Do you think this is OK?
Traditionally we have treated urinary tract infections in dogs with antibiotics for 10 to 14 days. Your vet must have been doing her reading. Westropp, et al. recently had an article in the Journal of Veterinary Internal Medicine entitled “Evaluation of the efficacy and safety of high dose short duration enrofloxin treatment regimen for uncomplicated urinary tract infection in dogs”. Their randomized, controlled, blinded clinical trial compared the effectiveness of high-dose short-duration, once-daily (HDSD) enrofloxin treatment (Group 1) with a convention 14-day course of twice daily amoxicillin-clavulanic acid (Group 2) in treating uncomplicated UTI. There were 68 dogs in the trial. Most of you know amoxicillin-clavulanic acid as the human drug AugmentinR or the veterinary drug ClavamoxR. The clinical cure rate was 88.6% for Group 1 and 87.9% for Group 2, essentially the same numbers. In humans with uncomplicated UTI, short treatment duration and decreased dosing frequency of antibiotics have been reported to increase compliance, lower costs, and decrease side effects. This is the first study of this type in dogs that I have seen and additional studies will be necessary for guidelines on protocols, but when I get back to work next week I’m going to give this protocol a try. Three days of enrofloxin is a lot less expensive than 14 days of ClavamoxR.
Many of you have dogs with inflammatory bowel disease (IBD) that are managed with diet, and/or immunosuppressives such as prednisone, azothioprine or cyclosporine. In cats we have had good success over the years with EntocortR (budesonide), along with dietary management. Recently Pietra et. al., reported on the efficacy of budesonide in dogs with IBD (Am J Vet Res 2013;74:78-83). They found that budesonide was rapidly absorbed and metabolized and gradually accumulated and resulted in adequate therapeutic response with no adverse effects. This is good news for those dogs that only respond well to prednisone as it offers an alternative to long-term prednisone and it’s attendant side effects.
I believe that justice is instinct and innate, the moral sense is as much a part of our constitution as the threat of feeling, seeing and hearing.