Interesting stuff on the URI front...

[GoBoilers]

Just going through my notes for school (we just had a guest speaker who happens to be a registered vet tech who works with some of the best exotic docs at Texas A&M and the University of Texas...and she runs her own reptile rescue). Anyway, she was filling us in on some of newer treatments for URIs and thought I'd share:

Naturally, vets are being encouraged to perform a cuture and sensitivity for any URI due to the fact that the bacteria responsible for the infections has become resistant to Baytril (enrofloxin). This is mostly due to indiscriminate scripts for the antibiotic (it happens to every vet...the client doesn't have the money for a c&s and asks for "something"...yes, it's cheaper for the client, but in the long run, we're not doing our snakes any favors by quickly eliminating every antibiotic in our arsenal to "save a buck."). Vets are now going to the aminoglycosides, amikacin, gentocin, ceftazidime. Two things that I found kinda interesting is that a few vets are experimenting with nebulizing amikacin (10-30 minutes 2-4 times a day for about a week) to get the antibiotic directly to the site of the infection (with the added bonus of not having to give something orally or by injection)! A very promising method! And the tech who spoke to us is working with another doctor who is experimenting with injecting the prey item with antibiotics then feeding it to the snake (the only caveat to this method being that the snake needs to be eating well).

Anyway, that's all I got so far...hope it helps someone out!

Jen

[2kdime]

Good point to bring this up.

I will let you know that not all RI's are created equal, and there are still plenty of RI causing bacteria out there that are still susceptible to Baytril.

The nebulizing of Aminoglycosides has also been going around for a while, especially in cats and dogs I believe. It has also been used with snakes for a while if I remember correctly.

I've had good luck with IM shots, but won't hesitate to try nebulizing stuff in the future. I'm still researching it at this point and time.

The only thing I don't like about it is that I wonder what the absorption rate is when stuff like that, especially stuff in the Aminoglycoside group. Gentamicin I believe it is is one that has a much more narrow window of safe therapeutic safety.

[GoBoilers]

Excellent! Thanks so much for the clarification (yeah, I was typing a little too quickly and my 'Baytril/resistance' statement came off a little too absolute)!

Yeah, I wondered about the aminoglycosides...I know they can be nephrotoxic (cats particularly)...does nebulizing them cut down on the risk?

[2kdime]

Yeah I thought Amikacin isn't used or barely used in cats since it can cause blindness. Don't worry about the fast posting, done that plenty of times!

Again, if I were to nebulize, I would use something like Amikacin and not the Genta purely because of the safe therapeutic window of the Genta.

I know it has been used with success, but if done, I'd like to combine shots with the nebulizer.

I know Becky has some info on this practice, maybe she'll see the thread and chime in.

[rabernet]

I was just reading Brian's blog (BHB) today and he talks about giving this nebulizer a try.

[CritterVet]

Yeah I thought Amikacin isn't used or barely used in cats since it can cause blindness. Don't worry about the fast posting, done that plenty of times!

Again, if I were to nebulize, I would use something like Amikacin and not the Genta purely because of the safe therapeutic window of the Genta.

I know it has been used with success, but if done, I'd like to combine shots with the nebulizer.

I know Becky has some info on this practice, maybe she'll see the thread and chime in.

Enrofloxacin (Baytril) should only be used as a last resort in cats because it can cause blindness by destroying their retinas. To my knowledge, this hasn't been documented in other species.

Aminoglycosides are nephrotoxic, and should only be used in well hydrated animals. If the hydration status of a patient is questionable, I will prescribe subQ fluids with the antibiotics. If I know they are dehydrated, I will hydrate them before starting aminoglycosides, and then give fluids with the shots anyway.

Considering the potential toxicity of aminoglycosides, I would not double dose with nebulization and injections. If you are doubtful about the efficacy, go with injections and skip the nebulizer.

[2kdime]

ALWAYS ensure hydration with Aminoglycosides.

I would NEVER nebulize and inject the same medication or even ones in the same class.

For example if the bacteria was susceptible to both an Aminoglycoside and a Cephalosporin, Id nebulize the Aminoglycoside and inject the Cephalosporin.

Thanks for the correction on the Baytril and cats, and not the Amikacin.

Enrofloxacin (Baytril) should only be used as a last resort in cats because it can cause blindness by destroying their retinas. To my knowledge, this hasn't been documented in other species.

Aminoglycosides are nephrotoxic, and should only be used in well hydrated animals. If the hydration status of a patient is questionable, I will prescribe subQ fluids with the antibiotics. If I know they are dehydrated, I will hydrate them before starting aminoglycosides, and then give fluids with the shots anyway.

Considering the potential toxicity of aminoglycosides, I would not double dose with nebulization and injections. If you are doubtful about the efficacy, go with injections and skip the nebulizer.