Continuing Uti, Switch To Baytril

[greyhead]

Both his regular vet and the specialist who saw him said that his case is very rare. That they have never seen a dog with glucose in the urine but no other symptoms of a kidney issue. So... I'm praying that this is an acute issue, rather than something progressive. I will continue to keep you posted. Thanks again for all of the info on Shane as reading his story definitely hit close to home and all of that information is very helpful as well.

 

Just before I pack up my tent and move on, I remembered that the last antibiotic we wound up using on Shane, again in a longer-than-normal course of treatment, was Orbax. At the end of that we saw an internist, who decided that Shane's then-problem was kidney disease. (He didn't know Shane and he didn't know me, and he was a newly-minted internist.) We held off on his orders to give Shane Proin for leakage and enalapril for the high BP that usually goes with kidney disease, especially since his BP wasn't high, and just complied with the food change. Even then we requested that the food rx be changed from low-protein to medium protein. It seems he has sustained some mild kidney damage and he does need that diet. Other than that, he's doing quite well, and even better since we decided to go ahead and treat for Lyme. Of course, doxy was the treatment for Lyme, and maybe it was really treating mycoplasma! I don't care, as long as he's well.

 

Yes, do keep us posted. And keep Orbax in mind if the Baytril hasn't done the job in the end.

[Guest undergreysspell]

I also had a dog who had repeated uti's - after about 8 months of different antibiotics she finally got orbax and never had another uti after that. Must be good stuff !

[Guest Djangobear]

Almost at the end of day 3 and still good... fingers crossed. The culture and sensitivity Django last had showed Baytril as being the most effective against the E Coli but I will keep Orbax in mind as a definite alternative. Thanks

[Guest Djangobear]

So today is the fourth day Django's been off his meds and sadly the infection has reared its ugly head... was up through the night last night and traces of blood found in his urine. Obtained some pain medication from the vet and holding off putting him on more antibiotics until Monday, after we've taken a urine sample in for another culture and sensitivity test. The vet wanted a test done while not on the antibiotics, sadly, we were hoping that we wouldn't be in this same situation yet again So frustrating and just feels like there's no end in sight to all of this. We were hoping that the Baytril would be the med to fix it where it showed in the last culture to be highly effective agains the E Coli. Unsure of what the plan will be from here... another antibiotic I suppose. Meanwhile he's continuing on the cranberry (unsure if that's really doing anything but there's no harm in it) and the acidopholus as well. Also, does anyone know why the vet does a urinalysis while dogs are on the antibiotic? Just doesn't make sense to me as the results always come back negative for infection while on the pills, then once off, surprise! the infection continues to be there. I guess I'm trying to understand why they do this when the test yields inaccurate results. Open to anymore advice and feedback you may have and will continue to keep you posted. Thanks!

[tbhounds]

Almost at the end of day 3 and still good... fingers crossed. The culture and sensitivity Django last had showed Baytril as being the most effective against the E Coli but I will keep Orbax in mind as a definite alternative. Thanks

Just an FYI--orbax is essentially Baytril :-)

Another thought for you to ask your vet--are you sure that the original infection hasn't been resolved (e coli is usually pretty easy to knock out) and you are not now dealing with cystitis?

Also are the urine samples that are positive for glucose being collected by cysto or are they voided samples?

[Guest Djangobear]

Django update. He continues to have the UTI. Our vet is going to consult with the internal specialist to determine what our options are. She mentioned the possibility of him having some sort of structural abnormality which is causing the bacteria to never completely go away, i.e. like a polyp or an abnormal nephron or something. She suggested the possibility of having a dye test done of his bladder and kidneys (he's already had an xray and ultrasound but she said that sometimes things can be missed in these tests) or a possible biopsy of his bladder. She said that if the antibiotics were to work that they would have worked by now. I also inquired about Orbax and she did say that it's essentially the same as Baytril but not usually prescribed in Canada where we are. So... in the meantime, he's going back on the Baytril (as it gets rid of his symptoms while on it) and we're waiting the exact results from today's culture and sensitivity and waiting to hear what our options are. This has all been very devestating as our pup is under a year and a half old And... aside from the UTI's, he's been healthy, hyper, and active, in every other way which makes it that much harder. We do not have a lot of money, my partner and I both have decent jobs but we also have student loans, mortgage, and car payments. This has been very stressful not only emotionally but financially as well. If our dog was elderly or suffering or not eating, etc. we may be able to make a more permanent yet painful decision, however, at this time given his young age and vitality and him being our baby (we do not have children) I cannot even entertain the thought. So... worried about what the future may hold. If anyone has any other ideas, recommendations, please post as I'm open to anything at this point. Thanks so much.

[Batmom]

Sometimes things that appear to be sensitive to an antibiotic in the petri dish, aren't as sensitive in the dog. Gidgie's UTI took 6 weeks (IIRC) of Zeniquin PLUS Clavamox to clear up.

[greyhead]

As to Baytril vs. Orbax, they are from the same class of drugs, but they are not identical. One may work better for some, the other will work better for others. We don't know why, but that's just because we don't know everything. It's analogous to the various statin drugs for cholesterol, or the triptan class of drugs for migraine. At least with the migraine triptans I do know that two major differences among them are speed of relief onset and duration of activity. But with antibiotics it's less obvious than that.

 

Not saying that you should try to get what you don't have in Canada, but I wasn't comfortable letting stand the idea that the two drugs are basically identical.

 

So sorry you're going through this, as I do know how hard it is. For what it's worth, I'll just offer that I came to think my vet was treating by the book (e.g., x days on the med, then off for y days, then test) rather than the individual needs of this infection in this dog. It clearly required a longer, uninterrupted course of medicine than he had been getting, and it finally cleared up after I insisted he have that. Every time we stopped the meds, the infection reasserted itself, which to me clearly meant that it was being beaten back but not killed. So before I did a lot more expensive and/or invasive testing of the dog, I'd consider insisting on that custom-designed-for-this-situation, uninterrupted course of Baytril. (And it could be that a different med from the same class of drugs would sneak up on the germs better at this point and have a better chance to kill them.) My only other suggestion would be to have someone let him out a couple times during the day while you're working, if that's possible.

[tbhounds]

Just for clarification--I mentioned that they were "essentially" the same drugs. Of course, they are not identical-however, they are in the same class of antibiotics--the op may be spinning his wheels using the same class drug.

Why is it always the argument? Please don't put "words" in my mouth.

 

Edited because I have bit my tongue trying to play well in the sandbox :-)

Edited November 26, 2012 by tbhounds

[Guest Djangobear]

Just to confirm, my vet didn't say that Baytril and Orbax were identical, but from the same family/class and for this reason I think she meant essentially the same drug where Orbax isn't prescribed here but Baytril instead. She also said that Baytril showed to be the most effective against the E Coli from the culture/sensitivity test. And the internall specialist that saw him a couple months back did mention that drugs don't always act the same way in a dog as they do in a petri dish and it was after this that we did another culture and sensitivity and switched from the Cephalex to Baytril. Our vet has since followed up with the internal specialist who did not feel further testing would be beneficial and did not believe it would yield any further results when all of his other tests, i.e. bloodwork, urine test, fanconi, xray, ultrasound, etc. all came back so normal. My vet mentioned that he may need to be on antibiotics for the rest of his life. The internal specialist also wants him on a supplement but I don't have any details on this as this was just left in a v/m message and the vet is going to discuss things in detail with me tomorrow. So as of today, he is back on the Baytril, and it is looking like it's going to be a long term, if not indefinite, treatment. Also, I'm home for an hour with my pup everyday over lunch to take him out for a long walk. When he's on then antibiotics he's symptom free and not having to urinate frequently, etc. but when he's off them, the infection flares up badly, frequent urination, up through the night, blood in the urine, straining, etc. So normally he is let out to pee in the a.m. then approx. 4 hours later over lunch, then 4 hours later we go for another walk when I'm home, and then let out a couple more times in the evening when let's us know he needs to go out. Just to recap, aside from all the testing, switching antibiotics, he's also on a cranberry supplement and takes acidopholus, and we changed his diet. I don't know what else to do. I may see if she can make a referral to a holistic vet and go that route Has anyone gone to a holistic vet or have you heard any benefits of this? Greyhead, could you tell me (you may have already mentioned this earlier) but how long of a course Shane had of the Baytril? Before coming off of it recently, Django was on it for one month. Thanks again for your support.

[Batmom]

If the longest he's been on the antibiotic is 4 weeks, try 8 weeks. Make sure the dosage is appropriate. Consider adding an antibiotic from another class, if indicated by the initial sensitivity.

 

THIS IS IMPORTANT: A couple days before the end of the 8 weeks, while he is still on antibiotics, do a repeat culture and see if anything grows (and if so, what). Repeat the culture when he's been off antibiotics for 5 days, then two weeks.

[Guest Djangobear]

Thank you Batmom. Yes, he had a culture done a few days before completing this last round of antibiotics and showed no infection. (Historically this has been the case). Then today, after being off the antibiotics for 6 days (although we observed some red flags a couple days prior) the infection is there. I will be talking to the vet again tomorrow to discuss his treatment plan from here and will discuss with her testing him again after a longer course of the antibiotics (like 2 months) and also I will inquire about adding an antibiotic from another class as well. I just want our little guy to get better so whatever it takes really. I'll keep you posted. Thanks again

[Batmom]

Sounds like your vet is on top of things. Best luck!

[greyhead]

Just for clarification--I mentioned that they were "essentially" the same drugs. Of course, they are not identical-however, they are in the same class of antibiotics--the op may be spinning his wheels using the same class drug.

Why is it always the argument? Please don't put "words" in my mouth.

 

Edited because I have bit my tongue trying to play well in the sandbox :-)

I have no idea what you're upset about, what "always the argument" means, or what words you think were put in your mouth. What we say is one thing, what others interpret is another. I was addressing the possibility that others down the road might interpret "essentially the same" in a way you didn't intend. Hope your tongue isn't too sore.

[greyhead]

Has anyone gone to a holistic vet or have you heard any benefits of this? Greyhead, could you tell me (you may have already mentioned this earlier) but how long of a course Shane had of the Baytril? Before coming off of it recently, Django was on it for one month. Thanks again for your support.

ETA: Checked back through my records and amended what I wrote below:

 

IIRC, Shane was on Orbax Baytril for six five weeks, and that's after having been on a different class of a/b off and on for months. I'll check my records, but I recall that his last C&S said the prior antibiotic would still work for his E. coli, though by then at a very high dose. So she switched him to Orbax Baytril. Essentially supports what Batmom said about what happens in the petri dish versus what happens in the dog. After the 5th week, I went to an internist. He gave us Orbax because that's what they carried. He was only on the Orbax for 7 to 10 days. Then the internist wanted to call it kidney disease and treat him that way. With the food change but without the kidney meds, he improved and didn't need more antibiotics.

 

We did/do have a holistic vet. She does our acupuncture/chiropractic work on both our dogs but also consults with us about their other conditions, and she's thoroughly trained in Chinese medicine. She and my regular vet both supported the use of Rehmannia-6 for Shane's kidney health, but that wouldn't have helped the UTI. She'd have liked Shane to take herbal supplements, but she only offers them in loose leaf/powder form. Due to problems our other dog had with intestinal infection, I don't want anything that's not already in pill form! (Just too many chances that loose herbs can become contaminated somewhere along the line, for my taste.) But that's just our story, YMMV.

Edited November 27, 2012 by greyhead

[Guest Djangobear]

Thanks Greyhead for the timelines. The internal specialist originally wanted Django on the Baytril for 2 weeks, but our vet (knowing his history) increased it to a month. I'm still waiting to discuss things with her further re options, although yesterday she said that if the antibiotic was going to cure the infection that it would've worked by now. The issue is that they do not know WHY the infection isn't going away. And right before he comes off the antibiotics there's no sign of infection or white blood cells... so it looks like it's gone... it's bizarre. I also know that one of the long term side effects of Baytril is lameness so I'm worried about that as well. This is so stressful and frustrating. I'm hopeful that a longer dose, maybe 3+ months of antibiotics might do the trick? I don't know :S

[Guest Djangobear]

Django update. We now have a plan!! Yay! We doubled his cranberry and his vitamin C and we're monitoring his urine PH with glucose strips. The goal is get his PH under 6... it's currently been around a 7+. Once under 6, he will be starting a new medication that is normally prescribed to humans with chronic UTI's, Methenamene. Had to get a special dose created just for him. He will take this drug 3x's a day while remaining on the Baytril (staying on that for another month) and then will remain on this drug long term, gradually weening him off this med once he is able to go for a length of time without further infections. How this drug works is that it will turn his urine into Formaldehyde which is an antiseptic. This will act as a urinary flush and hopefully rid his bladder of any remaining bacterial infection. Then hopefully we can keep his urine more acidic to reduce the risk of any future infections. I am so happy that our vet and specialist are really thinking outside the box on this one. The medication, where it's primarily a human drug, was not available through the vet pharmacy. When our vet called around to other pharmacies, they were all out. So... being the great vet she is, she started looking outside of our province of Nova Scotia and located the drug in a pharmacy in New Brunswick. Also, to save us some money (where we've already spent a LOT on tests, meds, etc.) she had that pharmacy direct bill us rather than going through the vet to avoid the mark up cost. We're very optimistic about this plan and hope that we can help little Django lead a relatively normal and infection free life. Fingers crossed!! Thanks for all of your advice and input.

[Guest Djangobear]

Hi folks! Just wanted to share the good news re our border collie pup Django who had been battling a chronic persistant UTI for several months. He has finally been cured through diet!! Please see the attached link for details. I highly recommend going this route should your furry friend have these kind of issues and the antibiotics aren't working. It really has saved his life

 

http://www.totallyrawdogfood.com/post/testimonials/django-3/

 

Hope all your canine companions are healthy and well!

 

Kim

[Guest 2greys2cats]

Maybe I should be posting in Soap Box instead cuz I'm feeling pretty frustrated. But in case someone may find this shared experience useful, or if anyone has advice or experience to share, I'll post here.

 

Shane has had an E. coli UTI for...months and months! His vet has kept wanting to call him incontinent, and said she was sure he didn't have a UTI. I finally requested a C&S when he refused food and became hard to rouse!

 

He has had four rounds of Amoxi-Clav-Pot, with recheck cultures after rounds 2 and 4. When I reported that he was still having leakage problems at the end of round 4, I left him with the vet for a little while, and my husband went to pick him up about a half-hour later. The vet handed him some literature and a letter asking for observations of his urinary habits, and it basically laid out the treatment options for incontinence. (And at the time, the vet told my husband, "We've done it her way, and now we're going to do it my way." This didn't tick me off at the time, but it does now.)

 

So I waited about 8 days after the medicine was finished and took in a new urine sample; the culture results came back positive again! Last night the vet called with this info and said that, amazingly, the sensitivity test showed the germs are still susceptible to the same antibiotic (though at a really really high dose at this point)! Well, we decided to switch. There was a pretty long list of possible antibiotics, and I asked for Baytril. We agreed to give him two weeks' worth and, if it's working well, give him a third week. Oh, and I was gracious in victory if one wants to call it that, but I am not happy. This vet has wanted to call this dog incontinent since he was 5 years old. But antibiotics cleared it up that time too. And that's one of the points I want to make here: his leakage completely stopped after the second round of antibiotic, stopped for two weeks. Then it started up again and continued unabated through rounds 3 and 4. So I'm guessing that it was just too entrenched when treatment started, so that even 20 days of antibiotic wasn't enough. We should have kept it up for a longer *continuous* time just for good measure.

 

I asked if this was some weird strain of E. coli that's hard to vanquish, but the vet didn't think so. Jeez. So for anyone who is curious, yes, apparently this kind of thing can last this long!!! Has anyone else here had such an experience, though?! And if you don't have anything else to say, please just give me an encouraging word, cuz I am so tired out by this.

 

The only thing that got rid of my grey's was Zeniquin. It's really strong...gave him diarrhea, but it did the trick.

[Guest Djangobear]

Please see my post above re the raw diet if your dog is still having these issues. It was the only thing that helped our little guy when he had an e coli UTI for several months. He was on Baytril again and again and this did not work. He was on every anti-biotic that was proven (in his urine cultures and sensitivity tests) to be effective against e coli and none of them got rid of his UTI. We tried the diet as a last resort and it's been over two months now that he's been infection free!! Not only that, his overall health has drastically improved. And the vet wanted him on life long antibiotics! Antibiotics can be scary, especially for extended periods of time. If the drugs aren't working, I highly recommend the diet as it saved our little guy's life and I will never go back to feeding him processed kibble again. We did a lot of research on this before coming to this decision and we also knew that life long antibiotics would only shorten his life span which we did not want for our young dog. Best of luck!

 

http://www.totallyrawdogfood.com/post/testimonials/django-3/