Amoxicillin, Clavulanate (Clavamox, Augmentin)

by | Apr 1, 2024 | Medications

Amoxicillin, Clavulanate (Clavamox, Augmentin)

Amoxicillin, Clavulanate

Antibiotic
(Clavamox, Augmentin)
By Dr. Karen Burgess

Brand name and formulations

  • Amoxicillin (generic)
  • Amoxi/clavulanate-Augmentin (human formula), Clavamox (animal formula), and generic
  • Tablets, Capsules, and Liquid

What is amoxicillin?
Amoxicillin is an antibiotic in the penicillin family. Amoxi/clavulanate is created by combining amoxicillin with clavulanic acid which expands the spectrum of bacteria treated. Both of these are considered good choices for general infections of uncertain origin.

How is amoxicillin given and what if a dose is missed?
Amoxicillin is typically prescribed for twice daily dosing. If a dose is missed and it is less than 12 hours late, go ahead and give missed dose. If it is within 12 hours of the next dose, skip a dose and resume regular schedule with next dose. It may be helpful to give on a full stomach.

How should amoxicillin be stored?
Tablets of amoxi/clavulanate are sensitive to moisture and should be protected from humidity. The liquid formula should be refrigerated. If amoxicillin/clavulanate is left out of the refrigerator overnight it should still be good; if longer then discard. The liquid version should be discarded after 10 days.

What is amoxicillin’s background?
Penicillin was developed in the late 1800’s and became popular in 1943 when it was used during World War II. There are several limitations with penicillin including its poor absorption from the intestine and short acting nature. In response amoxicillin and amoxicillin/clavulanate which are synthetic penicillins were developed to address these shortcomings.

What side effects are associated with amoxicillin?
Both drugs can cause upset stomach, loss of appetite and nausea. Giving on a full stomach may help with these signs.

What drugs should not be given with amoxicillin?
There are no specific drug interactions.

What follow up is necessary with amoxicillin use?
Medication should be used for some time after signs of illness or disease are gone. Notify us if a refill is necessary.

Acepromazine (Promace)

by | Apr 1, 2024 | Medications

Acepromazine (Promace)

Acepromazine

Promace
(Tranquilizer)
By Dr. Karen Burgess

Brand name and formulations

  • Promace and generic
  • Tablets, Injectable

What is acepromazine used for?
Acepromazine is used as a tranquilizer for dogs and cats. The effects can be variable causing excessive sedation in some and no sedation in others. Another concern is that acepromazine has minimal effect on anxiety. This would be similar to being afraid of snakes and then being put in a room with snakes just sleepy. Acepromazine can also assist with motion sickness by decreasing nausea.

How is acepromazine given and what if a dose is missed?
Acepromazine is typically prescribed to be used as needed. The effects of acepromazine can last anywhere from six to twelve hours. A very conservative initial dose is typically prescribed with instructions to repeat dosing.

What side effects are associated with acepromazine?
Acepromazine may cause excessive sedation, abnormal gait (walking as if drunk, unstable on feet), and decreased blood pressure. Elevation of the third eyelid is a common and normal occurrence with the use of acepromazine.

What patients should not take acepromazine?
Pets with liver disease, geriatric patients, and debilitated animals should use acepromazine cautiously. Pets with MDR1 mutations (more common in herding breeds) may have prolonged effect from acepromazine. Giant breeds, greyhounds, sight hounds, and Boxers also may be more sensitive. Aggressive patients may become uninhibited while taking acepromazine leading to spontaneous aggression despite the appearance of being sedate. Pets with a history of seizures should not use acepromazine.

What drugs should not be given with acepromazine?
Care should be taken when using acepromazine with other anesthetics, sedatives, or potentially depressing agents. Antacids may affect absorption of acepromazine. Do not use acepromazine with organophosphate insecticides.

Cruciate Rupture, Canine

by | Apr 1, 2024 | Leg and Hip Problems

Cruciate Rupture, Canine

Cruciate Disease

By Dr. Karen Burgess

What is a cruciate ligament?
There are two cruciate ligaments that help provide stability to the knee or stifle joint. The anterior cruciate ligament is also known as the ACL and is the most commonly affected by disease in dogs. The cruciate ligament is a band of tissue that helps connect the femur or thigh bone to the tibia or calf bone. The cruciate ligament is one of many ways that stability is provided to the stifle or knee joint of dogs. ACL injuries are relatively common in human sports including basketball, football, and skiing.

What is an ACL injury and how is it caused?
The ACL can be torn or partially torn. Very often they occur when a pet is performing a normal activity such as running the backyard. In some cases no known injury occurs prior to an ACL tear. An abnormal twisting of the knee joint can also lead to an ACL injury. In some breeds the angulation of the hip and knee may predispose to cruciate disease. Unfortunately if a dog tears one cruciate ligament they have a significant chance of tearing their other ACL in the future.

What are symptoms of ACL disease?
Pets with a partial or complete tear of their ACL will often come up suddenly lame on a hind limb. This functional injury causes a toe touching or non-weight bearing lameness. Very often dogs are not extremely painful and still willing to run around three legged which helps differentiate an ACL injury from a fracture. In the case of a partial tear an intermittent mild lameness may be noted until the point in time where the ligament tears completely. Most discomfort from ACL disease comes from joint swelling as opposed to from the torn ligament.

How is ACL disease diagnosed?
In the case of a complete tear palpation by a veterinarian for what is called a “cranial drawer” sign is diagnostic. This abnormal motion of the knee may require sedation or even palpation to detect in particular in heavily muscled or tense dogs. Radiographs are also often diagnostic. In the case of partial tears it can be much more difficult to diagnose. Subtle changes such as joint swelling may be the only detectable sign. In these cases scoping of the knee during general anesthesia may be required for diagnosis.

How is ACL injury treated?
Surgery is the definitive treatment and involves either creating a false ligament or changing the angle of the knee thereby creating stability. In the long run, the goal is to return a pet to comfortable function and help avoid arthritis down the road. There are several different types of surgery available for ACL tears and for larger pets (over 40#) this is the treatment of choice. It is important to understand that while commonly performed today in veterinary medicine, devastating complications can occur. For this reason, while it may be more expensive to have a surgeon (veterinarian that has received advanced training in surgery) perform the procedure, in the end it is often the safer option. Other options for ACL injury include benign neglect, or doing nothing, and/or rehabilitation. The body will eventually scar the injured joint providing a pain-free knee. However the degree of function will be more greatly affected and return to normal function often does not occur. In small dogs where less weight is being put on the knee joints scarring as a treatment is acceptable, but in larger dogs it is not optimal. Weight control and joint protectant medications are also recommended with or without surgical treatment.

How long is recovery from ACL disease/surgery?
With surgery recovery typically takes six to eight weeks with a gradual increase in exercise thereafter. For cases of self-healing, six weeks of limited and protected movement is recommended. Physical therapy including water treadmill can help with the recovery process.

Labwork, Urine Testing

by | Mar 31, 2024 | Labwork / Diagnostics

Labwork, Urine Testing

Urine Testing

By Dr. Karen Burgess

What is a urinalysis?
A complete urinalysis is made up of chemical (commonly called a dipstick) and microscopic or sediment examination. The dipstick portion looks for the presence of red and white blood cells, glucose, ketones, protein and bilirubin in the urine. It also quantifies the concentration and acidity of the urine. The sediment portion of a urinalysis involves physically looking at a sample under the microscope in search of red blood cells, white blood cells, crystals, bacteria, and abnormal kidney or bladder cells. The urine is one of the first ways that kidney disease can be identified in pets. If a bacterial infection is suspected a culture and sensitivity (C&S) may also be performed to identify specific bacteria and the appropriate antibiotic choice for treatment.

Pyoderma

by | Mar 29, 2024 | Allergy

Pyoderma

By Dr. Karen Burgess

What is pyoderma?
Pyoderma is another way of saying bacterial skin infection. Skin has bacteria present naturally, but when allowed to overgrow skin infection develops.

What causes pyoderma?
Pyoderma is an overgrowth or invasion of the hair follicle with bacteria. Typically pyoderma is secondary to some other cause. Examples include allergic skin disease (atopy), food allergy, matted hair, self-trauma, and underlying metabolic disease (hypothyroidism, Cushing’s).

What are the signs of pyoderma?
Superficial pyoderma affecting only the outer skin layers often appears as red bumpy areas that have crusts present. Hair loss or rough hair in the area may also be present. Deeper pyoderma can cause significant hairloss and open wound like lesions. In either case pets are often itchy and may paw or lick excessively at effected areas.

How is pyoderma diagnosed?
Visualization of lesions, history, and cytology of affected sites looking for bacteria are all involved in the diagnosis of pyoderma. In severe or chronic cases additional testing to rule out underlying medical conditions may be indicated.

How is pyoderma treated?
Mild localized cases of pyoderma can often be treated with medicated sprays or shampoos. More severe instances often require oral antibiotics until well beyond resolution of lesions. An Elizabethean collar is often essential in treatment to prevent pets from further self mutilation while medications are taking effect. Treatment of underlying medical conditions (ex. allergies, parasites) that predispose to pyoderma is also necessary.