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  1. #1
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    Default Vet ? - TMS antibiotic in dogs and blood levels?

    Any friendly vet-type people around? We got a copy of Pirate's blood work results when we picked him up, and my mom (who is a nurse) is kind of fretting about a couple of them (BUN and something else) being on the high side of normal and is trying to tell me we need to buy him special kidney food. (Which I am opposed to mainly on the grounds that I think most of the special vet foods have a lot of crap in them that I do not want to feed any dog. I am not opposed to possibly changing up his diet if necessary, but I want to do it with an understanding of what things need to change, and selecting the appropriate food from there, rather than just buying an overpriced bag of rubbish that has 'kidney diet' printed on the packaging. Anyway.)

    The vet didn't actually say anything about it - like I said, they're not high, they're on the high end of the 'normal' range - so I don't know if it's worth chasing up, or if it could be just as a result of either the infection in his teeth or the antibiotic he was on (he was on TMS for a week before the bloodwork was done, and another antibiotic the week before that.)

    Any thoughts? (I will come back when I have the blood work sheet and the name of the other antibiotic, so I can give better details. I just wanted to post before I forgot and I don't have them handy.)



  2. #2
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    Feb. 16, 2009
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    missouri
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    Would need some more info before deciding if the elevations are significant or not. The BUN and creatinine levels are indicators of how the kidneys are filtering, but can also be elevated by other things such as dehydration. How old is the dog and what type of symptoms was he/she showing? Was a urinalysis done and what did that show? Are the kidneys concentrating the urine (specific gravity- higher is better)? I'll try to check back tomorrow to see if you have more results. As far as kidney diets, if you need to use one they are very helpful for kidney failure. They are formulated with a lower protein level than diets that are available over the counter, which helps the kidneys not to work as hard.
    "I have been Foolish and Deluded," said he, "and I am a Bear of No Brain at All." - Winnie the Pooh



  3. #3
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    He's somewhere between 6 and 7 - we're not sure of his exact birthday because he's a rescue and the shelter that got him from his original owners seem to have put down the date they microchipped him as his 'birth date' and it seems pretty unlikely that it was actually his birthday. He's a shepherd mix possibly (maybe rottweiler? he has rotti-style markings) and is about 70lb.

    The blood work was done just as standard pre-anesthesia testing - he had a broken canine and also a bad/cracked tooth at the back on the same side, both of which were removed on Monday and his teeth cleaned at that point. So no urinalysis or anything like that was done. (The tooth extraction wasn't done by our regular vet, as he's semi-retired and so doesn't do surgical stuff any more, so part of why I'm asking is to find out if we should take him to see our normal guy sooner rather than later to keep tabs on things.)

    Anyway. The time on the test result print out is 11:19am - at that point he'd been without water since midnight (as per pre-surgical instructions) and without food since 6pm (again, as per instructions) and had also had a pre-anesthesia injection (type not specified on the information I have) to sedate him some prior to putting the IV in. (He did get IV fluids, but I don't know if they would've started those before doing the blood test?)

    The results read as follows (minus the little scale lines with low/normal/high because my ASCII art skills aren't that good ) :

    ALKP = 30 U/L
    ALT = 38 U/L
    BUN = 27 mg/dL
    CREA = 1.6 mg/dL
    GLU = 93 mg/dL
    TP = 6.6 g/dL

    The week immediately prior to the surgery/test he was on TMS 2 x 480mg tablets every 12 hours. (Or at least, the bottle says TMS 480mg and it's 2 tablets every 12 hours. I suppose the tablets could be 240mg each?)

    The week before that he was on Amoxicillin for the week (unfortunately I don't have the bottle anymore so I don't know the dose.) The reason for the switch was they tried to do the IV without the pre-anesthesia sedative and he didn't cooperate. So he came home and they switched him to the TMS for the week and then we took him in again. (With success - he seems much happier now that he has the teeth out, even though he's still healing up.)

    Really, other than the teeth he's always seemed pretty reasonably healthy. He doesn't seem to urinate any more/less often than any other fixed male dogs we've had, and it's not particularly dark or stinky. I'm not sure exactly how much he drinks because we have a shared water bowl for two dogs, but he doesn't drink so frequently or infrequently that anyone's noticed it as being odd.

    I think part of why my mom is concerned is we lost our last cat to kidney failure and so she feels like maybe she missed something important, you know?



  4. #4
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    Feb. 16, 2009
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    With his age and the lack of any symptoms, I would not be concerned about those results. If your mom is really concerned, your veterinarian could recheck them in a few months to see if they have changed. Does not sound like kidney problem so no need to change diet. Hope he feels better after getting the teeth out!
    "I have been Foolish and Deluded," said he, "and I am a Bear of No Brain at All." - Winnie the Pooh



  5. #5
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    Quote Originally Posted by kmsf View Post
    With his age and the lack of any symptoms, I would not be concerned about those results. If your mom is really concerned, your veterinarian could recheck them in a few months to see if they have changed. Does not sound like kidney problem so no need to change diet. Hope he feels better after getting the teeth out!
    Thanks so much. We'll just take a copy of the results to our regular vet next time we drop in (he's literally just down the road, so the dogs actually sometimes go just for a visit - means there's no dragging them to the vet when they do need to go, they love him) so he has it on file.

    He does seem somehow happier/healthier already, although I couldn't pinpoint exactly what it is. (My aunt had a dog with AWFUL teeth and he did the same sort of thing after getting his teeth fixed - it was like he just kind of bloomed somehow. Probably not terribly surprising, since inflammation is very hard on the body in general.)

    He is getting pretty sick of me peering at his gums by now, I'm sure. (I've just been having a look once a day or so to make sure nothing looks like it's very swollen or anything that would suggest he needs to go back to the vet.) Though probably the tasty food twice a day with his antibiotics in it helps offset the indignity.

    Last quick question, if you don't mind - is it actually worth trying to do the tooth brushing thing? In general what we feed them seems to keep their teeth pretty nice looking anyway (the non-damaged side of his mouth looked just fine, and our other dog's teeth are all fine, and we've had her from a puppy) so I don't want to get after them about it if it's going to be more stress than benefit. But on the other hand I don't want him to have to go through this sort of thing again if it's something that can be avoided by getting them used to some routine dental care, so.



  6. #6
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    Jul. 31, 1999
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    Last quick question, if you don't mind - is it actually worth trying to do the tooth brushing thing? In general what we feed them seems to keep their teeth pretty nice looking anyway (the non-damaged side of his mouth looked just fine, and our other dog's teeth are all fine, and we've had her from a puppy) so I don't want to get after them about it if it's going to be more stress than benefit. But on the other hand I don't want him to have to go through this sort of thing again if it's something that can be avoided by getting them used to some routine dental care, so.
    From what I've heard our vets say, it only does any good if you can brush their teeth at least 3x a week. I'd like to prolong the time between dental cleanings as much as possible, so I feed Eukanuba (dental protection in the kibbles...Iams has it too), give Hills Rx T/D kibbles as treats, and brush my pup's teeth almost every day. I follow up every tooth brushing with a CET rawhide chew (rawhide strips that are coated with an enzyme that helps break down plaque...most dogs love them!), which she enjoys enough to tolerate me brushing her teeth! Dental cleanings are expensive and the anesthesia can be hard on them, so I figure these are all little steps I can do to help. You can also talk to your vet about doing "pulse therapy," which is basically a 7-10 day course of antibiotics every 3 months (or so) that kills off all that bacteria growing in their mouths. We do that a lot for older dogs that can't handle the anesthesia but it can also be done for younger dogs that need frequent dentals to try and extend the time between cleanings.

    If your mom is still worried about the kidney values, get a urinalysis sent out to the lab and checked for microalbumin levels. Elevated microalbumin levels are one of the earliest indicators of kidney problems.

    Good luck!



  7. #7
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    Sep. 22, 2008
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    Ditto what's been said. To me that looks like really normal bloodwork for a dog of his age, and really one half his age! With the slight 'dehydration' factor of withholding water all you're really seeing there is that his kidneys CAN work to conserve water for the body when they need to.

    As far as teeth brushing, unless you're doing it a lot it's not really that great for keeping teeth clean. Personally I like the CET rinse you can add to their water for odor and plain rawhides work great for keeping the tartar down. Actually the dental specialist in this area says rawhides are her favorite 'chew toy' for keeping teeth in good shape. Hard enough to work and soft enough to not crack/chip teeth. Oh, and if they don't chew much and then start, some bleeding from the gums is actually a pretty good thing, means it's working!

    Katherine
    Vet Tech



  8. #8
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    Feb. 16, 2009
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    I agree with what has been said regarding brushing the teeth. Some dogs just seem to build up tartar more easily than others. Chewing something hard does help cut down on plaque and tartar. If he is 6-7 years old and hasn't needed a dental cleaning until now, he should be fine with just chewing and probably does not need brushing. One warning - be careful that he is just able to chew whatever you give him, and not actually able to swallow it. Had one patient who bit off a large piece of rawhide and it got caught in the esophagus at the base of the heart.
    "I have been Foolish and Deluded," said he, "and I am a Bear of No Brain at All." - Winnie the Pooh



  9. #9
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    Quote Originally Posted by Horsegal984 View Post
    Ditto what's been said. To me that looks like really normal bloodwork for a dog of his age, and really one half his age! With the slight 'dehydration' factor of withholding water all you're really seeing there is that his kidneys CAN work to conserve water for the body when they need to.

    As far as teeth brushing, unless you're doing it a lot it's not really that great for keeping teeth clean. Personally I like the CET rinse you can add to their water for odor and plain rawhides work great for keeping the tartar down. Actually the dental specialist in this area says rawhides are her favorite 'chew toy' for keeping teeth in good shape. Hard enough to work and soft enough to not crack/chip teeth. Oh, and if they don't chew much and then start, some bleeding from the gums is actually a pretty good thing, means it's working!
    I'll pass that on about the blood work, it'll probably make my mom feel better. (Like I said, I think a lot of it is just because of how we lost our cat - once something happens once, you sometimes get a bit hyper-alert to it, you know?)

    Is CET a brand name? I know I saw something that was advertised as helping to reduce tartar build up that you put in the water, but I can't remember what it was.

    Pirate kind of can take or leave gnawing - I kind of wonder if that was because of his teeth, though, because often he'd be very happy to take something, and then kind of abandon it unless it was something that our other dog had 'primed' so it already had a softened-up spot.

    That said, when we got him ALL of his teeth looked like they needed a clean, and then after about a month the 'good' side cleared right up. (Both bad/broken teeth were on the same side, so it seemed like he just didn't chew as much with that side.) That suggests to me that we're doing something right with what they get in terms of food and chews/toys.

    So if Pirate picks up gnawing a bit more once his mouth is all healed up, it sounds like his teeth will do just fine.

    (Kind of makes me feel better - he gets very confused by a lot of things and then easily stressed if he gets confused, so while I would've figured out the brushing thing if he needed it, it's good to not have to put him through the process of getting used to the whole business.)



  10. #10
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    I've found the CET chew things - but I can't seem to find online any guidance as to what size would be appropriate. Does anyone know? One dog is a cocker spaniel but she doesn't seem to be terribly intimidated by larger chews (she likes those ham-hock bone things they have at PetCo, and they're certainly more than a mouthful) and the other is Pirate, who has a fairly typically sized GSD-ish/Lab mouth. (Unless you're talking about a mammoth dog, anyway.)

    Pirate does tend to gobble food up, so I don't want to get something so small he'd just try to swallow it whole, but some 'extra-large' chews I've seen are really ridiculously large.



  11. #11
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    Jul. 31, 1999
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    We only carry the large chews at our clinic--we've ordered the "extra large" for folks in the past, and they honestly seem to be about the same size, but there are 1/2 as many in a bag and they cost 2x as much. They also make "small" sizes, but they're really tiny--probably an inch wide and 6" long--best suited for mini or toy breeds.

    There is some variation in a bag of chews, but I'd say the "large" size would probably work for both dogs. I'd say on average they are 3" wide and 8" long--they're thin like rawhides. I use the large size with my 55 pound lab--just make sure you keep an eye on them (like with all chews) to make sure they don't swallow the darn thing whole!



  12. #12
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    Quote Originally Posted by Ben and Me View Post
    We only carry the large chews at our clinic--we've ordered the "extra large" for folks in the past, and they honestly seem to be about the same size, but there are 1/2 as many in a bag and they cost 2x as much. They also make "small" sizes, but they're really tiny--probably an inch wide and 6" long--best suited for mini or toy breeds.

    There is some variation in a bag of chews, but I'd say the "large" size would probably work for both dogs. I'd say on average they are 3" wide and 8" long--they're thin like rawhides. I use the large size with my 55 pound lab--just make sure you keep an eye on them (like with all chews) to make sure they don't swallow the darn thing whole!
    Excellent, thanks. Yeah, I've noticed that lovely price jump in some stuff for 'extra-large' - honestly a couple of times I've gotten smaller sized treats for Pirate (because they're better value) and just held it for him so he was forced to chew.



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