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Chronic metronidazole

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  • Chronic metronidazole

    My beloved Siamese, Otto, who will be 15 on his assigned birthday this coming New Year's Day -- he turned up as a stray cadging barn cat food in June, 1999, with an estimated age of 18 months -- has surrendered several of his proverbial nine lives in the course of various ailments the past 8 years or so.

    All are successfully medically managed. One was successfully surgically managed, though because he lost one of his two thyroids and three of his four parathyroids 3-4 years ago, he receives painstakingly titrated daily calcitriol to make up for the parathyroid deficit. (His thyroid function with just one is fine without meds.) For a cat with low grade asthma, a stable cardiomyopathy for 9 years, IBD requiring a special diet, the parathyroid deficit and a missing thyroid, a destroyed lung lobe after a protracted lung infection, and a bit of arthritis that for three years has kept him from being the high jumping athlete he once was, Otto is the picture of health. He certainly seems so to see him. He play-fights successfully holding his own with his adopted Siamese 'nephew' just over half his age, and who outweighs him by 4 pounds.

    Not counting the meds, regular exams and shots and his special diet or insurance premiums, his healthcare cost is deep into five figures, maybe $4K of which will be recovered if I ever get around to filing his claims for the past 6 years. I also don't count the initial or annual fees for having Otto gene banked and storing the samples in hopes of getting him cloned someday. Obviously Otto is three standard deviations beyond extraordinary and we both are fortunate that it has been possible to cover his medical expenses.

    His chart at the North Carolina State College of Veterinary Medicine is an inch and a half thick or more. He has been seen by at least five departments, most, multiple times. The poor 4th year vet students who are expected to go through it whenever I bring him in are bleary-eyed by the time they meet us in the exam room to summarize for the resident.

    Otto's med list is extensive, including weekly B-12 injections and four chronic daily drugs specific for his existing various impairments, plus every-other-day aspirin. Happily he snarfs them all down with good grace.

    A few weeks ago Otto developed bad breath and some unprecedented flatulence, so his regular vet prescribed metronidazole, an antibiotic also used in human medicine (though Otto can be said with confidence not to have vaginitis or associated GU problems).

    Within two days the symptoms resolved. The drug was discontinued after a 7-10 day course. Three days later symptoms recurred, so there's some kind of undefined underlying bacterial infection. We resumed the metronidazole but it hasn't been long enough to remove the recurrent symptoms. I'm told that if a 3-4 week course doesn't abolish them permanently, he may need to take the drug permanently. I'm also told that resistance to this antibiotic doesn't occur.

    We suspect there may be some dental issue, though nothing is obvious now. He was evaluated and x-rayed by the NCSCVM Dental Service a year or so when he momentarily had some malocclusion with nothing found and had his teeth cleaned at that time while he was anesthetized for some other compelling procedure. But because of his mild cardiac issues, anesthesia solely for tooth cleaning or any other non-critical reason, is perceived to be unnecessarily risky.

    Does anyone else have a cat or dog or other critter on chronic metronidazole? If so, was it ever possible to sort out what the source of the chronic infection was? If so, what was it? Were there ever adverse effects from the antibiotic? How long has your critter been living or did s/he live after the chronic antibiotic regiment started?
    "Things should be as simple as possible,
    but no simpler." - Einstein

    “So what’s with the years of lessons? You still can’t ride a damn horse?!”

  • #2
    Yes, hyperthyroid cat who gets horrible diarrhea. He has been on the 'zole for over a year now. Likely not ideal, but it works and he's a holy terror to hospitalize. So far, no ill effects.

    It is an antibiotic, typically the low dose vets prescribe doesnt wipe out the flora in the gut, but with long term use you could certainly see some GI signs. It can also be neurotoxic to some animals,but again, generally its prescribed at low doses so these effects arent very common.

    Siamese are the most common feline breed to have gastrointestinal diseases (IBD, lymphoma etc), so I would keep an eye on him for any GI signs (vomit/diarrhea) if you dont see any changes with the metronidazole.

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    • #3
      I also just heard from my horse vet that metronidazole has gone up tenfold in price....yikes!
      "You can't really debate with someone who has a prescient invisible friend"
      carolprudm

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      • #4
        Maybe add in a probiotic to up the good bacteria. Long term use is often with minimal side effects.

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        • #5
          I'm sorry to hear that you've had such challenges with his health! He's awfully lucky to have you!

          As far as staying the metronidazole long term, my dog was on it for 2 weeks, off for 7, then on for 6 weeks for GI inflammation of unknown origin. I'm not aware of any problems that it may have caused though it didn't help the issue that we're having (still having liquid stools at my house...)

          With the IBD that you've already had diagnosed, is it possible that there is again (for some reason) some inflammation and the metronidazole is helping with that? Or do they really think there's an infection? The way I understood it, metronidazole is more to manage an inflammatory response than to act as a standard antibiotic. But I'm not a vet nor do I play one on TV.

          I guess if I were in your shoes, especially with the IBD being a known factor, I'd probably feel pretty comfortable doing another couple weeks of metronidazole plus a probiotic.

          Hang in there! It's awfully frustrating to not KNOW what you're dealing with, isn't it?
          A good horseman doesn't have to tell anyone...the horse already knows.

          Might be a reason, never an excuse...

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          • #6
            I pretty much live on metronidazole myself. I have a type of immuno-suppression that makes it difficult for me to fight off common bacterias that affect the GI tract like Clostridium difficile. My immune system produces inflammatory responses at low levels and throws my whole system out of whack and I can get really sick really quickly.

            Metronidazole is a different type of antibiotic than your broad spectrum drugs. This specifically targets anerobic bacteria which are more commonly "bad" GI bacteria that, when prolific, causes GI upset. It does not kill the good GI bacteria like other antibiotics can.

            I do take a good probiotic as well just to try to build up the good bacteria but metronidazole is a 3x/day staple for me.

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            • #7
              Yes, Zelda was on metronidazole for over a year--maybe two? If she was still alive she would still be on it. She had completely liquid diarreah (sp? COTH needs a spell check for people like me) without it. She never tested positive for Ghiardia or anything we could find, but definitely had IBS. I can't remember the inital dose, but after two weeks at full dose the vet had us cut her down to one pill once a day, then gradually to half a pill which she eventually maintained on (I think we had to go back to a full pill somewhere in there for awhile). She varied from 71-73 lbs.

              We were able to stop the metronidazole after six months when she wasn't showing allergy signs anymore (her GI upset was pollen related). We had to restart it when the allergies came back. We also needed to have her on it when she was boarded, as the stress seemed to trigger the tummy upset.

              The only long-term drug we had major issues with was Vetalog (long acting steriod). Led to surgery complications. I don't think the metronidazole was ever a problem. The vet did indicate it wasn't great that she was on it when we had her on Deremaxx and Tramadol the weeks before she died, but she didn't elaborate why and that was short-term. I put it on a spoon with peanut butter and she licked it right up. I also fed her yogurt occasionally.

              It was a HUGE relief for us and for her. She felt so bad about pooping in the house. Uncontrolled liquid squirts are baaaaaad.
              DIY Journey of Remodeling the Farmette: http://weownblackacre.blogspot.com/

              Comment

              • Original Poster

                #8
                Thank you all for sharing your experience with this antibiotic.

                Otto's bad breath and other symptomatology has resolved since we reinstituted it.
                "Things should be as simple as possible,
                but no simpler." - Einstein

                “So what’s with the years of lessons? You still can’t ride a damn horse?!”

                Comment


                • #9
                  Our pug mix has been on this drug daily for IBS for over 2 years with no problem. My vet assures me that there is no problem with its longterm usage. Wigii also takes a daily probiotic.

                  I don't know about the price. I may be in for an unpleasant surprise as i need to order a new batch soon.

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                  • #10
                    My dog has been on it for a couple of years for immune mediated stomatitis. We're hoping to take him off once his full mouth extraction is complete. So far he has been OK and does not seem to have any health problems other than stomatitis. He is a 4.5 kg dog and is on 125 mg/day.

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