Dear Dr. John,
Our old Goldendoodle has a heart problem. He has been seeing a cardiologist and is on medications for his advanced Grade 5 murmur and chronic cough. Those include Pimobendan and Furosemide. He is also prone to bad skin but most recently he has again started with green nasal discharge and some eye mucus. Our primary vet gave him antibiotics about six weeks ago and we are scheduled to be seen because it started again, and his appetite is down. Could it return so soon due to an antibiotic resistance? He seemed to improve last time. He has taken the Cephalexin quite a few times for the respiratory discharge issues and chronic bad skin. Should our vet consider another antibiotic and is the heart a factor? M.N.
Dear M.N.,
Antibiotic resistance is one of the largest challenges to medicine today, both in animals and people. There are some bacteria that have developed the ability to fight antibiotic therapy which can go on to have serious, if not fatal, effects. This does occur in canines, but I have not seen it much myself due to judicious use of antibiotics and using a culture and sensitivity (C&S) if I feel something is not being treated effectively.
Also called antimicrobial resistance (AMR), we see certain bacteria more difficult to treat than others. The best known of these is MRSA, this is also seen in dogs, and is seen with certain species of Staphylococcus. In dogs, other pathogens such as E. coli and Pseudomonas have also been seen to develop AMR. One needs to consider proper dosing, comorbidities such as your dog’s chronic cardiac condition, and frequency of use before suspecting resistances. Chronic skin issues that do not improve with antibiotics might also suggest an immune issue. Additional therapy such as medicated shampoos might be needed. The fact that your dog improved a short time ago with the same nasal discharge issue suggests to me that the Cephalexin did work and perhaps a slightly stronger dosage or length of use might knock out whatever infection is likely occurring. It is worth talking with your veterinarian about your questions.
Dr. John de Jong owns and operates the Boston Mobile Veterinary Clinic; 781-899-9994.
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