Antibiotic Article from a Dog Blog

I found this on a dog blog and found it to be quite helpful. Note that some of the drugs listed are banned for use in poultry.

Please consult your vet before using any antibiotics!
All doses mentioned are for dogs, not poultry.

A dog blogger wrote:

ANTIBIOTIC THERAPY
Most dogmen whether active in hunting dogs or not, will at one time or another need to use antibiotics on their dogs. There is a lot of ignorance regarding antibiotic therapy, and many people use these drugs incorrectly, which can be worse for a dog than not using them at all. In the article that follows I will attempt to explain, to the best of my knowledge, the proper uses and dosages of antibiotics. I will also list the most effective antibiotics available as well as which circumstances require their use and some mistakes that are commonly made.

I think I shall begin at the beginning. That is to say, I will begin where most people first encounter or use antibiotics on their dogs, the pet store or pet supply catalogs. There are sources of fish or livestock antibiotics, and some people worry about the differences in QUALITY CONTROL, but these differences are for the most part imaginary. The following article will be discussing human or veterinary-approved drugs, but there are some over-the-counter drugs labeled for fish (discussed in Jolly Jumper’s "Saving Money" chapter) that work just fine. If some people are worried about using human-grade drugs, I also list foreign vendors in my "Saving Money" chapter that you can order as well, though the turn-around time isn't as fast. Also, if you are in the dog game you will also meet people who can help you out.

Almost all human antibiotics can be used on dogs and most everyone knows people with a medicine cabinet full of bottles of pills they never took. Be creative and you will be surprised how easy these drugs are to come by. Again, ask experienced dogmen and they can help, but if not, the resources I list in my "Saving Money" chapter will be all you ever need. Anyway, this chapter is to teach you what to use and how to use them.

OK, why do we give antibiotics? To stop an infection from forming or to eliminate a pre-existing infection. How do we do this? Well the fifty-cent answer to that question would take up a whole page and be really boring so I'll give you the ten-cent version. Antibiotics stop infection one of two ways. Either by inhibiting the spread and growth of bacteria, thereby allowing the bacteria to die off naturally and be destroyed by the body's immune system, or by actually killing the bacteria by means of bacterial death upon contact with certain concentrations of the drug. Antibiotics that use the first method are called bacteriostatic drugs. The ones that kill bacteria are called bactericidal.

It can be important for you to know which antibiotics fall into which class, and I will discuss these differences later, but what is important to understand now is this: regardless of which method of stopping infection you use, realize that some bacteria are hardier and take longer to kill or die. These bacteria will live on if antibiotics are discontinued too soon. These few bacteria that were not destroyed will begin to reproduce, and in some cases after having been exposed to one antibiotic will build their own immunity to that antibiotic. This is called building resistance and this is why chemists have to keep coming up with new drugs year after year. It's because the old drugs won't work after a while. I had an Immunologist from the Academy of Health Sciences tell me that approximately 75 percent of all the bacteria he cultures comes up resistant to Penicillin. That means Penicillin will not do squat to about 75 percent of the infections out there. What this means to you and me is this: If we are going to use an antibiotic we best use it correctly because we can only mess up a few times, after which our dog will be screwed because we will not have anything to give him that will work. What this adds up to is making sure you give the PROPER DRUG ... at a PROPER DOSE ... for the PROPER AMOUNT OF TIME.

The proper amount of time generally means giving it at least 7 days - or for however long it takes the wound to heal completely ... and then FOR 3 DAYS AFTER you see no more signs of infection (if the drugs are given more than 7 days). This is important so I will give examples.

Say you have a dog who gets an infected bite. The wound is red, swollen and oozing puss. You put him on an antibiotic and in 3 days the wound looks great, no more pus. It's no longer red and the swelling went down. Well, you DO NOT stop the antibiotics. You give them a full 7 days. KEY POINT: Seven days is the MINIMUM amount of time to give an antibiotic. OK?

Now, let's say your dog has an ear infection, so you start antibiotics. On the 7th day of giving them he seems to be 100% healed. Now here you DO NOT stop at seven days. You give them 3 more days for a total of 10 days. Remember: you give antibiotics for a MINIMUM of seven days OR until the wound is healed PLUS 3 more days after that. In this case, the wound took seven days to heal, so you must go another three days after that, and then you stop. One more time. You have a dog with infected mammary glands. You start the drugs and keep giving them for 14 days because your vet said 14 days the last time this happened. But at 14 days they are still infected, so you KEEP giving the antibiotics until you see NO signs of infection - and then go 3 more days. This is to ensure absolutely 100% of the germs are killed. If any survive they may become resistant and then the drug you used will be no good if the infection comes back.

Finally, if your dog starts to get worse while on any antibiotic, or if no change occurs after seven days, then you need to upgrade to a new antibiotic. For our purposes here I am going to list a few good, effective antibiotics that are easy to come by. I will also list what they are best used for and the correct dosage of each. If you wish to gain a deep understanding of antibiotics and their uses, I suggest you purchase The Compendium of Veterinary Products as well as The Merck Veterinary Manual. However, the following list should be all you will ever need.

Before I do this, however, I will give an example of how to figure out dosages for those of you who may not know how. Say I have a 50-pound dog. I have a drug that's dosed at 6.25 mg per pound every 6 hours. I multiply 6.25 mg x 50 lbs. That equals 312.5 mg needed for this dog. I need to give 312.5 mg every 6 hours. The drug comes in 250 and 500 mg capsules, 250 mg is close enough. Give one 250 mg capsule every 6 hours. If the dose came out to 412.5 mg, I would go with the 500 mg capsules. If you have injectable drugs just read the label to see the dose. It will read mg/ml or mg/cc (cc and ml are the same), so if the bottle said 250 mg/ml, I figure I have 250 mg for each 1 ml or cc of drug I inject. So for 312.5 mg I would draw up 1 1/4 mls (250 mg + 62.5 mg) and give that every 6 hrs. Use a calculator. Don't be ashamed to ask someone to make sure the dose is right. It's better to be humble and correct than proud and wrong.

As far as Antibiotics and hunting dogs go, REMEMBER THIS TOO: The best thing you can do for your dog is give him a good, thorough bath with a Betadine (or Nolvasan) scrub ... and follow this with proper wound cleansing. If possible, let his own immune system fight off infection, if he's not too bad. Simply keep him indoors and clean the wounds twice daily. If the cuts are deep, try to use only mild preventative antibiotics at first, again only for deep wounds, not superficial cuts. Proper wound care begins with a cleansed disinfected dog PRIOR to any hunt (even practice) ... it continues with a second cleansing of the dog and ALL wounds AFTER the hunt ... and it is finished off with attentive wound management 2-3 times a day thereafter until healing starts. The worst thing you can do is START a hunt with a dirty dog, leave him dirty afterwards, not clean out any wounds ... and then wonder why he got such a bad infection. Be a professional and start and end with a thoroughly-cleansed dog.

Assuming you have taken these precautions, many times antibiotics won't even be necessary. If you wish to add antibiotic therapy to your aftercare, the following is a basic list of standard antibiotics that should be fairly easy to come by. I rate the drugs based on their potency and in the order I believe they should be used. In other words, you don't just use the strongest antibiotics you can find, right out of the gate, you start out with mild preventative antibiotics, and you upgrade only if you have to. When you upgrade, go to a moderate antibiotic before you resort to a very strong antibiotic.

Sometimes, a dog will get 2 or more different bacteria infecting a wound, for which no "one" antibiotic will work. Other times, a particular antibiotic "should" work on the bacteria present, but the infection is so deep that the antibiotic can't penetrate effectively. In either case, the infection can worsen, and so combination therapy might be warranted.

First of all, any time you have an infection present that does NOT respond to a solid drug choice, like Clavamox or Cephalexen ... or especially Baytril or Cipro ... you ought to take your dog to the vet and ask him to run a CULTURE & SENSITIVITY TEST on the wound. Because if the solid antibiotics are not working, you could be dealing with a problem that requires a special antibiotic, or several bacteria that require combination antibiotic therapy, and a CULTURE & SENSITIVITY TEST will tell you exactly what bacteria are present and exactly which antibiotic(s) your dog needs. This can be absolutely critical, so if you EVER have a dog not respond to one of the stronger antibiotics, go to your vet to have this test run immediately.

However, if you are unwilling and/or unable to go to your vet, there are some general antibiotic combinations that work very well together, and there are some that don't. I will touch on some of the combinations that work, so that if you are out in the field and can't get to a vet you can put some good mixes in together.

ANTIROBE / BAYTRIL: This is a combination that would be a good choice for a deep bone infection or a deep dental infection that doesn't seem to respond to any "one" drug. A deep abscess that is unresponsive might be a reason to combine these two drugs.

BAYTRIL / CEPHALEXEN: This is a combination that would be a good choice for a deep tissue infection or even a deep bone infection that doesn't seem to respond to any "one" drug. Or use this as an attempt to try and cover "everything" if you have a persistent infection but have not identified the problem.

BAYTRIL / CLAVAMOX: This is a combination that would be a good choice for a deep tissue infection or even a deep bone infection that doesn't seem to respond to any "one" drug. Or use this as an attempt to try and cover "everything" if you have a persistent infection but have not identified the problem. * Best Choice *

CLAVAMOX / GENTAMICIN: This is a combination that would be a good choice for a deep tissue infection, or you can use this as an attempt to try and cover "everything" if you have a persistent infection but have not identified the problem.

CLAVAMOX / METRONIDAZOLE: This is a combination that would be a good choice for a deep absess or a deep flesh infection that doesn't seem to respond to any "one" drug. Metronidazole is a very penetrating drug, and allows the Clavamox "access" to cell entry in an abscess that it might otherwise not have used on its own. Metronidazole also gets some specific anaerobic bacteria of its own, while Clavamox is broader-spectrum, but the two work synergistically together.

Remember, though, troubleshooting like this is a poor substitute for getting a Culture & Sensitivity test and using exactly the recommended drug(s). Further, it is unwise to make combination therapy like this "standard practice"; use such therapy only in EXTREME CIRCUMSTANCES, when nothing else seems to be working. In other words, don't even consider combination therapy unless you have a serious problem. Just stick to standard choices if you simply have a fresh wound, and these should suffice quite nicely.

Some Final Words Finally, some injectable antibiotics will be in dry powder form in their vials and you must mix them into a liquid. Do not use anything other than what the label says to use. If it says use "sterile water for injection" do not use " 0.9% saline solution" - or vice versa. The local pharmacy will carry these dilutents and they are cheap. Also, ALL antibiotics should be given with PLENTY OF WATER for the dog to drink. A dog being well hydrated is critical for the antibiotics to be transported effectively in the bloodstream! If you are giving antibiotics to a dehydrated dog, they won't work! This is why giving antibiotics in conjunction with IV Fluid Therapy is considered Best Practice.

I will say this one last time, hopefully to drill it in: USE THE RIGHT DRUG FOR THE RIGHT PURPOSE. In other words don't use Penicillin for a deep ear infection, use Clavamox. Don't use Baytril for a fresh bite wound, use Amoxicillin or Penicillin. Get the idea? Always start by giving the lighter antibiotics immediately after a wound as a prophylactic (preventative), and you should never need to use one of the Big Boys. If you do get a dog which starts to get infected anyway, then move to a mid-grade antibiotic. Only if an infection persists in spite of a solid antibiotic like Clavamox or Cephalexin should you pull out the heavier artillary and move to a Baytril, etc. And if this happens, again, Best Practice calls for a Culture & Sensitivity Test at this point.

But, just winging it, if I personally had to choose only 2 antibiotics to have in the field, I would chose Clavamox and Baytril (or, in human form, Augmentin and Cipro). These 2 drugs are extremely effective by themselves, they're easy to come by ... and they combine well together to cover just about anything. So between them they can handle most any infection you will ever come across, either by themselves and especially when grouped together.

If you can only get "one" antibiotic, and you don't have any money to afford a complete medicine chest, then try to get Cephalexen, because it is good, it's available everywhere, and it is cheap. As dogmen we will most commonly use antibiotics for accidental bite wounds and Cephalexen can get the job done on its own 99% of the time.

OTHER ANTIBIOTICS
There are a few other antibiotics / would like to mention, some of which have application to wounds, while others have some good practical applications to our dogs that are NOT wound-related, but still very important. They are:

TETRACYCLINE: This is a broad spectrum antibiotic, but it has a few side effects, so you should use it in wound care only if you have no other antibiotics to choose from. There are some rare bacteria that are only affected by the tetracyclines, however, so it is a good drug to have in your medicine cabinet. The tetracyclines are for the most part bacteriostatic as well, so it is important that your dog have a good immune system when you use this drug. It is a good choice for treating bronchopneumonia (kennel cough). Another great use for Tetracycline is for the treatment of Lyme Disease. The oral dose is 10 mg per pound 3-4 times a day (every 6 - 8 hrs), depending on the severity. Side effects: If you give tetracycline to a pregnant ***** or a puppy before the adult teeth have come in, the teeth of the pup will be permanently stained yellow or light brown. Also tetracycline can sometimes kill off the natural flora or "good" bacteria in the intestines. This can cause a change in stool or diarrhea. Also, they inhibit calcium formation and should not be used on an animal with any bone fracture that requires healing. And, one final note, NEVER use expired Tetracycline on your dogs, just throw it away if it goes passed the expiration date. Tetracycline becomes highly-toxic once it becomes outdated. You can easily obtain this drug, labeled for fish, in a product called "Fish Cycline Forte: Tetracycline 500mg "

DOXYCYCLINE: This drug is a derivative of Tetracycline, but (as a rule) it is far superior. From minimizing the side¬effects, to having a broader spectrum of efficacy, to having deeper penetration into cells, Doxycycline is a very important drug to have in your medicine cabinet. Doxycycline is an adequate choice to fight infection, and could be placed alongside Cephalexen and Clavamox in this article. It also has a strong use in fighting mastitis, kennel cough, urinary infections, etc., but perhaps its greatest use is in fighting the tick-born diseases. From ehrlichia, to babesia, to Rocky Mountain spotted fever, Doxycycline is a great choice in the treatment of all of the tick-born ailments that can plague our dogs. The oral dosage for Doxycycline is 5 mg per pound, given 1-2 times a day (every 12-24 hours). You can easily obtain this drug, labeled for birds, in a product called "Bird Biotic: Doxycycline Hyclate 100mg "

TRIMETHOPRIM-SULFA: This is a solid choice for wound care, that can also stand alongside Cephalexen, Clavamox and Doxycycline, but its real value is in treating mastitis, as it penetrates deeply into mammary tissue and milk and it should be in every breeder's medicine box. Like Clavamox (which is potentiated Amoxicillin), Trim ethoprim-Sulfa is potentiated Trimethoprim, and is a very good choice for many infections. It is dosed at 15-20 mg per pound, given orally, one to two times daily (every 12-24 hrs). You can easily obtain this drug, labeled forbirds, in a product called "Bird Sulfa: Sulfadimethoxazole 400mg, Trimethoprim 80mg "

GENTAMICIN: is a strong antibiotic that is bactericidal very quickly. Unfortunately, bacteria can also build resistance to it quickly, and it also has some negative side-effects to the kidneys, especially in pregnant animals. Gentamicin is best used in combination with Amoxicillin, and especially Clavamox, because it is a gram-negative drug and the other gram-positive. Used together, they can work to great synergistic effect. In fact, a relative to Gentamicin (Streptomycin) used to be available in combination with Penicillin-Procaine, in a drug called "Combiotic." However, because of side-effects, and because of such a wide resistance built up to both drugs over the years, "Combiotic" was eventually discontinued. Still, Gentamicin can be combined with (Clav)Amoxicillin to great effect, yet there are less risky drug choices to make. The dosage for Gentamicin is 1.5 - 3 mg per pound IM or SQ one to two times daily (every 12 - 24 hrs).

FLAGYL: (Metronidazole) Generally-speaking, this drug is not used in wound-management, but rather it is used to fight off amoeba-like intestinal infections (giardia, trichomoniasis, amebiasis). However, Flagyl is a fairly effective anaerobic, bactericidal drug that has certain wound applications (see below). The general dosage rate of Flagyl is 20 mg per pound given orally on Day 1, followed by 10 mg per pound given on the following days. For giardia, Flagyl is dosed at 11.5 mg per pound ... and for trichomoniasis it's dosed at 30 mg per pound ... and you treat either condition for 5-7 days. You can get Metronidazole, labeled for fish, in a product called "Fish Zole: Metronidazole 250mg, or Fish Zole Forte: Metronidazole 500mg"

CHLORAMPHENICOL: This drug can cause a human's body to stop making red blood cells and nothing can make it begin again. Basically it can kill you or your dog. It is rare to have this reaction but do not take the chance - do not mess with Chloramphenicol.

EXTREMELY POWERFUL

The following antibiotics are extremely powerful and should NEVER be used as a first choice, but only as a last resort for a severely infected dog that couldn’t be treated successfully with the above drugs:

ANTIROBE: (Clindamycin) All of the above antibiotics have been bactericidal, meaning they actually kill bacteria when at the proper dose. Antirobe is bacteristatic; that is, it halts bacteria so the body can fight off the infection itself. However, Antirobe is a great drug for deep infections of the bone, deep abscesses, and other ailments requiring deep penetration, such as lung infections also. As can be guessed by its name, Antirobe gets anaerobic bacteria, meaning bacteria that do not require oxygen to survive. Hence it is one of the primary drugs of choice for deep infections of injured joints, broken bones, tooth abscesses, etc. Antirobe is dosed at 4 mg per pound, given orally, every 12 hours. There are potential side-effects, so caution should be used and the dog watched closely. Again, this drug should NOT be used as a first choice, but only for very deep infections that the above drugs have failed to cure.

BAYTRIL: (Enrofloxacin) This is a very well known drug. People think it is good for everything, and for the most part they are right. Again, this drug should NOT be used as a preventative antibiotic. It is best used with bad infections or when other antibiotics have not worked. It is excellent for skin, ear, flesh, urinary, mammary, and bone infections, as well as being an effective remedy for mycoplasma, and sometimes brucellosis. However, if Baytril keeps being used as a first choice antibiotic, sooner or later it will go the way of penicillin and be useless. This is especially true if it is used incorrectly. The dose for the injectable form is 0.25 ml per 5 pounds of weight in one muscular injection, but you must then follow this with the tablets, as the injectable is hard on the kidneys. The dose for the tablets is either 5.7 mg per 5 pounds of weight given orally TWICE a day, every 12 hours ... or 11.4 mg per pound given orally ONCE, every 24 hrs. The tablets come in 4 sizes: 5.7mg, 22.7 mg, 68 mg, and 136 mg. Example: If you have a 40 pound dog you would give either two of the 22.7 mg tablets every 12 hours, or four of the 22.7 mg tablets once a day. The easy way to dose this is: 22.7mg tablet twice a day for a 20 pound dog, 68 mg tablet twice a day for a 60 pound dog. Again, double the dose and you can give it only once a day.

Unfortunately, Baytril is usually only available by prescription and there are no "over-the-counter" versions of it, However, the human equivalent to Baytril is CIPRO (Ciprofloxacin). Also you can find:

Fish Flox: Ciprofloxacin 250 mg
Fish Flox Forte: Ciprofloxacin 500 mg

The dosage for Cipro is 5 mg per pound, given twice daily. Unlike Baytril, you can NOT double the dose of Cipro and give just once daily; it must be given every 12 hours. However, Cipro is much less expensive than Baytril and every bit as effective in fighting infections.

***NOTE: Baytril and Cipro are called Fluoro-quinolones and again SHOULD NOT be used as a first choice. They also SHOULD NOT be used in puppies under 8 months old. They can cause damage to the leg cartilage in pups making them permanently lame. They also should be fed on an EMPTY STOMACH, one hour before feeding, or 3 hours after. Also, do NOT use with Pepcid AC as it interferes with the potency. ***

STRONGER FIGHTERS

The following drugs can be used to treat an infection that has actually developed in a dog, where one of the above preventative medications failed to work:
CEPHALEXIN: This is a very good drug for skin and flesh infections, as well as mastitis and infections of the bone. In fact, Cephalexen is one of the best "all-purpose" antibiotics you can find. What's more, Cephalexen is also easy to come by, and very inexpensive. Cephalexen only comes in oral form, and the dose is 11 mg per pound of body weight given every 6 to 8 hours, depending on the severity. If you are using a maintenance dose, give every 8 hours. If the case is severe, use every 6 hrs. This drug is a "must have" in every dogman's medicine cabinet. You can easily obtain this drug, labeled for fish, in a product called "Fish-Flex"

CLAVAMOX: This is derivative of Amoxicillin but is a bit stronger, as it is a "potentiated" version of it, having Potassium Clavulanate added to it, and is thus better at fighting infection. The addition of this ingredient basically makes it harder for susceptible bacteria to build resistance to the Amoxicillin. Clavamox can also be used for mastitis, respiratory and ear infections, as well as pyometra - and is safe for pregnant bitches. It is only given orally. This drug is great but can cause vomiting occasionally. It is dosed in a 1:4 ratio, that is one part Potassium Clavulanate to four parts Amoxicillin. For convenience, the manufacturers lump them all together when they dose it out. The oral dose is 6.25 mg per pound. It comes pre-packaged in foil strips in 3 sizes and also drops for small pups. There are 62.5 mg for 10-pound puppies, 250 mg for 40-pound dogs, and 375 mg for 60-pound dogs. There is a human drug that is the same as Clavamox, but it is called Augmentin. Although these drugs are expensive, both Clavamox and Augmentin are worth their weight in gold to a dogman.

MILD PREVENTATIVES
These drugs are best used immediately after a hunt, before an infection starts

AMOXICILLIN: A good “all purpose” antibiotic that is compatible with many other antibiotics. Amoxicillin is good for wounds of the flesh. It is best used as a *preventative* antibiotic, given before an infection is present. It can be used to treat actual infections that develop, but there are better choices. It comes in capsule form and injectable. Both work well. The oral dosage for Amoxicillin is 5 mg per pound given every 12 hours. The injectable dosage is 4 mg per pound given IM every 12 hours. You can easily obtain the oral version of this drug, labeled for fish, in a product called "Fish-Mox"

AMPICILLIN: Another good "all purpose" antibiotic, a little stronger than Amoxicillin, but is NOT compatible with other antibiotics. Ampicillin is also good for wounds of the flesh, and is also best used as a preventative, given before an infection is present. It can also be used to treat infections that are already present, but again there are better choices. Ampicillin comes injectable form but you can also give it orally. The injectable dosage is 5 mg per pound given IV, IM, or SQ every 12 hours. The oral dosage is 10 mg per pound given every 8 hours. You can easily obtain the oral version of this drug, labeled for fish, in a product called "Fish-Cillin"

PENICILLIN G: Penicillin is good to use only in the injectable form. It is only valuable as a preventative agent, and even this value is becoming suspect. Penicillin will not generally work well to treat wounds that are already infected, and if it does work once it will seldom work on the same dog twice. The best use for Penicillin is to give it right after damage occurs along with a good anti-bacterial bath or scrub. The injectable dose on Penicillin G is listed in "units" the product you have may come in a strength of 10,000 units per ML (or some other strength higher or lower so check the bottle). Also there are different types on the market and they all stay in the body different lengths of time. Compare your bottle to the list below for how often you must give it. They all should be given IM but can be given under the skin if the dog reacts to the pain of the injection. This is a product you may obtain through any catalogue or at any feed store.

The different Penicillin Injectables:

• Penicillin G potassium, 12,500 IU per lb, given every 6 hours
• Penicillin G sodium, 10,000 IU per Ib, given every 6 hours
• Penicillin G procaine, 15,000 IU per Ib, given every 12-24 hrs
• Penicillin G benzathine, 20,000 IU per Ib, given every 2-3 days

The trade names differ on each product so read the labels. Some common products are Crystiben and Benz-pen. Also, DO NOT mix penicillin with other antibiotics!