Not so fast. Going nuclear with antibiotics can cause bigger problems than it solves
By Kim Campbell Thornton
What's the first thing you do when you're feeling sick or your pet has diarrhea? Is it to ask your doctor or the veterinarian to prescribe antibiotics to knock down whatever it is quickly?
That's a common request in human and veterinary medicine, but it's not necessarily the right one. From urinary tract infections to dental disease, antibiotics seem to be the easy answer, but their overuse in animals and humans is creating resistant bacteria. Instead of being killed off by the drugs, bacteria continue to multiply, becoming stronger than ever. That makes them ever more difficult to treat. And oftentimes, they're not even necessary.
"Lots of ailments that we see are caused by viruses, which antibiotics won't do anything for," says Tony Johnson, DVM, an emergency and critical-care specialist. "Lots of ailments that we see are going to go away on their own without antibiotics. We prescribe antibiotics for things that there's absolutely no need for. If a dog gets hit by a car and doesn't have a mark on it, he doesn't need antibiotics. If a dog has a cut less than the size of a dime, it'll heal on its own; he doesn't need antibiotics. Veterinarians are as guilty of this as the general public."
A review of antibiotic use in dogs, published in June 2011 in the Journal of Small Animal Practice, found that there was a confirmed infection in only 17 percent of the prescriptions. In 45 percent, infection was suspected; for instance, the patient had an open wound or discharge from the eyes or nose. In 38 percent, there was no documented evidence of infection. In those cases, the antibiotics were often given for "preventive" reasons, such as after surgery.
A better practice is to culture the skin, blood, urine or other tissue to confirm an infection and pinpoint the type of bacteria causing it. That allows the most appropriate antibiotic to be prescribed.
"If we see a big, infected wound or if we have a dog with pneumonia, we can culture that, find out what the bug is and what antibiotic will specifically target it, as opposed to using an overly broad-spectrum antibiotic that isn't needed," Dr. Johnson says.
But cultures can be expensive. While the cost of a culture is often worth it, not everyone is willing or able to pay for it.
That leaves veterinarians guessing at the best way to proceed. If they guess incorrectly, the dog or cat is in discomfort longer than necessary, and they are potentially contributing to the problem of bacterial resistance to antibiotics.
What's the answer? The World Health Organization and other institutions are calling for antibiotic stewardship: using the drugs only in cases with a definite diagnosis, ruling out viral and fungal infections, parasites and other conditions that don't respond to antimicrobial therapies.
For instance, antimicrobials aren't indicated for viral upper respiratory infections such as feline herpesvirus or canine influenza unless they are accompanied by secondary bacterial infections. Most cases of feline lower urinary tract disease don't involve bacterial infection. Treatments such as a change in diet or stress relief techniques are more effective. And some wounds may simply require cleaning with a topical antiseptic solution.
"If your dog or cat or child is not in pain and it's not life-threatening, let their body deal with it, whatever it is," Dr. Johnson says. "Antibiotics are a very powerful tool, and they save lives, so you don't want to not use them when necessary, but the main thing to understand is that they are not a cure-all."
Lyme disease affects
dogs and humans
Q: Do dogs get Lyme disease? I have always heard that they don't, so why is there a canine vaccine for it? -- via email
A: That's an interesting question with a complex answer. The short version is that yes, dogs can get Lyme disease from the bite of an infected tick. We see clinical signs in approximately 10 percent of infected cases, according to my colleague, Richard E. Goldstein, an internal medicine specialist at New York City's Animal Medical Center. He spoke on Lyme disease in dogs recently at the North American Veterinary Conference in Orlando, Florida.
Now, 10 percent might not seem like much, but if you look at the numbers, Lyme disease is pretty common. Even if most dogs don't show signs, the infection rate is 50 percent to 75 percent in some areas of the Northeast. Clinical signs in 10 percent of those dogs is a lot of dogs.
It can take two to five months after infection for a dog to show signs, such as lameness, lethargy and fever. They may last for approximately three days, and the arthritis and fever are usually treatable.
In more serious -- but fortunately, less common -- cases, dogs can develop a type of kidney disease called Lyme nephritis, which is often fatal, even in young, healthy dogs, as well as myocarditis -- inflammation of the heart muscle -- and neurological disease. And in many, if not most, dogs, the bacteria are the unwanted guests who never leave, even in the face of antibiotic treatment.
Good tick control is the first line of defense against Lyme disease in dogs. Vaccination alone isn't enough. If you live in an area where the disease is endemic, talk to your veterinarian about your dog's risk level, the prevalence of the disease and whether vaccination is appropriate for your dog. -- Dr. Marty Becker
Do you have a pet question? Send it to firstname.lastname@example.org or visit Facebook.com/DrMartyBecker.
First White House pets
were dogs and horses
-- Pets have made themselves at home in the White House since the very beginning. The nation's second president, John Adams, was the first to take up residence there, and of course the family dogs accompanied him and his wife, Abigail, to their new digs. The Adams family had several mixed-breed dogs, including two named Satan and Juno, according to the Presidential Pet Museum. Of Juno, the First Lady wrote to her granddaughter: "You will be glad to learn that Juno yet lives, although like her mistress she is gray with age."
-- Since 2008, it has been a federal felony to sponsor, exhibit, buy, sell, deliver, possess, train or transport an animal for participation in animal fighting, a crime punishable by a five-year prison term and a $250,000 fine. But until recently, spectators at dogfights got off lightly. In 24 states, the act of attending a dogfight is only a misdemeanor, carrying penalties of a small fine and no jail time. With passage of the Animal Fighting Spectator Prohibition Act, included in the 2014 Farm Bill, it is now a federal misdemeanor to knowingly attend a fight as a spectator and a federal felony to bring a minor under the age of 16 to a dogfight or cockfight.
-- Do you think his friends call him "metal mouth"? Wesley, a golden retriever puppy, is sporting braces after his owner, Molly Moore, noticed that he was having trouble eating and was losing weight. She brought the problem to the attention of her father, Jim Moore, an associate professor of oral surgery at Michigan State University's College of Veterinary Medicine. Moore realized Wesley's mouth didn't close properly and was causing pain. The braces will alleviate the problem in plenty of time for Molly's wedding next year. Maybe she'll have a canine ring bearer. -- Dr. Marty Becker, Kim Campbell Thornton and Mikkel Becker
ABOUT PET CONNECTION
Pet Connection is produced by a team of pet-care experts headed by "The Dr. Oz Show" veterinarian Dr. Marty Becker and award-winning journalist Kim Campbell Thornton. They are affiliated with Vetstreet.com and are the authors of many best-selling pet-care books. Joining them is dog trainer and behavior consultant Mikkel Becker. Dr. Becker can be found at Facebook.com/DrMartyBecker or on Twitter at DrMartyBecker. Kim Campbell Thornton is at Facebook.com/KimCampbellThornton and on Twitter at kkcthornton. Mikkel Becker is at Facebook.com/MikkelBecker and on Twitter at MikkelBecker.