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Dr. John
Dr. John, Texas Veterinarian
Category: Dog
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Experience:  Over 14 years of clinical veterinary experience
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I have a male yorkie age 12 and he's been congested and

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i have a male yorkie age 12 and he's been congested and having trouble breathing through one side of his nose. he has a scope done a year ago because he was severely congested and we wanted to make sure he did not have nasal cancer. Tissue samples were sent for biopsy and he was put on marblefloxcin last September. He seem to get better in December and was off of his medication. In April of this year the congestion started again, mostly at night and he had a severe nose bleed that wouldn't stop. I took him to the vet and they finally stopped the bleeding. Put him back on Marblefloxocin and Temaril P and cerenia. Because he was still congested at night i requested to change antibotic because he had been on marblefloxocin for so long. He was put on Azrithromycin, Temaril P and cerenia. He still had rough night and started with mucas with brown tent. I requested dr to biopsy his sinuses. Biopsy results came back and he has Pseudomonas aeruginosa. Dr says that this bacteria is resistant to his Azrithroymicin so he had to send off for another test to see what other antibiotic can be used. Do you have any experience with Pseudomonas Aeruginosa and how to get rid of it?
JA: I'm sorry to hear that. The Veterinarian will know what to do about this bleeding. I'll connect you ASAP. Is there anything else the Veterinarian should be aware of about the dog?
Customer: he's not having any nose bleeds right now, just congestion at night. I've been putting a humidifier on at night to open his sinus.

Hello. Thanks for writing in. My name is***** and I would be happy to help you. I am not set up to do phone calls but would be happy to answer any questions you do have online. If you get a request for a phone call, it is from the website and not myself. Pseudomonas is a very nasty bacteria that tends to be resistant to a lot of antibiotics. It is usually an opportunistic infection, so it typically develops after chronic infections. It is also a bacteria that is big concern with infections caught in hospitals. We tend to see it most commonly in chronically infected ears. Marbofloxacin tends to be an antibiotic that it is susceptible to, but resistance to that antibiotic is very easy to achieve. It tends to also be resistant to aminoglycoside antibiotics, such as gentamicin and amikacin. These are injectible antibiotics only and do carry a concern for kidney toxicity. The good news is that they can be used in nebulizers to achieve higher doses to the respiratory tract and less so in the blood stream and kidneys. That may be the way to go with this infection. I would wait until the antibiotic sensitivity results come back before starting anything. If sensitive to marbofloxacin again, I would also start on round of that as well. Please let me know if you have any other questions or concerns. Hope this helps. Please let me know if you have any other questions or concerns. Hope this helps.

My goal is to make sure that you get all your question answered and all the information you need. If you are satisfied with my answer, PLEASE RATE IT. Rating it is the only way I get credit for helping you. If you feel like it is not helpful to you, or if there is more information you need, please respond back to me before rating. Realize that our conversation is not intended to diagnose or treat a condition. There has to be a valid veterinary-client-patient relationship established with an exam, according to law. You should always follow up with your vet.

Customer: replied 1 month ago.
He wasn't sensitive to marblefloxocin I just felt it wasn't working cause he was on it since September 2015. Is Gentamicin and amikacin to be put in nebulizer? Or something else ? I will wait for sensitivity test but I'm trying to do my research too for my baby

You can put the gentamicin and amikacin in the nebulizer. It will give higher concentrations of the drug to the area that needs it. They usually given as injections but carry a risk for kidney damage. Not so with the nebulizer. The infection may have been sensitive to the marbofloxacin before, but these bacteria can adapt and become resistant. Even though it is a strong antibiotic, bacteria can easily become resistant to that class of antibiotics. As mentioned previously, I am not set up to do phone calls. I can opt out to see if another expert can fulfill that request, or we can continue the conversation online. Hope this helps.

My goal is to make sure that you get all your question answered and all the information you need. If you are satisfied with my answer, PLEASE RATE IT. Rating it is the only way I get credit for helping you. If you feel like it is not helpful to you, or if there is more information you need, please respond back to me before rating. Realize that our conversation is not intended to diagnose or treat a condition. There has to be a valid veterinary-client-patient relationship established with an exam, according to law. You should always follow up with your vet.

Customer: replied 1 month ago.
This puts me a little at ease until I get sensitivity test in. Can you tell me how does he get this infection if it is know to be in hospitals? Also, can I catch this from him?

Well, it can be caught in hospitals, but it is ubiquitous in the environment. It is a bacteria that tends to invade when there is already chronic damage from other bacteria or a lowered immune system, but it tends to be very resistant to a lot of antibiotics if it causes an infection. When people develop infections from hospitals, it tends to be one of the bacteria that causes that. Hope this helps.

My goal is to make sure that you get all your question answered and all the information you need. If you are satisfied with my answer, PLEASE RATE IT. Rating it is the only way I get credit for helping you. If you feel like it is not helpful to you, or if there is more information you need, please respond back to me before rating. Realize that our conversation is not intended to diagnose or treat a condition. There has to be a valid veterinary-client-patient relationship established with an exam, according to law. You should always follow up with your vet.

Hi,
I'm just following up on our conversation about your pet. How is everything going?
Dr. John

Hello. I was following up to see how your Yorkie is doing and to see if you have any further questions.

Customer: replied 1 month ago.
The sensitivity test came in but I missed the call from dr. He called in a prescription ciprofloxacin 2xday. I still want to ask about the antiobitic In nebulizer as you suggested

Thanks for the update. I would ask about using a nebulizer with gentamicin or amikacin if that is an option based on the culture and sensitivity results. Let me know if you have further concerns.

My goal is to make sure that you get all your question answered and all the information you need. If you are satisfied with my answer, PLEASE RATE IT. Rating it is the only way I get credit for helping you. If you feel like it is not helpful to you, or if there is more information you need, please respond back to me before rating. Realize that our conversation is not intended to diagnose or treat a condition. There has to be a valid veterinary-client-patient relationship established with an exam, according to law. You should always follow up with your vet.

Customer: replied 1 month ago.
It's either one or the other or both in a nebulizer?

One or the other. It may depend on what they have in the hospital as well.

My goal is to make sure that you get all your question answered and all the information you need. If you are satisfied with my answer, PLEASE RATE IT. Rating it is the only way I get credit for helping you. If you feel like it is not helpful to you, or if there is more information you need, please respond back to me before rating. Realize that our conversation is not intended to diagnose or treat a condition. There has to be a valid veterinary-client-patient relationship established with an exam, according to law. You should always follow up with your vet.

Customer: replied 1 month ago.
Would the nebulizer be taken with the Ciproflixacin ? Or in place of Cipro? I haven't given Cipro yet and his dr is off tomorrow.

I would use both of them together. An oral antibiotic that gets more systemic and antibiotic in the nebulizer that gets concentrated at the site of the infection. Hope this helps.

My goal is to make sure that you get all your question answered and all the information you need. If you are satisfied with my answer, PLEASE RATE IT. Rating it is the only way I get credit for helping you. If you feel like it is not helpful to you, or if there is more information you need, please respond back to me before rating. Realize that our conversation is not intended to diagnose or treat a condition. There has to be a valid veterinary-client-patient relationship established with an exam, according to law. You should always follow up with your vet.

Customer: replied 1 month ago.
Ok I'll request it and see what he tells me. What is the dosage for a 6.5lbs Yorkie almost 13 years old?

For his size, I would probably use 35-50 mg of gentamicin in 3-4 ml of sodium chloride. I have also heard of some vets using tobramycin eye drops into the nose for chronic upper respiratory infections. It is another option but probably wouldn't work as well.

My goal is to make sure that you get all your question answered and all the information you need. If you are satisfied with my answer, PLEASE RATE IT. Rating it is the only way I get credit for helping you. If you feel like it is not helpful to you, or if there is more information you need, please respond back to me before rating. Realize that our conversation is not intended to diagnose or treat a condition. There has to be a valid veterinary-client-patient relationship established with an exam, according to law. You should always follow up with your vet.

Customer: replied 1 month ago.
I really appreciate your input.. Hoping to get my baby well again. Should we continue the TermarilP? And Cerenia? They prescribed Cerenia for anti- inflammatory.

I would for now. If the symptoms start to improve, I may talk to your vet about weaning off the Temaril. I just wouldn't do anything different right now.

My goal is to make sure that you get all your question answered and all the information you need. If you are satisfied with my answer, PLEASE RATE IT. Rating it is the only way I get credit for helping you. If you feel like it is not helpful to you, or if there is more information you need, please respond back to me before rating. Realize that our conversation is not intended to diagnose or treat a condition. There has to be a valid veterinary-client-patient relationship established with an exam, according to law. You should always follow up with your vet.

Customer: replied 1 month ago.
Is gentocin the same as gentamicin that you were talking about? .2mL with .5mL saline
Gentocin Inj (100mg/ml)

Yes, it is the same thing. That sounds good. Have you started it yet?

My goal is to make sure that you get all your question answered and all the information you need. If you are satisfied with my answer, PLEASE RATE IT. Rating it is the only way I get credit for helping you. If you feel like it is not helpful to you, or if there is more information you need, please respond back to me before rating. Realize that our conversation is not intended to diagnose or treat a condition. There has to be a valid veterinary-client-patient relationship established with an exam, according to law. You should always follow up with your vet.

Customer: replied 1 month ago.
No I just picked it up... The dr wasn't there and the nurses never seen this prescribed for a nebulizer so it scared me
Customer: replied 1 month ago.
they gave me saline in a bottle. Is that right too ?

Yes it is. It is used very often in nebulizers. I assume the veterinarian prescribed it, correct?

Customer: replied 1 month ago.
When I went to pick up the medicine to put in nebulizer there was no saline so she went out done in a bottle. My concern is that I don't want it being a saline due cleaning wounds or is that the same kind?

Saline is saline. There are no different kinds. It most likely came from a sterile bottle or sterile bag of sodium chloride (same as saline) IV fluids. Hope this helps.

My goal is to make sure that you get all your question answered and all the information you need. If you are satisfied with my answer, PLEASE RATE IT. Rating it is the only way I get credit for helping you. If you feel like it is not helpful to you, or if there is more information you need, please respond back to me before rating. Realize that our conversation is not intended to diagnose or treat a condition. There has to be a valid veterinary-client-patient relationship established with an exam, according to law. You should always follow up with your vet.

Customer: replied 1 month ago.
I guess the problem is the dr isn't there and they aren't sure. She poured some of her saline into a medicine bottle .09 concentration she said.

You would have thought that the vet would have left instructions for that. I usually use 35-50 mg (0.35-0.5 ml) of gentamicin in 3-4 mls of saline.

My goal is to make sure that you get all your question answered and all the information you need. If you are satisfied with my answer, PLEASE RATE IT. Rating it is the only way I get credit for helping you. If you feel like it is not helpful to you, or if there is more information you need, please respond back to me before rating. Realize that our conversation is not intended to diagnose or treat a condition. There has to be a valid veterinary-client-patient relationship established with an exam, according to law. You should always follow up with your vet.

Customer: replied 1 month ago.
Do you think the strength of 100mg is too strong for my little one?

I wouldn't use 100mg. I would only use 35-50 mg. That is 0.35-0.5 ml. The concentration of 100mg/ml is the only way that gentamicin comes. Hope this helps.

My goal is to make sure that you get all your question answered and all the information you need. If you are satisfied with my answer, PLEASE RATE IT. Rating it is the only way I get credit for helping you. If you feel like it is not helpful to you, or if there is more information you need, please respond back to me before rating. Realize that our conversation is not intended to diagnose or treat a condition. There has to be a valid veterinary-client-patient relationship established with an exam, according to law. You should always follow up with your vet.

Customer: replied 1 month ago.
Ok am I understanding this correctly and I hate to continue to bother you with this but the bottle he poured it in was called gentocin .2mL with .5mL saline
Gentocin Inj (100mg/ml)

It was already mixed up?

Customer: replied 1 month ago.
No. Just reading off the typed label on the medicine bottle he put it in..

Okay. Thanks. So 0.2 ml of 100 mg/ml gentamicin equals 20 mg of gentamicin to mix with the 0.5 ml of saline. That should be good. If you have further questions, don't hesitate to let me know. I want to make sure you are understanding it correctly.

My goal is to make sure that you get all your question answered and all the information you need. If you are satisfied with my answer, PLEASE RATE IT. Rating it is the only way I get credit for helping you. If you feel like it is not helpful to you, or if there is more information you need, please respond back to me before rating. Realize that our conversation is not intended to diagnose or treat a condition. There has to be a valid veterinary-client-patient relationship established with an exam, according to law. You should always follow up with your vet.

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