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15 year old 85 pound black lab with re-occuring UTI.

Hello. 15 year...

Hello. 15 year old 85 pound black lab with re-occuring UTI. Cephlaxin and Amoxicillin not working. Also mild case of cough, maybe a kennel cough strain that's in my sled dog kennel (in rural Alaska). 104 temp. Used azithromycin tablets a few weeks back but UTI came back. Want to knock it down then keep away with low level mild antibiotic. Is Azithromycin safe for these current conditions for this dog?

Veterinarian's Assistant: I'll do all I can to help. Coughing can be worrying. The Expert will know what you should do. What is the dog's name?

Bart. Coughing is not bad, and when we had kennel cough years ago it was a much more noticable occurance. He's also arthritic, and his latest metabolic numbers from two months ago were actually very good for his age.

Veterinarian's Assistant: Is there anything else important you think the Veterinarian should know about Bart?

No just my main vet feels that he is winding down on his lifespan. Best looking 15 year old large dog I've seen. Has had issues with bladder and bowel control. Last time on this drug he had very big blowouts and it knocked him down bad, but it seems to be best option now. I am away from home and he is watched by my employees/sled dog handlers, and a vet is too far away. Any help, recommendation on doseage is appreciated.

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Customer reply replied 7 months ago
Hi waiting on the question above, estimated time was 8 minutes a while ago. Just curious about timeline.
Answered in 2 hours by:
1/20/2018
Drhollowayvet
Category: Dog Veterinary
Satisfied Customers: 1,127
Experience: Relief Veterinarian at Aloha Animal Hospital
Verified

Hello my name is***** but you can call me Dr. H, and I am al icensed veterinarian who has been practicing for the past 6+ years. I am sorry no one was availalbe when you first posted your pet concerns, but I just logged in online and figured I could help answer your questions.

Give me a moment to type up a reply.

- Dr. H

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Customer reply replied 7 months ago
OK I'm waiting

I understand that your pet has been having a chronic UTI infection. Have you seen any blood in the urine? Has the vet done a urine culture yet?

The cough is concerning. Has Bart been tested for heartworm disease? Any recent chest x-rays?

- Dr. H

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Customer reply replied 7 months ago
No blood in urine. Was taken to vet for past UTI. No heartworm in Alaska so that's not an issue. No chest x-ray. I have a sled dog kennel of about 25 dogs. For the last few weeks a few have had a cough from a bug that was brought into our area from dog teams training in a different area. Common occurence. I've seen Kennel Cough twice in my yard over the last 35 years, this cough if it's KC is much more mild. Not much of a deep hacking, but other dog mushers have it and are calling it KC. No other symptoms, the sled dogs do not show any other problems. But KC impacts pets stronger so I'm not surprised my old lab is less comfortable. But still no deep hacking cough. Fever was a surprise. He's lethargic but he always moves very slowly. Numbers a few months ago showed good metabolic function, kidneys, liver, etc. Just this reoccuring UTI. In the past it was knocked down for many months by Cephalixin. It did not work last month so he was treated with Zpack. It hit him very hard with side effects but he was OK for about 10 days-2 weeks. UTI is back, loss of bladder control, very strong odor.

Many cases where a UTI does not respond to the initial antibiotic, there is a resistant bacteria, so a urine culture is the next best step. ALso in an older dog, if the urine culture comes back where the selected antibiotic was the appropriate one to use, I would consider getting an abdominal radiograph +/- ultraosound done to check for possible urinary bladder stones and/or tumors in the bladder. These are our top causes for a non-responsive UTI with selected antibiotics.

- Dr. H

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Hmm. I see. So heartworms is low risk here. Got it.

Fever can occur in pets who have never been protected against kennel cough or in pets that have developed a lower airway infection (pneumonia). I would suspect this may be involving the lower airway now. : (

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Customer reply replied 7 months ago
My vet said it may be stones or tumor. But he can't go to the vet for a bit (two hours away, and weekend). And frankly vet said that a 15 year old dog may not have many options. My concern is how strong Zpak impacts him. He was treated with 500mg tablets for three days. I have another dose. For now, until he can go to Fairbanks next week, should I give him this antibiotic for fever, maybe secondary pneumonia, or KC. Seems like it can be given. And at what dose? I can cut tablets.
Customer reply replied 7 months ago
I don't think anything got to lower airway, no wheezing. Although I'm not with him now, my dog handlers are. But they are very perceptive and have him around all the time. He does snore a lot, older dog and such. Has a bit of nasal discharge too.

Azithromycin can have some side effects. Especially in an older dog, but they can alos be used to treat some resistant airway infections as well. Let me check his dosage really quickly for the Azithromycin. How much does he weigh?

What other dosage of medication are you seeking at this time?

- Dr. H

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Customer reply replied 7 months ago
I'm basically looking for the treatment that will help over the weekend until I can re-evaluate and get him to the city. Switch from Amoxicillin (he's on now, not working, and bypassing Cephalixin since it didn't work last time) to the Z pack, and what dose, and if it's good or bad with the 104 temp.
He's about 80-85 pounds. Last time he had big stool blowouts, abdominal discomfort, did not dig life. Looking at the side effects I guess this is common. Give with Pepto-Bismol? Considering he has poor bowel control all the time, this is a major issue but one that my handlers will deal with for the few days.

Outward wheezing isn't always heard in pets that have fluid in their lungs. Especially in a large breed, older dog in the beginning stages of pneumonia, especially if he is pretty mellow anyway. Just want to forewarn you.

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Customer reply replied 7 months ago
OK. Sounds like an antibiotic that works wonders like Azithromycin should be given soon. Only other med he's on is CBD oil for arthritis and Adequin shots once a month. Rimadyl for his joints was not a good long term solution, his hair was falling out. Responds well to the CBD oil.

Ok. I understand you wanting to help him fo the meantime. I would not give Pepto Bismol in this situation, becuase it is contraindicated if the pet has any type of bacterial infection. And with a fever we can assume he has an infection for sure. I would instead give him a probiotic (Culturelle over the counter) and fiber (1-2 tsp of canned pumpkin, no the pie filling) in his food daily. I will look into the Azithromycin dosage for an 80 lb dog just to be safe. Give me a moment.

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Customer reply replied 7 months ago
OK good to know.

There is a good range for Azithromycin. It ranges anywhere from 5-10 mg/kg for 3-7 days. 1kg=2.2lbs. So for an 80 lb dog that is around 250mg of Azithryomcyin once a day for 3-7 days.

-Dr. H

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Poor guy. I hope he feels better soon!

- Dr. H

Drhollowayvet
Category: Dog Veterinary
Satisfied Customers: 1,127
Experience: Relief Veterinarian at Aloha Animal Hospital
Verified
Drhollowayvet and 87 other Dog Veterinary Specialists are ready to help you
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Customer reply replied 7 months ago
OK thanks, ***** ***** He was on twice the strength the first time. Maybe his side effects will be less severe. Appreciate your help, thanks.

You are most certainly welcome. Best of luck to you moving forward and I hope that Bart is able to make a full and speedy recovery. Take care.

* Please don't forget to leave me a rating for the service I have provided for you and your pet tonight. Thank you so much for your feedback. Take care. *

- Dr. H

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