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Hi This is Dr. Hill. Wrigley has been through the ringer over the last week! Is she on any other medications besides the nitrofurantoin? Pain meds for CCL?
Was the urine cultured to see what type of bacteria present? Did she have any bloodwork when she was diagnosed?
Okay, so I would stop the Rimadyl for now. It can cause some gastrointestinal issues and I would start her on 20 mg of pepcid AC by mouth twice daily. Does she seem to be in pain?
That is a little bit more pain than we typically see with an ACL tear, especially after being on meds for several days. It sounds like her abdomen hurts. Did she have any bloodwork when you took her in initially?
Here are my thoughts. 1. Nitrofurantoin is not a first line drug that we typically use for uti's. If she had a urine culture and it showed a multi drug resistant infection, then I can see using it. It can cause gastrointestinal issues and liver issues. 2. She really needs to be rechecked and have some bloodwork. The drugs may be making her feel sick but she is a large breed, middle aged girl and we should know how her liver and kidneys are holding up. Did they say why they started Nitrofurantoin?
Okay that stinks. there are new guidelines for what bacteria we are treating nowadays. Has she had a history of utils. Do you know the names of the bacteria. It matters for the purpose of supplements and for length of treatment.
Okay. So, I think the next best step is to get some bloodwork. If her liver values are elevated she may need a different antibiotic, if possible. If you can get a copy of the urine culture I can look at what other options are available for her. If she on glucosamine? It is also beneficial for joints and for her bladder wall. With her not eating much, the meds are just going to make her feel worse.
So, I would stop the Rimadyl and start the Pepcid AC. Pepcid will kick in pretty quick to help with gastrointestinal discomfort. She is on a pretty hefty dose of Tramadol. How much does she weigh?
Definitely try the rice and boneless/skin less chicken breast tonight. Pepcid AC is over the counter at any drug or grocery store. Make sure you get the 20 mg size. She is a big girl!! Send the report once available and I will keep a look out for it today. I am typically off and on the net over the course of the day until about 10 pm.
It is not uncommon for her not to have a bowel movement for several days. She is not eating very much, so nothing pushing food along into the colon. She is probably not able to posture very well to defecate, but that will get better with time. I would not do anything for that now, unless you note that she is straining. How are you supporting her outside?
Let me know when you get the results.
you can give her 20 mg by mouth twice daily.