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Cat Forum / Health and Behavior / November 2003Enrofloxacin vs Orbafloxacin ?
My cat Casper had her teeth cleaned a few weeks ago and the vet told me that she had a high level of red blood cell in her urine. After 1 week of Clavamox the level was still high and the urine culture results came back negative, i.e. they weren't able to grow anything. So my vet is saying that she probably has an infection in the kidneys and wants her to take Enrofloxacin. Today I faxed him the following article : http://www.vin.com/VINDBPub/SearchPB/Proceedings/PR05000/PR00528.htm "Enrofloxacin has recently been associated with retinal degeneration in cats at the recommended dose rate. Affected cats present with rapid onset of blindness after systemic enrofloxacin administration. Affected cats have typical lesions of retinal degeneration. Discontinuation of enrofloxacin as soon as visual problems are noted may result in improvement in vision in some, but not all cases. No doubt guidelines will be forthcoming regarding the use of enrofloxacin in cats in view of increasing numbers of anecdotal adverse reaction reports as well as published data or its potential toxicity." I asked him if Orbifloxacin (recommended by Phil) is safer but he said that there are not enough statistics to show that it is safer. He said there are a lot more statistics on Enrofloxacin because it's been used on millions of cats during the past 10 years. So I told him that I wanted to think about it for a few days. What would you do in this situation ? Casper seems to be doing better and has gained back some weight during the past week. She's recovering from IBD and doesn't need Prednisone that much any more but this probably has nothing to do with blood in the urine. Thanks in advance for your suggestions. > I asked him if Orbifloxacin (recommended by Phil) is safer > but he said that there are not enough statistics to show > that it is safer. He said there are a lot more statistics > on Enrofloxacin because it's been used on millions of cats > during the past 10 years. So I told him that I wanted to > think about it for a few days. Another fluoroquinolone is Zeniquin, which has been in use on cats long enough (perhaps) to satisfy your vet. It is pretty expensive though. I would also be wary of Baytril, and I am disappointed with your vet's resistance to your concerns. :( -Alison in OH >> I asked him if Orbifloxacin (recommended by Phil) is safer >> but he said that there are not enough statistics to show [quoted text clipped - 10 lines] > >-Alison in OH My vet doesn't have Orbifloxacin in stock but I just called an animal hospital in the area and found that they have it (but the technician I talked to had never heard of Zeniquin). Has anybody seen any evidence that Orbifloxacin is safer than Enrofloxacin ? If you could refer me to a web site showing the studies that would be even better. Thanks again. >From: chester@nospam.com >Has anybody seen any evidence that Orbifloxacin is safer than >Enrofloxacin ? If you could refer me to a web site showing >the studies that would be even better. I believe the FDA has a website where adverse reactions are reported, but I'm sorry I don't have a link. Lauren ________ See my cats: http://community.webshots.com/album/56955940rWhxAe Raw Diet Info: http://www.holisticat.com/drjletter.html http://www.geocities.com/rawfeeders/ForCatsOnly.html Declawing Info: http://www.wholecat.com/articles/claws.htm > >> I asked him if Orbifloxacin (recommended by Phil) is safer > >> but he said that there are not enough statistics to show [quoted text clipped - 14 lines] > an animal hospital in the area and found that they have it > (but the technician I talked to had never heard of Zeniquin). Yngver is right, there's the issue of the organism's susceptibility to the specific drug that could be influencing your vet's desire to use that particular antibiotic. However, it only takes one dose of Baytril to blind a cat. The vet I worked with used it on two animals while I was there, both with bated breath--and both with excellent results against infections that were resistant to everything else. Clearly, YMMV. Zeniquin, or marbofloxacin, is produced by Pfizer. See http://www.zeniquin.com/. I'm not making this stuff up. :) -Alison in OH >> >> I asked him if Orbifloxacin (recommended by Phil) is safer >> >> but he said that there are not enough statistics to show [quoted text clipped - 26 lines] > >-Alison in OH As stated earlier the urine culture results came back negative. My vet is assuming that she has a kidney infection but doesn't know what kind of organism it is (if it's really an infection). So it may not be easy to say if enrofloxacin or Orbifloxacin will work better in this case. Thanks again for the info. >As stated earlier the urine culture results came back negative. >My vet is assuming that she has a kidney infection but doesn't [quoted text clipped - 4 lines] > >Thanks again for the info. I should add that in my case, my cat was clearly very sick and it wouldn't have been prudent to waffle about whether to switch her from Baytril to Orbax when she had not responded to other antibiotics prior to administering Baytil. In your case, it's not even clear that your cat has an infection, correct? The evidence was the blood in the urine sample, but is there any other sign of infection? My cat was running a very high fever. Here are some references you can look at: http://www.vetmedcenter.com/professional/content_main.asp?docid=2688&doctype=ED http://www.tufts.edu/vet/vet_common/pdf/petinfo/dvm/case_march2003.pdf This second one from Tufts may have the info you are looking for. It describes studies designed to determine a correlation between dosage of Baytril and Orbax and retinal degeneration in cats. While both drugs produced incidences of blindness at high dosages, the mfr of Orbax determined the drug to be safe at a dosage of 15 mg/kg per day (although one cat did develop retinal degeneration on this dosage), while Bayer's toxicity test of Baytril found no incidence of retinal damage at the currently recommended max dosage of 5 mg/kg per day. You may want to show this article to your vet, if you still want to argue the case with him. >>As stated earlier the urine culture results came back negative. >>My vet is assuming that she has a kidney infection but doesn't [quoted text clipped - 31 lines] >You may want to show this article to your vet, if you still >want to argue the case with him. Thanks Yngver. My cat lost some weight a couple of weeks ago (which I thought was due to all the smoke from the wild fires) but has gained most of it back. Right now beside the high red blood cell counts in the urine she's doing just fine. I don't even have to give her Prednisone (for the IBD) that often any more. Another option is to check her urine again in a week or two. I think there's a good chance it will be normal again. >Thanks Yngver. My cat lost some weight a couple of weeks ago >(which I thought was due to all the smoke from the wild fires) [quoted text clipped - 6 lines] >Another option is to check her urine again in a week or two. >I think there's a good chance it will be normal again. You're welcome. I think if you are leery of the antibiotics, doing another urine check later would be a good option. While urinary tract infections can be resistant, and your vet was following a reasonable protocol (if the first antibiotic, often Clavamox or Amoxicillin) doesn't work, try another like Baytril), why give an antibiotic if it's not necessary? When my cat (different cat) had microscopic amounts of blood in her urine, there was no evidence of any kind of infection, and so the vet suspected it was simply due to sample contamination. Since she wasn't showing any signs of illness by then, the vet recommended just watching her. She was fine. >My cat Casper had her teeth cleaned a few weeks ago >and the vet told me that she had a high level of red [quoted text clipped - 32 lines] > >What would you do in this situation ? I don't want to start another argument over the comparative safety of Baytril vs. Orbax, but if it were me, I wouldn't panic over the use of Baytril. As your vet notes, it has been used safely with millions of cats, even at much higher dosages than the newly recommended guidelines. And there is evidence that with some types of organisms, Baytril is more effective than Orbax, if I recall. However, I wonder how your vet took the urine sample. If he used a needle, that can introduce some blood into the sample. Did he take another sample? If you are leery of Baytril, you can insist your vet prescribe something else. On the other hand, you can also decide to trust your vet's expertise. That's what I did when one of my cats once was prescribed Baytril for an infection that did not respond to other antibiotics, but you need to make your own decision. >Casper seems to be doing better and has gained back some >weight during the past week. She's recovering from IBD >and doesn't need Prednisone that much any more but this >probably has nothing to do with blood in the urine. > >Thanks in advance for your suggestions. > My cat Casper had her teeth cleaned a few weeks ago > and the vet told me that she had a high level of red [quoted text clipped - 39 lines] > > Thanks in advance for your suggestions. Chester, I would go with Orbax -- so do all four of our vets - who see considerably more animals per year than the average vet. There's really no rational reason for using Baytril. Orbax is same-class antibiotic, its safer, more potent, and requires a smaller dose... Its even less expensive... which might free-up money for additional tests and treatment, if needed, for people on a tight budget. Remember, the extensive original efficacy testing found Baytril to be most efficacious at 20 mg/kg... Now, after almost *5 years* of numerous reports of blindness in cats, Bayer reduced the dosage by *75%* (5 mg/kg)... If Baytril was *really* efficacious at *25%* of the original recommended dose, why wasn't the *original* recommended dose 5 mg/kg??? Its the same principal as taking 1/2 an aspirin instead of two and expecting the same results... So, if I were you, I would take the arguments by the Baytril proponents with a grain a salt... Some people are awakened with a feather... Others need to be hit with a sledgehammer before they wake up... Have you tried Hill's Prescription Diet d/d for Casper's IBD? It contains a single protein source. We've had *excellent* results with d/d in our IBD cats. Good luck. Phil. >I would go with Orbax -- so do all four of our vets - who see >considerably more animals per year than the average vet. > ... >Have you tried Hill's Prescription Diet d/d for Casper's IBD? >It contains a single protein source. We've had *excellent* >results with d/d in our IBD cats. Thanks Phil. I'll ask my vet to write me a prescription for Orbax or call the animal hospital to prescribe it for me. I haven't tried Hill's d/d but I may be able to buy this from the animal hospital too. > >I would go with Orbax -- so do all four of our vets - who see > >considerably more animals per year than the average vet. [quoted text clipped - 5 lines] > Thanks Phil. I'll ask my vet to write me a prescription for > Orbax or call the animal hospital to prescribe it for me. That's the smart play. > I haven't tried Hill's d/d but I may be able to buy this from > the animal hospital too. Just remember to make the transition to the d/d gradually - otherwise, you'll defeat the purpose. Best of luck. Phil >From: chester@nospam.com >>I would go with Orbax -- so do all four of our vets - who see >>considerably more animals per year than the average vet. [quoted text clipped - 8 lines] >I haven't tried Hill's d/d but I may be able to buy this from >the animal hospital too. Hi Chester, If your cat has IBD, I would highly recommend joining the Yahoo IBD group. People there are very supportive and have first hand experiences to share about their IBD cats and what diets have worked for them: http://groups.yahoo.com/group/FelineIBD/ Also, here are a couple of interesting articles on feline nutrition: http://www.avma.org/convention/recap/news/tuesday16.asp http://home.earthlink.net/~jacm2/id1.html As to the antibiotics, has the vet made a specific diagnosis where antibiotics are clearly indicated? Lauren ________ See my cats: http://community.webshots.com/album/56955940rWhxAe Raw Diet Info: http://www.holisticat.com/drjletter.html http://www.geocities.com/rawfeeders/ForCatsOnly.html Declawing Info: http://www.wholecat.com/articles/claws.htm >Hi Chester, >If your cat has IBD, I would highly recommend joining [quoted text clipped - 15 lines] > >Lauren Thanks for the info. All he knows is that Casper has blood in the urine. The urine culture came back negative so he's assuming that she has a kidney infection. > Thanks for the info. All he knows is that Casper has blood > in the urine. The urine culture came back negative so he's > assuming that she has a kidney infection. If the urine culture was negative, an infection seems unlikely. Interstitial cystitis seems a more likely differential. Blood in the urine (hematuria) can result from urinary mucosal inflammation, irritation/inflammation from crystals, or from tearing the bladder mucosa from straining to urinate (or from overdistention of the bladder in males with urethral obstruction). Inflammation in the bladder and/or urethra causes a nervous sensation in cats that mimics the sensation that's normally induced by a full bladder. The nervous impulses that control the urge to pee are repeatedly stimulated so that the cat has the urge to pee whether her bladder is full or empty -- which can make a cat strain to pee... which can tear the bladder mucosa. Has Casper displayed any symptoms or strain to pee or does she make frequent attempts to pee with little or no urine? Phil ><chester@nospam.com> wrote" >> [quoted text clipped - 5 lines] >she make frequent attempts to pee with little or no urine? >Phil I'm with her all the time and she doesn't pee any more often than normal. |
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