Hi,

I'm sorry you & Bud are having to deal with recurrent MRSA. MRSA infections are always difficult to treat & have a tendency to recur repeatedly, even with appropriate antibiotics. Your initial posts were concerning to me, because Bud's infection was being treated with Baytril…Baytril is a flouroquinolone. This classification of antibiotic is notorious for promoting mutation and resistance in MRSA infections and long ago was taken out of the treatment spectrum for both community(CA) & hospital(HA) acquired MRSA in humans. I would be very concerned about this possibility, particularly with the recurrence.

Because Bud developed this infection after ortho surgery, it shoud be assumed it is HA-MRSA & treated accordingly, although the line between treatment for HA-MRSA & CA-MRSA is blurred because of the widespread prevalence of the organisms. It sounds like they may have treated based on in vitro culture sensitivities, which might initially look like CA, but mutate rapidly.

Human medicine has waged the MRSA battle for decades now and treatment protocols are constantly evolving because of ongoing, ever changing drug resistance. If there is a treatment failure with a particular antibiotic, it is not repeated. Resistance is assumed while cultures are pending. The first line therapies for humans are available in veterinary medicine and it might be worth talking to your vet or pursuing another opinion about antibiotic options. I don't know why veterinary protocols are so contrary, but I would want to be sure the therapy was the optimal. There has to be some veterinary infectious disease specialist your vet could consult.

I work in an acute care facility with nationally recognized infection control /policies for resistant infectious disease. Every patient admitted to the hospital for any reason, is immediately screened for MRSA.  Even our therapy dogs undergo MRSA surveillance cultures quarterly and are not allowed to visit any long term care facilities and only a few other acute care facilities, who share our policies. MRSA is a zoonotic infectious disease, very easily transmitted between dogs & humans

A lot of public information you will find with a google search is outdated.The most recent human guidelines can be found in the Feb 1, 2011 issue of The Journal of Clinical Infectious Disease-vol 52, issue 3. You can find a direct link at the bottom of this article:

http://blogs.cd…..re/?p=1389

The problem with the quinolones: MRSA very often is sensitive to it in vitro, but, the minute the organism sees the drug, it mutates. When they are used, it is in combination therapy. 

Osteomyelitis only refers to an infection in a bone & has nothing to do with the organism.  Removing the source of the infection has little impact on the organisms still present.

I can do a literature search for you & send some info if you'd like. You will find the current treatment protocols on the link above. I think you are going to have to look to human medicine and it's many years of experience for guidance

PM me with an address if you'd like. I'll try to pull some literature tonight, but the most up to date protocols will be those on the link.

Sorry you're going through all of this….

I'm so sorry Bud has to deal with this again. He should be waiting for squirrels and spring, not wondering if he's going to get the right drugs to fix him up. You are probably going to have to be an aggressive, pushy advocate for him. I think you're up to the task. You're a mom, right?  

If they're consulting with CSU, I'd like to think somebody's on the ball. But if they're using something that allows or even encourages mutations, as Cynthia said, it seems like somebody's sleeping through class. You had the amputation done at Alameda East, correct? They are really on top of things. One of the best clinics out there. Somebody needs to treat Bud like he's a human and not a canine. This is serious, frightening stuff. Keep us posted.

Shari

Thanks Shari for your support and concern

Cynthia. I am sending pm

Thanks to monkeybutt dogs for their nose kisses

I am gonna hope to heck this is just a bacterial skin infection!!!!

We are all praying around here, B made his preK class say a lil prayer with him too!