Carmella's first round of test results came back today (the segment which tests for bacteria and antibiotic sensitivity) and they found E-coli, Streptococcus Group G, Pseudomonus, and Enterococcus in abnormal levels. The part of the culture for fungii should be in within the next few days.
I spoke with Dr. Norwood over the phone today and he said that she should be put on both Clavomox and Ciprofloxacin. Some of the bacteria respond to one and not the other. He is also going to prescribe Hyrdoxezine for her itching, and a medicated shampoo with antibiotic in it. He thinks she may have rolled in something when she was outside and because of her compromised immune system it took hold in her body.
She now has this stuff not only on her feet,
but more of it on the left side of her face,
and inside her ears.
She's beginning to treat the plastic collar the way some people treat their glasses; hardly noticing
it's there and eating,
it's there and eating,
and running as though she didn't have it on.
A case study, written by a vet a Cornell describes what is known as Necrotizing Faciitis, one of two presentations of the Streptococcus Group G bacterial infection. In the case of this boxer the dog had to be hospitalized to have dead tissue removed surgically and was given IV antibiotics to save its life. It did recover but I hope that won't have to happen to Carmella, because removing dead tissue is really just a more minor form of amputation. It sounds horrible. http://dspace.library.cornell.edu:8080/bitstream/1813/11267/1/2003%20Gerdin.pdf
I sent pictures to Dr. Norwood tonight to see whether he thinks any of the skin on her paws is necrotic. He should receive my e-mail in the morning. Here are some I took of her left front and back paws (the ones that are affected the worst.
I am concerned because when I picked up her back paw to photograph it the skin oozed some sort of clear liquid.
This article which appeared in the Journal of Clinical Microbiology documents the likelihood that streptococcus Group G bacteria can jump species from dogs to humans. That is kind of scary! http://jcm.asm.org/cgi/content/full/45/7/2327
Some of the other material I read said that spreading to humans is not very common, but at the same time not enough study has been done for them to know for sure.
My reading about Pseudomonas reveals that it, like Streptococcus Group G can be a very nasty bacteria that is hard to get rid of and can cause serious damage. Pseudomonas tends to attack the ear and in some cases can damage it so badly that surgery is needed. Some dogs have had to have cochlear implants as a result of such damage.
Pseudomonas is most often treated with Flouroquinalones and when present in the ear the dosage must be high in order to hit the bacteria hard and fast before it has a chance to become resistent to it. Sometimes medications are also given directly to the ear in addition to oral medications, and in tougher cases inhections are even given. Treatment can be costly and the infection can sometimes re-occur and require treatment again.
This article goes into quite a bit of detail about strategy in treating difficult bacterial infections, and talks about how certain bacteria interact. http://www.vin.com/proceedings/Proceedings.plx?CID=WSAVA2007&PID=18189&Category=2993&O=Generic
I sent the above link on to my vet as well. I really hope this won't be a long, drawn-out process and that these antibiotics will work on the first try. Carmella has had so much happen to her in just a year she deserves to be healthy the rest of her life.
Carmella's vet bill is now over $2,000. so your help is urgently needed. Be sure to stop by my Etsy store and make use of the month-long sale. You may find that you love being a repeat customer! Buy your mother a nice gift, and help a dog continue to get the treatment she needs.