Suberbug bites dog, the sequel

Just when I thought I had this damn thing figured out... it's ba-ack.



No, I'm not really laughing. I spent Sunday morning at the emergency vet because late last night, Kyrie's drug resistant staph infection (MRSI) got out of control for the first time in months. I brought her most recent skin culture results along with me, and the ER didn't have one single drug in stock that we could use. So they clipped her fur, took some goop for a culture and sent me home with topicals and the advice to call my vet first thing in the morning.



Remind me to go to the other ER next time.  At least we're one day ahead on the culture than if I'd waited until tomorrow.



What's particularly upsetting, other than seeing Kyrie suffer, is that in the last few months I'd developed what I thought was a pretty good system for handling her occasional flare-ups. I checked her daily for little red patches anywhere on her body, and if I saw them, I immediately bathed her in tea tree oil shampoo and put Neosporin+pain on the reddened area, as much for its numbing effect as its anti-microbial action, although it works better than the lydocaine spray my vet gave me.



Then I'd treat the spots every few hours with a 5 percent tea tree oil spray. (Tea tree body wash and salve in the same concentrations as the products I'm using have been shown to be more active against human MRSA than even prescription topical drugs.)



I tried using the honey bandages that had been so helpful with her first bout of MRSI for a while, but when you're dealing with a flare-up on a heavily coated breed like a Borzoi, it ends up being extremely messy and almost impossible to keep in good contact with the skin. The first time I used it, she'd been shaved.



As you can see in the photo above, she's been shaved this time, too, so I'm packing the raw areas with honey and hoping my vet can see us early.



But here's the reality: I have a column due at 9 AM, and having spent half my day at the ER already on Sunday, I need to get my work done in the morning before I can take her to the vet. Which reminds me of a question a reader asked me after I emailed her my management routine for Kyrie's condition in response to her request for tips on dealing with her dog's resistant staph problem.



"Don't you ever go on vacation?" she asked me. "What do I do if I'm not there and my dog has a flare-up?"



I found myself about to type words I never, ever thought I could think, let alone say: Put your dog on antibiotics while you're out of town.



And then I stopped. That's the kind of thinking that got us drug-resistant staph in the first place. And yet I didn't know what else to say, because the reality of dealing with a dog who is a carrier of drug-resistant staph is that flare-ups can happen, and they can be unpredictable and unpreventable, and a few hours delay in treating them can be the difference between a dime-sized hot spot and a raw, bloody, painful patch the size of your hand.



Many people reading this might wonder how Kyrie "got" the drug resistant staph in the first place, but that's not really the right question. We all have staph all over us, and so do our dogs; some percentage of those staph bugs have some genes for drug resistance. Every year we have a greater percentage of resistant staph bugs on us, and so do our dogs. And every year they acquire genes for resistance to even more drugs, as the bacteria trade genes with other bacteria they encounter.



Simply having a certain percentage of the normal staph on your body being drug-resistant isn't in and of itself going to cause symptoms in most people and dogs. I doubt anyone reading this doesn't have at least some resistant staph on their skin right now, and yet most of us don't have so much as a rash, let alone look like we've been blowtorched.



No, there's really no question that Kyrie has some underlying condition that's causing the recurrent infections. The problem is, we can't find anything wrong with her other than the fact that her allergies have gone crazy. Thyroid panel: perfect. Kidney and liver function: perfect. Blood work, ultrasound, x-rays: perfect. The vets don't have anything else to test for. We don't know why her allergies have become so bad, and if they're really the whole story of what's causing these infections.



So I check her obsessively and don't go out of town, and hope one day they just go away and don't come back. And when she has an area of red skin, yes, I go nuts on it, and for the last several months, on at least a dozen occasions, that was enough.



Until last night.



And we thought chemistry was supposed to be about better living.

Comments

[Nicole]

It is interesting that the allergies appear when the flare up appears. Is that always the case? I think the flare up of the MRSI causes the immune system to overreact in its efforts to fight the infection and begins to recognize everything as a threat creating a systemic allergic response.



I had told you about my dog’s neck infection and surgeries etc. I didn’t go into detail about the bodies response. He swallowed a needle, it broke, one half with the string migrated through the trachea into the front neck thyroid area. I knew he was having a problem (I didn’t know he swallowed a needle) brought him to the vet who practically dismissed me. Anyway, two weeks later, he developed a full blown insane allergic response. Although we didn’t know it at the time, his body was attacking the foreign object and in the process his entire immune system overreacted and every single part of his body itched. He continued to have horrible allergies until the needle and thread and infections that developed were cured. He has not had a single allergic episode since. This went on for two years until I found a vet that took my complaints and his symptoms seriously.



If we are to make any sense of this and things work the same as I saw them work, I think the MRSI flare up is causing the allergic response rather than the other way around. That doesn’t really help you, I know.



Another possible connection is that with my dog, the needle and surgeries and infection was right at the thyroid causing the thyroid to become low. He also developed the MRSI during the course of all of this after the surgery. Anyway, I wonder if the low thyroid was helping to allow the MRSI and allergies. The needle and thread sat practically on the thyroid the whole time. Is it possible that the tests for your dog’s thyroid was perhaps not sensitive enough. I know there are special tests that are done, not just a regular test. I can’t remember what it is called though.



There is also a test to check if the immune system is not operating properly. I can’t remember what the test is. It may be that is the condition itself and you can look and look and not find anything else.



It is very frustrating and heart breaking and I feel so bad for your dog and you because I know what it is like to go crazy trying to find out what is wrong. I did that for two years. I am sorry you are having such a problem. I hope you can find answers, and if not, that you continue to keep it well managed which you are doing.

[Phyllis DeGioia]

Christie, I'm sending gentle healing zen for Kyrie because I have nothing else to offer. You know my late therapy dog, Fred, apparently contracted MRSA (technically, MRSI from the tests they ran at the vet school) at the hospital where we volunteered, and he was medically retired from the program. He only had one skin infection and it responded to the first antibiotic we tried (Simplicef, I think). I didn't have to go down the road you are so am sending my best thoughts to your girl.

[Christie Keith]

I'm scared to death of Atopica for the same reason I'm not going to give her steroids: it works by supressing the immune response. That's good if it takes the edge off her allergies, and bad if it causes staph to grow more freely. I'm not there yet in the risk-to-benefit equation.



Her thyroid was normal across the board -- rock solid normal in every range, which is not actually that typical of sighthounds, who tend to run at the low ends of normal. No help there.

[Barbara A. Albright]

Christie, I forget if you discussed the option of Atopica? And if her thyroid is NOT low normal or abnormally high T3?



I'm praying for a good solution/permanent outcome for Kyrie's condition!



Barbara, Pocket's Story from New Hampshire

[Lori]

Poor Kyrie, not again! How does she deal with all the shaving and applying and bathing? Is it an itchy thing or does it just hurt like the dickens? Poor baby!

[Giselle]

Antibiotic-Resistant Staph Infection Destroyed By Blue Light



http://www.medicalnewstoday.com/articles/137297.php

[Ajay]

I hesitate to offer the following since I understand the problem with anecdotal evidence, and the problem equating human to canine - and to top it off, I am a science geek and born again skeptic. (That blue light article mentioned above sounds really promising, and hopefully that kind of treatment will be available to you and Kyrie sooner rather than later. ) But, meanwhile...for what it's worth:



BOTH my husband and I had recurring bouts with staph infections during a decade after traveling in Irian Jaya. Doctors, worthless; drugs, sickening; surgeries, too many to count. Current solution: at the hint of redness, or even just any slight skin breach (imagined or real scratch, bug bite, abrasion etc.) the area is doused with apple cider vinegar, and we start shoveling as much yoghurt as possible in our mouths. Don't know why this works for us, but it halts and reverses skin infection from the moment of discovery.



Bouts 8-10 times a year for each of us have been reduce to debating whether the Braggs's should be replaced this year even though it's unopened.



Stress was also clearly a facter in depressing our immune systems enough for opportunistic staph to go crazy.



If nothing else, the vinegar is soothing and may give some pain/itch relief for your beloved Kyrie.

[Colorado Transplant]

Awful news that the superbug has returned.



Just wondered if the outbreak was seasonal--if the house or apartment is dry in the winter, there would be less oil on Kyrie's skin. That would lead to less skin protection.



Just going by my skin outbreaks when it is dry in the winter--toss my advice out if it does not apply. Superbug--go away from k

[Julie]

Could the emotional distress of Kyrie being separated from you caused her immune system to temporarily decline causing the infection to take hold again. Emotions affect the immune system. Is she happy,does she wish for more walks,play.Try more exercise. It might help some even though I know your need drugs to treat staph.

[Christie Keith]

She's not separated from me! She sleeps on my bed and I work at home, LOL!



Kyrie gets two long walks a day, I work in a home office, I take her out more frequently many days, we live on a huge, beautiful park, and I have another dog who she gets along with well. We moved to the city after her entire life in the country two and a half years ago, but she adapted well and these infections only started less than a year ago, so I don't think that's it.

[Barbara A. Albright]

Oh boy, yes, I know Atopica depresses the immune system, but some dogs have benefitted greatly with skin allergy/infections a thing of the past.



Another thought would be just to "try" her on a low dose of thyroid for 3 weeks to see if any changes.



I am heartbroken for both you and Kyrie, and there is an underlying cause to be yet discovered. Barb

[Gina Spadafori]

Christie ... may we see a picture of Miss Kyrie Borzoi's lovely FACE with the next update? Please?

[Christie Keith]

Well, she says that whenever her face appears in the press, she's hounded by the paparazzi... but I'll try to sneak one soon..

[CathyA]

When nothing else makes sense test for Addison's. Can't hurt, might help.

[Christie Keith]

She was tested for Addison's/Cushings. Not those either.

[Deanna]

"Hounded" by the paparazzi... good one!



I adore Borzoi. If they can be trained to fetch feathers, I might consider making room in my home for at least one.



Best wishes to you and Miss Kyrie.

[Cooper]

There is a vet in the Seattle area with an interesting protocol.



http://www.drplechner.com/home.html



I haven't tried this and don't personally know anyone that has but maybe it is worth looking into for a long term improvement.



For healing, here's an article comparing different treatments in MRSA ulcers.



http://sciencelinks.jp/j-east/article/200423/000020042304A0795980.php



Have you tried Manuka honey?



http://www.activemanukahoneyusa.us/Natural-MRSA-Treatment.htm

[Tee]

Hi there



I had something very simliar, but slightly different I have to be honest, but she last most of her hair in areas. The wondering the constant vet visits and the amount of discomfort the dog is in, is so distressing. I really feel for you. She had been on steroids and a varietyof other things and all the scrapes etc came back with nothing. They thought it was psychological. Anyway, i put her on fish oil and then she did not like it...so I found a multi-vitamin with Omega 3 and she is so so so much better. She does not lose hair or itch as much anymore and her hair is growing back. I hope you find something that works.

[Liz]

My dog recently got diagnosed with MRSP. She'd had MRSI before and then another staph infection shortly after. The MRSP she has is resistant against Cloramphenical (the drug that worked with her first bout of MRSI). Now I have no other choice but to start her on Amikacin, as the extended sensitivity panel came back as that being the only drug that could kill what she has now. I am keeping my finger's crossed she makes it through the treatment safely and comes out healthy. My vet told me because her staph infections keep getting more and more resistant if she doesn't improve this time she is going to be considered a health risk and I'll have no option but to put her down. The idea breaks my heart. I hope Kyrie is back on the road to recovery. My thoughts are with you both.

[Christie Keith]

Liz, where is her infection, on the skin? I got there with Kyrie, too, but I've been treating topically and it's WORKING.

[Liz]

She has two spots, one on her foot and the other on her neck. I purchased the medi-honey and have been cleaning and applying twice a day, I bathe her feet once a day in Epsom Salt and wipe her feet with antibacterial wipes once a day. And she gets two baths a week, one with Douxo the other with Malacetic, each prescribed by her dermatolgist. Is there something above those things I can do? I'd love advice, I've had her since she was a puppy (she's 10 now).

[Tania Ortega]

I have two Sheltie's which were diagnosed with MRSI last November and they were treated with different antibiotics. The oldest has been also diagnosed with Cushions as well(which in his case is the underlayer problem of the MRSI). They were on Cloramphenical but the MRSI came back, so they are on Amikacin now. We have tried the honey and the tea tree, Neosporin+Pain, bathing with Aveeno and anti-bacterial shampoo's. The MRSI signs are still there (but not as aggressive), yet, we can only afford 10 days worth more ($420+) and we have been battling this for months. The next thing our Vet is going to do is shave them both and I'm to shampoo them every other day. Does anyone have any suggestions on best shampoo or if they have any luck with any natural product to control MRSI. Desperately seeking help. Please email me to [email protected] w/subject MRSI or respond here. Tania Ortega. BTW, Christie, how is Kyrie doing?

[Maureen]

We have a 14 yr. old enlish spring spaniel who has suffered for years with allergies. He was just diagnosed with MRSP. The vet is taking blood tests on Monday to test his liver function - if okay then will put on another antibiotic (first ones he prescribed won't work (both topical and oral). If you were just starting on a treatment plan, what would you do differently?

Thanks, Maureen

[Laura]

I wonder what the lastest update was Kyrie, have you been able to get on top of this thing yet? My 4 year schnoodle has been having skin issues for awhile but ut has never gotten raw, only had her chewing alot. The vet thinks it is staph so she is on antibiotics and I am using tea tree oil and antihistimes. I hope all is well.

[Christie Keith]

Laura, yes, she hasn't had an outbreak in more than a year -- or more. I haven't really sat down and checked that!



The key for her was getting her on thyroid medication. But her thyroid tested consistently normal for months before we finally got a sub-normal reading.

[Viki Harrison]

I have a service dog (BORDER COLLIE).She has itching problems daily. I took her to our vet ,and doctor put her on BENADELL 50mg twice a day. that seems to work for a while, then it just got worse So i took matters in my hands I knew i would not STOP till i figured it out. Well it made my day when it worked (THE MIRCLE WAS SKIN-SO-SOFT ) from avon. I put three quarters of SOS in a 12oz bottle fill the rest with water. spray on two to three times a day ,i love the way it smells on her and it has slowed the itching down so much,so GOODLUCK to all with all your BABIES we two go for walks three to four times a day, Im not sure what I would do w/o her she knows so much about me DOGS R SO SMART and then to have her as a service dog to I LOVE HER SO MUCH,