The rise of multi-drug-resistant bacteria may be the most important health threat in the coming years. Currently, antibacterial resistance is estimated to kill more than 700,00 people globally each year. Some estimates say by 2050 more than 10 million people will die from it each year, which is more than die from car accidents or cancer.
Although still an emerging issue in Australia, we do see cats and dogs with resistant infections, most commonly ear infections. Pet owners and veterinarians have an important role to play in reducing the inappropriate use of antibiotics.
Antibacterial resistance has occurred due to the overuse and misuse of antibiotics. There is also a lack of newer antibiotics in production due to cost and regulatory issues. A major cause of antibacterial resistance in small animal medicine includes treatment of dogs and cats with antibiotics when inflammation or infection is not due to a bacterial infection. In addition, treating at lower doses or not completing the course of antibiotics allows the opportunity for bacteria to become resistant.
Making a difference
Veterinarians can help prevent the development of this antibacterial resistance by ensuring antibiotics are actually indicated. Some common health conditions for which antibiotics are frequently prescribed don’t respond to antibiotics. One example is dogs with kennel cough, which is a viral illness. A course of antibiotics will not alter the outcome or duration of the illness, and other supporting treatments should be used. These include rest, isolation, fluids, herbal cough elixirs and immune support. Occasionally, an antitussive (anti-cough) medication may be required.
Idiopathic cystitis in cats is bladder inflammation caused by factors including stress and possibly highly concentrated or alkaline urine. Ideally, treatment includes diluting and acidifying urine with a moist red-meat-based diet as well as addressing underlying stress. (Male cats are at risk of blockage and should always be checked by your vet).
Tests can be done before prescribing antibiotics, to show whether inflammation is due to a bacterial infection or not. Such a culture and sensitivity test can be costly. However, a cheaper test is a stained swab and is often enough to show vets whether antibiotics are required and which to use.
When a dog or cat has repeated infections requiring antibiotics, there may be other underlying health issues. Repeated skin infections can be due to food allergies, skin barrier disfunction and hormone imbalances such as hypothyroidism or Cushing’s disease. These can be treated with diet adjustment, herbal support, essential fatty acid supplementation and specific medications if required, negating the need for repeated antibiotics.
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Antibiotics, when prescribed, need to be taken at the correct dose and for their entire course. If you have trouble with dosing or you believe they may cause side-effects, your vet or the support staff can help. After a course of antibiotics, give your pet a probiotic supplement for at least one month. Antibiotics will affect the microbiome — the micro-environment of bacteria that populate the gut as well as other body systems. This may lead to other infections, such as yeast in ears or on skin. Altered gut bacteria also causes dysbiosis and leaky gut syndrome, which can lead to more chronic inflammation.
There are natural treatments with antibacterial effects that may be used in place of antibiotics. Topical tea-tree diluted to 1 per cent may be used in larger dogs to treat bacteria or yeast infections of skin (tea-tree oil can be toxic to small dogs and cats). Herbs containing the alkaloid berberine also have an antibacterial effect. Examples are Oregon grape, barberry, goldenseal and bloodroot. Echinacea root has antimicrobial as well as immune-modulating and anti-inflammatory effects and can be used for acute and chronic bacterial infections. Ask your holistic vet for advice before using herbs in your pet.
One advantage when using plant based treatments is that herbs are, in theory, much less likely to induce resistant species of bacteria. Antibiotic drugs are a pure chemical, whereas plants are made of many chemicals working together, which increase the number of avenues of “attack” that bacteria need to overcome. There is some suggestion that some bacteria may have a natural resistance to some plant antimicrobials. Despite this, the use of herbs is currently under investigation as an alternative to treat infections due to multi-drug-resistant bacteria.
Preventive medicine plays a vital part in reducing the need for antibiotics. Regular health checks (annual for young dogs and twice yearly as they get older) can pick up problems such as dental disease, ear infections, dry eye syndrome, dysbiosis and skin allergies. Dental disease, in particular, is one of the most common health issues in our pets and results in gingivitis, periodontal disease and the need for antibiotics and dental surgical procedures. Early intervention will help stop the antibiotic roundabout. Health screens should included faecal flotation tests to rule out intestinal parasites, and vaccine titre tests to check for protective antibodies against serious viral infections.
By working with your vet to maintain your pet’s wellness, and only using antibiotics when appropriate, you can do your bit to help reduce antibacterial resistance and allow health practitioners to be able to use antibiotics when needed to treat serious bacterial infections.
