18 Treatment Plan
You explain to Jan your treatment plan for Nemo which includes
Buprenorphine for pain relief, a diet change to canned food to increase
Nemo’s water consumption, and using a product like Feliway while he
adjusts to the move and the new house. You also recommend that
she place an additional litter box in a different area of the house so
Nemo can choose which location he is more comfortable with. Then
you remind her cats like clean litter boxes so she should clean all the
boxes out at least once if not twice per day.
Jan responds, “I don’t understand, why am I not getting any antibiotics? Doesn’t Nemo have an infection?”
You explain to Jan “No, Nemo does not have an infection. Improper use of antibiotics has caused a huge problem recently with the development of antibiotic resistant ‘super bugs’. Using an antibiotic when it is not indicated can create resistant bacteria strains that are not easily treated and have the potential to be transmitted to other animals or even people.”
Jan responds, “Is that like this MRSA superbug I’ve been hearing about? That sounds awful! I don’t want Nemo to get that and I certainly don’t want to get that myself!”
What is antimicrobial resistance?
- Antimicrobial resistance occurs when a microorganism develops the ability to resist the action of an antimicrobial. Basically, the microorganism develops the ability to survive and reproduce in the presence (and dose) of an antimicrobial that used to prevent these actions.
- Antimicrobial resistance could occur through:
- “Selection pressure” – even if an effective antimicrobial is used, rarely, if ever, will 100% of the organisms be killed during the course of treatment. The few surviving and potentially resistant organisms could then transfer their genetic material to offspring or other unrelated organisms.
- Mutations – bacteria that were at one time susceptible to an antibiotic can acquire resistance through mutation of their genetic material or by acquiring pieces of DNA that code for the resistance properties from other bacteria. The DNA that codes for resistance can be grouped in a single easily transferable package. This means that bacteria can become resistant to many antimicrobial agents because of the transfer of one piece of DNA.
Examples of resistant strains of bacteria that have developed:
- Methicillin Resistant Staphylococcus aureus (MRSA)
- Multidrug Resistant Tuberculosis (MDR TB) – TB that is resistant to at least two of the best anti-TB drugs, isoniazid and rifampicin
- Extremely Drug Resistant Tuberculosis (EDR TB) – TB that is resistant to isoniazid and rifampin, plus any fluoroquinolone and at least one of three injectable second-line drugs (amikacin, kanamycin, or capreomycin)
- Staphylococcus pseudointermedius
- Fluoroquinolone-resistant Campylobacter
- Multi Drug Resistant Salmonella
- Vancomycin Resistant Enterococci (VRE)