Brain Tumour/ Meningitis Or Something Else

[JulesP]

What dose was she on?

Amber has been on Metronidazole for 5-6 years now.

She has been on 225mg twice a day since May and they recently upped it to 500mg twice a day because of her upset stomach. She's been on that higher dose for 5 days when it happened. She is 17kgs.

From my Googling it seems that later dose is top end of normal but with her liver issues, I don't know. I'm just so confused. This latest Specialist certainly sounded like she knew what she was talking about and she said it was a toxic ( or very close to ) dose. I've checked with my OH and he said yes, she definitely did say that. But I came out a bit bamboozled after talking to her and tbh I just wanted to get Mya :) :) She actually said that the blood test they ran at the end of Mya's treatment came back normal for liver enzymes and questions Mya's original hepatitis diagnosis????? She is going to ask for a copy of the original liver biopsy report and we go back to see her in 2 weeks, so I can ask more questions then.

500mg twice a day? As in 2 x 500mg? Not 2 x 250mg to make up 500mg?

From my googling 400mg a day would be top dose!

Amber is on 200mg a day and is 15kg.

[persephone]

What dose was she on?

Amber has been on Metronidazole for 5-6 years now.

She has been on 225mg twice a day since May and they recently upped it to 500mg twice a day because of her upset stomach. She's been on that higher dose for 5 days when it happened. She is 17kgs.

From my Googling it seems that later dose is top end of normal but with her liver issues, I don't know. I'm just so confused. This latest Specialist certainly sounded like she knew what she was talking about and she said it was a toxic ( or very close to ) dose. I've checked with my OH and he said yes, she definitely did say that. But I came out a bit bamboozled after talking to her and tbh I just wanted to get Mya :) :) She actually said that the blood test they ran at the end of Mya's treatment came back normal for liver enzymes and questions Mya's original hepatitis diagnosis????? She is going to ask for a copy of the original liver biopsy report and we go back to see her in 2 weeks, so I can ask more questions then.

It all a bit of a mess and for now I just want to concentrate on looking after Mya. I'm exhausted. I will talk to my vet but want to be absolutely sure of the facts before I do.

Here's a couple of phone pics of my skinny girl this morning. Goodness she has lost weight quickly, it'll be hard road to get the weight back on her, she's not a great eater at the best of times, but we'll get there.

2016-10-15_09-36-30 by Tee Kay, on Flickr

2016-10-15_09-35-59 by Tee Kay, on Flickr

And a little video of her walking ( and almost getting pee'd on the head by Luka. Thanks Luka, you doofus :laugh: )

Mya's recovery from Metronidazole toxicity. She is walking so much better but still not quite right. by Tee Kay, on Flickr

:D so lovely to see her at home again . I think you are both exhausted,confused and need some recovery time !

I am also glad that the current vet is doing some followup .

[teekay]

What dose was she on?

Amber has been on Metronidazole for 5-6 years now.

She has been on 225mg twice a day since May and they recently upped it to 500mg twice a day because of her upset stomach. She's been on that higher dose for 5 days when it happened. She is 17kgs.

From my Googling it seems that later dose is top end of normal but with her liver issues, I don't know. I'm just so confused. This latest Specialist certainly sounded like she knew what she was talking about and she said it was a toxic ( or very close to ) dose. I've checked with my OH and he said yes, she definitely did say that. But I came out a bit bamboozled after talking to her and tbh I just wanted to get Mya :) :) She actually said that the blood test they ran at the end of Mya's treatment came back normal for liver enzymes and questions Mya's original hepatitis diagnosis????? She is going to ask for a copy of the original liver biopsy report and we go back to see her in 2 weeks, so I can ask more questions then.

500mg twice a day? As in 2 x 500mg? Not 2 x 250mg to make up 500mg?

From my googling 400mg a day would be top dose!

Amber is on 200mg a day and is 15kg.

Yep, 500mg twice a day. 1000mg a day

Her maintenance dose has been 225mg twice a day, so 500mg a day. Which the specilaist also said was double what she should have been on.

I got so confused Googling because many sites didn't seem to clarify if they were talking about dose levels or daily levels

Is Amber on the Metronidazole for liver issues?

[Rappie]

I'm so glad she is improving.

Just a brief comment on dose rates - they are usually discussed on a per dose basis, with the exception of a few medications which are certain dose rate per day and then that total dose may be divided into 2-3 smaller doses. The published dose range (even in one the 'standard' drug bible) for metronidazole in dogs is quite wide, but the information you have been given by your specialist is consistent with current trends.

[tdierikx]

My foster pup just finished a 10 day course of 200mg twice a day... she's around 9-10kg and about 7 months old. She's fine, but after reading this thread with 2 days left to dose, I was getting a bit worried...

T.

[JulesP]

Is Amber on the Metronidazole for liver issues?

Yes it helps prevent ammonia or other toxins from building up. These are caused by the liver not working properly.

(I hate writing about vet stuff when Rappie is reading :laugh: )

If she is dodgy then she can have 2 x 200 a day.

[Shoelace]

Firstly, Teekay, I'm so glad Mya is home and it's great to see the photos.

I'm not commenting on the dose, as I'm not a vet or even a vet nurse.

However, my issue with our vet was that we were not told of any possible side effects of Metronidazole. He simply prescribed it and we were following the dose prescribed. It was not a high dose, but was a 6 week course. Then when Ben suddenly could not stand up, we had no idea what was going on.

The vets at the emergency centre didn't pick it up either, so 1 1/2 days later and 3 more doses of Metronidazole, the specialist picked it up.

When I asked our vet if was aware of Metronidazole toxicity, he said yes, but it was very rare and he'd only seen one case in 30 years of practice. When I asked him why he hadn't told us about possible side effects he said it would add too much time to his consultations. At which time I saw RED and he got an ear full.

I'm assuming Teekay's vets didn't provide any advice about side effects either. I wonder if they were even aware of it as it appears they took bloods and checked for ticks, etc. The specialist centre didn't seem to be aware of it either as they proceeded with a spinal tap and then referred Mya for an MRI. It was only when Teekay contacted them and said stop, could it be Metronidazole toxicity, that they suddenly started looking at it and commenced treatment.

While it is a very good drug, vets need to spend that extra 2 minutes and outline the possible side effects, particularly if the dog is going on a long course or a high dose.

That 2 minutes would save people like us and Teekay going through the nightmare experience that we've both been through, not knowing what the hell was going on with our fur kids.

Teekay, that would be my first question to your vet - why didn't you tell me about the possible side effects.....

Edited October 15, 2016 by Shoelace

[westiemum]

teekay Mya and Luka are just beautiful and I'm so glad your girl is improving. It always so worrying when they are suddenly so ill. Great pick up shoelace. Well done.

[bianca.a]

I am so glad she is home and on the improve!

I hope your vet will have a good close look at what has happened and reimburse you.

[teekay]

Well, Mya continues to improve every day.

She is still not walking 100% right but it's so good to see her getting better. She reminds me of a very young foal that just can't quite coordinate their limbs yet :laugh: She did manage a little run in the garden yesterday because someone opened the meat drawer in the fridge and she sprinted to get inside She is very hungry atm, but unfortunately her poos are still not right ( which is what started this whole saga off in the first place) so I still don't want to go overboard on the food. . Not sure what, other than probiotics, to do there

On a side note, my son fractured his wrist yesterday, spent all morning in the emergency room. Fun times I need a weeks

I'm so glad she is improving.

Just a brief comment on dose rates - they are usually discussed on a per dose basis, with the exception of a few medications which are certain dose rate per day and then that total dose may be divided into 2-3 smaller doses. The published dose range (even in one the 'standard' drug bible) for metronidazole in dogs is quite wide, but the information you have been given by your specialist is consistent with current trends.

Thanks for popping in here and clarifying Rappie :)

Firstly, Teekay, I'm so glad Mya is home and it's great to see the photos.

I'm not commenting on the dose, as I'm not a vet or even a vet nurse.

However, my issue with our vet was that we were not told of any possible side effects of Metronidazole. He simply prescribed it and we were following the dose prescribed. It was not a high dose, but was a 6 week course. Then when Ben suddenly could not stand up, we had no idea what was going on.

The vets at the emergency centre didn't pick it up either, so 1 1/2 days later and 3 more doses of Metronidazole, the specialist picked it up.

When I asked our vet if was aware of Metronidazole toxicity, he said yes, but it was very rare and he'd only seen one case in 30 years of practice. When I asked him why he hadn't told us about possible side effects he said it would add too much time to his consultations. At which time I saw RED and he got an ear full.

I'm assuming Teekay's vets didn't provide any advice about side effects either. I wonder if they were even aware of it as it appears they took bloods and checked for ticks, etc. The specialist centre didn't seem to be aware of it either as they proceeded with a spinal tap and then referred Mya for an MRI. It was only when Teekay contacted them and said stop, could it be Metronidazole toxicity, that they suddenly started looking at it and commenced treatment.

While it is a very good drug, vets need to spend that extra 2 minutes and outline the possible side effects, particularly if the dog is going on a long course or a high dose.

That 2 minutes would save people like us and Teekay going through the nightmare experience that we've both been through, not knowing what the hell was going on with our fur kids.

Teekay, that would be my first question to your vet - why didn't you tell me about the possible side effects.....

Well, I don't remember them talking about side effects but she was originally put on these pills back in May. I still think I would have remembered though and when the dose was increased it certainly was not mentioned. However, I found the receipt for the medication and it does state on there the warning signs of ataxia, flicking eyes etc. I probably did read that when I first got the pills but obviously didn't think of it when all this happened. AND obviously neither did the vet!! It's one thing to have, possibly inappropriately, put her on too high a dose but not realising that could be the problem when presented with Mya's symptoms certainly compounded the problem.

[MadWoofter]

So glad to hear she is continuing to improve teekay, it must be such a relief for you all.

And your poor boy as well, broken wrists are ouchies !!

Hope he improves too :)