Bacterial Alphabet Soup

There has been a fair amount in the press recently about antibiotic resistant super bacteria that are going to end the world. TV, print, Internet, all talking about MRSA, MRSI, MRSP, and even the dreaded flesh eating bacteria, I think that I will skip the horrid flesh eating bacteria for now, as it is mostly a human disease problem and the pictures would be far to gruesome for this blog. If you have a genuine interest or just want to see gross pictures, you can follow the link here.

Let's start with MRSA. I'll translate, first from alphabet to medicalese, to English. French translation will require a different author. The initials stand for Methecillin Resistant Staph. Aureus. Staph. Aureus is a round (cocci) bacteria commonly found on the skin. While we used to think that all of these potentially disease causing cocci were Staph aureus, it turns out that this is a pathogen of people and other species have there own species of Staph. Here is group of Staph as seen under the microscope, a Staph meeting as it were.




The M is for methecillan, an antibiotic and the R is for resistant. MRSA is resistant to, that is not killed by methecillin or any penicillin type antibiotic. The problem is that many of these bacteria also develope multi drug resistance, that is that many antibiotics will not affect them. As you can see this can cause a big problem.

MRSA has become a huge source of complications in human hospitals as this is a place were there are alot of sick people, and bacteria, and antibioitics to stimulate resistance. (We can talk about how bacteria become resistant in another post if anyone comments and is interested)

Dogs can get colonized by MRSA. They get it from their owners and it might not ever cause a problem. However, if they should have some weakening in their immune system, allowing these bugs to get a foothold, then we can have a problem. At our practice, we have seen several cases of MRSA recently. In each case we were able to trace the source of infection back to an owner that had been treated in some sort of health care facitlity.

What about the other intitials you ask? Well, as I alluded to earlier, other species of animals have there own staph bacteria. In dogs they were reclassified as Staph. intermedious (SI) and most recently, Staph. pseudintermedious. Here is a picture of staph, closer up. Can you tell what species it is? No one can just by looking. Special tests are needed.

In fact, you can't tell if this is a resistant staph or just a plain old staph just by looking at a photo micrograph. Sensitivity to antibiotics is determined by doing cultures and sensitivities in the clinical path lab. We have seen an increase in the number of MRSP infections in our practice over the last few months. I'm not sure if that is because more of our staph infections are resistant to methecillin, or if we are just more aware and doing more cultures. These animal staphs can colonize people and cause diseae if the opportunity arises.

Now, were do we see most of these resistant staph infections in our animal patients? The number one location is in the ear. That is why your veterinarian should not just look at an ear like this and send you home with anti biotics.

Or even worse, just take a phone call from you and dispense antibiotics without a thorough examination. We do a cytology exam on all ear infections. (look under the micrscope to see if there are bacteria present). If there are bacteria, we do a culture and sensitivity so that we can prescribe the best medication to cure the infection. Then we set up a maintenence program to prevent future infections. The indescriminant use of antibiotics is one cause of the increased incidence of resistant infections. You need to wash your hands after treating infections so that you don't pick up these bacteria and have them growing in you waiting to cause disease.

Here is the other very common location for bacterial infection, the skin. People often mistake this type of lesion as ringworm (another topic for another day) but this is a classic presentation for a staph infection in a dog. These also need to be treated with appropriate antibiotics, both topical and systemic.

Now what can we do to prevent the spread of bacterial diseases from patient to care giver, owner to pet, and pet to owner?

WASH YOUR HANDS!! Do it frequently and do it well. Use antibacterial soap. Use the hand sanitizer stations that popped up during the swine flu scare. These will kill bacteria as well as flu viruses.


Keith Niesenbaum, VMD

www.CrawfordDogandCatHospital.com

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Spring is here and the smell of what? is in the air?

So the weather has turned warm and I was finally out for one of those long bike rides that I have been promising myself for the past month or so. My first long course triathlon is rapidly approaching and it is time to get some hours in the saddle as it were. We were out on the North Shore tooling around the hills of the Gold Coast and dodging landscaper's trucks who were also out taking advantage of the nice weather to tend to their chores, when I was taken back to a childhood memory by a familiar smell. Now the overwhelming odor was chocolate, but that could easily have come from the melted Reese Peanut Butter cups that I use to refuel myself on these long rides, but there was a subtle difference. This was a more earthy smell. Now I remember.

When I was but a lad, back in the day, my Pop-pop worked in some capacity for the EB Evans Company. The company is still in existence (a quick google search will confirm this but that is really tangential to where I am going with this story.) I remember that his company made Ice Cream toppings. You know, Butterscotch, Hot Fudge, maraschino cherries. Sidebar here, don't eat an entire bottle of maraschino cherries, I seem to recall that it will make you puke. Anyway, attempt at self induced cherry poisoning aside, my Pop-pop would bring us all sorts of great stuff to pile onto our ice cream, or dump into our milk. Although I'm sure this didn't help my weight issues growing up, it was a wonderful thing for a pre-teen boy to have access to. Tastes aside, smell is a stronger memory trigger and I remember that he also gave my dad huge burlap bags of old cocoa hulls to use as garden mulch. Back in the early '60s, this was novel. The company perceived this as a waste product and my dad thought it was the best gardening product ever. As a kid, I thought it was wonderful that the entire yard smelled like a gigantic chocolate bar, only more earthy like a truffle soaked chocolate bar.

Now, 50 years later, cocoa mulch is very popular. I guess that as more people have figured out that this is a good mulch and the companies that probably paid to have the stuff hauled away, or at least turned their backs when employees gave their grandsons early childhood spring time memories are selling it by the ton. Add in the new popularity of truffles, the earthy chocolaty smell of this mulch was everywhere this weekend.

But, if you've been reading some of my earlier posts, you know that there is often a flip side to these sorts of things. While I was content to lay out on the lawn and smell the chocolate, dogs are not quite so content. As with some other items, such as carpet, they eat this stuff. Maybe they think it really is truffle soaked chocolate (mmmmmm) or maybe they are less discerning and just acting like, well dogs. The thing is, chocolate mulch has two problems. One is it's chocolate and we talked about that a while ago. There is enough chocolate in the stuff to cause all the problems we mentioned with eating the real stuff. The second problem is it's mulch, not meant to eat and can cause all sorts of intestinal blockage requiring human intervention to remove the garden supply.


Here we are, a young Rottweiler, on the table with a belly full of something. The hands belong to the talented and patient Dr. Spar who is removing all sorts of goodies from the insides of this silly beast, via an opening that didn't exist until a few moments before the picture was taken. The suspect foreign body was carpeting. I don't know if the dog had read the last post and thought it was an instructional manual or if he came up with the idea on his own, but the owner was pretty sure that carpet was the offending material as some of it was passing out the rectum for several days. Well, we all get to be wrong sometimes and this was the owner's time.

The thing is that this pup isn't particular at all. He didn't even care about the flavoring, he just wanted to eat plant material.

This is just a small sampling of the leaves that were removed from his stomach. If my botany serves me well, they were mostly oak leaves. Can't tell you what type, mostly slimy oak leaves from spending the better part of the week inside the dark confines of a dog.

The thing is, we really need to watch what our pets get into. If this had been the cocoa laced mulch, this dog would have had all the signs of chocolate toxicity in addition to the physical obstruction of the non edible plant material. Happy ending tho, leaves out, dog home, and I will ride on the North Shore again this weekend searching out the smells of my childhood.

Keith Niesenbaum, VMD

www.CrawfordDogandCatHospital.com

and for healthier snack options.

www.TheVetsChoice.com