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Medication Fright

I’m writing this post several days after everything has returned to normal, in part because I was a bit emotional about the situation while it was in progress.

A couple of weeks ago, big Sheltie boy Copper (who is as big as a largish Collie and deaf) was having bloody diarrhea. It seemed consistent with giardiasis, which had been brought into the house (and yard) by Tigger, the puppy who’d been with us for only a few weeks. Diarrhea is, of course, hard on one’s system and we didn’t want to risk Copper getting dehydrated; it’s also hard on the carpets when a dog doesn’t get outside in time, and it’s easy for the yard to get continuously re-contaminated and causing infections in other dogs.

Consequently, we jumped right onto the situation to get it under control as quickly as possible. We started Copper on a regime of metronidazole (generic for Flagyl®), which is a recommended antibiotic (which we stock because of its broad usage) for a number of intestinal infections, including giardia. He seemed to improve over the next day or two, but both Barbara and I sort of vaguely noticed (without mentioning it to one another!) that Copper seemed slightly “out of it”, maybe a little awkward or clumsy. We didn’t think too much about it (which is probably why we didn’t say anything to one another about it) until about the third day when he was clearly and significantly ataxic!

Ataxia is, of course, the word used to describe loss of coordination of muscle movements. In this case, it manifested itself as a very wobbly and uncertain walk and difficulty in standing. Poor Copper finally laid down (“collapsed” is only a slight overstatement) and couldn’t get back up. Now, most of you haven’t met Copper, so you don’t know that he’s got this fully little head tilt that we think might be related to his deafness — the vet thinks that both may have been caused by an encounter with a car when he (Copper, not the vet) was about a year old. Well, his head tilt was noticeably worse, and his limb movements became very jerky and he got a bit rigid. In short, he was not doing well at all!

These symptoms are known side effects of a metronidazole overdose! Fortunately (well, unfortunately, in a different way), we’d seen this before. Some years ago, we’d actually given an overdose of metronidazole to Annie, an ancient and abused Sheltie we’d rescued from down in St. George. She had similar symptoms, so it was familiar, but also quite scary. Naturally, we immediately stopped giving Copper the medication. A little research revealed that he’d been getting a 33% overdose for a couple of days. That’s not horrible, but apparently he is somewhat sensitive to that medication.

Now, most of us would think that a dog would start to improve…or, minimally, not get any worse…when you stop giving him the thing that’s causing the problems. Not so… By that evening, he was significantly worse. I was seriously wondering if we were going to lose him. Naturally, it was Friday evening after Cottonwood Animal Hospital had gone to emergency room hours (and costs). Barbara phoned them, but the ER vet on duty was somebody with whom we’d never worked and she wouldn’t give us the time of day over the phone. (Side note: I guess that’s not unreasonable, since the vet didn’t know us, but we’re used to dealing with vets at Cottonwood who know us and our experience level and are thus willing to give advice based on our descriptions, etc.)

To avoid the much-higher costs of taking a dog to the ER, and because we’d had experience with this problem before (and because Barbara was doing extensive research about this problem on the web), we decided to keep Copper at home. We knew that the medicine would gradually, over three to six or seven days, leave his bloodstream, and Barbara’s web research uncovered the fact that phenobarbitol (yes, the anti-seizure medication) was reported to help detox from metronidazole overdose! Who would have guessed? And, yes, we stock phenobarb because of the various seizure dogs we’ve had over the years.

So we started giving Copper subclinical doses of phenobarb, which really did seem to help. It’s less that it seemed to remove the metronidazole from his bloodstream than it controlled the neurological effects of the metronidazole and reduced his ataxia and other symptoms.

Recall that I mentioned above that Copper is Collie-sized? That includes his weight, roughly 30 kilograms (65 pounds). No way could Barbara pick him up, and it was incredibly difficult for me to lift his dead weight while he was lying down. And he couldn’t stand! Obviously, I couldn’t hold him in an appropriate position outside for him to pee or poop, so for a couple of days, we had no choice but to allow him to just pee where he was lying on the floor :( Poor guy…he was extremely unhappy about that, but we put him on a pad that would protect the floor and carpet.

After a couple of days, he was able to sort of pull himself into a sitting position, so I did pick him up and carry him outside. When I set him down on the ground, he was actually able to (barely) stand for a few seconds while he peed, and I snatched him back up before he collapsed into the puddle he’d just made. Back inside onto his pad he went. The next day, same thing, twice…and on the first time, he was able to take a couple of steps without collapsing. Next day, more of the same, but he could walk a little bit more. Still, he wasn’t willing to tackle walking down the ramp or back up it to get back into the house, so I continued to carry him in and out. By the day (Wednesday) I had to leave for a 2-day business meeting in California, he was clearly on his way to recovery, but I was still carrying him in and out, although he could manage to pee and poop by himself while outside.

When I got to my hotel Wednesday night and phoned Barbara, she had the superb news that Copper had actually been able to walk outside, do his business, and walk back in. He was, she said, still a bit wobbly, but clearly much better. By the time I got home late Friday night, Copper was almost 100% back to normal…just a little extra head tilt and a slight tendency to get tired and have to lie down more often than normal. And, by today (Monday, July 5), he appears to be completely normal, like it never happened.

Poor guy! We tried to help him overcome one problem (diarrhea) and created another, rather scary, problem. He was clearly scared about what was going on, but he trusted us to do the right thing for him and he let us do what had to be done. He was such a good boy about the whole thing, and obviously grateful that we were willing to carry him in and out.

Lesson learned! Check the dosing very carefully before giving medications! And know your dogs’ weights!!

Oh, and to make matters really frustrating…we finally concluded that poor Copper’s diarrhea wasn’t caused by giardia after all, but that he’d picked up coccidia (which also came into our house courtesy of Tigger). And coccidia should be treated with sulfadimethoxine (generic for Albon®), not metronidazole.

On this day..

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9 comments to Medication Fright

  • Wow, what an EPIC ordeal for you three! I’m soooo glad Copper is doing better!

  • This is just so hard, especially when you have a whole house-full of dogs!  Have you managed to stop the initial problem, Tigger’s issues?  So that you don’t have to do this over and over times 20 dogs?
    I am glad Copper is better.  What an ordeal for all of you!

  • Bobbie and Dawn, it’s just a “Day In The Life”…another episode of the on-going soap opera that is rescue. Yes, it was scary, to us as well as to Copper, and it was a little exceptional, and we were a bit more tired than usual. But we often have crises (not always caused by our own actions, happily!) analogous to this. It’s just part of the job.

    Tigger, happily, is cured of both giardia and coccidia, and has already gone off to his new forever home (as has Sparky, stories and pictures for both when we have a spare hour). We think that Copper was probably the last in the string of dogs who were affected by the infections; some of the others (especially the coprophagia-prone) had also gotten it, but we managed to avoid over-dosing them and they recovered quickly.

    Copper’s completely back to normal now and is his happy, lovable, and sometimes frustrating self :)

  • Kim and Dan

    Oh YAY, Copper is back to normal!  That is happy news.
    Sparky is doing well.  He gets excited when Jerry and Misty get excited, and even barks sometimes – especially when playing.  He likes to be right next to me as often as possible, and I have learned to look before I step anywhere just to make sure I’m not going to step on him.  He loves meal times but understands that not all three bowls are for him, and we are working on sitting and waiting for food.
    So far it has been a very smooth transition adding Sparky to our pack.  He is extremely unobtrusive but certainly not a wall flower, he’s one of the gang.
    We now have three of the easiest-going dogs ever – but of course, they are shelties after all.  Thank you SRU.
    Kim and Dan

  • Oh I am sooooo very happy to hear Tigger got adopted!!! Some lucky person is going to have a lot of fun with that sweet little boy. I bet Jodie misses him, though.

  • Kim and Dan, thanks so much for the update on Sparky! He has a very special place in my heart. He is such a gentle soul and looked so lost and confused when he first got here. He and I became really close during his few months in rescue and I am so, so happy that he’s with you guys. I know you’ll give him all the love and attention that he deserves and needs, and it makes me smile to read how well he’s fitting in. Thanks so much for allowing him to join your family!!

    Please do post some pictures in a blog post. If you don’t want to do all that, at least email us some and we’ll try to get them posted.

  • Bobbie, Jodee really misses Tigger. Both Tigger and Jill left in the same week, and nobody else can play as hard as Jodee wants to do. She runs around the back yard like a banshee trying to burn off some energy. The other dogs — even Abby — get exhausted trying to keep up with her. On the flip side, she’s become much more attentive to me and turns to me for her play and affection. That’ll come in handy during training!

  • anita

    Jim I am reading this and hoping for a similar outcome. Our lovely sheltie received 5 doses of flagyl at the correct dose. 3 days ago he became ataxic unable to walk and then developed seizures. He has not recovered power as yet but seizures are being controlled with phenobarbitone and diazepam. This neurotoxicity is described. I have found information online that collies can have MDR1 mutations that make them sensitive to flagyl and other drugs. My purpose of posting this is to share with others who might find themselves in this dreadful and very sad position. Secondly can you post the timeline as to when things improved. I would be interested to know of your dog had any movement in those early days and when / how things improved. I am trying to remain hopeful but at day 3 now and as yet no movement I am very concerned.

  • Anita, I’m so glad that you telephoned us today, as we no longer pay much attention to this blog — people don’t seem to care as much about blogs these days as they do about FaceBook.

    As I told you on the phone, the Washington State University, which has done most of the research and publishing on the MDR-1 gene and its effects, does not state now that metronidazole (a/k/a Flagyl) is particularly dangerous to MDR-1 dogs, even mutant/mutant dogs. At one time, they thought differently, as the article on which you commented indicated, but that is no longer on their website.

    I hope by now that you’ve been able to talk to our vet and get some ideas that your vet and pursue to help Luka get through this scary event. Please do keep us posted by telephone, email, messaging, or FB. Sheltie Rescue of Utah has a facebook page that you can easily find.

    Paws crossed!

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