MRSA Infection

[janicedyh]

@janicedyh Her vet did perform cultures and sensitivities - she posted the results above. The only thing additional that the vet could have done is to identify the specific strain of the Staphylococcus Aureus. My vet had an extended culture identification done on Hank's MRSA and if I remember right it was pretty darned expensive.

I must have overlooked that. I have known a lot of people that have been diagnosed with MRSA and the doctor just throws basic antibiotics at them withour testing wguch would work

 

[theletterv]

@janicedyh Yes, the first test we did that uncovered MRSA was a culture with a sensitivity test. We wouldn't have known it was MRSA unless we knew it was methicillin (and amoxicillin, and penicillin) resistant, so the sensitivity test was what gave us the diagnosis, and they were prescribed an antibiotic that it was shown to be susceptible to. All the tests we have done, on both the babies and ourselves, included sensitivity testing. One thing I know for sure is that sulfamethoxazole-trimethoprim was always shown to be a susceptible antibiotic.

Also I should perhaps introduce myself a little better. I am actually a "he" and you can call me Vince.

 

[theletterv]

I thought I would post the first lab results we got back in October, just in case anyone is interested. Done by a different lab and not as much information about antibiotic sensitivity. But you can see that both tests were said to be MRSA then. I also notice that there was enterococcus fecalis present in the separate baby's poop. The vet never mentioned that to me, and it clearly isn't present now... Hmm.

 

[Hankmacaw]

I found this regarding enterococcus f. It seems to be associated with yolk infections. Could have been left over from the original infection your guys had.

Bottom right of page 969;
http://avianmedicine.net/wp-content/uploads/2013/03/33.pdf

 

[theletterv]

That’s good to know and I think that sounds quite likely. I’m glad that at least that bacteria didn’t show up in the recent cultures. I was wondering also whether you remembered the dose of sulfamethoxazole trimethoprim one of your birds was on, though I guess you might not know the mg/kg amount... Of course I will do what my vet decides is best but I’m trying to do some research myself to talk to her about it. I have seen it suggested on a few pages online that the dose for birds is between 50 and 100mg/kg every 12 hours, and from my calculations the babies were on about 40mg/kg. So I’m wondering whether it should be raised. I’ll bring it up with the vet, but it looks like I won’t hear from her until Monday.

 

[Hankmacaw]

Vets are always much more careful with babies, that may be the reason for the low dose. But I would definitely talk to her about a higher dose. I'm always concerned a bout developing resistance to an antibiotic with low dosages and too short of a treatment time.

 

[theletterv]

Yes, that's what they've been telling me. They're about five months old now and I wonder whether they are at a much higher risk at this age. I want to be careful with them, of course, but especially considering there has been no (at least positive) change in the past month, it seems to me like we definitely have to change something... Hopefully the vet will agree. I'll update after I've heard from her and we've come to a decision. Thanks for your help as always.

 

[theletterv]

Just an update, even though there isn't anything really new. I've been able to get more antibiotics from the vet and permission to treat for at least another month. They're on 75mg/kg at the moment and seem to be doing fine on the higher dose. I have also separated all of them into rather small, temporary cages. I hate to do it, but it at least gives me the best chance at controlling the bacteria. The vet and the vet techs keep saying to me that they really don't want to treat them if they don't "seem" sick and also that treating for longer is going to increase the risk of further resistance developing. This is despite the fact that they are underweight and have very sour-smelling droppings, which I think are definitely signs of not being entirely well. And for whatever reason, the vet doesn't seem to be of the opinion that treatment for MRSA can require months of antibiotics. For now, I can get the antibiotics from this vet, but if they decide to stop prescribing it, I can at least drive an hour away to a vet who agreed with me about treating for longer. The only thing is that the babies would have to go in for exams (which is pricey for four birds) before she could prescribe for them. But if necessary I'll do that. I would like to try another two months before testing again, but maybe we'll test after another month. Anyway, that's mostly just me venting, I'm going to keep on keeping on. Happy holidays to everyone.

 

[WendyN]

Thank you for the update.
Happy Holidays to you!

 

[Clueless]

Thanks for the update and hanging with them.

 

[Alien J]

Happy holidays to everyone.

And to you!

 

[theletterv]

Hello everyone and happy New Year. We're still chugging along here, and still on the higher dose of the antibiotic without any observable negative effects, which is good. After hearing about how birds should be supplemented with vitamins when undergoing longer courses of sulfamethoxazole-trimethoprim I decided to get a good vitamin supplement, which the little ones get in their water a few times a week. We are also doing probiotics mixed into their chop once or twice daily, usually an hour or two after their doses of antibiotic. Luckily they are very good eaters because I introduced them to fresh foods early. I have noticed that their poop smells sour less often, and less so in general. Sometimes before the smell could fill the whole room. But now, most days, I don't smell much of anything, though I do notice a smell now and then. I am very guarded about allowing myself to hope too much, though.

My daily routine for cleaning is to remove soiled newspapers, then use paper towels and F10 (diluted at a 1:250 ratio) to first wipe down all surfaces in the cages, including the bottom grate, and make sure to remove any visible debris, and then spray with F10 (including perches and toys) and basically leave to dry. I take out their bowls and clean with soap and water and then spray with F10 and let sit for at least 10 minutes. I then rinse out the bowls and put them back in. Currently I am doing a deeper clean once a week, where the bottom grate and tray of the cages, as well as perches and toys, are scrubbed with soap and water and then sprayed afterwards and again allowed to dry. Their cages are also all on a table which is wiped down every day. I am even washing the blankets that I use to cover their cages at night every few days. Hopefully I am doing enough. If anyone can think of something I could be doing better, please let me know.

Otherwise, they are mostly pretty happy birds. I do wish they could come out and be handled more often, and interact with each other more. Hopefully someday that can change. Thank you all for sticking around and reading through my monologues!

 

[Hankmacaw]

Thank goodness those babies came to someone who has the perseverance to do what is necessary to defeat MRSA. I basically quit living when my birds had MRSA and did nothing other than clean disinfect and medicate.

You are doing great - those guys must have had a terrible infection of MRSA.

You are winning.

 

[Alien J]

You are the BOMB!

 

[Clueless]

Way to go!!!

 

[Tiel Feathers]

You are the BOMB!

 

[theletterv]

Thank you all for the words of support! I am just trying my best to do right by the little guys. I do feel like my life is a bit consumed by this at the moment, but that's all right. It's necessary. I just hope you are right and that we can win this.

 

[theletterv]

Just thought I would update again... Unfortunately, I am having more issues with my vet. She doesn't want to give me a refill of the antibiotic after less than another month of treatment. I've told her that I actually waste quite a bit of antibiotic because I am still mixing it up in a very small amount of formula -- I mix it up so that each mL of formula has a dose of antibiotic in it. I mix it up like this because the babies are so picky and even if the antibiotic is strawberry flavoured, they will shake it out of their beaks regardless, if they even let me get it in there in the first place. They give me an anxious look if I even dare use a new syringe! I didn't want to utterly damage my relationship with them by grabbing them and restraining them as I force them to take the antibiotic, which I have done a few times. But even though they are weaned, they are happy to have a little taste of formula as a treat. The reason I waste a lot is because, even in a tiny cup, a lot of the final mixture ends up stuck to the sides of the cup and it's very difficult to draw up into the syringe. Mixing up 6 doses instead of four, for example, makes it much easier for me.

Anyway, it seems like my vet thinks that this is a chronic, untreatable issue and I shouldn't be treating them at all, but rather resigning myself to them being carriers and only treat "if they seem sick". Which is, in my opinion, absurd anyway, because birds usually don't show obvious signs of illness until it is very advanced. And I guess she has no knowledge of people having to treat for 16+ weeks to cure MRSA. It's so frustrating. It looks like I'm going to have to try the other vet, but I don't think I can afford four more exams for the babies in order to get the vet to prescribe for them. Another $300 just to have them looked at and weighed, which I can do myself, is not really doable... I guess I'm going to have to talk to the vet and see what's possible.

I just don't know why none of the vets here seem to have heard of people having to treat for months to cure this. My vet continues to tell me that we're going to cause more resistance to develop if we treat any longer, but that doesn't seem to be the story I get from other bird and pet owners who have successfully cured MRSA. I'm trying so hard to not give up on them, but this is just yet another struggle.

 

[Monica]

My best suggestion is to have all the papers and information on the babies faxed over to the other vet and have a consultation rather than taking them in. With any luck, you'll be able to express your concerns to the new vet and hopefully have some idea on where to go next.

 

[theletterv]

Hi again everyone, it's been a while. I managed to get a bit more antibiotic and when I was starting to run out, I made an appointment with the avian specialists nearby. We had our appointment today. She said that she cannot promise that we can cure the babies (which we understand, of course) and mentioned that the few birds who have MRSA that she has treated were not successfully cleared of the bacteria. We sent off more fecal samples for culture and sensitivity tests. The vet did some reading and decided to prescribe them chloramphenicol, thinking that it would be more likely to work. I was warned a great deal to be very, very careful with giving the antibiotic, to always wear gloves, not let it touch my skin, etc. So that is a little bit concerning--I always wear gloves when I handle them, though. I gave the first dose this evening and am still feeling a little unnerved. Still, the vets at that practice have a lot of experience with birds, the most in our province I'm sure. I should hear back about the most recent tests in about four days, but the new vet is willing to treat for up to 3 months if need be. However, she thinks that eventually we may have to accept that it won't be possible to cure them. I just thought I owed everyone an update after quite a long silence. If anyone has any experience with this antibiotic, chloramphenicol, definitely feel free to chime in.

ETA: I forgot to mention that we are also contemplating the possibility of buying a nebulizer and using that as well; the vet thought that it might possibly be in their sinuses and it’s harder for antibiotics to reach places like that. I was glad that this vet was willing to give the babies a chance. I think she could tell that I’m willing to put in the hard work necessary... And I do wonder sometimes whether the reason other people may have failed to get rid of MRSA was because the environment wasn’t sufficiently disinfected. So I am going to keep up the daily cleaning.