Long Term Azithromycin (zithromax)?

For those of you following Mousse's saga, she didn't have her teeth extracted. She also doesn't have stomatitis. The dental specialist said it looks like gingivitis and some deformed teeth. We couldn't do any extractions, unfortunately, because we also found moderate-severe HCM (hypertrophic cardiomyopathy) after she was sent for a heart ultrasound with the cardiologist. Right now, we are trying to maintain quality of life and enjoy the time we have left as the disease is progressive. She's taking;


Then, the vet took a blood panel (senior blood) and nasal swab. The reason for the nasal swab was because she had calicivirus when I got her and her nose never really recovered. She's had chronic stuffiness, greenish secretions, etc. It responds to short courses of antibiotics but returns soon after. The blood panel came back awesome -- kidneys, liver, thyroid, white and red blood cells, blood sugars, etc. are all great. The nasal swab came back with two viruses and one bacterial infection. The two viruses are calicivirus and herpes. The bacteria is mycoplasma felis (not the blood kind). The vet gave us azithromycin. He had taken it before for only 14 days and it helped not only her nose but her gum swelling went away completely. A week after discontinuing it came back. The specialist wants to keep her on it for 30 days this time and the re-evaluate. But, he says she might have to be on it either long-term or on-and-off. The dental specialist, cardiologist, and internal medicine specialist are working together on Mousse's case. We will be following up often. We also got buprenorphine for pain as needed but I haven't given it more than once because the azithromycin has gotten rid of all nasal and oral symptoms (for the time being).

She is on day three of the azithromycin and heart medications. She is like a completely different cat. I thought she was doing well before because she was so much improved from when I got her but, omg, I can't believe the difference now. She seeks out attention more from us, cleans out her plate by herself (without hand feeding), and is overall more alert. I'm not sure if it's the heart meds, the antibiotics, or a combination of the two.

1. Is it ok to give azithromycin for as long as 30 days or even for life? The vet said that with the HCM she could live happily anywhere between 6 months to 3-4 years. Her nose is doing so well and so are her gums that I really don't want to take her off the medications. Has anyone had a cat maintained on this drug? It's once a day for 5 days and after that one dose ever 3 days.

2. Could mycoplasma be causing the gum inflammation? She's a very flat nosed persian so everything is kind of squished together on her face. Is it possible the nose bacteria infiltrated her gums?

3. The internal medicine specialist said we can keep the idea of antivirals in our back pocket but for now he doesn't want to risk it. He said to continue with l-lysine and saline nose drops for the calicivirus and herpes virus. Also, low stress environment. Is there anything else I can do to boost her immune system that wouldn't interact with the drugs she is taking?

The bacteria will eventually become resistant to the antibiotic. But if her lifespan will be somewhat limited, that may never come up. If it helps her, it's probably worth doing until it doesn't work anymore.

Willowy said:

The bacteria will eventually become resistant to the antibiotic. But if her lifespan will be somewhat limited, that may never come up. If it helps her, it's probably worth doing until it doesn't work anymore.

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Oh

Do you know how long it takes until she will become resistant? The specialist said we will do this for 30 days and then assess again but she may need to be on it off-and-on for life. If she has a three year lifespan (best case), is there anything else we can do?

maybe the resistance won't be a problem.

my husband had a long-time recurring infection. only one antibiotic affects it, and he was on and off it for years. it still worked, although it may not have worked as well - who knows?

basschick said:

maybe the resistance won't be a problem.

my husband had a long-time recurring infection. only one antibiotic affects it, and he was on and off it for years. it still worked, although it may not have worked as well - who knows?

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That's a good point. If we keep her on it long term and the bacteria is gone, I'm not sure how it could become resistent. I think the specialist mentioned long-term because it keeps recurring when she's taken off of it. Also because it seems to keep her oral inflammation away.

Thank you! I guess we will see with time.

On and off therapy with azithromycin is a strategy also for humans, especially in chronic lungs diseases. Don't worry, I believe you are on the right track. Just be sure to monitor any potential adverse reaction

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Post #2 above is really irrelevant - should any resistance occur, there are a number of other a/b's which are also effective for this bacteria.

Noirele said:

On and off therapy with azithromycin is a strategy also for humans...

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Yes, and done for cats as well. This technique is called "PULSING".


So:
Question #1: IMO, yes, it's just fine.
Question #2: A question better for the specialist/your Vet. I just don't have the background to absorb some of the biology involved. It might not seem to, though, as this bacteria appears to do its nastiness on a cellular surface level....again, ask the Vets.
Question #3: The only other 'supplement' that comes to my mind is bovine lactoferrin: Stubborn herpes infection? Add Lactoferrin in addition to Lysine

I'm sure you'll run any additions to her drug 'cocktail' by the Vet/specialist as well, as there might just be potential interactions.....

Hope that might help.
.

white shadow said:

.
Post #2 above is really irrelevant - should any resistance occur, there are a number of other a/b's which are also effective for this bacteria.

Yes, and done for cats as well. This technique is called "PULSING".


So:
Question #1: IMO, yes, it's just fine.
Question #2: A question better for the specialist/your Vet. I just don't have the background to absorb some of the biology involved. It might not seem to, though, as this bacteria appears to do its nastiness on a cellular surface level....again, ask the Vets.
Question #3: The only other 'supplement' that comes to my mind is bovine lactoferrin: Stubborn herpes infection? Add Lactoferrin in addition to Lysine

I'm sure you'll run any additions to her drug 'cocktail' by the Vet/specialist as well, as there might just be potential interactions.....

Hope that might help.
.

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Thank you SO much! I'm going to ask my specialist about the mycoplasma and whether it can impact the gums. I can't believe how much better they are right now. It's like a miracle but I know it's probably temporary and because of the antibiotic. I'm going to look into bovine lactoferrin!

My cat was treated with azithromycin and a few other drugs for chronic lung disease. We used it about a month and he is much better now. His condition was really bad when we started. So yes, I think it is fine to use it for a month, and it works well. I can't answer q2. For q3 I can't answer but I might add that even though azithromycin is an antibiotic it also has some anti viral characteristics according to my vet. So it may help with a viral infection too. We also used interferon alpha to boost his immune system. He will use it for the rest of his life.