Experiences with Orbax/Orbifloxacin?

[Time 2 Recognize]

Anyone have experiences with this antibiotic for UTI treatment or otherwise? I'm super concerned about what I'm reading online about this class of antibiotics. My cat was prescribed this, .8cc daily for two weeks (that seems like a long time??). Urine culture that was collected from home indicates e-coli...and I'm wondering if there is a safer option to use but her vet isn't back in the office until Thursday, so I can't even ask her any questions or call if there is an issue.

My cat is acting normal and I've been keeping her quite hydrated since the culture was sent out last week. She hasn't indicated any pain at urination or in general...very good appetite, super playful. So I almost want to wait until my vet is available to discuss or is at least around should something not be right if I give her this....

 

[Sonatine]

14 days is not an unusual amount of time to treat for a UTI in cats. My own cat had a UTI and was treated with this drug, for that length of time. She's had no ill effects from it.

It seems that most of the adverse effects associated with orbifloxacin are observed at much higher doses than would be typical to treat a UTI. Orbifloxacin can increase the likelihood of seizures, but this is usually only a problem in pets that already have an underlying seizure disorder. Some of its muscular effects are more likely in animals that are still growing, so it may not be the best choice for a kitten. Vision issues are possible but very rare.

Orbifloxacin should cover e. coli, assuming that bacteria is what is causing the infection and not a result from contamination of the sample (which can happen easily). Other drugs can cover e. coli too, however, so there may be other options depending on what your vet says.

Of course, I am not a vet. But most approved drugs are approved because their benefit outweighs their risk. Even the safest drugs have some risks, but in most cases this risk is small and is justified by their efficacy in treating whatever they've been prescribed for.

All that said, if she's asymptomatic, you might be alright waiting until your vet is in the office to ask questions about it. Is it possible to speak with another vet, just to make sure that it's okay to wait to start therapy if that's what you decide to do?

 

[FeebysOwner]

Hi! In the past, when Feeby has had a UTI it has been e-coli related. And, after urinalysis/urine culture, Orbax was the antibiotic her vet said would work best for her. (She previously was given Covenia but it did not eradicate the infection.) She is typically on it for at least 10 days, with 14-day routines being fairly common. The dosage of Orbax is based on weight, so Feeby at 16.0 lbs has gotten 1.75ml/cc daily - based on a 30mg/ml potency. She has had no adverse reactions to it.

She has no issues with taking it, as long as it is administered to her mixed with some canned tuna or chicken water. I tried once giving it to her via the oral syringe and she foamed at the mouth and spit it out! After that, I simply measure the daily dosage into a dish and add just enough tuna/chicken water to mask the taste. She readily laps it up and then I give her a piece of the tuna or chicken as a treat afterward. As with almost all antibiotics, to avoid tummy issues, it is best to give with some food.

 

[Time 2 Recognize]

14 days is not an unusual amount of time to treat for a UTI in cats. My own cat had a UTI and was treated with this drug, for that length of time. She's had no ill effects from it.

Ok thats good to hear. I wonder why in cats it's so much longer? I have gotten 5-7 days then rechech, in the past when I have had UTI.

Orbifloxacin can increase the likelihood of seizures, but this is usually only a problem in pets that already have an underlying seizure disorder.

So I guess this is in part what concerns me...because my kitty gets these twitches sometimes when falling asleep. Like muscle contractions. Not all the time, but fairly often. I've tried to show my vet video, but she doesn't see what I'm talking about or says it's dreaming (it's not). So there's a part of me that gets concerned about this reading the neurological side effects this medication potentially has.

All that said, if she's asymptomatic, you might be alright waiting until your vet is in the office to ask questions about it. Is it possible to speak with another vet, just to make sure that it's okay to wait to start therapy if that's what you decide to do?

I wish, but calling any other vet office will get me the "well we'd have to see her to offer any input" type response. Which I get, but it's not helpful for today. I did try asking online in either vet forum on reddit or petcoach and get the ol "trust your veterinarian" or even "call the vet with your concerns" despite me explaining that I CANT until tomorrow. The main thing is that I don't like being in a position where I have no where to go today if there is an issue...or I'd have to go somewhere completely new to me and my cat and given my experiences with vets this past year, that is not ideal circumstances.

 

[FeebysOwner]

...So I guess this is in part what concerns me...because my kitty gets these twitches sometimes when falling asleep. Like muscle contractions. Not all the time, but fairly often. I've tried to show my vet video, but she doesn't see what I'm talking about or says it's dreaming (it's not). So there's a part of me that gets concerned about this reading the neurological side effects this medication potentially has.

I am not saying there is any guarantee about the seizures one way or the other - with any type of med; and there are many that have seizures as a possible side effect. But, I will tell you Feeby jerks in her sleep quite frequently, and the vet did seem to think there might be some mild neurological issue behind it. But, he said if she does not demonstrate any other signs of neurological problems, that he doesn't feel the need to be concerned. She has done the twitchy-thing for years, but it is not any different/worse/etc. when she is on Orbax.

You have a right to be concerned, and I won't use Bravecto (flea treatment) on Feeby because it too reports a possibility of seizures. But, I felt OK with Orbax because it isn't used continually and ongoingly - like Bravecto would be, for example.

 

[Time 2 Recognize]

In the past, when Feeby has had a UTI it has been e-coli related. And, after urinalysis/urine culture, Orbax was the antibiotic her vet said would work best for her. (She previously was given Covenia but it did not eradicate the infection.) She is typically on it for at least 10 days, with 14-day routines being fairly common. The dosage of Orbax is based on weight, so Feeby at 16.0 lbs has gotten 1.75ml/cc daily - based on a 30mg/ml potency. She has had no adverse reactions to it.

Thank you! It is helpful to hear that it's not had adverse effects for at least two others. I've never given my girl medication before really. Will definitely do the med in some food when I do give it to her. I'm mainly uncomfortable with the vet not being in office today :/ I do like her more than most, and do trust she is conservative about medications...but their hours and frequency of days not open or vacations has been getting frustrating. They're only open 3 days this week.

 

[FeebysOwner]

I'm mainly uncomfortable with the vet not being in office today :/ I do like her more than most, and do trust she is conservative about medications...but their hours and frequency of days not open or vacations has been getting frustrating. They're only open 3 days this week.

Then, wait until you can talk to her, since your cat seems to be doing OK so far. If you have the urinalysis/sensitivity report, it will list the various antibiotics that might or might not work, and you could look those up in advance of your discussion with the vet to see if those too have potential seizures as a side effect - just so you know what the options are.

I believe there were a couple of others that Feeby could have tried, but the vet said those came in pill form and had to be administered twice daily - he thought the Orbax would be easier to administer. If there is another antibiotic that would be as effective for your girl, and it only comes in pill form - you could always ask about compounding it into liquid form if that would work better for you and your cat. I didn't think of that at the time Feeby was first given Orbax.

 

[Sonatine]

I can at least clarify a little about the duration of medication in UTIs. Humans have some medications that are proven to clear up UTIs in 5-7 days, some as little as 3. We feel comfortable giving meds for just that time because we've researched it and know it works. Either the meds available to cats haven't been researched for shorter durations in cats, or they're proven to need longer to work, so vets prescribe them for 10-14 days (and at least one of the best treatments for UTI in humans is not approved for cats).

I don't know if what you describe when your cat sleeps has any neurological component or if it's just a sleep thing, so I can't say if that would increase her risk for seizures. However, even in pets with known seizure disorder, orbifloxacin doesn't guarantee a seizure, it simply raises the risk of one (still a good reason to choose another drug). Generally, it's a rare side effect. Other meds do cover e. coli; augmentin is (usually) one of them and it doesn't have a significant association with seizures. That said, it has a higher incidence of diarrhea and vomiting (a possibility with any antibiotic, but more likely with Augmentin than some others). Note: most of my knowledge is based on this drug in humans, and a brief conversation with my vet about it.

However, it's pointless for me to speculate what might work. Your vet has the culture; they can just look at that. Ultimately, we went with orbifloxacin for Mischief because it would be once daily dosing and I would be leaving town before she was finished with her treatment (so the petsitter would have to do it). Mischief also has a somewhat sensitive stomach, so I chose the drug with lower GI side effects.

TLDR; I think it is very, very likely that it will be safe, just as it would still likely be safe if you went with a different drug. But I am not your vet and if your cat isn't showing any symptoms, it's likely also safe to wait as long as it isn't more than a day or two so you can talk to them.

 

[Time 2 Recognize]

But, I will tell you Feeby jerks in her sleep quite frequently, and the vet did seem to think there might be some mild neurological issue behind it. But, he said if she does not demonstrate any other signs of neurological problems, that he doesn't feel the need to be concerned. She has done the twitchy-thing for years, but it is not any different/worse/etc. when she is on Orbax.

Is it like rhythmic muscle clenching? As she's falling asleep, but not after she has fallen asleep?
Echo doesnt have any other signs that I've become aware of.

I gave her first dose this morning with food around 9:20am. She seems ok with it thus far....I started noticing that last evening that her energy was a bit low, and stayed up debating to give it to her at night when the only thing open is emergency clinic should something go wrong... And also questioning still. I spoke to the vet briefly, but she only had a few minutes to talk and called me back when I was in middle of something. She thinks things will be fine and also mentioned when the culture results came in, the numbers were fairly low compared to some infections.

I was supposed to go to conneticut tomorrow for part of the day, but I think I will cancel. My sister in law won't be happy, but I'm not liking the idea of giving her a dose in the AM then being gone for 4-5 hours (I work from home but have to pick up tables my brother built me for a show).

 

[FeebysOwner]

Is it like rhythmic muscle clenching? As she's falling asleep, but not after she has fallen asleep?

It does seem to be a bit rhythmic. I call it a jerking motion. I am not sure whether Feeby is just falling asleep or after she has already fallen asleep, because sometimes she will just lay there like she is asleep, but she really isn't. I know if I gently put a hand on her with just a tad bit of pressure, I can get her to stop.

Good luck with the Orbax, I hope your cat (name? - and, is your avatar a pic of her?) does as well with it as Feeby seems to do!! I haven't even noticed a diminished appetite when Feeby has taken it, I don't know if that is because I do give it to her with food or not!

 

[Time 2 Recognize]

I know if I gently put a hand on her with just a tad bit of pressure, I can get her to stop.

Ah see usually my putting a hand on her might stop if for a moment while she looks up at me but, then I will feel/see it continue. Like her muscles are pulse vibrating (it's not purring though).

Her name is Echo I'll put a picture below. So we are on day 3 of .8cc Orbax as of this morning. I have been mixing it with tbs of food, giving her that in a bowl first, then the rest of her breakfast once she's eaten it. I think things are ok so far, but was up last night till 3am worried, because she took a small pee, then strained in the poop pose with no results. I actually gave her a small slurry with a tiny bit of canned+water, some corn silk drops (five of this kind incase it was UTI related or I was freaking out that it might be crystals?).

She did pee around 7-8am though, small average...and then later again close to noon after a poop attempt...then she took the #2 pose again and did manage to pass some. Part was a bit dry constipated and what I'm guessing was end bit was closer to soft serve. I have given her some mercola probiotics in food since starting the Orbax, but finding the balance between too much or too little is still in progress I guess. Vet is closed now until Tuesday. If the diarrhea continues or gets worse I'll stop the antibiotic but will try calling either another clinic or a 24 hour place first to advise.

This is Echo Her eyes are a bit more green than the photo shows since there's a warm toned filter on it.