weighing risks v. benefits of convenia

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Charliemeow

Charliemeow

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My civie has been diagnosed with stomatits. We are considering participating in a trial that uses a drug cocktail (thanks kelly & oscar!! :YMHUG: ) to very successfully treat stomatitis. Darla would need a dental cleaning first, followed by injections of depomedrol (I think that was what she said) and convenia. I'm a little scared of convenia because it is so long acting, and it can do real damage if the cat has a reaction to it. To my knowledge, she has never been treated with it before. I am thinking that it is worth the risk to get in this trial. The stomatitis cocktail sounds so promising! Any thoughts? Thanks!
 
I thought Dr. Lisa just posted that Convenia isn't even good for dental issues? Go to her site and read up on Convenia as far as tooth/gum problems. Antirobe is used more for that problem I believe but I know the liquid is awful tasting.
 
From Dr. Lisa's site.........

While we are on the topic of antibiotics and dentistry, please note that antibiotics are rarely needed for dental issues and this is an area where antibiotics are very often abused. Dr. Frasier Hale is a board-certified veterinary dental specialist and has written a paper for his website entitled Antibiotic Use in Veterinary Dentistry.

Here is a quote from that paper: "In general, antibiotics are vastly over-used in veterinary dentistry, often to the detriment of the patient."

I share Dr. Hale's frustration but want to take it one step further as it pertains to Convenia. IF it has been determined that a patient fits into the fairly 'rare' dental category and does need antibiotics, Convenia is NOT an appropriate first-choice antibiotic for any dental issue since its spectrum of antibacterial activity is not targeted toward the bacterial species that normally live in the oral cavity.

Antibiotics vary significantly in their ability to kill various species of bacteria so it is important to match the correct antibiotic with the target infection.

When it comes to dental care, the most important issue is to remove the bacteria by cleaning the teeth (under general anesthesia - not by using anesthesia-free services) and addressing any infected tooth by removing it or doing root canal therapy. The answer is not to use antibiotics in an attempt to kill the bacteria which is often unsuccessful and even if it is successful, it will only be temporary as outlined in Dr. Fraser's paper.
 
I think they do the convenia because a lot of stomatitis kitties have infections in the mouth, unrelated to the teeth. I assume there is a reason they want to use such a long-acting one, but I didn't ask the reason.
 
You should be just as leery of the depo Medrol as the Convenia, quite frankly. Depo is a steroid. Gandalf received an average of 3 shots of it per year over 7 years for eosinophilic granuloma, swellings on his mouth and foot pads. It's a wonder he didn't become diabetic before he was 12! It is a long lasting steroid and stays in the body quite a while. It was wonderful at clearing up the swellings (they would break open too) and he'd go about 3 months before needing another shot. I knew nothing about the risk of diabetes that steroids posed.
 
Well the depo is just once. The drug cocktail has no steroids or chemotherapeutic drugs in it. The convenia and depo are, to my understanding, to reduce the inflammation and get rid of infections before the treatment starts. I think my only options are this or a full mouth extraction which costs an arm and a leg. Maybe I'll ask about an alternative to the convenia. I have to read up on it more.
 
Using a third generation cefa drug (Convenia) for oral bacteria makes zero sense. I would not consider this to be a logical - or safe - treatment

Full mouth extractions are my first choice for serious stomatitis.
 
Houdini had terrible stomatitis...Dr chose not to do a full mouth extraction but removed a few teeth that were bad. We used Clindamycin (sp?) for two weeks and it went away. Four years later it has not returned...knock wood.
 
This clinic has supposedly seen remarkable improvements in these stomatitis kitties. My vet is looking over the information now. Hopefully she'll have some ideas for me when she calls me back about it. I'd really rather avoid the full mouth extraction. My friend had a stomatitis cat who still had stomatitis after the removal of all his teeth. I know that ECID, but that would really suck to pay over $2000 and still have the stomatitis.
Gail & Houdini said:
Houdini had terrible stomatitis...Dr chose not to do a full mouth extraction but removed a few teeth that were bad. We used Clindamycin (sp?) for two weeks and it went away. Four years later it has not returned...knock wood.
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That's interesting! Maybe a round of that wouldn't be a bad place to start. It couldn't do much harm to try it.
 
Gail & Houdini said:
Houdini had terrible stomatitis...Dr chose not to do a full mouth extraction but removed a few teeth that were bad. We used Clindamycin (sp?) for two weeks and it went away. Four years later it has not returned...knock wood.
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This is also a very sound protocol.

Clindamycin makes much more sense than using Convenia.
 
Charliemeow said:
This clinic has supposedly seen remarkable improvements in these stomatitis kitties.
Click to expand...

But understand that they are giving a powerful long-acting steroid along with an *inappropriate* antibiotic.

My friend had a stomatitis cat who still had stomatitis after the removal of all his teeth. I know that ECID, but that would really suck to pay over $2000 and still have the stomatitis.
Click to expand...

Yep...this does happen. FME is no guarantee but it sure does help a lot of cats.

That's interesting! Maybe a round of that wouldn't be a bad place to start. It couldn't do much harm to try it.
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This would be much more sound and logical than using Convenia.
 
I'm hoping the vet will call today to talk about the trial. I'll request that we use clindamycin instead of convenia after her dental. Hopefully she will have so more insight into this for me. I liked it better when she was my healthy cat...I already had my hands full with charlie :sad:
 
Clindamycin is a very good oral antibiotic. My Ennis has a trash mouth, but he's too feeble to go under for a dental again. We give him a round of Clinda every 4 months or so to knock down the oral bacteria.
 
hmmm. With so many people having good luck with clindamycin for mouth issues, I wonder if that's part of the drug cocktail. The ingredients are proprietary since they plan on patenting it after the study, but I figure there must be an AB and an NSAID in it. Just a guess, though. Thanks for sharing all your experiences. I am afraid to put darla under anesthesia since she has had bad reactions to anesthesia before (that vet used the crappiest of everything, though, I'm coming to learn). Plus she has an arrythmia that scares me. Maybe we can try clindamycin alone first and see if that helps her issues at all...then if it doesn't we can go forward with the dental and research study. Full mouth extraction would be a last resort.
 
Well I just got off the phone with my awesome vet. She did have some more info on generally what was in the cocktail, though she wants to get the disclosure of ingredients by signing the waiver before recommending that I put darla on it. She said that the tech she spoke with at the clinic doing the protocol didn't mention either convenia or depomedrol before starting the cocktail, but she said that she only uses depo or convenia as a last resort, and she agrees with you all that they are not a good idea in this situation. For now we are going to do a dental, and see if clindamycin clears up any of the inflammation. If that doesn't help we are going to pursue the research protocol further and if she doesn't find any of the ingredients to be concerning we will do that. I feel so fortunate to finally have a caring, responsive, seemingly knowledgeable vet team. they are wonderful with charlie's acromegaly, and now they are being wonderful with helping to treat darla's stomatitis. flip_cat flip_cat flip_cat I am also fortunate to have this community to learn from. :YMHUG: Thanks again!
 
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