Orbax (orbifloxacin) for Snakes?

PsychoSnake · 12-27-16, 08:03 PM

My vet prescribed this for my retic's secondary bacterial RI as her current Rx for Fortaz (worked great in the beginning!) is losing momentum. She keeps getting sick after stopping Fortaz despite great environment settings (the snake room feels like a jungle in SE Asia!). While she is still on Fortaz he wanted to try this oral medicine for typically cats and dogs. He's experienced with reptiles and has been very helpful. My question is has anyone had experience using it?

Albert Clark · 12-28-16, 06:44 AM

Orbax is probably being prescribed bc the synergistic effect is greater than with only the fortaz alone. Depending on the c & s results may also weigh in the vet's decision. Just my two cents, keep the change. Fortaz is a great antibiotic with almost no adverse effects. Orbax is a flourquinolone whose actions are similar to Batril but has a different half life and may be indicated in targeting different organisms..

PsychoSnake · 12-28-16, 07:13 PM

You're right! She hasn't responded 100% to Fortaz and since she's been on it for 6 weeks now the vet wanted to try another option. He wants to avoid Baytril cause the injections cause necrosis at the injection site and the oral route he said tastes disgusting. He said Orbax was a middle of the road approach as it wasn't so off putting that it would further stress the snake. So what he said to do was inject a mouse with it and feed it to her. So fat she has had two and is enjoying her "treats".

MDT · 12-28-16, 09:23 PM

The big question though...was there a culture done and based on the sensitivity, what antibiotics is the isolated organism susceptible to?

Sounds like your vet is throwing stuff at the wall to see what sticks.

PsychoSnake · 12-29-16, 01:45 AM

No culture done, because he doesn't want to put her under anesthesia and further stress her. If this round doesn't work (one week trial) then he'll probably go down that route. But cost is the other problem.

Anesthesia: $400
Sensitivity: ~$200

He's hoping an even broader spectrum of antibiotics should take care of it before getting expensive and invasive.

**Aaron_S** · 12-29-16, 08:48 AM

Quote:

Originally Posted by MDT

The big question though...was there a culture done and based on the sensitivity, what antibiotics is the isolated organism susceptible to?

Sounds like your vet is throwing stuff at the wall to see what sticks.

The good doctor with the comment of the day!

Quote:

Originally Posted by PsychoSnake

No culture done, because he doesn't want to put her under anesthesia and further stress her. If this round doesn't work (one week trial) then he'll probably go down that route. But cost is the other problem.

Anesthesia: $400
Sensitivity: ~$200

He's hoping an even broader spectrum of antibiotics should take care of it before getting expensive and invasive.

To my knowledge, snakes aren't put under anesthesia for this type of culture. It's a tracheal wash I believe. It'll suck for sure as a tube and liquid goes down the throat but the snake isn't put under for it.

Your vet may not want to go down that route but without it you're just going to waste more and more money on antibiotics. Finally when/if this oral one doesn't work he'll want the $600 for this test and the meds on TOP of it afterwards...plus everything beforehand. Should have just started with the culture.

Albert Clark · 12-29-16, 04:45 AM

Wow, that's understandable. I was told by my vet some time ago that the necrosis is really minimal and can be decreased even further by altering the injection site. Also that injectable medication is more effective than the oral route. I guess it's a trade off. Has to do with absorbtion rates too. You should bring it up with the vet. Hoping to see her back in form soon, good luck PS....

MDT · 12-29-16, 09:31 AM

Aaron is correct, tracheal aspirate shouldn't need anesthesia, unless he/she was going to do a bronchial lavage(?).

Psychosnake, please take this the right way, I am not busting on you...but your snake (if I'm reading this right) is really no better off after slapping a bunch of antibiotics on it.

The problem is, you START with a broad spectrum antibiotic, then with the sensitivity, you may have to narrow it down to a more efficacious medication.

There is no such thing as a "middle of the road" approach, or a "synergistic effect", or even a "stronger antibiotic"... if you appropriately select the medication for the identified bacterium or bacteria (if more than one species identified), it will kill the bacteria. Fortaz and Orbax are used for different reasons. There is some overlap of a few bugs, but they are used for fairly different infections. As far as oral vs injectable, some antibiotics (Levaquin- a human cousin of Orbax- for example) is 100% bioavailable whether oral, IV, or injected. So route of administration doesn't matter. Some antibiotics, IV or IM administration is mission critical..but not across the board.

Now, you have an animal on antibiotics for six weeks. If you were on antibiotics for six weeks, you'd likely either have a hellacious yeast infection or be in the hospital with C. diff colitis.

You don't know if your snake has an untreated or partially treated bacterial infection (and just needs a better selected antibiotic) , a fungal pneumonia (which none of the meds you listed would even touch), a prolonged viral infection (which NOTHING will cure except time and chicken noodle soup) or if something physiologic is wrong (pulmonary edema, heart failure, etc)...

You vet may be a great guy/gal.. and obviously, I'm trying to equate human medicine to reptile medicine (there are some glaring differences, you know the whole one lung thing)...but overall, just make sure you ask informed questions,and get good answers for the best outcome for your snake (and your checkbook).

PsychoSnake · 12-29-16, 11:55 AM

Thanks guys, I appreciate the feedback. Trust me I do ask questions! We've talked about putting her on probiotics once the antibiotics have been finished, which reminds me now he said we would have to wait a week off antibiotics to get a proper culture. I am going to ask for blood tests to rule some things out. She has already had xrays of her lungs and they looked okay. Her Dx right now is primary viral infection with secondary bacterial infection and mite infestation (a whole other story).

Meanwhile her setup is about as ideal as it can be with raised temperatures.

MDT · 12-29-16, 12:41 PM

Great! Sounds like you're on it...best of luck, keep us updated!!

Albert Clark · 12-29-16, 01:27 PM

There is no such thing as a "middle of the road" approach, or a "synergistic effect", or even a "stronger antibiotic"... if you appropriately select the medication for the identified bacterium or bacteria (if more than one species identified), it will kill the bacteria. Fortaz and Orbax are used for different reasons. There is some overlap of a few bugs, but they are used for fairly different infections. As far as oral vs injectable, some antibiotics (Levaquin- a human cousin of Orbax- for example) is 100% bioavailable whether oral, IV, or injected. So route of administration doesn't matter. Some antibiotics, IV or IM administration is mission critical..but not across the board.

@ MDT: Okay, Here we go. There typically is no " middle of the road " approach as you put it however there certainly is a "synergistic effect" as it relates to antibiotics whether you want to acknowledge it or not. I referenced c & s in my earlier comment. As well as the differences in Fortaz and Orbax. In the cases where a vet is trying to treat multiple organisms he or she can certainly go with a "synergistic" approach to treat effectively with more than one antibiotic. How dare you say there is no difference in absorbiton rates in oral vs. Injectable. That is a basic pharmacotherapeutic concept. But I see where you want this to go and I have said my piece. Have a happy New Year.. Oh, now you want to compare a "human" cousin of a medication to one that is used for animals?????? Really!

PsychoSnake · 12-29-16, 01:57 PM

Guys let's be civil. I'm just collecting info to ensure the best quality of care for my baby. And we shouldn't fight about what's best as she is young and appears to have several problems going on. My vet is an exotics specialist and has an oncall snake specialist. He's not above asking other's opinions if I bring questions.

MDT · 12-29-16, 02:15 PM

Quote:

Originally Posted by PsychoSnake

My vet is an exotics specialist and has an oncall snake specialist. He's not above asking other's opinions if I bring questions.

this is what you need... good to know.
Hang in there!

**Aaron_S** · 12-29-16, 03:09 PM

Quote:

Originally Posted by Albert Clark

There is no such thing as a "middle of the road" approach, or a "synergistic effect", or even a "stronger antibiotic"... if you appropriately select the medication for the identified bacterium or bacteria (if more than one species identified), it will kill the bacteria. Fortaz and Orbax are used for different reasons. There is some overlap of a few bugs, but they are used for fairly different infections. As far as oral vs injectable, some antibiotics (Levaquin- a human cousin of Orbax- for example) is 100% bioavailable whether oral, IV, or injected. So route of administration doesn't matter. Some antibiotics, IV or IM administration is mission critical..but not across the board.

@ MDT: Okay, Here we go. There typically is no " middle of the road " approach as you put it however there certainly is a "synergistic effect" as it relates to antibiotics whether you want to acknowledge it or not. I referenced c & s in my earlier comment. As well as the differences in Fortaz and Orbax. In the cases where a vet is trying to treat multiple organisms he or she can certainly go with a "synergistic" approach to treat effectively with more than one antibiotic. How dare you say there is no difference in absorbiton rates in oral vs. Injectable. That is a basic pharmacotherapeutic concept. But I see where you want this to go and I have said my piece. Have a happy New Year.. Oh, now you want to compare a "human" cousin of a medication to one that is used for animals?????? Really!

I don't think you know the meaning of synergistic. It doesn't mean when using two things at the same time. It would be using two antibiotics at the same time and both work better together than alone.

Quote:

Originally Posted by MDT

this is what you need... good to know.
Hang in there!

This is true! Hope for the best!

MDT · 12-29-16, 02:13 PM

I'll tell you what Albert, when you go back to school, and either get your Pharm. D/MD/DO/DDS/DVM....or a PA/NP degree, you and I can have a coherent discussion about the mechanisms of antibiotics... until then, stay away from Google.

Treating multiple organisms with combination therapy is standard of care in several types of infection (I never said it wasn't), however, they each do their own thing. Fortaz is not "made better" by Orbax. They each stand alone to kill their respective organsims by different mechanisms (hence it's good to know what you're trying to kill).

As far as bioavailability goes, I very clearly stated "some antibiotics".. and yes, it's true, some drugs do have equal efficacy regardless the route of administration. Hey btw, Doctor Albert, Fortaz is a "human drug" being used on an animal in this case... so what?

Simmer down dude...