Archive of Newsletters
July 2001
MIC (Minimum Inhibitory Concentration) for Dummies
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This Newsletter will try and simplify MIC (Minimum Inhibitory Concentration) for the general practicing vet in the trenches. Please look at http://www.dermapet.com to see our many updates, Protocols including Malassezia Dermatitis, the popular TrizEDTA Bacterial Otitis Protocol, the Pruritic Clinical Trial, previous Newsletters and articles. THE NEW BROCHURE IS ON LINE.
Please go to http://www.dermapet.com or
call 800-755-4738 for DIRECT sales. We also sell via select distributors such as Burns , Columbus Serum, NLS, MWI, Penn Vet, PVP, Merritt, Premier, R
& S Pharma, R. Weinstein (Hawaii), TW Vet Supply, Vet Med Supply and Vetpo. We now can
provide you a dominant distributor anywhere you may be in the USA (including Alaska and
Hawaii). We are also available in Japan, Thailand, Taiwan, Korea, Hong Kong, Central
America and soon in Europe.
EUROPEAN VETS (and others worldwide): We are shipping TrizEDTA for $11.99 (per 4
ounce/cases of 12) INCLUDING SHIPPING BY FEDEX.
We will be in Boston for the AVMA June 14-17. Next will be the World Small Animal
Veterinary Association (WSAVA) meeting in Vancouver on August 8-11.
MedRx is offering CE doing their EAR Seminars on the road next in BALTIMORE on July 8 and
SEATTLE on July 29. Be there to hear LOU GOTTHELF teach you the latest, state of the
art otology. Ears represent the #1 complaint of pet owners to vets (VPI insurance
claims, 2000). Call Kenny Keith at 888-392-1234 to register or find out when one is coming
near you.
YADA, YADA, YADA
Catalog Houses have been selling ethical vet products for years. How they buy them varies.
Now, the Internet has led many to link to informative websites like ours. It was recently
reported to me from one of our distributors that a new startup generic dermatological
company is saying that DermaPet links to a catalog house. It is true that many companies
and even apparently a catalog house, link to us; be assured we do not link back to them.
In the same way we may cite Reuters, the Wall Street Journal, the Washington Post or the
New York Times although obviously having no affiliation with them. Many of our
competitors are available from multiple catalogs, although their non-existent or
non-functional web sites are not worth a link since they do not provide educational
information. Keep in mind, we sell only to vets and protect our prices by using a password
and customer ID.
The 1st annual DermaPet Invitational golf tournament at Lakewood Country Club in Potomac,
Maryland was won by LOU GOTTHELF teamed with GARY BOUGE
in a tight match decided on the 18th hole. Gary chipped in leaving Yours Truly a 20-foot
putt, which precariously perched on the rim (49.999% of the ball was in!) of the final
hole before fatefully stopping. Before a wind came along GARY snatched it away as a
"gimme." KENNY KEITH (MedRx) computed the handicapped scoring
in a manner that makes MIC calculations seem easy (see MIC calculation instructions by Lou
Gotthelf in this Newsletter.)
Late breaking industry news. Webster Supply has been sold to Patterson Dental. Methinks
this distributor will be national by year's end. Will Jeff Webster, who reputedly hits a
300-yard drive, now be able to find the time to further polish his golf game?
According to researchers at the University of Leicester, playing songs by REM, Lou Reed,
Aretha Franklin and Simon and Garfunkel encourages cows to produce more milk, as much as
3% more than cows with no music. The opposite was true when academics played the
animals upbeat songs by groups such as Jamiroquai, Supergrass and The Wonderstuff. A
sound system was fitted in the cowsheds and music played 12 hours a day. The work was
prompted by curiosity over whether the effects of music on the mood of humans would be the
same for animals. (Brakke Newsletter/PA News) Ed. Note: How would taking them out of the
sheds, placing them on grass and listening to the Beatles and Rolling Stones affect them?
Also from the Brakke Newsletter
ISRAEL Israeli researchers have determined that they can identify BSE in
a simple urine test. Currently, the only definitive way to test for BSE is to
examine the brain after death. The findings, published in the June
edition of the Journal of Biological Chemistry, indicate that a urine test
can identify the prion or protein particle that causes the disease before
symptoms appear. Urine samples from hamsters, cattle and humans known to be infected all
revealed the presence of prions before any clinical signs
manifested themselves. (Reuters) Surely, this should be of interest to our carnivorous
colleagues in endemic countries.
How to use MIC information to make therapeutic decisions
By Lou Gotthelf
In order to insure that the correct oral dose of Enrofloxacin is being used to treat a
Pseudomonas infection, the endpoint MIC needs to be known. Dr. GBADAMOSI at Tuskegee
(334-727-8940, gbadam@tusk.edu) is computing these for as little as $18.
Endpoint MIC is the lowest concentration of an antibiotic that will effectively prevent
growth of the organism. It is important that there is at least 8 times the MIC
that can be achieved in tissue to kill all of the organisms. This is called the
Inhibitory Quotient (IQ).
With the MIC known, look at the drug insert to find the Cmax of the drug at 2 hours.
The Cmax is the level of antibiotic in a particular tissue at various times after
either oral or percutaneous administration. For the external ear (which is skin) the
Cmax for enrofloxacin is 0.66 mcg/g at the dose of 2.5 mg/kg ( THERESE DeMANUELE showed
that in severely inflammed skin or ears that Cmax can be doubled) . If the lab
reports the MIC for the Pseuudomonas is 0.25mcg/ml (sensitive) then the calculation
is as follows:
IQ=Cmax/MIC
IQ=0.66/.25
IQ=2.64
This is less than the preferred IQ of 8, so this would be an ineffective dose of
enrofloxacin.
To achieve the desired IQ of 8, 3 times the 2.5mg dose would be required (8/2.64=3.03) or
a 7.5 mg/kg dose of enrofloxacin.
In the case of a resistant organism with an MIC of 1.5 mcg/ml or greater, extremely high
oral or parenteral doses of enrofloxacin are required, which are almost impossible to
achieve without toxicity. In that case topically applied enrofloxacin would be a
better choice to achieve the desired Inhibitory Quotient. For example,
IQ=Cmax/MIC
IQ=.66/1.5
IQ=0.44
To achieve an IQ of 8, 18 times (8/.44) the 2.5 mg/kg dose would be required or 47mg/kg of
Enrofloxacin. This is impractical orally or by injection, so topical therapy would
be necessary.
Ed note: TrizEDTA synergizes most antibiotics by mechanisms and a protocol described in
other newsletters and found in various places at http://www.dermapet.com
AMITRAZ TOXICITY TO MAN
Posted on the TVMA Listserv by BONNIE BEAVER
One of our colleagues recently called TVMA and then me regarding the reaction a clinic
staff member had following the treatment of a dog with amitraz. Within a few
hours after dipping the dog, using all the normal precautions, the staff person was sick
enough to go home. This veterinarian later learned that the staff member was taking
a selected serotonin reuptake inhibitor (SSRI).
The veterinarian become worried about other staff members who might also be taking SSRI
(Prozac-like drugs) or even tricyclic antidepressants (TCAs) and potentially handling
monoamine oxidase inhibitors (MAOIs) like amitraz. The withdrawal time for
individuals who are taking serotonin acting drugs and then switching to MAOIs, or the
reverse, is weeks. That certainly indicates the two drug types should even
"cross paths" with each other.
Not only would staff be vulnerable, but with a high percentage of the general population
on these drugs, what warnings should be be giving clients if amitraz is dispensed for them
to dip their dogs at home? (Ed note: or place on pet's collars?).............
For Malassezia and Bacterial Otitis PROTOCOLS and the Malassezia Derm Protocol please go
to the web site and read Seven Steps to Treating Ears, visit the many articles at our
website or look at archived Newsletters.
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Steve Melman VMD
http://www.dermapet.com
dermapet@aol.com
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301-983-8387 outside US
301-365-0191 fax
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Archive of Newsletters
| Steven Melman VMD DermaPet Animal Dermatology and Behavior Clinics Potomac, MD 20854 |
dermapet@aol.com http://www.dermapet.com 800-755-4738 fax 301-365-0191 |
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Potomac, Maryland
20854
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