Convenia question

I am looking for a little input. Here is the scenario:

Last Tuesday, I noticed one of my ferals limping and favoring his front, left paw. I called a vet and she told me to keep an eye on it for a day or two because he may have sprained it. By Thursday, it was worse and by Friday it was looking swollen. It took me three days to trap him and I was able to bring him into the vet Monday morning. He has some sort of puncture wound on the bottom of his paw. It was cleaned and he was given pain medicine and Convenia for an antibiotic. He is recovering in my garage. He is eating ok, not really drinking any water but I am giving him wet food. He is using the potty alright but the paw looks the same (today is Wednesday, so he got the Convenia a little over two days ago), maybe even a little more puffy. There is a tiny bit of drainage but nothing significant. My question to anyone that has been in this situation before is, how long does it take to see results?  I called the vet back and they said to give it until Friday. I just feel like I should be seeing some improvement even if it is just him flexing his foot a little or decrease in swelling. I am super impatient!! Plus--I know he wants out of this garage cage and to be reunited with his family.

Thanks!

I think it depends on where the problem is. I wouldn't expect the cat to stop limping immediately after the injection or even 2 days later. I think because it is weight bearing and the tissue is being moved around with walking rather than a cut for example on his back, it's going to take time to competely allow weight to be put on the paw. I think he's progressing ok. One concern may be that Convenia may not be the most effective for the type of infection but probably all that can be used on the feral. So this may also cause a delay.

I would expect the swelling to have stopped within 12-24 hours and gone down after that.  There is no way it should still be a problem now if that was the right antibiotic.  Convenia is often used for ferals because you can't pill them, so it works with just one injection, but personally I have found that Clavamox works fastest with wounds and abscesses.  There are some bacteria Convenia just doesn't kill and Clavamox does kill.  It was originally designed for skin infections in dogs, not for use in cats at all, and it's really not the best choice for dental conditions, and most cat wounds are related to cat bites and thus have the nasty cat mouth bacteria as the cause of the problem. 

A neighbor recently had a cat medicated for an upper respiratory infection using Convenia.  She took it back to the vet for a check up after 2 weeks and there were still rales in spots in the lungs.  The cat is now on Clavamox, and hopefully it will clear up.

It is quite easy to get Clavamox into ferals actually, IF you are confining them, as you appear to be doing with this one.  Although the liquid Clavamox vets use taste terrible, and of course would require you to put it in his mouth, and pilling him with the little white pills is probably not a choice either, the easiest way to get Clavamox into a feral is to dissolve one of the tablets into a few drops of water (you need the liquid to be clear to you see if has dissolved, which takes a few minutes), THEN add a little half and half or goats milk and mix it with a little strong tasting food such as TUNA or HAM or TURKEY BACON and give it to the cat.  Mine always gobble it right down.  I have tasted it and it isnt bad as long as it's FRESHLY added to the food.  If it sits around, it becomes less e\appetizing, except to cats who are starving. 

If I were you, I would get some Clavamox from the vet and start dosing him with that in the way I just mentioned

Also, if your cat has had CONVENIA, you should always supplement him with probiotics, because Convenia kills off the gut bacteria and flora and can cause serious digestive problems.  It acts as an antibiotic for 10 days to 2 weeks but stays in the system for 65 days, so if a cat is having any bad reaction to it, there is nothing to do except treat the symptoms.  Lethargy and loss of appetite are common.  Not all cats have bad reactions but probiotics is always a good idea with this drug.

I would also suggest you google Convenia and read about it if you have not done so already.  Here is an article by a vet I respect:

http://www.catinfo.org/?link=convenia

Here is another very technical article about Convenia and what it is best used for:

http://www.drugs.com/vet/convenia.html

Here is an excerpt from that article:

General Dosing Information

A sample of the lesion should be obtained for culture and susceptibility testing prior to beginning antimicrobial therapy. Once results become available, continue with appropriate therapy. If acceptable response to treatment is not observed, or if no improvement is seen within 3 to 4 days, then the diagnosis should be re-evaluated and appropriate alternative therapy considered.

Can I give him Clavamox now even though he just got Covenia, or do I have to wait to make sure the first antibiotic is out of his system? 

The vet I had to take him to (because he is feral) is far away (about an hour). I have Amoxicillin already at my house. The dosage for it is 50mg twice daily, could I give that to him in place of the Clavamox?

Ok---I have a friend that does feral rescue that has Clavamox available for me to use.  I know this is a question for a vet, but is it ok to give the Clavamox even though he just got a Covenia shot on Monday?

I also have probiotics that I will start him on.

I appreciate all of the feedback! Thanks so much!

There is no contraindication to using Clavamox (or amoxicillin) which are in the penicillin family, after Convenia.  I did that recently on one of my cats from the shelter and she had no ill effects, and she got over the infection promptly.  We use it all the time for bite wounds and abscesses.  It is an entirely different type of antibiotic than the Convenia, which is in the cephalosporin family.  The drugs that Convenia should NOT be used with are NSAIDS (like Ansior and Metacam), ketoconozole and doxycycline, to name a few drugs commonly used on cats. 

The difference between amoxicillin and Clavamox is that Clavamox is a penicillin combination antibiotic, and the second ingredient (clavulanate) prevents bacterial resistance to the amoxicillin.  It is very effective against a wide variety of bacteria and has few side effects. 

Thank you so much for your response. It was extremely informative and I feel much better about my decision to go ahead with the other antibiotic.

I was able to start him on Clavamox last night and he has now had 2 doses of 1ml. His paw looks extremely painful and I feel so bad for the little guy.

 I hope I don't have to take him back in to get it lanced--it is still so puffy!!!

Give it another day unless it is getting worse.  The Clavamox usually stops these things in their tracks at 24 hours and then the swellng starts to go down and the wound is less painful after 48 hours.  This one had quite awhile to get going so it may take a little longer to start going down.  BTW, look at the pictures of Grey Boy by my signature.  He had an open compound fracture of one of the bones in one of the legs, and he had been injured probably at least 5 days if not more before he showed up and I got him to the vet.  They cleaned him up and bandaged him, and the only antibiotic he was ever on was Clavamox.

I went ahead and took him back to the vet today. I know I am impatient, but after 4 doses of Clavomox, there was still no change and I didn't want to go into the weekend without having him seen. The vet told me that the Covenia and Clavamox are in the same family so even though Covenia is slower acting,  they both kill the same bacteria/infection. She told me to not bother with the Clavamox since he has the Covenia injection and she started him on Orbax for 10 days and gave him an anti-inflammatory shot as well. We noticed tonight that he is finally flexing his claws a bit in that hand even though it is still pretty swollen.  He is in good spirits, purring, eating, etc. I know he is sick of being in the dog kennel, but I don't want him jumping on it for a few more days. I also had him tested for FIV and FeLV just in case his immune system was suppressed causing a slower heal , but he came back negative. (Yay!)

Just out of curiosity, if this were any of you, would you continue to give him the Clavamox anyway? In addition to the Orbox and Convenia injection?

Nope because an overload of antibiotic can be toxic and kill your cat. Plus the vet is not recommending you continue it. It looks like he really just needs the steroid injection. But bacteria can be resistent and sometime you just need another type of antibiotic to kill it.

Thanks Hexiesfriend!!!

I certainly do not want him becoming toxic or having further issues. I will just give the Orbax once a day like she told me to and monitor him closely!  Hopefully he is on the mend!

NO, do not keep using the Clavamox.   He had two days on the Clavamox and it wasn't doing the job either, so you were right to take him back to the vet.  Some nasty bugs do require two drugs together to treat kill it, and pseudomonas is one that neither Convenia nor Clavamox kills unless combined with another type of drug. (Pseudomonas is a bacterium commonly found in soil and contaminated water, once established, it is very resistant to antibiotic treatment.)   It's unlikely your cat has this, I'm just using it as an example.

Orbax can have the same side effects on cats as Convenia (depression, lethargy, loss of appetite, problems with vision, dizziness) so just watch for any changes until you see if he tolerates the drug well and if the foot responds to this one.  If not, you may need to get a culture & sensitivity done so you know exactly what bug you are dealing with and what medications it responds to.  Wishing you good luck with the Orbax and hope your guy's foot starts healing up.