March 2015
Peer Reviewed

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Doxycycline

Dogs: 5–10 mg/kg PO q12h for 2–4 weeks1-3
Cats: 5 mg/kg PO q12h or 50 mg/cat q24h  for 7–10 days1,4,5

Doxycycline is a tetracycline antibiotic that inhibits protein synthesis at the ribosomal level and remains the first-line antimicrobial therapy for bordetellosis in dogs and cats. Because of its bacteriostatic nature, doxycycline is not ideal for patients suspected of having pneumonia.6

Amoxicillin–Clavulanic Acid

Dogs: 13–20 mg/kg PO q12h for 2–4 weeks1-3,7
Cats: 62.5 mg/cat PO q12h for 7–10 days1,7

Image (right). Left lateral thoracic radiograph of a dog with bronchopneumonia secondary to B bronchiseptica infection. Note the patchy interstitial to alveolar infiltrates in the dependent portions of the right middle and left cranial lobes.

Amoxicillin–clavulanic acid, a potentiated β-lactam antibiotic that inhibits cell wall synthesis, is a fair choice for patients with bordetellosis, as it is relatively broad-spectrum; however, resistance has been reported8-10 with increasing frequency.

Azithromycin

Azithromycin maintains good efficacy against a wide variety of respiratory pathogens.

Dogs: 5 mg/kg PO q24h for 5–7 days2,3
Cats: 15 mg/kg PO q72h for 7–10 days or 5 mg/kg PO q24h for 3–5 days, then q72h up to 7–10 days5,11

As a macrolide, azithromycin inhibits protein synthesis by ribosomal binding. It maintains good efficacy against a wide variety of respiratory pathogens, including B bronchiseptica, and its slow elimination from the body allows for shorter treatment duration.

Enrofloxacin

Dogs: 5–10 mg/kg PO q24h for 2–4 weeks1,2,7
Cats: 5 mg/kg PO q24h for 2–4 weeks1,7

Enrofloxacin, a quinolone antibiotic, has excellent tissue penetration within the respiratory tract12 and maintains good overall gram-negative coverage, inhibiting the enzyme DNA gyrase. In general, use of fluoroquinolones should be based on bacterial culture results and should not be considered first-line therapy. Because of potential for retinal toxicity, the label dose should never be exceeded in cats; other fluoroquinolones may be safer.13

Marbofloxacin

Dogs: 2.75–5.5 mg/kg PO q24h for 2–4 weeks12
Cats: 2.75–5.5 mg/kg PO q24h for 2–4 weeks12

A third-generation fluoroquinolone, marbofloxacin acts via DNA gyrase inhibition and has a similar spectrum to enrofloxacin. In the U.S., the drug is primarily marketed for use in cats because of its reportedly lower incidence of retinal toxicity as compared with enrofloxacin, though these effects have still been reported, particularly in cats with renal insufficiency.12

Pradofloxacin

Dogs: Use contraindicated (U.S. label)14
Cats: 7.5 mg/kg PO q24h for 2–4 weeks15-17

A third-generation fluoroquinolone with broad-spectrum bactericidal activity, pradofloxacin can be advantageous for the treatment of respiratory tract infections in cats, owing to its extended spectrum and fewer side effect incidents as compared with lower-generation fluoroquinolones. Pradofloxacin does not appear to be associated with retinal toxicity in cats but is contraindicated for use in dogs because of myelotoxicity potential and proarrhythmic effects.

Chloramphenicol

Dogs: 30–50 mg/kg PO q8h for 2–4 weeks1,12,18,19
Cats: 50 mg/cat PO q12h for 1–3 weeks1,12,19

Chloramphenicol inhibits protein synthesis and can be bacteriostatic or bactericidal. It remains a good choice for serious infections (eg, pneumonia) in small animals, as its infrequent use has helped limit resistance. Because of idiosyncratic but rare incidence of aplastic anemia in humans, veterinarians should counsel owners to take precautions handling and administering.20

Treatment Choices

Antibiotics chosen for B bronchiseptica infection in the upper respiratory tract of dogs and cats may differ from those chosen for bronchopneumonia secondary to B bronchiseptica infection. A blood–bronchus barrier prevents penetration of certain antibiotics (eg, penicillins, aminoglycosides) as a function of pH, molecular size, and poor lipid solubility.

Many cases of B bronchiseptica infection are mild and self-limiting, thereby not requiring antiinfective therapy. Antimicrobial therapy should be reserved for patients with persistent clinical signs or evidence of bronchopneumonia or pediatric patients, as the disease can progress rapidly in young animals.6

In cases of persistent upper respiratory tract signs in the dog or cat, doxycycline for 7–10 days is considered the empiric antimicrobial of choice. Alternatives presented here describe other choices for patients with more severe tracheobronchitis or bronchopneumonia, and their use should be guided by bacterial culture and susceptibility when available.2,4,6

References and author information Show
References

1. Molecular epidemiology of feline bordetellosis in two animal shelters in California, USA. Foley JE, Rand C, Bannasch MJ, et al. Prev Vet Med 54(2):141-156, 2002.
2. Infectious tracheobronchitis. Ford R. In King LG (ed): Textbook of Respiratory Disease in Dogs and Cats—St. Louis: Saunders Elsevier, 2004, pp 364-372.
3. Canine infectious tracheobronchitis (kennel cough). Sherding R. In Birchard SJ, Sherding RG (eds): Saunders Manual of Small Animal Practice, 3rd ed—St. Louis: Saunders Elsevier, 2006, pp 151-153.
4. Bordetella bronchiseptica infection in cats. ABCD guidelines on prevention and management. Egberink H, Addie D, Belák S, et al. J Feline Med Surg 11(7):610-614, 2009.
5. Feline respiratory disease complex. Cohn LA. Vet Clin North Am Small Anim Pract 41(6):1273-1289, 2011.
6. Bordetellosis. Sykes JE. In Sykes JE (ed): Canine and Feline Infectious Diseases—St. Louis: Saunders Elsevier, 2014, pp 372-379.
7. Bacterial pneumonia in dogs and cats. Dear JD. Vet Clin North Am Small Anim Pract 44(1):143-159, 2014.
8. Characterization of antibiotic resistance plasmids from Bordetella bronchiseptica. Speakman AJ, Binns SH, Osborn AM, et al. J Antimicrob Chemother 40(6):811-816, 1997.
9. Antibiotic susceptibility of bacterial isolates from 502 dogs with respiratory signs. Rheinwald M, Hartmann K, Hahner M, et al. Vet Rec Dec 2014; ePub ahead of print.
10. Antibiotic susceptibility of canine Bordetella bronchiseptica isolates. Speakman AJ, Dawson S, Corkill JE, et al. Vet Microbiol 71(3-4):193-200, 2000.
11. Efficacy of amoxycillin and azithromycin for the empirical treatment of shelter cats with suspected bacterial upper respiratory infections. Ruch-Gallie RA, Veir JK, Spindel ME, Lappin MR. J Feline Med Surg 10(6):542-550, 2008.
12. Antibacterial drugs. Sykes JE, Papich M. In Sykes JE (ed): Canine and Feline Infectious Diseases—St. Louis: Saunders Elsevier, 2014, pp 66-86.
13. Retinal safety of a new fluoroquinolone, pradofloxacin, in cats: Assessment with electroretinography. Messias A, Gekeler F, Wegener A, et al. Doc Ophthalmol 116(3):177-191, 2008.
14. Bayer Animal Health (2012). Veraflox (product label). Shawnee Mission, KS.
15. Pharmacokinetics, pharmacodynamics and therapeutics of pradofloxacin in the dog and cat. Lees P. J Vet Pharmacol Ther 36(3):209-221, 2013.
16. Evaluation of pradofloxacin for the treatment of feline rhinitis. Spindel ME, Veir JK, Radecki SV, Lappin MR. J Feline Med Surg 10(5):472-479, 2008.
17. Pradofloxacin: A novel veterinary fluoroquinolone for treatment of bacterial infections in cats. Sykes JE, Blondeau JM. Vet J 201(2):207-214, 2014.
18. Community-acquired infectious pneumonia in puppies: 65 cases (1993-2002). Radhakrishnan A, Drobatz KJ, Culp WT, King LG. JAVMA 230(10):1493-1497, 2007.
19. Chloramphenicol 2. Clinical pharmacology in dogs and cats. Watson AD. Aust Vet J 68(1):2-5, 1991.
20. Chloramphenicol 1. Hazards of use and the current regulatory environment. Page SW. Aust Vet J 68(1):1-2, 1991.

Author

Jonathan Dear

DVM, DACVIM (SAIM) University of California, Davis

Jonathan Dear, DVM, DACVIM (SAIM), is an assistant professor of clinical internal medicine at University of California, Davis, where he also completed a residency in small animal internal medicine. Dr. Dear’s research interests include vector-borne infectious disease, lower urinary tract disease, and infectious respiratory disease of dogs and cats.

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