Hello all,

I have a pregnant bitch here ( this is day 27) and this is her second litter. The first one really could not have gone smoother: steady weight gain, no upset tummies, vomiting, really nothing at all to worry about.
Seven pups out at the end - all of them healthy and they absolutely thrived as a litter.

This time we were a little more concerned. Although it seems now to have stopped (this last 24 hours) for the prior 2 days prior there have been tiny amounts of blood in her urine. Truly, very, very small amounts. We watched her like a hawk over that 48-hour window and I don't see that she could have passed more than half a teaspoon all in. That said, we wanted to play it safe so we brought her scan forward to today and informed the vet that we'd seen little amounts of blood.

She didn't seem terribly concerned but I did say at this point that if putting her on antibiotics was the safe approach (thinking she would pick something that has been tested as safe in pregnant animals) then I would be happy to do that.
We went ahead with the scan, and yes it looks as though she's pregnant but as it's so early we couldn't see much more than that. The vet said things look "a little bit angry, but not much" and said that she would give us a 7-day course of antibiotics to take home and a cup for a urine sample.

Having had a Google of what she gave us (Clavaseptin) I'm a bit concerned about giving it to her. We're just about to take the urine sample and she said she'll get the results of that back to us tomorrow. We've decided to hold off until the results are back before we start the antibiotics as this girl really looks absolutely fine - she's not off her food or water, happy to play with our other pets as per usual, hasn't vomited once and her stool looks fine too. The vet agreed that her physical exam is absolutely fine too.

Obviously if the results come back positive for an infection then we'll need to take some course of action - whether it's giving her the Clavaseptin or pushing for an alternative antibiotic, if it's pyo then we would look at fixing her and she'll stay here happily as a pet, but I was hoping I might get a few responses from the community here from people who have experience in this area. Either having given Clavaseptin priorly, or another antibiotic... I'll take what I can get.

I do of course know that the bad options here are very bad so we're absolutely not being passive or flippant and our girl certainly will be well looked after so please don't feel the need to drive that point home.
As with all of us, we're just seeking to do the best for her and make sure she's getting the best care possible.

Thanks very much for any advice,
J.

From the NOAH website in UK re use with in whelp nitches

Use during pregnancy and lactation
The safety of the product has not been established during pregnancy and lactation. Laboratory studies in rats have not produced any evidence of teratogenic, foetotoxic or maternotoxic effects. Use only according to the benefit/risk assessment by the responsible veterinarian.

Thanks for this - I did have a bit of a look into this and came across this type of information.
I'm actually a medical research scientist (but, to be up front, this is absolutely not my area and I'm certainly not a vet of any sort) so I had a look at studies too.

I found one, a case study of a Mini-Dachshund, where they confirmed pyometra and gave Clavamox as a result. It looks from that example that they were able to rectify the pyo and 2 pups were born https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4629608/

I don't know quite what to do as anecdotally there are a couple of horror stories on this forum about giving the drug to a pregnant bitch... I guess we'll find out a lot tomorrow when her urine comes back but I think even then I might be taking her tomorrow to get a second opinion and go from there.

I can't stress enough though - she looks absolutely fine. Wishing the vet had taken her temperature though. I would have thought this would something a vet would do before prescribing antibiotics? But alas...
We'll monitor her very closely and be straight back to the vet if anything changes certainly.

J

If it were pyo, I think you would be seeing discharge at other times than when she is urinating.  If you're seeing anything, it wouldn't just be blood, it would be pus as well in all likelihood, and she would probably seem unwell in other ways (although not always). 

I would assume it is most likely a urine infection.  I'd agree with your idea of waiting for the results from the urine sample to come back.  Whilst these ABs are safe during pregnancy, you really don't know if they are going to treat what she has - so I'm not sure why the vet has already prescribed them if it's only a case of waiting another 24 hours for results to come back.  You don't want to start these ABs and then find she needs some others. 

How did you even notice half a teaspoon of urine over several days??  Unless she is weeing on something white, I'm not sure how you'd have even seen this? 

If I were you, whether or not you start ABs I'd also put her on Cranimals cranberry powder - which will help if it's a urine infection and help prevent it reoccur in future.

And I've no idea what she means by things looking 'a little angry but not too bad' or something...?  What body organ is she even talking about??  I just don't have faith in the ultrasound ability of vets unless I know they are good with it!!

Thanks very much for the reply.
Yeah I know what you mean about vets and ultrasound - I didn't feel particularly confident in her at all. If she had a good understanding of what she was looking at, she did a pretty good job of giving the alternative impression.

Well  the white fur helps a little. We got lucky in that I just happened to catch a glimmer of red when she'd come back in after a pee. There was a small amount also of clear discharge too which it was catching it, meaning it was lingering around her vagina after she'd had a pee. This wasn't at all cloudy and didn't have any kind of unpleasant smell either. But after about 24 hours it was just urine with a tiny amount of blood in it that we were spotting - obviously we may have missed something but we're checking her for discharge every couple of hours and it seems to just have happened following a pee. That's us nearing 36 hours now since the last sight of blood so I'm feeling a bit better now about it all. We also managed to catch a urine sample (harder than I was expecting!) and handed that off the vet before closing time - so we'll expect the results tomorrow.

When you say that these antibiotics are safe, can I ask what you mean? Are you referring to Clavaseptin? As the company who make it certainly don't make any claim as to it being safe in pregnant animals. Do you have anecdotal evidence of using this product on your own dogs whilst pregnant?

Thank you for the advice on the cranberry powder. I'd forgotten about this stuff but a breeder friend of mine has used it before and swore it gave her some good results - I don't think it was Cranimals though as I'm not sure if that can be sourced here in the UK?

J

>When you say that these antibiotics are safe, can I ask what you mean? Are you referring to Clavaseptin?

Yes.  See page 82 here - Clavamox is the same thing:  https://pdfs.semanticscholar.org/27b2/f2145105d569559d1fd6050eac81868af691.pdf  Many antibiotics are not specifically tested properly and fully in pregnant dogs, so we have to go with tests on other animals and for human pregnancies.  Got to say though, that many minor UTIs do clear up by themselves without ABs - no one can make the decision for you about whether to start them.  We do know that ABs affect the microbiome...

>I don't think it was Cranimals though as I'm not sure if that can be sourced here in the UK?

You can get Cranimals from Amazon although it sometimes goes totally out of stock, I think because of availability of cranberries after Xmas although I might just be making that bit up!

>This wasn't at all cloudy and didn't have any kind of unpleasant smell either.

Clear discharge which doesn't smell (or even slightly opaque discharge) is a very good sign of pregnancy, especially around the time where you are now (day 27).  Of course it can also be pyo, so keep a close eye.  My bitch had opaque creamy discharge around day 21 for a few days, on her two pregnancies and no further probs and healthy litters.

That's great - thank you very much again for your advice.
I'll make sure to reply in the coming weeks with the outcome as in the past I've gotten a lot from this forum but it can be difficult to benefit in that way when people (understandably enough to be fair) don't update the thread with the ultimate outcome.

If anyone else has any experience in this area then again, it would be warmly received. :)

Thanks again
J

Following up on https://forum.champdogs.co.uk/topic_show.pl?tid=151102 but with a bit of a broader question now.

Just by way of quick summary, our girl is expecting (for now at least) her second litter. The first one was problem free but this time we began noticing a small amount of mucus with a small amount of blood in it - mostly being discharged along with urination.
We took her to the vet for a scan and the vet decided she is indeed pregnant, gave us some antibiotics (Clavaseptin) due to the blood we spotted and a urine sample collection cup.

Okay - so since then we've returned the sample and had the results back. There was no sign of infection in her urine. We got about 2 hours of happiness at this news but unfortunately at her last time going out to pee the mucus was back (and perhaps even a bit more than there had priorly been) and again there was a little blood in it.

Does anyone have any past experience of this? Should we be expecting to lose the litter? And as for the Clavaseptin. As it isn't approved for use in pregnant dogs, we're reluctant to give it - especially as we've now been told they didn't find any indicators of infection in her pee. Do you think we should just give her the Clavaseptin? Push for a new antibiotic? Although our vet said there are no pregnancy-safe antibiotics, something I'm sure she knows to be untrue. Probably just keen to shut us up. Or just forget the ABs as her urine came back clear anyway?

Would love a bit of guidance here from anyone with experience in this situation.

Thank you very much for your help.

J

As I said before, I really wouldn't be at all worried about the mucous by itself - this is a positive sign of pregnancy and you should be celebrating it, instead of being worried about it.  (In the absence of pus or colouration or any other physical signs of her being unwell.) 

With the blood, I don't have any experience of this.  Is it frank red blood?  How much is coming out? 

To be honest, starting random antibiotics without having diagnosed anything and just to throw something at a problem and hope it sticks kinda of thing, just doesn't seem like good veterinary medicine to me.  Nor would throwing some other random antibiotic at it.  What are you treating for?  Having said that, I've posted above evidence that Clavaseptin is safe during pregnancy.

If a urine test shows no sign of infection, then all that means is you can cross off a UTI as the cause of the blood you are noticing.  Which in turn suggests it could be coming from her vagina rather than urethra.  If you want to pursue finding out what the blood is about, then the next step would be an ultrasound to look for signs of pyo and a blood test to look for white blood cells or markers of infection.  Whether you escalate things to that or decide to wait and see, is up to you...keeping in mind that veterinary procedures are not stress-free for pregnant dogs, though.  If your vet isn't suggesting these things, then you probably need to look for a new vet with more experience of reproduction.  (Some forum members may be able to recommend one if you say roughly where you live...)

If you have ruled out a UTI, and if the cause is a pyo, there's nothing you can do to save the litter anyway - ABs aren't going to fix/stop a pyo.  They may delay its development somewhat but not for an entire pregnancy...

I'd have to query the why prescribe a/bs if there's no UTI going on?

Yeah I totally understand about the mucus, it's the blood that has us a little concerned. It is bright red blood yes and only a very small amount.

So we decided to go for a second opinion and went to a different vet today (at a different practice).
This vet checked her over and was happy with her overall condition. She took her temperature and that was fine too.

Anyway, this vet said there really wasn't any reason to give antibiotics since her urine has come back clear, the discharge doesn't smell and she looks well. Interestingly enough when I asked her if it would be the cautious approach to put her on a course of pregnancy-safe antibiotics, just in case, she told me that; "They don't make antibiotics safe for pregnant dogs". She's the second vet to say this to me in as many days... When I mentioned Synulox she said "Well that's an injectable [looks like there are tablet forms out there though to me] and we don't have access to it at this practice." Which I felt a bit let down by to be honest. I have a biomedical/biotech background myself so I have a very slight understanding of what we're talking about and in any event I can definitely be reasoned with - this is the first time I've ever questioned my vet's decision at all in fact - so to just lie like that in order to make the consultation go smoother and get me to agree to do whatever they want seemed a bit unpleasant frankly. I'm always really polite and deferential to them but anyway...

For now we're just taking the 'wait and see' approach. You mentioned an ultrasound. Perhaps I didn't say but the first vet did an ultrasound 2 days ago and said 'It looks a little angry in there but not too much'.
If anyone can translate that then I'd certainly appreciate it. We're going back for another scan next week and I'm presuming that will ultimately be the final verdict. If there are pups there then we'll expect there to be a litter and Pyometra would, I imagine, be unambiguously visible at this point.

I suspect you're right about needing to find a different vet. This is the first time, very fortunately, that we've ever had any reason to visit a vet beyond routine check-ups and scans etc. and I'm realising that we really don't feel as if we have a vet we can just rely on and defer to confidently.

Sadly when it comes to breeding, you're very unlikely to find a vet experienced enough and there's a lot more resting on our shoulders to research things we're presented by and 'demand' certain things of vets.  It really shouldn't be that way, but it is.  When vets stop being so intent on neutering everything that walks through their doors and show some interest in how dogs procreate, things may change!

It's total BS that there are no antibiotics that are safe in pregnant dogs.  That's ridiculous.  And you're right that Synulox isn't just an injectable - it comes in easily accessible tablet form and is one of the most commonly prescribed antibiotics for a wide range of different things - in tablet form.  Any vet who doesn't have access to it, I would seriously not return to.

If she hasn't got an infection she doesn't need antibiotics anyway.

Synolox comes in easily accessible tablet form and is one of the most commonly prescribed antibiotics for a wide range of different things - in tablet form.  Any vet who doesn't have access to it, I would seriously not return to.

It is virtually ALWAYS the 'well we will try these to start' for ANYTHING that may be an infection!

Hello all,

Bit of an update. So, if you can believe it, we called around the 6 most local vets to us and not one of them has access to Synulox.
We started to get a bit worried that we weren't taking any action at all so we ultimately bit the bullet and gave the Clavaseptin. Having looked through the ingredients it didn't look as if there was anything to be horrified over - same active ingredients as Synulox with everything else seemingly quite banal. I still wasn't entirely comfortable with this but if I'm honest I felt like I'd run out of road and needed to be doing something about this discharge.

Having previously been clear, I'm a bit worried to say that it's turned a little more milky but there's still no odour from it. She's still eating and drinking okay too and seems okay. We're thinking she's maybe a little lethargic (kind of hard to judge as she's not exactly a manic dog to begin with) but then again, if indeed she is pregnant, this will be Day 33. Speaking of which, her nipples have also gotten very big too.

Her follow-up ultrasound is scheduled for Tuesday (this is 7 days after the first) and we're all pretty nervous to be honest. We took her to a vet just a few days ago for a second opinion on her and that vet was of the view that she's fine but the milkiness of the discharge has got us kinda worried. No smell. No blood. And we wouldn't really say there's any green-is hue to it either. If anyone is reading this but hasn't seen my posts above, she's been screened for a UTI and this came back negative too.

Any thoughts ahead of our ultrasound? Is it fair to say that we can expect a definitive answer at this appointment? We know from past experiences that a litter will be visible but Pyometra concerns are new to us, would this be something we could expect our vet to catch given that it would now have been advancing for a week if indeed she does have an infection?

Thank you very much for any advice - we really appreciate it.

J

How very strange that none of the vets have"access"to this drug, when they could have quite simply written you a prescription for it & you could have obtained it online via a certified pharmacy ?

I feel there’s some layer to your message that I’m not quite understanding. Perhaps things are done a little differently in the UK, if indeed you’re not from here? I’m of course aware that they could write a prescription and I could take it to a pharmacy but I can’t force them to do so.

Between the scan, Clavaseptin and second opinion I’ve handed over £200 in the past 6 days to my local veterinary practices - with another appointment scheduled for tomorrow. I’d have been happy to, and still would be happy to, pay whatever was needed for the script and Synulox.

>I’m of course aware that they could write a prescription and I could take it to a pharmacy but I can’t force them to do so.

In the UK if you request a written prescription the vet is obliged to issue one, as long as they've examined the animal. There will be a charge though.

https://www.animeddirect.co.uk/synulox-palatable-tablets-priced-per-tablet-500mg.html?gclid=Cj0KCQiAsbrxBRDpARIsAAnnz_N5zsgfcTtJyegaCOnqDZQshiaBcr4YtMdChiUZG3tFa39GQ8gABJ4aAg8EEALw_wcB  just as an example for future reference.
Just ask for a script if the vet isn't for coming and agrees synulox would be the a s of choice
. Not all are quick to think prescription as an alternative or for cheapness .

I feel there’s some layer to your message that I’m not quite understanding. Perhaps things are done a little differently in the UK, if indeed you’re not from here? I’m of course aware that they could write a prescription and I could take it to a pharmacy but I can’t force them to do so

Not sure why you believe there is a "hidden" message. I personally cannot understand why a vet would not have"access"to a drug that is often prescrbed for animals especially when it is available online with a prescription.

Are you saying you are not in the UK when your ISP is from the UK as is mine ?? Most particular thing to write

Most ‘particular’ indeed...
The country you’re located in wasn’t showing up at the time of writing (perhaps because I was doing it via my phone) but what I meant was that I am located in the UK and if it happened to be that you are not, it might be that we have different systems. The abundance of inverted commas in your messages might lead to someone thinking there’s an underlying point you’re trying to make for future reference.

To be fair, I don’t recognise the system you seem to be describing here. One where I, or any client, can force a vet to provide me with a prescription for something the animal has never had before. In the UK it would appear that the law obliges the vet to offer a prescription for recurring medications (and perhaps for medicines they’re prepared to let you leave with that day). But what would be the point in a system where veterinary medicines were only available by prescription but the vet has a legal obligation to issue any prescription demanded of them their by their clients? The drugs might as well be available over the counter in that instance as the prescription is a formality. As I said, I can’t make them give me the script - although next time I’ll ask again and hopefully they’ll be more co-operative.

Anyway, thank you very much all for your help. Although I’ve consulted it regularly since our first litter 4 years ago, I was quite reluctant to post in this forum as in amongst all of the very useful advice, there seems to quite a hostile tone that emerges in many of these threads. Quite why anyone would think I wasn’t pursuing this fully and trying my very best for my dog is a mystery to me but I guess that can’t be helped. I’ll post a short update in a few weeks to let anyone else who might be in a similar position in the future know the outcome.

Thank you again.

J

Could this lack of keeping Synulox these days be down to having moved on to something vets consider, or have been persuaded to believe, that something like Clavaseptin is 'better' or even less expensive?    I'm always amazed at being given an a/b I've never heard of (given we've kept hounds since 1972) pretty much every time I go to my vet these days.

Ideally I'd not want to have to give a/bs to a pregnant bitch, period.   And I'd certainly have to have confirmation that they are needed before doing so.  When I have one of mine on a/bs, I usually give them natural yogurt (pro-biotic) too counter the possible bad effects of an a/b.     Years ago we had a hound who went down with what was said to be a really bad gastro -enteritis when he was only 11 weeks.  By the time his health was restored, he had NO bacteria in his gut, good or bad.   We had to leave him back with his breeder as we were leaving the country and it took her 4 months before he was well enough to join us out there.

Re people being harsh on here - seems to me it's how many forums can be - people write things they'd probably never say to anybody's face.   Sometimes I just have to take a time-out, not only from this place which tends to be better than some.

>Having previously been clear, I'm a bit worried to say that it's turned a little more milky but there's still no odour from it.

Still perfectly normal discharge.  Clear or milky white discharge is an excellent sign of pregnancy and not a sign that a dog should be put on antibiotics.  (You only need to google 'discharge' and 'pregnancy' along with 'champdogs forum' to get all previous posts up on the subject, which will concur almost always - how do I know?  Because my own bitch had this in both her normal pregnancies and I googled it on champdogs...).

synulox and clavamox appear to be the same drug marketed under different names.

> synulox and clavamox appear to be the same drug marketed under different names.

That possibility did occur to me although I didn't look it up

https://www.cuteness.com/article/side-effects-synulox
It would appear one name is used in the UK and the other in America.

I've not looked up how Clavaseptin fits into all this, but presumably it's just another penicillin based drug?

Maybe all these changes in name are the same - old drug with a new name LOL

Seems so .its very likely some uk vets are now using that supplied with the us name / packaging

Hello all,

True to my word I wanted to update the thread with the eventual outcome as I’ve found these really helpful over the years but their utility is pretty limited when you don’t know what the conclusion was.

We gave a 5 day run of the Clavaseptin, and the discharge stopped. It returned again for around a week later in the pregnancy too. And  gave a second 5 day run of it at this point too. In essence, she basically had some volume of mucous discharge for huge swathes of her pregnancy, only stopping in the final 2 weeks or so. When she popped her mucous plug a day or so before birth, the volume of mucous (egg white in appearance) was absolutely huge! But she seemed unfazed.

Today she gave birth to 5 pups (no stillbirths) and they all look very good. No birth defects and their birthweight is about 10% bigger than her last litter so that’s interesting.

Hope that proves to be of some use to someone one day and thanks to those who advised during her gestation.

J

Again, white mucous discharge is perfectly normal during pregnancy and not a need to use antibiotics.

And the effect of antibiotics means that puppies' birth weight is higher - this is well known effect, but not a reason to use antibiotics or a 'good' thing.  Curiously, human children given antibiotics below the age of 5yo are many times more likely to grow up to be obese, compared to children not given them.

The microbiome of animals given antibiotics is less diverse (so, the immune system is weaker) than those not given it.

Antibiotics have a purpose and a function and society would be in a mess without them, but they are not side-effect free - and I'm not talking about birth defects, but long-term implications...