If you are one of the more than 13 million people that have TB disease, you can potentially spread the disease to others.  You will need to begin taking antibiotics immediately, and continue to do so for at least six months.  Fortunately, you will begin feeling better within a month.  Unfortunately, you may be required to stay at a hospital for anywhere from two to four weeks to avoid spreading the disease. Only 1/3 of people with active primary TB have symptoms, which is part of the reason it is so prevalent. If you have an active TB infection, the infection is spreading within your body, and the infection is extremely contagious.  It will remain contagious for the first few weeks of treatment, and can easily be passed to others when you cough, sneeze, and even when you laugh, sing, or speak.  Accordingly, take care to preventing spreading TB by avoiding contact with others until your doctor tells you that your infection is no longer contagious. If you are diagnosed with active TB, your immediate contacts should be screened by a doctor, as they may also need to be treated or put on prophylactic treatment. Curing active TB requires a regimen of multiple antibiotics. Based on the local sensitivities of TB to drugs in your area, you will most likely be started on four drugs (isoniazid, rifampin, pyrazinamide, and ethambutol), each to be taken every day. Then, after sputum cultures come back with more specific sensitivities for the strain of TB that you have, your doctor may decrease some of these antibiotic and will also decide at that time how long you need to be on them.  Most people are on all four for two months, then two (isoniazid and rifampin) for four months. If the TB becomes resistant to these drugs, then your treatment will be different and may be longer. You will likely start feeling better in two weeks or so. Even if you begin to feel better, you must always complete the course of antibiotics in order for them to fully rid your body of TB bacteria. Never stop taking them early because you feel better or to try and save them for later. Not only must you complete the course of antibiotics your doctor prescribes, you must take the drugs every single day.  If this becomes challenging for you, work with your doctor to develop a plan to help you stay on top of your drug regimen.  For instance, someone from your treatment team may visit you in your home to ensure you’re taking your antibiotics, or you can set up a plan to visit a treatment facility everyday. Stopping or forgetting to take your antibiotics may allow your infection to become resistant to antibiotics.  This is not only extremely dangerous to you, it endangers those who may catch TB from you as well. If nothing else, missing doses will likely lead to your having to take antibiotics for a longer period of time. After completing your treatment and seeing a TB specialist to ensure your body is rid of the infectious bacteria, you will not need to get regular checkups; however, it is possible to catch TB again as a separate infection, so stay on the lookout for common symptoms, especially incessant coughing and pain in the chest. The most common type of active TB infection is pulmonary TB, which predominantly affects your lungs; however, if your TB infection has spread beyond your lungs, your doctor will likely recommend the same types of antibiotics for a longer period of treatment.  Examples of extra-pulmonary TB include: infection of lymph nodes, meningitis (covering of the brain), pericarditis (covering of the heart), and bone (called "Pott Disease"). Often, extrapulmonary TB infections require a full year of antibiotic treatment. If the infection has spread to you brain or heart, you may also be prescribed a corticosteroid.  This will help reduce the swelling and inflammation caused by your infection, and potentially ease any symptoms affecting your nervous and circulatory systems. You must complete the full course of antibiotics as prescribed in order to provide the best chance of a full recovery. If you’re pregnant or breastfeeding at the time of diagnosis, or become pregnant while taking TB medications, tell your doctor. Further, rifampin significantly diminishes the effectiveness of a number of different birth controls, making them almost completely ineffective. Make sure you are using a backup birth control (like condoms) if you are taking rifampin. Side effects associated with the antibiotics used to treat TB infections are rare.  Nonetheless, take care to record any side effects that you experience and share this information with your doctor. In particular, achy joints, excessive bruising and bleeding, persistent fever, loss of appetite, tingly in your extremities or around your mouth, stomach discomfort, and yellow skin or eyes should all be reported next time you see your doctor.  If you are taking isoniazid, you must abstain from drinking alcohol even in small amounts. The the combination of the two together can cause hepatitis. Rifampin may cause your urine to appear darker, or even orange.  This is normal, and is not cause for concern.

Summary: Understand what an active TB diagnosis means. Cover your mouth and nose. Take any prescribed antibiotics diligently. Consider getting assistance taking the antibiotics. Watch out for recurring symptoms of TB. Take antibiotics longer for extrapulmonary TB. Talk to your doctor if you’re pregnant. Watch out for the side effects of TB medication.


If your dog is urinating around the house, it may simply be marking. However, inappropriate urination can sometimes be a sign of a more serious problem, like a urinary tract infection. If you’re not sure what’s causing your dog’s behavior, schedule a visit with your vet.  Let your vet know when the behavior started and tell them if you’ve noticed your dog acting sick or displaying any other unusual behaviors or symptoms. Tell your vet about any recent changes in your dog’s home environment or routine, such as a move or the addition of a new pet. Sexually mature dogs that aren’t spayed or neutered are much more likely to mark than dogs that are fixed. If you haven’t already done so, schedule an appointment with your vet to get your dog fixed as soon as possible.   The earlier you neuter or spay your dog, the more likely it is that you can prevent or eliminate marking behaviors entirely.  If your dog already has a habit of marking, neutering may help, but you’ll probably need to combine it with training. Anxiety is a common cause of marking behaviors in dogs. While the best solution is usually to deal with the cause of the anxiety, medications can also help. Talk to your vet about giving your dog an anxiety medication to help it stay calm while you work on modifying the marking behavior. Your vet may prescribe an antidepressant medication, such as a tricyclic antidepressant or an SSRI (selective serotonin reuptake inhibitor), to help calm your dog and reduce marking behaviors. If other treatment approaches aren’t working or you just aren’t sure where to start, ask your vet to recommend an animal behaviorist. They can help you get to the root of the marking problem and suggest strategies for changing your dog’s behavior.  Before taking your dog straight to a behaviorist, it’s a good idea to see a vet first. Not only can they recommend a reputable behaviorist, but they can help rule out possible physical problems that a behaviorist won’t be able to diagnose or treat.  A behaviorist can also help you determine whether your dog is truly marking or if you’re seeing another type of behavior problem, such as submissive urination or poor housetraining.
Summary: See your vet to rule out underlying medical causes. Have your dog spayed or neutered. Ask your vet about medications to treat anxiety. Get a referral to a behavioral specialist if you need extra help.