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Cook AK, Behrend E. SGLT2 inhibitor use in the management of feline diabetes mellitus. J Vet Pharmacol Ther 2024. [PMID: 38954371 DOI: 10.1111/jvp.13466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Revised: 05/07/2024] [Accepted: 06/10/2024] [Indexed: 07/04/2024]
Abstract
Sodium-glucose cotransporter-2 (SGLT2) inhibitors are routinely used in the management of human type 2 diabetes and have been shown to effectively mitigate hyperglycemia and reduce the risks of cardiovascular and renal compromise. Two SGLT2 inhibitors, namely bexagliflozin and velagliflozin, were recently FDA approved for the treatment of uncomplicated feline diabetes mellitus. These oral hypoglycemic agents are a suitable option for many newly diagnosed cats, with rapid improvements in glycemic control and clinical signs. Suitable candidates must have some residual β-cell function, as some endogenous insulin production is required to prevent ketosis. Appropriate patient selection and monitoring are necessary, and practitioners should be aware of serious complications such as euglycemic diabetic ketoacidosis.
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Affiliation(s)
- Audrey K Cook
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas, USA
| | - Ellen Behrend
- Veterinary Information Network, Davis, California, USA
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2
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Mack C, Gibson JS, Meler E, Woldeyohannes S, Yuen N, Herndon A. Antimicrobial susceptibility patterns of aerobic bacteria isolated from canine urinary samples in South East Queensland, 2013 to 2018. Aust Vet J 2024; 102:362-368. [PMID: 38654674 DOI: 10.1111/avj.13333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 03/10/2024] [Accepted: 04/01/2024] [Indexed: 04/26/2024]
Abstract
Urinary tract infections are a common diagnosis in dogs presenting to veterinary practice. Veterinarians often treat suspected infections empirically, either in the absence of culture and susceptibility testing results or whilst waiting for them. This study aimed to identify the bacteria most frequently isolated from canine urinary samples and their antimicrobial susceptibility patterns in South East Queensland (SEQ) to help guide responsible empirical antimicrobial prescription by the veterinary community in this geographical location. Cumulative antibiograms were generated from the results of 1284 culture-positive urinary samples in SEQ, obtained from a commercial veterinary laboratory over a 5-year period. Escherichia coli was the most commonly isolated bacterial species (43%), followed by Staphylococcus spp. (23%), Proteus spp. (21%) and Enterococcus spp. (10%). Of the six most common isolates, 97% had susceptibility to at least one low-importance antimicrobial. Susceptibility to the low-importance and first-line antimicrobial recommendation, amoxicillin, was 81% for E. coli and 24% for Staphylococcus spp. Susceptibility of both E. coli and Staphylococcus spp. to medium-importance and commonly recommended empirical antimicrobials, trimethoprim sulphonamides and amoxicillin-clavulanic acid was ≥85% and >92% for high-importance antimicrobials enrofloxacin and ceftiofur. Of the E. coli and Staphylococcus spp. isolates, 8.8% and 4%, respectively, were considered multidrug resistant. There was no increase in resistance to antimicrobials detected over the study period. Susceptibilities suggest low- and medium-importance antimicrobials remain acceptable first-line empirical treatments. However, this should be continually assessed and updated using local surveillance data.
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Affiliation(s)
- C Mack
- School of Veterinary Science, University of Queensland, Gatton, Queensland, Australia
| | - J S Gibson
- School of Veterinary Science, University of Queensland, Gatton, Queensland, Australia
| | - E Meler
- School of Veterinary Science, University of Queensland, Gatton, Queensland, Australia
| | - S Woldeyohannes
- School of Veterinary Science, University of Queensland, Gatton, Queensland, Australia
| | - N Yuen
- School of Veterinary Science, University of Queensland, Gatton, Queensland, Australia
| | - A Herndon
- School of Veterinary Science, University of Queensland, Gatton, Queensland, Australia
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Niessen SJM, Kooistra HS, Forcada Y, Bjørnvad CR, Albrecht B, Roessner F, Herberich E, Kroh C. Efficacy and safety of once daily oral administration of sodium-glucose cotransporter-2 inhibitor velagliflozin compared with twice daily insulin injection in diabetic cats. J Vet Intern Med 2024. [PMID: 38884190 DOI: 10.1111/jvim.17124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 05/14/2024] [Indexed: 06/18/2024] Open
Abstract
BACKGROUND Options for treatment of diabetes mellitus in cats are limited to insulin injections and monitoring for hypoglycemia. HYPOTHESIS Once daily sodium-glucose cotransporter-2 inhibitor velagliflozin PO is noninferior to insulin injections. ANIMALS Client-owned diabetic cats (127 safety; 116 efficacy assessment). METHODS Prospective, randomized (1 mg/kg velagliflozin), positive controlled (titrated Caninsulin), open label, noninferiority field trial, comparing number of cats with treatment success in ≥1 clinical variable and ≥1 glycemic variable (margin Δ: 15%) on Day 45; secondary endpoints included glycemic and clinical assessments during 91 days. RESULTS On Day 45, 29/54 (54%) velagliflozin-treated cats and 26/62 (42%) Caninsulin-treated cats showed treatment success, demonstrating noninferiority (difference -11.8%; upper 1-sided 97.5% confidence interval, -∞ to 6.3%). By Day 91, quality of life (QoL), polyuria, and polydipsia had improved in 81%, 54% and 61% (velagliflozin); on blood glucose (BG) curves, mean BG was <252 mg/dL in 42/54 (78%; velagliflozin) and 37/62 (60%; Caninsulin); minimum BG was <162 mg/dL in 41/54 (76%; velagliflozin) and 41/62 (66%; Caninsulin); serum fructosamine was <450 μmol/L in 41/54 (76%; velagliflozin) and 38/62 (61%; Caninsulin). Velagliflozin's most frequent adverse events were loose feces/diarrhea (n = 23/61, 38%), positive urine culture (n = 19/61, 31%), and nonclinical hypoglycemia (BG <63 mg/dL; n = 8/61, 13%); Caninsulin's: clinical and nonclinical hypoglycemia (n = 35/66, 53%), positive urine culture (n = 18/66, 27%), and loose feces/diarrhea (n = 10/66, 15%). Diabetic ketoacidosis occurred in 4/61 (7%; velagliflozin) and 0/66 (Caninsulin). CONCLUSIONS AND CLINICAL IMPORTANCE Once daily oral administration of velagliflozin was noninferior to insulin injections, showed good QoL and glycemia without clinical hypoglycemia.
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Affiliation(s)
- Stijn J M Niessen
- Veterinary Specialist Consultations & VIN Europe, Hilversum, The Netherlands
- Royal Veterinary College, University of London, Hertfordshire, United Kingdom
| | - Hans S Kooistra
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - Yaiza Forcada
- Veterinary Specialist Consultations & VIN Europe, Hilversum, The Netherlands
- Royal Veterinary College, University of London, Hertfordshire, United Kingdom
| | | | - Balazs Albrecht
- Boehringer Ingelheim Vetmedica GmbH, Ingelheim am Rhein, Germany
| | | | - Esther Herberich
- Boehringer Ingelheim Vetmedica GmbH, Ingelheim am Rhein, Germany
| | - Carla Kroh
- Boehringer Ingelheim Vetmedica GmbH, Ingelheim am Rhein, Germany
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Simon KE, Russell K, Mondino A, Yang CC, Case BC, Anderson Z, Whitley C, Griffith E, Gruen ME, Olby NJ. A randomized, controlled clinical trial demonstrates improved owner-assessed cognitive function in senior dogs receiving a senolytic and NAD+ precursor combination. Sci Rep 2024; 14:12399. [PMID: 38811634 PMCID: PMC11137034 DOI: 10.1038/s41598-024-63031-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2024] [Accepted: 05/23/2024] [Indexed: 05/31/2024] Open
Abstract
Age-related decline in mobility and cognition are associated with cellular senescence and NAD + depletion in dogs and people. A combination of a novel NAD + precursor and senolytic, LY-D6/2, was examined in this randomized controlled trial. Seventy dogs with mild to moderate cognitive impairment were enrolled and allocated into placebo, low or full dose groups. Primary outcomes were change in cognitive impairment measured with the owner-reported Canine Cognitive Dysfunction Rating (CCDR) scale and change in activity measured with physical activity monitors. Fifty-nine dogs completed evaluations at the 3-month primary endpoint, and 51 reached the 6-month secondary endpoint. There was a significant difference in CCDR score across treatment groups from baseline to the primary endpoint (p = 0.02) with the largest decrease in the full dose group. No difference was detected between groups using in house cognitive testing. There were no significant differences between groups in changes in measured activity. The proportion of dogs that improved in frailty and owner-reported activity levels and happiness was higher in the full dose group than other groups, however this difference was not significant. Adverse events occurred equally across groups. All groups showed improvement in cognition, frailty, and activity suggesting placebo effect and benefits of trial participation. We conclude that LY-D6/2 improves owner-assessed cognitive function over a 3-month period and may have broader, but more subtle effects on frailty, activity and happiness as reported by owners.
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Affiliation(s)
- Katherine E Simon
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
| | - Katharine Russell
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
- Southeast Veterinary Neurology, Miami, FL, USA
| | - Alejandra Mondino
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
| | - Chin-Chieh Yang
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
| | - Beth C Case
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
| | - Zachary Anderson
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
| | - Christine Whitley
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
| | - Emily Griffith
- Department of Statistics, College of Sciences, North Carolina State University, Raleigh, NC, USA
| | - Margaret E Gruen
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
| | - Natasha J Olby
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA.
- Comparative Medicine Institute, NC State University, Raleigh, NC, USA.
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Temmerman R, Berlamont H, El Garch F, Rose M, Simjee S, Meschi S, de Jong A. Antimicrobial Susceptibility of Canine and Feline Urinary Tract Infection Pathogens Isolated from Animals with Clinical Signs in European Veterinary Practices during the Period 2013-2018. Antibiotics (Basel) 2024; 13:500. [PMID: 38927167 PMCID: PMC11200364 DOI: 10.3390/antibiotics13060500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2024] [Revised: 05/24/2024] [Accepted: 05/27/2024] [Indexed: 06/28/2024] Open
Abstract
Bacterial urinary tract infections (UTIs) occur frequently in companion animals and are often treated with antibiotics. However, antimicrobial resistance can severely hamper treatment success. Therefore, antimicrobial susceptibility monitoring is key. UTI isolates were obtained from dogs and cats in two collection periods (ComPath II: 2013-2014 and ComPath III: 2017-2018) as part of CEESA's ComPath programme. Susceptibility testing of the UTI isolates (2021 in total) was carried out at one central laboratory using agar and broth dilution methodology as recommended by the Clinical and Laboratory Standards Institute. Escherichia coli was the most frequently isolated bacterium in UTI in both dogs (46.9%, 43.1%) and cats (61.2%, 48.3%) across ComPath II and ComPath III, respectively. The percentage of resistance in E. coli was low (<10%) across both programmes in both dogs and cats except for trimethoprim-sulfamethoxazole (dogs ComPath III: 12.9%; cats ComPath II: 13.0%) and enrofloxacin (10.5%), marbofloxacin (11.4%), and doxycycline (98.8%) for dogs in ComPath III. Three (7.5%) of the 40 isolated S. aureus bacteria in total were MRSA and harboured mecA. The level of multidrug resistance (MDR) was generally low and ranged from 0.0% for feline coagulase-negative Staphylococcus spp. to 11.7% for canine Proteus spp., except for a peak of MDR observed in canine Klebsiella isolates from ComPath II (36.7%). Overall, antimicrobial resistance for most canine and feline UTI pathogens isolated during the ComPath II and ComPath III programmes was low (1-10%) to moderate (10-20%).
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LeVine DN, Goggs R, Kohn B, Mackin AJ, Kidd L, Garden OA, Brooks MB, Eldermire ERB, Abrams-Ogg A, Appleman EH, Archer TM, Bianco D, Blois SL, Brainard BM, Callan MB, Fellman CL, Haines JM, Hale AS, Huang AA, Lucy JM, O'Marra SK, Rozanski EA, Thomason JM, Walton JE, Wilson HE. ACVIM consensus statement on the treatment of immune thrombocytopenia in dogs and cats. J Vet Intern Med 2024. [PMID: 38779941 DOI: 10.1111/jvim.17079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Accepted: 04/04/2024] [Indexed: 05/25/2024] Open
Abstract
Management of immune thrombocytopenia (ITP) in dogs and cats is evolving, but there are no evidence-based guidelines to assist clinicians with treatment decisions. Likewise, the overall goals for treatment of ITP have not been established. Immunosuppressive doses of glucocorticoids are the first line treatment, but optimal treatment regimens beyond glucocorticoids remain uncertain. Additional options include secondary immunosuppressive drugs such as azathioprine, modified cyclosporine, and mycophenolate mofetil, usually selected based on clinician preference. Vincristine, human IV immunoglobulin (hIVIg), and transfusion of platelet or red blood cell-containing products are often used in more severe cases. Splenectomy and thrombopoietin receptor agonists are usually reserved for refractory cases, but when and in which patient these modalities should be employed is under debate. To develop evidence-based guidelines for individualized treatment of ITP patients, we asked 20 Population Intervention Comparison Outcome (PICO) format questions. These were addressed by 17 evidence evaluators using a literature pool of 288 articles identified by a structured search strategy. Evidence evaluators, using panel-designed templates and data extraction tools, summarized evidence and created guideline recommendations. These were integrated by treatment domain chairs and then refined by iterative Delphi survey review to reach consensus on the final guidelines. In addition, 19 non-PICO questions covering scenarios in which evidence was lacking or of low quality were answered by expert opinion using iterative Delphi surveys with panelist integration and refinement. Commentary was solicited from multiple relevant professional organizations before finalizing the consensus. The rigorous consensus process identified few comparative treatment studies, highlighting many areas of ITP treatment requiring additional studies. This statement is a companion manuscript to the ACVIM Consensus Statement on the Diagnosis of Immune Thrombocytopenia in Dogs and Cats.
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Affiliation(s)
- Dana N LeVine
- Department of Clinical Sciences, College of Veterinary Medicine, Auburn University, Auburn, Alabama, USA
| | - Robert Goggs
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA
| | - Barbara Kohn
- Small Animal Clinic, School of Veterinary Medicine, Freie Universität Berlin, Berlin, Germany
| | - Andrew J Mackin
- Department of Clinical Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, Mississippi, USA
| | - Linda Kidd
- Linda Kidd Veterinary Internal Medicine Consulting, Carlsbad, California, USA
| | - Oliver A Garden
- School of Veterinary Medicine, Louisiana State University, Baton Rouge, Louisiana, USA
| | - Marjory B Brooks
- Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA
| | - Erin R B Eldermire
- Flower-Sprecher Veterinary Library, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA
| | - Anthony Abrams-Ogg
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
| | - Elizabeth H Appleman
- Department of Internal Medicine, The Animal Medical Center, New York, New York, USA
| | - Todd M Archer
- Bluff City Veterinary Specialists, Memphis, Tennessee, USA
| | - Domenico Bianco
- College of Veterinary Medicine, Western University of Health Sciences, Pomona, California, USA
| | - Shauna L Blois
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
| | - Benjamin M Brainard
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, Georgia, USA
| | - Mary Beth Callan
- Department of Clinical Sciences and Advanced Medicine, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Claire L Fellman
- Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, Massachusetts, USA
| | - Jillian M Haines
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Washington State University, Pullman, Washington, USA
| | - Anne S Hale
- Zia Pet Hospital, Rio Rancho, New Mexico, USA
| | | | - John M Lucy
- Oradell Animal Hospital, Paramus, New Jersey, USA
| | - Shana K O'Marra
- Northwest Veterinary Critical Care Services, Vancouver, Washington, USA
| | - Elizabeth A Rozanski
- Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, Massachusetts, USA
| | - John M Thomason
- Department of Clinical Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, Mississippi, USA
| | - Jenny E Walton
- Veterinary Apheresis Service UK, Washington, Tyne and Wear, United Kingdom
| | - Helen E Wilson
- Langford Vets, University of Bristol, Langford, Somerset, United Kingdom
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Weese JS, Mosher M, Low R, West E, O'Kelley B, Morrison JA, Kimmerlein A, St. Bernard S, Blackie K, Gronlund U, Battersby I. Evaluation of antimicrobial purchasing by companion animal veterinary facilities in Canada, the United Kingdom, and the United States of America (2019-2021). J Vet Intern Med 2024; 38:1520-1534. [PMID: 38660791 PMCID: PMC11099783 DOI: 10.1111/jvim.17068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 03/26/2024] [Indexed: 04/26/2024] Open
Abstract
BACKGROUND Measuring antimicrobial use is a core component of antimicrobial stewardship. Purchasing data may be easier to obtain than prescription data in some situations, but differences in clinic size, caseload and collection timeframes must be considered. OBJECTIVE Our objective was to evaluate purchases of systemic antibacterial agents by small animal veterinary facilities in 5 networks across 3 countries, using a mg/veterinarian full time equivalent (FTE)/week as the metric. METHODS Data were obtained from purchasing records of 2194 veterinary facilities from networks from the United States (US, n = 3: US-A, 1036 facilities; US-B, 101 facilities; US-C, 886 facilities), Canada (n = 1: 117 facilities) and the United Kingdom (UK, n = 1: 54 facilities) during 2019-2021. RESULTS In total, 20 020 269 767 mg (20.02 t) of antimicrobials were purchased. Overall differences between the UK and North America were driven by significantly higher purchases of amoxicillin-clavulanic acid in the UK (P < .001), with substantially less purchasing of third generation cephalosporins in the UK (P < .0001). A significant association was found between FTE and purchasing, with decreased purchasing (mg/FTE/week) as facility FTE increased. Significant differences also were found among US regions. Facilities in the top 10% of total purchasing accounted for 23%-30% of purchases, compared to only 1.6%-3.8% for the bottom 10%. CONCLUSIONS AND CLINICAL IMPORTANCE These data provide useful information about general purchasing trends, inter- and intraregional differences and differences among facility types and identify high purchasing outliers for further investigation.
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Affiliation(s)
| | | | | | | | - Ben O'Kelley
- BluePearl Veterinary Partners LLCTampaFloridaUSA
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Robbins SN, Goggs R, Kraus‐Malett S, Goodman L. Effect of institutional antimicrobial stewardship guidelines on prescription of critically important antimicrobials for dogs and cats. J Vet Intern Med 2024; 38:1706-1717. [PMID: 38465850 PMCID: PMC11099728 DOI: 10.1111/jvim.17043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 02/28/2024] [Indexed: 03/12/2024] Open
Abstract
BACKGROUND Veterinary hospital antimicrobial stewardship (AMS) guidelines might help combat antimicrobial resistance (AMR). OBJECTIVES Determine the conditions and types of infection for which antimicrobial drugs (AMDs) deemed critically important (CIA) by the World Health Organization (WHO) were prescribed and assess the effect of hospital AMS guidelines on adherence to International Society for Companion Animal Infectious Diseases published guidelines for the treatment of superficial bacterial folliculitis, respiratory tract disease and urinary tract infection in these cases. ANIMALS Dogs and cats managed at an academic veterinary hospital from 1/21 to 6/21 and 9/21 to 6/22. METHODS Prescriptions of cephalosporins (third or fourth generation), glycopeptides, macrolides/ketolides, polymyxins, and quinolones were identified. Data on culture and susceptibility (C/S) testing and previous AMD exposure were collected. Frequencies were compared between time periods using Fisher's exact test with Bonferroni corrections. RESULTS In animals prescribed ≥1 WHO-CIA AMD, fluoroquinolones were the most frequently prescribed WHO-CIA class in dogs (567/1724, 32.9%) and cats (192/450, 42.7%). No animals were prescribed carbapenems, dihydrofolate reductase inhibitors/sulfonamides, or polymyxins. No cats were prescribed aminoglycosides or amphenicols. Institutional guidelines were followed in 57.8% (324/561) cases. The most frequent causes of nonadherence were failure to perform C/S testing 46.0% (109/237) and unnecessary use of a higher-tier AMD 43.0% (102/237). Bacterial C/S testing was more frequently performed after AMS guideline institution (59.7% vs. 46.8%, P = 0.0006). CONCLUSIONS AND CLINICAL IMPORTANCE Adherence to published guidelines remained poor despite an increase in C/S testing. There were no changes in the frequencies of confirmed infections, positive cultures or AMD resistance between time periods.
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Affiliation(s)
- Sarah N. Robbins
- College of Veterinary MedicineCornell UniversityIthacaNew YorkUSA
| | - Robert Goggs
- College of Veterinary MedicineCornell UniversityIthacaNew YorkUSA
| | | | - Laura Goodman
- College of Veterinary MedicineCornell UniversityIthacaNew YorkUSA
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Kurtz M, Pey PBM, Mortier J, Manassero M, Da Riz F, Canonne‐Guibert M, Maurey C, Benchekroun G. Usefulness of serum amyloid A for the diagnosis of pyelonephritis in cats: A prospective evaluation. J Vet Intern Med 2024; 38:1542-1552. [PMID: 38669563 PMCID: PMC11099735 DOI: 10.1111/jvim.17082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 04/05/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND The diagnosis of pyelonephritis in cats is challenging and development of a noninvasive and accurate biomarker is needed. HYPOTHESES Serum amyloid A (SAA) is increased in cats with pyelonephritis, but not in cats with other urinary tract diseases. ANIMALS A cohort of 125 cats (149 observations). METHODS This was a prospective study. Group 1 included cats with a diagnosis of pyelonephritis either confirmed by bacterial culture of pelvic urine (Group 1a) or presumed (1b). Group 2 included cats for which pyelonephritis was ruled out (with certainty: Group 2a or judged unlikely: Group 2b). SAA concentration was compared between groups, and accuracy of SAA for the diagnosis of pyelonephritis was calculated using a Receiver Operating Characteristic (ROC) curve analysis. RESULTS Median SAA concentration was significantly higher in Group 1a (86.8 mg/L [73.3; 161.5]; n = 8) than in Group 2a (4 mg/L [1.8; 5.6], n = 19; P < .001) and in Group 2b (5.4 mg/L [3.1; 9.7], n = 113; P < .001). It was also significantly higher in Group 1b (98.8 mg/L [83.1; 147.3]; n = 9) than in Group 2b (P < .001) and Group 2a (P < .001). Optimal diagnostic cut-off for SAA concentration was 51.3 mg/L. yielding a sensitivity of 88% (95% confidence interval: [64%; 99%]) and a specificity of 94% (95% confidence interval: [88%; 97%]). CONCLUSIONS AND CLINICAL IMPORTANCE Measurement of SAA could be used to rule out pyelonephritis in the case of low suspicion of the disease. Increased SAA concentration is suggestive of pyelonephritis despite a lack of specificity.
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Affiliation(s)
- Maxime Kurtz
- École Nationale Vétérinaire d'Alfort, CHUVAService de Médecine InterneMaisons‐AlfortFrance
| | - Pascaline Bénédicte Marie Pey
- Antech Imaging ServicesIrvineCaliforniaUSA
- Veterinary Hospital “I Portoni Rossi,” Anicura, Zola Predosa (BO)BolognaItaly
| | - Jérémy Mortier
- Ecole Nationale Vétérinaire d'Alfort, CHUVAService D'Imagerie MédicaleMaisons‐AlfortFrance
| | - Mathieu Manassero
- École Nationale Vétérinaire d'Alfort, CHUVAService de ChirurgieMaisons‐AlfortFrance
| | - Fiona Da Riz
- École Nationale Vétérinaire d'Alfort, CHUVAService de Médecine InterneMaisons‐AlfortFrance
| | - Morgane Canonne‐Guibert
- École Nationale Vétérinaire d'Alfort, CHUVAService de Médecine InterneMaisons‐AlfortFrance
- Ecole Nationale Vétérinaire d'Alfort, CHUVAService D'Imagerie MédicaleMaisons‐AlfortFrance
| | - Christelle Maurey
- École Nationale Vétérinaire d'Alfort, CHUVAService de Médecine InterneMaisons‐AlfortFrance
| | - Ghita Benchekroun
- École Nationale Vétérinaire d'Alfort, CHUVAService de Médecine InterneMaisons‐AlfortFrance
- Ecole Nationale Vétérinaire d'AlfortUniv Paris Est Créteil, INSERM, IMRBMaisons‐AlfortFrance
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Moni CA, Dias ME, Lopes CE, Siqueira FM. Escherichia coli isolated from pyometra and cystitis in the same animal exhibit a wide phenotypic similarity. J Appl Microbiol 2024; 135:lxae108. [PMID: 38692849 DOI: 10.1093/jambio/lxae108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Revised: 04/09/2024] [Accepted: 04/29/2024] [Indexed: 05/03/2024]
Abstract
AIMS Pyometra and cystitis caused by Escherichia coli are common diseases identified in canine or feline females. The origin of pyometra infection remains uncertain, and effective prevention strategies for this disease are still unknown. This study aimed to provide a phenotypic characterization, including antimicrobial resistance and virulence profiles, of endometrial pathogenic (EnPEC) and uropathogenic (UPEC) E. coli strains isolated simultaneously from the same animal. METHODS AND RESULTS Sixteen E. coli strains, from eight different animals, were analyzed in this study. The antimicrobial susceptibility profile of EnPEC and UPEC strains was determined using the disc diffusion method, which showed a similar susceptibility profile among strains (EnPEC and UPEC) from the same animal. The virulence profile of the strains was assessed through biofilm formation, as well as serum resistance abilities. EnPEC and UPEC strains from the same animal exhibited slight variations in their virulence and antimicrobial resistance capabilities. Overall, most of the strain pairs showed a high similarity in their ability to establish biofilms and survive in serum complement activity. CONCLUSIONS Overall, strains of E. coli isolated from both pyometra and cystitis in the same animal, despite presenting distinct clinical diseases, exhibit a wide phenotypic similarity, suggesting a common origin for the strains.
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Affiliation(s)
- Camila Azevedo Moni
- Laboratório de Bacteriologia Veterinária, Universidade Federal do Rio Grande do Sul, Av. Bento Gonçalves, 9090, 91540-000 Porto Alegre, RS, Brazil
| | - Maria Eduarda Dias
- Laboratório de Bacteriologia Veterinária, Universidade Federal do Rio Grande do Sul, Av. Bento Gonçalves, 9090, 91540-000 Porto Alegre, RS, Brazil
| | - Cassiane Elisabete Lopes
- Laboratório de Bacteriologia Veterinária, Universidade Federal do Rio Grande do Sul, Av. Bento Gonçalves, 9090, 91540-000 Porto Alegre, RS, Brazil
- Programa de Pós-Graduação em Ciências Veterinárias, Universidade Federal do Rio Grande do Sul, Av. Bento Gonçalves, 9090, 91540-000 Porto Alegre, RS, Brazil
| | - Franciele Maboni Siqueira
- Laboratório de Bacteriologia Veterinária, Universidade Federal do Rio Grande do Sul, Av. Bento Gonçalves, 9090, 91540-000 Porto Alegre, RS, Brazil
- Programa de Pós-Graduação em Ciências Veterinárias, Universidade Federal do Rio Grande do Sul, Av. Bento Gonçalves, 9090, 91540-000 Porto Alegre, RS, Brazil
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11
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Quintavalla F, Basini G, Fidanzio F, Bussolati S, Sabetti MC, Crosta MC, Grolli S, Ramoni R. Blood plasma and urinary biomarkers of oxidative stress in cats with urethral obstruction. BMC Vet Res 2024; 20:163. [PMID: 38678221 PMCID: PMC11055255 DOI: 10.1186/s12917-024-04009-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 04/08/2024] [Indexed: 04/29/2024] Open
Abstract
BACKGROUND This study aimed to investigate variations of the oxidative status in cats affected by urethral obstruction (UO) under Feline Idiopathic Cystitis (FIC) and Bacterial Cystitis (BC), in comparison with a group of healthy subjects. In both groups, the levels of several markers (either direct or indirect) indicative of the oxidative attack and of the antioxidant response were analyzed on plasma and urine samples. In particular, the plasma samples were evaluated for nitric oxide (NO), hydroperoxides derived by reactive oxygen activity (d-ROMs test), superoxide anion (O2-), glutathione peroxidase activity (GPx), superoxide dismutase activity (SOD), and ferric reducing antioxidant power (FRAP test); while on urine the levels of NO, d-ROMs, FRAP, SOD, malondialdehyde (MDA) and 8-hydroxydeoxyguanosine (8-OHdG) were measured. Urine of UO patients was also subjected to urine-culture test. RESULTS The analytical data on plasma showed that UO, independently of the FIC or BC etiology, induced the insurgence of oxidative stress conditions at the systemic level. In the urine of the UO patients, except for SOD that increased, the markers of redox status were markedly decreased due probably their compromised filtration, thus suggesting involvement of renal function (assessed also by the high levels of plasma creatinine and proteinuria) with no oxidative damage of the lower urinary tract. Moreover, the adoption of a novel oxidative stress index' (OSI) allowed to establish, by means of a numerical value, the different degrees of oxidative stress conditions for single UO patients, both in terms of oxidative attack and antioxidant response. CONCLUSIONS Feline urethral obstruction, induced by Idiopathic Cystitis and Bacterial Cystitis, causes oxidative stress conditions at the systemic level that do not interest the lower urinary tract. Despite to the high variability of the profiles of oxidative stress indexes both in healthy and UO patients, the determination of OSI made possible the evaluation of their single degrees of oxidative stress. Possibly the results of this investigation can be compared with those of correspondent pathologies both in humans and in other animal species.
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Affiliation(s)
- Fausto Quintavalla
- Department of Veterinary Sciences, University of Parma, Via del Taglio 10, Parma, 43126, Italy
| | - Giuseppina Basini
- Department of Veterinary Sciences, University of Parma, Via del Taglio 10, Parma, 43126, Italy
| | - Francesca Fidanzio
- Department of Veterinary Sciences, University of Parma, Via del Taglio 10, Parma, 43126, Italy
| | - Simona Bussolati
- Department of Veterinary Sciences, University of Parma, Via del Taglio 10, Parma, 43126, Italy
| | - Maria Chiara Sabetti
- Department of Veterinary Sciences, University of Parma, Via del Taglio 10, Parma, 43126, Italy
| | | | - Stefano Grolli
- Department of Veterinary Sciences, University of Parma, Via del Taglio 10, Parma, 43126, Italy
| | - Roberto Ramoni
- Department of Veterinary Sciences, University of Parma, Via del Taglio 10, Parma, 43126, Italy.
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12
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Rocholl C, Zablotski Y, Schulz B. Online-Assisted Survey on Antibiotic Use by Pet Owners in Dogs and Cats. Antibiotics (Basel) 2024; 13:382. [PMID: 38786111 PMCID: PMC11117295 DOI: 10.3390/antibiotics13050382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2024] [Revised: 04/19/2024] [Accepted: 04/22/2024] [Indexed: 05/25/2024] Open
Abstract
The aim of the study was two-fold: first, to collect data on the use of antibiotics in Germany for dogs and cats and, second, their owners' experiences and opinions. Using an anonymous online survey, dog and cat owners were asked about the last antibiotic administration in their pet. The inclusion criterion was any antibiotic administration within the last year. A total of 708 questionnaires from 463 dogs and 245 cats could be evaluated. Diarrhea was reported as the most common reason for antibiotic administration in dogs (18.4%). Wound infection/abscess/bite injury was the second most common reason in dogs (16.0%). In cats wound infection/abscess/bite injury was the most common reason (23.3%), followed by dental treatment (21.2%) and upper respiratory tract infections (16.7%). The most common antibiotics used systemically in both species were amoxicillin/clavulanic acid (32.5%), amoxicillin (14.8%), metronidazole (6.9%), and doxycycline (6.8%). While efficacy (99.9%) and tolerability (94.8%) were rated as most important for the choice of antibiotics, costs (51.6%) were cited as predominantly unimportant. First-line antibiotics were used significantly more often than critically important antibiotics. The majority of animal owners show awareness for avoidance of antibiotic resistance and the use of critically important antibiotics.
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Affiliation(s)
- Clara Rocholl
- Clinic of Small Animal Medicine, Centre for Clinical Veterinary Medicine, Ludwig Maximilian University of Munich, 80539 Munich, Germany
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13
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Lomiya MAE, Raguvaran R, Mondal D, Dosar S, Nair SS, Jitha KR, Chandni AR, Thakur NS, Yadav N, Jambagi K. Mitigating antimicrobial resistance, an approach to stewardship in canine urinary tract infection. Vet Res Commun 2024:10.1007/s11259-024-10387-z. [PMID: 38647986 DOI: 10.1007/s11259-024-10387-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2024] [Accepted: 04/17/2024] [Indexed: 04/25/2024]
Abstract
Urinary tract infection (UTI) caused by antimicrobial resistant bacteria is common in dogs leading to serious health impact in pet animal as well as on human health. Understanding the prevalent uropathogens and their drug susceptibility is essential for limiting the antimicrobial resistance through implementation of stewardship policies. In view of this, present study was envisaged to determine the prevalent bacterial uropathogens and their antibiogram from clinical cases of canine UTI. Urine samples were collected from 35 dogs presented with clinical signs of UTI and a total of 27 bacterial isolates were recovered. Among that Escherichia coli was the most predominant isolate followed by Klebsiella aerogenes, Staphylococcus aureus, Proteus mirabilis, Enterococcus sp. and Citrobacter freundii. All isolates were found resistant to one or more 1st line antibiotics recommended by consensus guidelines and 70% of total isolates showed multidrug resistance. Additionally, this study evaluated the weightage of empirical therapy as per the consensus guidelines over antimicrobial susceptibility test guided treatment. Dogs with uncomplicated UTI were selected and categorized into three different groups (n = 6). Group 1 was treated with common empirical choice amoxycillin-clavulanic acid and dogs showed susceptible to ciprofloxacin were kept in Group 2 and treated with ciprofloxacin along with urinary alkalizer disodium hydrogen citrate. Nitrofurantoin susceptible cases were kept in Group 3 and treated with a combination of nitrofurantoin and urinary acidifier ammonium chloride. Therapeutic outcome was evaluated and success rate was higher in Group 2 and 3 than Group 1 suggested that selection of antibiotics with the use of local or institutional antibiogram data is more considerate than acknowledged international guidelines in the existing situation.
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Affiliation(s)
- M A Ensha Lomiya
- Division of Medicine, Indian council of Agricultural Research- Indian Veterinary Research Institute, Bareilly, Uttar Pradesh, India
| | - R Raguvaran
- Division of Medicine, Indian council of Agricultural Research- Indian Veterinary Research Institute, Bareilly, Uttar Pradesh, India.
| | - Debabrata Mondal
- Division of Medicine, Indian council of Agricultural Research- Indian Veterinary Research Institute, Bareilly, Uttar Pradesh, India
| | - Shivangi Dosar
- Division of Medicine, Indian council of Agricultural Research- Indian Veterinary Research Institute, Bareilly, Uttar Pradesh, India
| | - Sonu S Nair
- Division of Bacteriology and Mycology, Indian council of Agricultural Research- Indian Veterinary Research Institute, Bareilly, Uttar Pradesh, India
| | - K R Jitha
- Division of Public Health, Indian council of Agricultural Research- Indian Veterinary Research Institute, Bareilly, Uttar Pradesh, India
| | - A R Chandni
- Division of Public Health, Indian council of Agricultural Research- Indian Veterinary Research Institute, Bareilly, Uttar Pradesh, India
| | - Navjot Singh Thakur
- Division of Medicine, Indian council of Agricultural Research- Indian Veterinary Research Institute, Bareilly, Uttar Pradesh, India
| | - Narayani Yadav
- Division of Medicine, Indian council of Agricultural Research- Indian Veterinary Research Institute, Bareilly, Uttar Pradesh, India
| | - Kaveri Jambagi
- Division of Medicine, Indian council of Agricultural Research- Indian Veterinary Research Institute, Bareilly, Uttar Pradesh, India
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14
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Mandese WW, Suero M, Reynolds PS, Kariyawasam S, Beatty S, Griffin F. Urinalysis and culture results of free-catch urine samples in dogs: a randomised controlled trial. J Small Anim Pract 2024. [PMID: 38622928 DOI: 10.1111/jsap.13730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Revised: 02/05/2024] [Accepted: 03/20/2024] [Indexed: 04/17/2024]
Abstract
OBJECTIVES To evaluate the prevalence of bacterial presence in free-catch urine samples preceded by either a standardised prepped ("clean-catch") protocol versus unprepped (non-cleaned) voiding. MATERIALS AND METHODS The study was a single-centre prospective single-blinded randomised controlled trial. Urine samples were obtained from 100 client-owned dogs presenting for routine evaluation. Dogs were randomly assigned to either the prepped group (preputial or peri-vulvar area cleaned with sterile saline before collection) or the unprepped group (no preliminary cleansing) stratified by sex. Urinalysis and urine culture (blood and MacConkey agar) were performed on all samples. Significant bacterial presence on urine culture was defined as >104 colony forming units (CFU)/mL. RESULTS There were no statistically significant associations between prepped versus unprepped collection method or sex with a urinalysis positive for bacteriuria. However, on culture, significant bacterial growth was almost five times more likely to be associated with males relative to females (odds ratio 4.59, 95% confidence interval 1.61 to 13.10). The probability of finding a positive culture was not statistically associated with prep method (odds ratio 1.43, 95% confidence interval 0.50 to 4.08). CLINICAL SIGNIFICANCE For the majority of dogs without clinical signs of urinary tract infection, free-catch urine collection does not result in significant bacteriuria found on analysis or culture. The presence of bacteria found in free-catch samples may be secondary to sample contamination or subclinical bacteriuria. Sample contamination or subclinical bacteriuria may be more prevalent in male dogs.
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Affiliation(s)
- W W Mandese
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL, 32610-0126, USA
| | - M Suero
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL, 32610-0126, USA
| | - P S Reynolds
- Department of Anesthesiology, Statistics in Anesthesiology Research (STAR) Core, College of Medicine, University of Florida, Gainesville, FL, 32610-0126, USA
| | - S Kariyawasam
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL, 32610-0126, USA
| | - S Beatty
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL, 32610-0126, USA
| | - F Griffin
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL, 32610-0126, USA
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15
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Lea C, Kelly D. Single-step, non-surgical placement of permanent low-profile cystostomy tubes in dogs: 10 cases (2018-2023). J Small Anim Pract 2024. [PMID: 38616108 DOI: 10.1111/jsap.13732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 03/11/2024] [Accepted: 03/27/2024] [Indexed: 04/16/2024]
Abstract
OBJECTIVES Low-profile cystostomy tubes provide an alternative to conventional cystostomy tubes with external tubing. Previously, these have been placed surgically involving coeliotomy, cystotomy and cystopexy, or have been used as replacement tubes in existing stoma sites. The purpose of this study is to describe a technique for, and the outcomes of, single-step, non-surgical low-profile cystostomy tube placement. MATERIALS AND METHODS All cases that had single-step, non-surgical placement of low-profile cystotomy tube attempted at the authors' institutions were included in this study. Data, including success rates, outcomes and complications, were extracted from the medical records. RESULTS Ten client-owned dogs were inclided. Single-step, non-surgical placement was successful in eight out of 10 dogs, with placement being unsuccessful in two thus necessitating coeliotomy. The median duration that low-profile cystostomy tubes were in place was 7.0 months (range 4 days to 38 months). Seven of the eight dogs required replacement of their cystostomy tube. Mean time until first tube replacement was 103 days (range 13 to 363 days). CLINICAL SIGNIFICANCE Single-step, non-surgical placement of a low-profile cystostomy tube is a viable alternative to surgical placement. Lack of cystopexy does not appear to result in complications. Conversion to coeliotomy might be required if tube placement is not successful with this technique. Complications seen with non-surgical tube placement such as inadvertent tube removal were similar to those previously reported for surgically placed tubes.
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Affiliation(s)
- C Lea
- Southern Counties Veterinary Specialists, Ringwood, Hampshire, UK
| | - D Kelly
- Southern Counties Veterinary Specialists, Ringwood, Hampshire, UK
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16
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Frey E, Kedrowicz A, Hedgpeth MW. Decision making on antimicrobial use: Cat and dog owners' knowledge and preferences for veterinary communication. Vet Rec 2024; 194:e3411. [PMID: 37691448 DOI: 10.1002/vetr.3411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 07/05/2023] [Accepted: 08/21/2023] [Indexed: 09/12/2023]
Abstract
BACKGROUND Veterinarians' understanding of cat and dog owners' perceptions about antimicrobial use will enhance their ability to communicate with clients to uphold antimicrobial stewardship guidelines. METHODS A total of 571 cat and dog owners were surveyed via an online platform to understand their antimicrobial knowledge and preferences for veterinary communication in antimicrobial use decision making. Data were analysed descriptively and inferentially to determine relationships between variables. RESULTS Cat and dog owners' backgrounds had an impact their antimicrobial knowledge. Women, individuals with a university degree, those with a health/science background and those identifying as white had a higher level of knowledge of antibiotics and antibiotic resistance. Owners' trust in veterinarians positively impacts adherence to recommendations. Where there was a strong preference for one type of messaging regarding antimicrobial use and stewardship, the owner's background was not predictive of a difference in response. LIMITATIONS The study population was mostly white, which reflects the US population and the reported distribution of pet owners who own dogs and cats. Respondents may have been susceptible to recall bias and/or social desirability bias. CONCLUSION Veterinarians should tailor their communication to meet clients' level of knowledge and rely on competent communication to enhance understanding and facilitate adherence to antimicrobial stewardship guidelines.
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Affiliation(s)
- Erin Frey
- Department of Clinical Sciences, North Carolina State University College of Veterinary Medicine, Raleigh, North Carolina, USA
| | - April Kedrowicz
- Department of Clinical Sciences, North Carolina State University College of Veterinary Medicine, Raleigh, North Carolina, USA
| | - Mari-Wells Hedgpeth
- Department of Clinical Sciences, North Carolina State University College of Veterinary Medicine, Raleigh, North Carolina, USA
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17
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McClosky M, Cole S, Seidel EJ, Hess RS. Clinical Differences in Dogs with Enterococcal Bacteriuria Compared with Other Bacteriuria: A Retrospective, Case-Control Study. J Am Anim Hosp Assoc 2024; 60:53-59. [PMID: 38394693 DOI: 10.5326/jaaha-ms-7355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/05/2023] [Indexed: 02/25/2024]
Abstract
A retrospective case-control study was performed to determine the clinical differences between dogs with enterococcal bacteriuria (n = 96 cases) and control dogs with any other bacteriuria (n = 288). More dogs with nonenterococcal bacteriuria demonstrated lower urinary tract clinical signs such as hematuria, pollakiuria, and stranguria (40% versus 27%, P = .02). Recessed vulva (odds ratio [OR] 2.5, 95% confidence interval [CI] 1.4-4.2, P < .001), hyperadrenocorticism (OR 0.149, 95% CI 0.004-0.066, P = .03), chronic kidney disease (OR 2.29, 95% CI 1.14-4.51, P = .01), and myelopathy (OR 5.77, 95% CI 3.07-10.82, P < .001) were more common in dogs with enterococcal bacteriuria. Enterococcus spp. cases were more likely to have polymicrobial growth than controls (OR 28.52; 95% CI 12.63-69.62, P ≤ .001). Pugs (OR 7.4, 95% CI 2.6-19.9, P < .001), bearded collies (OR 24.3, 95% CI 2.9-205.5, P = .003), and Saint Bernards (OR 17.3, CI 1.9-154.4, P = .01) had increased odds of enterococcal growth compared with mixed-breed dogs. In the control (but not the case) population, there was an association between resolution of clinical signs and administration of antimicrobials (P = .01). The signalment, clinical signs, comorbidities, and response to therapy in dogs with enterococcal bacteriuria are different from dogs with other bacteriuria.
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Affiliation(s)
- Megan McClosky
- From the Department of Clinical Sciences and Advanced Medicine (M.M., E.J.S., R.S.H.), School of Veterinary Medicine, University of Pennsylvania Philadelphia, Pennsylvania
| | - Stephen Cole
- Department of Pathobiology (S.C.), School of Veterinary Medicine, University of Pennsylvania Philadelphia, Pennsylvania
| | - Emily J Seidel
- From the Department of Clinical Sciences and Advanced Medicine (M.M., E.J.S., R.S.H.), School of Veterinary Medicine, University of Pennsylvania Philadelphia, Pennsylvania
| | - Rebecka S Hess
- From the Department of Clinical Sciences and Advanced Medicine (M.M., E.J.S., R.S.H.), School of Veterinary Medicine, University of Pennsylvania Philadelphia, Pennsylvania
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18
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Kendall A, Byron JK, Westropp JL, Coates JR, Vaden S, Adin C, Oetelaar G, Bartges JW, Foster JD, Adams LG, Olby N, Berent A. ACVIM consensus statement on diagnosis and management of urinary incontinence in dogs. J Vet Intern Med 2024; 38:878-903. [PMID: 38217372 PMCID: PMC10937496 DOI: 10.1111/jvim.16975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 12/12/2023] [Indexed: 01/15/2024] Open
Abstract
Urinary incontinence (UI) is a disorder of micturition that can occur in dogs of any age, sex, and breed depending on the underlying cause and time of onset. Diagnosis and treatment for various causes of UI in dogs have been described by multiple comprehensive single author review articles, but large prospective clinical trials comparing treatment outcomes in veterinary medicine are lacking. The objectives of this consensus statement therefore are to provide guidelines on both recommended diagnostic testing and treatment for various causes of UI in dogs. Specifically, pathophysiology directly related to the canine urinary system will be reviewed and diagnostic and therapeutic challenges will be addressed. A panel of 12 experts in the field (8 small animal internists [L. Adams, J. Bartges, A. Berent, J. Byron, J. Foster, A. Kendall, S. Vaden, J. Westropp], 2 neurologists [J. Coates, N. Olby], 1 radiologist [G. Oetelaar], and 1 surgeon [C. Adin]) was formed to assess and summarize evidence in the peer-reviewed literature and to complement it with consensus recommendations using the Delphi method. Some statements were not voted on by all panelists. This consensus statement aims to provide guidance for management of both male and female dogs with underlying storage or voiding disorders resulting in UI.
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Affiliation(s)
- Allison Kendall
- Department of Veterinary Clinical SciencesNC State University College of Veterinary MedicineRaleighNorth CarolinaUSA
| | - Julie K. Byron
- Department of Veterinary Clinical SciencesThe Ohio State University College of Veterinary MedicineColumbusOhioUSA
| | - Jodi L. Westropp
- Department of Veterinary Medicine and EpidemiologyUniversity of CADavisCaliforniaUSA
| | - Joan R. Coates
- Department of Veterinary Medicine and SurgeryUniversity of Missouri College of Veterinary MedicineColumbiaMissouriUSA
| | - Shelly Vaden
- Department of Veterinary Clinical SciencesNC State University College of Veterinary MedicineRaleighNorth CarolinaUSA
| | - Chris Adin
- Department of Small Animal Clinical SciencesCollege of Veterinary Medicine, University of FloridaGainesvilleFloridaUSA
| | - Garrett Oetelaar
- VCA Canada Calgary Animal Referral and Emergency (CARE) CentreCalgaryAlbertaCanada
| | - Joe W. Bartges
- College of Veterinary MedicineUniversity of GeorgiaAthensGeorgiaUSA
| | | | - Larry G. Adams
- Department of Veterinary Clinical SciencesPurdue University College of Veterinary MedicineWest LafayetteIndianaUSA
| | - Natasha Olby
- Department of Veterinary Clinical SciencesNC State University College of Veterinary MedicineRaleighNorth CarolinaUSA
| | - Allyson Berent
- Service of Interventional Radiology and Interventional EndoscopyAnimal Medical CenterNew York CityNew YorkUSA
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19
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KuKanich KS, Anderson EE, Carcamo Tzic AD, KuKanich B. Florfenicol urinary excretion and its potential for treating canine urinary tract infections. J Vet Pharmacol Ther 2024. [PMID: 38420879 DOI: 10.1111/jvp.13434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 02/07/2024] [Accepted: 02/10/2024] [Indexed: 03/02/2024]
Abstract
The canine urinary excretion of florfenicol was evaluated to explore its potential for treating urinary tract infections. Nine healthy male intact purpose-bred Beagles and four healthy client-owned dogs each received a single oral dose of florfenicol 20 mg/kg (300 mg/mL parenteral solution) with food. All voluntary urinations were collected for 12 h. Although florfenicol is reportedly bitter tasting, 7/9 Beagles and 4/4 client-owned dogs completely ingested the florfenicol and were enrolled; salivation (n = 1) and headshaking (n = 3) were observed. The last measured urine florfenicol concentrations were variable: Beagles (0.23-3.19 mcg/mL), Pug (3.01 mcg/mL) English Setter (21.29 mcg/mL), Greyhound (32.68 mcg/mL), and Standard Poodle (13.00 mcg/mL). Urine half-life was similar for the Beagles and the Pug, 0.75-1.39 h, whereas the half-life was 1.70-1.82 h for the English Setter, Greyhound, and Standard Poodle. Larger breed dogs exceeded 8 mcg/mL florfenicol (wild-type cutoff) in their urine at 12 h, whereas the Beagles and Pug had <8 mcg/mL; it is unclear if this is an individual, breed, or size difference. These data suggest oral florfenicol may need to be administered q6-12h for canine urinary tract infections, but further data are needed (more enrolled dogs, multiple-dose regimens) before considering clinical trials or breed-specific differences.
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Affiliation(s)
- Kate S KuKanich
- Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, Manhattan, Kansas, USA
| | - Elayna E Anderson
- Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, Manhattan, Kansas, USA
| | - Astrid D Carcamo Tzic
- Department of Anatomy & Physiology, College of Veterinary Medicine, Kansas State University, Manhattan, Kansas, USA
| | - Butch KuKanich
- Department of Anatomy & Physiology, College of Veterinary Medicine, Kansas State University, Manhattan, Kansas, USA
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20
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Abad-Fau A, Sevilla E, Oro A, Martín-Burriel I, Moreno B, Morales M, Bolea R. Multidrug resistance in pathogenic Escherichia coli isolates from urinary tract infections in dogs, Spain. Front Vet Sci 2024; 11:1325072. [PMID: 38585298 PMCID: PMC10996866 DOI: 10.3389/fvets.2024.1325072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 02/12/2024] [Indexed: 04/09/2024] Open
Abstract
Escherichia coli (E. coli) is a pathogen frequently isolated in cases of urinary tract infections (UTIs) in both humans and dogs and evidence exists that dogs are reservoirs for human infections. In addition, E. coli is associated to increasing antimicrobial resistance rates. This study focuses on the analysis of antimicrobial resistance and the presence of selected virulence genes in E. coli isolates from a Spanish dog population suffering from UTI. This collection of isolates showed an extremely high level of phenotypic resistance to 1st-3rd generation cephalosporins, followed by penicillins, fluoroquinolones and amphenicols. Apart from that, 13.46% of them were considered extended-spectrum beta-lactamase producers. An alarmingly high percentage (71.15%) of multidrug resistant isolates were also detected. There was a good correlation between the antimicrobial resistance genes found and the phenotypic resistance expressed. Most of the isolates were classified as extraintestinal pathogenic E. coli, and two others harbored virulence factors related to diarrheagenic pathotypes. A significant relationship between low antibiotic resistance and high virulence factor carriage was found, but the mechanisms behind it are still poorly understood. The detection of high antimicrobial resistance rates to first-choice treatments highlights the need of constant antimicrobial resistance surveillance, as well as continuous revision of therapeutic guidelines for canine UTI to adapt them to changes in antimicrobial resistance patterns.
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Affiliation(s)
- Ana Abad-Fau
- Departamento de Patología Animal, Facultad de Veterinaria, Instituto Agroalimentario de Aragón-IA2, Universidad de Zaragoza, Zaragoza, Spain
| | - Eloisa Sevilla
- Departamento de Patología Animal, Facultad de Veterinaria, Instituto Agroalimentario de Aragón-IA2, Universidad de Zaragoza, Zaragoza, Spain
- Centro de Encefalopatías y Enfermedades Transmisibles Emergentes, Facultad de Veterinaria, Universidad de Zaragoza, Zaragoza, Spain
| | - Ainara Oro
- Departamento de Patología Animal, Facultad de Veterinaria, Instituto Agroalimentario de Aragón-IA2, Universidad de Zaragoza, Zaragoza, Spain
| | - Inmaculada Martín-Burriel
- Laboratorio de Genética Bioquímica, Facultad de Veterinaria, Instituto Agroalimentario de Aragon, Universidad de Zaragoza, Zaragoza, Spain
| | - Bernardino Moreno
- Departamento de Patología Animal, Facultad de Veterinaria, Instituto Agroalimentario de Aragón-IA2, Universidad de Zaragoza, Zaragoza, Spain
- Centro de Encefalopatías y Enfermedades Transmisibles Emergentes, Facultad de Veterinaria, Universidad de Zaragoza, Zaragoza, Spain
| | - Mariano Morales
- Departamento de Patología Animal, Facultad de Veterinaria, Instituto Agroalimentario de Aragón-IA2, Universidad de Zaragoza, Zaragoza, Spain
- Albéitar Laboratories, Zaragoza, Spain
| | - Rosa Bolea
- Departamento de Patología Animal, Facultad de Veterinaria, Instituto Agroalimentario de Aragón-IA2, Universidad de Zaragoza, Zaragoza, Spain
- Centro de Encefalopatías y Enfermedades Transmisibles Emergentes, Facultad de Veterinaria, Universidad de Zaragoza, Zaragoza, Spain
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21
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Acharya KR, Cohen A, Brankston G, Soucy JPR, Hulth A, Löfmark S, Brownstein JS, Davidovich N, Ellen ME, Fisman DN, Moran-Gilad J, Steinman A, MacFadden DR, Greer AL. An Evaluation of the Impact of an OPEN Stewardship Generated Feedback Intervention on Antibiotic Prescribing among Primary Care Veterinarians in Canada and Israel. Animals (Basel) 2024; 14:626. [PMID: 38396594 PMCID: PMC10885889 DOI: 10.3390/ani14040626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 02/06/2024] [Accepted: 02/09/2024] [Indexed: 02/25/2024] Open
Abstract
An interrupted time-series study design was implemented to evaluate the impact of antibiotic stewardship interventions on antibiotic prescribing among veterinarians. A total of 41 veterinarians were enrolled in Canada and Israel and their prescribing data between 2019 and 2021 were obtained. As an intervention, veterinarians periodically received three feedback reports comprising feedback on the participants' antibiotic prescribing and prescribing guidelines. A change in the level and trend of antibiotic prescribing after the administration of the intervention was compared using a multi-level generalized linear mixed-effect negative-binomial model. After the receipt of the first (incidence rate ratios [IRR] = 0.88; 95% confidence interval (CI): 0.79, 0.98), and second (IRR = 0.85; 95% CI: 0.75, 0.97) feedback reports, there was a reduced prescribing rate of total antibiotic when other parameters were held constant. This decline was more pronounced among Israeli veterinarians compared to Canadian veterinarians. When other parameters were held constant, the prescribing of critical antibiotics by Canadian veterinarians decreased by a factor of 0.39 compared to that of Israeli veterinarians. Evidently, antibiotic stewardship interventions can improve antibiotic prescribing in a veterinary setting. The strategy to sustain the effect of feedback reports and the determinants of differences between the two cohorts should be further explored.
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Affiliation(s)
- Kamal R. Acharya
- Department of Population Medicine, University of Guelph, Guelph, ON N1G 2W1, Canada;
| | - Adar Cohen
- Koret School of Veterinary Medicine, The Robert H. Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot 7610001, Israel; (A.C.); (A.S.)
| | - Gabrielle Brankston
- Department of Population Medicine, University of Guelph, Guelph, ON N1G 2W1, Canada;
| | - Jean-Paul R. Soucy
- Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5T 3M7, Canada; (J.-P.R.S.); (D.N.F.)
| | - Anette Hulth
- Public Health Agency of Sweden, 171 82 Stockholm, Sweden; (A.H.); (S.L.)
| | - Sonja Löfmark
- Public Health Agency of Sweden, 171 82 Stockholm, Sweden; (A.H.); (S.L.)
| | - John S. Brownstein
- Computational Epidemiology Lab, Boston Children’s Hospital, Boston, MA 02115, USA;
- Harvard Medical School, Harvard University, Boston, MA 02115, USA
| | - Nadav Davidovich
- School of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva 84105, Israel; (N.D.); (J.M.-G.)
| | - Moriah E. Ellen
- Department of Health Policy and Management, Guilford Glazer Faculty of Business and Management, Ben-Gurion University of the Negev, Beer Sheva 84105, Israel
- Department of Health Policy and Management, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva 84105, Israel
- Institute for Health Policy, Management and Evaluation, University of Toronto, Toronto, ON M5T 3M6, Canada
| | - David N. Fisman
- Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5T 3M7, Canada; (J.-P.R.S.); (D.N.F.)
| | - Jacob Moran-Gilad
- School of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva 84105, Israel; (N.D.); (J.M.-G.)
| | - Amir Steinman
- Koret School of Veterinary Medicine, The Robert H. Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot 7610001, Israel; (A.C.); (A.S.)
| | | | - Amy L. Greer
- Department of Population Medicine, University of Guelph, Guelph, ON N1G 2W1, Canada;
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22
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De Marchi L, Vernaccini M, Meucci V, Briganti A, Lippi I, Marchetti V, Intorre L. Six-Year Prescription Pattern of Antimicrobial Use in Cats at the Veterinary Teaching Hospital of the University of Pisa. Animals (Basel) 2024; 14:521. [PMID: 38338164 PMCID: PMC10854698 DOI: 10.3390/ani14030521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 01/19/2024] [Accepted: 02/01/2024] [Indexed: 02/12/2024] Open
Abstract
The use of antimicrobials has greatly contributed to improving animal health. However, their inappropriate use reduces their effectiveness in treating bacterial infections and contributes to the selection of resistance. This study aimed to retrospectively evaluate the six-year pattern (2017-2022) of antimicrobial use in cats visiting the Veterinary Teaching Hospital (VTH) of the University of Pisa (Italy). The total number of prescribed antimicrobials, the number of animals for which an antimicrobial was prescribed, and the total number of antimicrobial prescriptions showed a significant time trend decrease during the study period, except for the fixed-dose combinations. The most frequently prescribed antimicrobials were amoxicillin-clavulanic acid (Synulox) (39.1%) followed by enrofloxacin (29.8%). These antimicrobials were mostly prescribed to treat infections affecting the genitourinary tract (~30%), followed by the gastrointestinal tract, skin, and respiratory system affections. Antimicrobials in empirical associations represented 13.0% of the total antimicrobial prescriptions, and the combination of amoxicillin-clavulanic acid (Synulox) with enrofloxacin accounted for the majority. The oral route represented the main route of administration of prescribed antimicrobials, followed by parenteral and topical ones. Amoxicillin-clavulanic acid (Synulox) (37.2%), ceftriaxone (2.7%), and tobramycin (2.8%) were the most prescribed antimicrobials for the oral, parenteral, and topical routes, respectively. Antimicrobial prescriptions complied with prudent use recommendations in terms of availability of diagnosis, respect to the dose range, duration of treatment, and the use of medicinal products approved for the species. On the contrary, antimicrobial susceptibility tests were used infrequently (5.2%), lacking compliance with the existing guidelines observed in companion animal practice. Overall, additional interventions are required not only to improve the responsible use of antimicrobials in our feline practice but also to implement antimicrobial stewardship programs, enhancing diagnostics such as culture and sensitivity testing in the future.
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Affiliation(s)
| | | | - Valentina Meucci
- Veterinary Teaching Hospital, Department of Veterinary Sciences, University of Pisa, 56124 Pisa, Italy; (L.D.M.); (M.V.); (A.B.); (I.L.); (V.M.); (L.I.)
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23
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Wang Z, Diaz A, Isdale R, Kofron K, Carr SV, Lappin M. Effect of tamsulosin on urethral tone in healthy male cats. J Feline Med Surg 2024; 26:1098612X231220845. [PMID: 38381462 PMCID: PMC10911306 DOI: 10.1177/1098612x231220845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2024]
Abstract
OBJECTIVES Alpha-adrenergic antagonists are commonly used to prevent recurrent urethral obstruction in cats with mixed reports of efficacy. No published data on tamsulosin use in cats are available. The objective of this study was to measure changes in urodynamic parameters and blood pressure in five healthy male cats before and after administration of tamsulosin orally for 4 and 10 days. METHODS Five young healthy adult male cats from a research colony were administered tamsulosin at 0.1 mg/cat PO q24h for 10 days. Urethral pressure profile and blood pressure measurements were performed before treatment and approximately 6 h after treatment on days 4 and 10. Maximum urethral closure pressure (MUCP) for the prostatic and penile urethra, functional urethral length (FPL), functional area (FA) and systolic blood pressures were recorded and compared between the time points. RESULTS Significant changes in blood pressure on day 4 (121.1 mmHg ± 20.2 mmHg) and on day 10 (112.6 mmHg ± 14.9 mmHg) compared with day 0 (141.1 mmHg± 33.4 mmHg) were not detected (P = 0.18) in anesthetized cats. No significant difference in MUCP, FA or FPL measurements were detected among baseline, day 4 and day 10 of treatment. Hematuria and transient pollakiuria were induced in two cats with 3.5 Fr urethral catheters. CONCLUSIONS AND RELEVANCE Tamsulosin at 0.1 mg/cat PO q24h did not induce hypotension in healthy cats. Urodynamic testing performed 6 h after the tamsulosin pill was administered did not detect consistent decreases in urodynamic functions induced by tamsulosin. Repeated catheterization of tom cats with 3.5 Fr catheters may induce significant urethral trauma.
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Affiliation(s)
- Zhe Wang
- Department of Clinical Sciences, Colorado State University, Fort Collins, CO, USA
| | - Amanda Diaz
- Department of Clinical Sciences, Colorado State University, Fort Collins, CO, USA
| | - Rachael Isdale
- Department of Clinical Sciences, Colorado State University, Fort Collins, CO, USA
| | - Kristine Kofron
- Department of Clinical Sciences, Colorado State University, Fort Collins, CO, USA
| | - Susan V Carr
- Department of Clinical Sciences, Colorado State University, Fort Collins, CO, USA
| | - Michael Lappin
- Department of Clinical Sciences, Colorado State University, Fort Collins, CO, USA
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24
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de Jesus L, de Oliveira MC, Lopes DJ, da Silva Mello FP, de Faria Valle S, Pöppl ÁG. Applying children's enuresis treatment with amitriptyline for canine post-spaying urinary incontinence: A pilot estriol-controlled randomized clinical trial. Res Vet Sci 2024; 167:105118. [PMID: 38150943 DOI: 10.1016/j.rvsc.2023.105118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 12/14/2023] [Accepted: 12/18/2023] [Indexed: 12/29/2023]
Abstract
Urinary incontinence due to urethral sphincter mechanism incompetence (USMI) affects up to 20% of bitches that undergo spaying surgery. Amitriptyline is a tricyclic antidepressant whose urinary retention is a reported side effect. This study aimed to assess the efficacy and safety of amitriptyline when compared to estriol orally. Fifteen bitches with a clinical diagnosis of post-spaying UI were evaluated during 60 days in a non-blinded randomized clinical trial. All patients were enrolled after clinical evaluation consisting of anamnesis, physical examination, and complementary exams (complete blood count, biochemical parameters, urinalysis, and abdominal ultrasound). The amitriptyline (AMT) group consisted of 8 bitches, which received the initial dose of 1 mg/kg every 12 h, whereas the estriol (EST) group consisted of 7 bitches which were initially treated with 1 mg/animal every 24 h. Patients underwent clinical evaluation at 7 days, and then at 21 and 60 days of treatment to assess safety and efficacy, as well as adjustments of dose when necessary. A urinary incontinence scale was used to assess the level of incontinence and therapeutic response to treatment. During the period of the study, estriol was fully effective in 71% of cases and amitriptyline in 62%. Both drugs proved safe in the medical treatment of USMI, with adverse effects such as somnolence (AMT, n = 5/8) and male attraction (EST, n = 1/7). The results support the amitriptyline recommendation as a substitute for estriol in USMI treatment.
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Affiliation(s)
- Luciana de Jesus
- Veterinary Sciences Post-Graduation Program, Faculty of Veterinary, Federal University of Rio Grande do Sul (UFRGS), 9090 Bento Gonçalves Av., Agronomia, Porto Alegre, RS 91540-000, Brazil
| | - Milena Cleff de Oliveira
- Faculty of Veterinary, Federal University of Rio Grande do Sul (UFRGS), 9090 Bento Gonçalves Av., Agronomia, Porto Alegre, RS 91540-000, Brazil
| | - Daniela Jardim Lopes
- Veterinary Sciences Post-Graduation Program, Faculty of Veterinary, Federal University of Rio Grande do Sul (UFRGS), 9090 Bento Gonçalves Av., Agronomia, Porto Alegre, RS 91540-000, Brazil
| | - Fabíola Peixoto da Silva Mello
- Veterinary Clinical Hospital, Federal University of Rio Grande do Sul (UFRGS), 9090 Bento Gonçalves Av., Agronomia, Porto Alegre, RS 91540-000, Brazil
| | - Stella de Faria Valle
- Department of Veterinary Clinical Pathology, Faculty of Veterinary, Federal University of Rio Grande do Sul (UFRGS), 9090 Bento Gonçalves Av., Agronomia, Porto Alegre, RS 91540-000, Brazil
| | - Álan Gomes Pöppl
- Veterinary Sciences Post-Graduation Program, Faculty of Veterinary, Federal University of Rio Grande do Sul (UFRGS), 9090 Bento Gonçalves Av., Agronomia, Porto Alegre, RS 91540-000, Brazil; Department of Animal Medicine, Faculty of Veterinary Medicine, Federal University of Rio Grande do Sul, 9090 Bento Gonçalves Av., Agronomia, Porto Alegre, RS 91540-000, Brazil.
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25
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Farrell S, Bagcigil AF, Chaintoutis SC, Firth C, Aydin FG, Hare C, Maaland M, Mateus A, Vale AP, Windahl U, Damborg P, Timofte D, Singleton D, Allerton F. A multinational survey of companion animal veterinary clinicians: How can antimicrobial stewardship guidelines be optimised for the target stakeholder? Vet J 2024; 303:106045. [PMID: 38000694 DOI: 10.1016/j.tvjl.2023.106045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 10/03/2023] [Accepted: 11/20/2023] [Indexed: 11/26/2023]
Abstract
Antimicrobial stewardship initiatives are widely regarded as a cornerstone for ameliorating the global health impact of antimicrobial resistance. Within companion animal health, such efforts have largely focused on development and dissemination of antimicrobial stewardship guidelines (ASGs). However, there have been few attempts to understand veterinarian attitudes towards and knowledge of ASGs or to determine how awareness regarding ASGs might best be increased. An online survey regarding ASGs was formulated for veterinarians who treat companion animals. The survey was distributed across 46 European and associated countries between 12 January and 30 June, 2022. In total, 2271 surveys were completed, with 64.9% of respondents (n = 1474) reporting awareness and usage of at least one ASG. Respondents from countries with greater awareness of ASGs tended to report more appropriate use of antimicrobials (Spearman's rank coefficient = 0.6084, P ≤ 0.001), with respondents from countries with country-specific ASGs tending to score highest across both awareness and appropriate use domains. Respondents prioritised guidance around antimicrobial choice (82.0%, n = 1863), duration of treatment (66.0%, n = 1499), and dosage (51.9%, n = 1179) for inclusion in future ASGs, with 78.0% (n = 1776) of respondents preferring ASGs to be integrated into their patient management system. Awareness of ASGs and their use in companion animal veterinary practice appears to be greater than previously reported, with respondents tending to report antimicrobial prescription decision making broadly in line with current clinical recommendations. However, further initiatives aimed at maximising accessibility to ASGs both within countries and individual veterinary practices are recommended.
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Affiliation(s)
- S Farrell
- Department of Computer Science, Durham University, Durham, UK
| | - A F Bagcigil
- Department of Microbiology, Faculty of Veterinary Medicine, Istanbul University-Cerrahpaşa, Istanbul, Turkey
| | - S C Chaintoutis
- Diagnostic Laboratory, Department of Clinical Sciences, School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 11 Stavrou Voutyra str., Thessaloniki, Greece
| | - C Firth
- Unit of Veterinary Public Health and Epidemiology, University of Veterinary Medicine, Veterinaerplatz 1, 1210 Vienna, Austria
| | - F G Aydin
- Ankara University, Faculty of Veterinary Medicine, Department of Pharmacology and Toxicology, 06070 Altindag/Ankara, Turkey
| | - C Hare
- Department of Veterinary Medicine, University of Cambridge, Madingley Road, Cambridge CB3 0ES, UK
| | - M Maaland
- Department of Production Animal Clinical Sciences, Norwegian University of Life Sciences, 4325 Sandnes, Norway
| | - A Mateus
- World Organisation for Animal Health, 12 Rue de Prony, 75017 Paris, France
| | - A P Vale
- School of Veterinary Medicine, University College Dublin, UCD Belfield, Dublin, Ireland
| | - U Windahl
- Swedish National Veterinary Institute, 75189 Uppsala, Sweden
| | - P Damborg
- Department of Veterinary and Animal Sciences, University of Copenhagen, Stigbøjlen 4, 1870 Frederiksberg, Denmark
| | - D Timofte
- Department of Veterinary Anatomy Physiology and Pathology, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Leahurst Campus, Neston CH64 7TE, UK
| | - D Singleton
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, UK
| | - F Allerton
- Willows Veterinary Centre and Referral Service, part of Linnaeus Veterinary Limited, Highlands Road, Shirley, Solihull B90 4NH, UK.
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26
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Ruchti N, Braissant O, Overesch G. Real time detection of pathogenic bacteria in veterinary microbiology using isothermal microcalorimetry - A different approach. Vet Microbiol 2024; 288:109929. [PMID: 38048670 DOI: 10.1016/j.vetmic.2023.109929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 09/14/2023] [Accepted: 11/20/2023] [Indexed: 12/06/2023]
Abstract
With today's challenges regarding antibiotic resistance and the importance of the implementation of prudent use of antibiotics, fast and reliable diagnostic tools for bacterial infections and subsequent antimicrobial susceptibility testing are of utmost relevance. Isothermal microcalorimetry (IMC) is a broadly applicable method, with which metabolic heat flow in reproducing bacteria can be measured in real time. To the best of the authors' knowledge, this is the first report on examination of 124 urine samples from feline and canine urinary tract infection with an IMC-based prototype instrument. A concentration-dependent time of peak heat flow by dilution series with Escherichia coli and Enterococcus faecalis reference strains demonstrated the general good performance of the prototype for detection of these bacteria. With diagnostic culture being set as a gold standard, the diagnostic sensitivity of IMC compared to bacteriological culture was 80 %, the diagnostic specificity was 97 %. With a Cohens' kappa value (κ) of 0.80, the two methods show good concordance. The results from our study demonstrate that the IMC technology is suitable to allow reliable, but much faster detection of bacteria than conventional culture, especially for Escherichia coli. Thus, implementing IMC technology could markedly speed up the bacteriological diagnostic process in veterinary medicine.
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Affiliation(s)
- Nadine Ruchti
- Institute of Veterinary Bacteriology, University of Bern, Länggasstrasse 122, CH-3012 Bern, Switzerland
| | - Olivier Braissant
- Department of Biomedical Engineering, University of Basel, Gewerbestrasse 14, CH-4123 Allschwil, Switzerland
| | - Gudrun Overesch
- Institute of Veterinary Bacteriology, University of Bern, Länggasstrasse 122, CH-3012 Bern, Switzerland.
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27
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Aurich S, Wolf SA, Prenger-Berninghoff E, Thrukonda L, Semmler T, Ewers C. Genotypic Characterization of Uropathogenic Escherichia coli from Companion Animals: Predominance of ST372 in Dogs and Human-Related ST73 in Cats. Antibiotics (Basel) 2023; 13:38. [PMID: 38247597 PMCID: PMC10812829 DOI: 10.3390/antibiotics13010038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 12/13/2023] [Accepted: 12/26/2023] [Indexed: 01/23/2024] Open
Abstract
Extraintestinal pathogenic Escherichia coli (ExPEC) account for over 80% and 60% of bacterial urinary tract infections (UTIs) in humans and animals, respectively. As shared uropathogenic E. coli (UPEC) strains have been previously reported among humans and pets, our study aimed to characterize E. coli lineages among UTI isolates from dogs and cats and to assess their overlaps with human UPEC lineages. We analysed 315 non-duplicate E. coli isolates from the UT of dogs (198) and cats (117) collected in central Germany in 2019 and 2020 utilizing whole genome sequencing and in silico methods. Phylogroup B2 (77.8%), dog-associated sequence type (ST) 372 (18.1%), and human-associated ST73 (16.6%), were predominant. Other STs included ST12 (8.6%), ST141 (5.1%), ST127 (4.8%), and ST131 (3.5%). Among these, 58.4% were assigned to the ExPEC group and 51.1% to the UPEC group based on their virulence associated gene (VAG) profile (ExPEC, presence of ≥VAGs: papAH and/or papC, sfa/focG, afaD/draBC, kpsMTII, and iutA; UPEC, additionally cnf1 or hlyD). Extended-spectrum cephalosporin (ESC) resistance mediated by extended-spectrum β-lactamases (ESBL) and AmpC-β-lactamase was identified in 1.9% of the isolates, along with one carbapenemase-producing isolate and one isolate carrying a mcr gene. Low occurrence of ESC-resistant or multidrug-resistant (MDR) isolates (2.9%) in the two most frequently detected STs implies that E. coli isolated from UTIs of companion animals are to a lesser extent associated with resistance, but possess virulence-associated genes enabling efficient UT colonization and carriage. Detection of human-related pandemic lineages suggests interspecies transmission and underscores the importance of monitoring companion animals.
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Affiliation(s)
- Sophie Aurich
- Institute of Hygiene and Infectious Diseases of Animals, Faculty of Veterinary Medicine, Justus Liebig University Giessen, 35392 Giessen, Germany; (E.P.-B.); (C.E.)
| | - Silver Anthony Wolf
- Genome Competence Centre, Robert Koch Institute, 13353 Berlin, Germany (L.T.)
| | - Ellen Prenger-Berninghoff
- Institute of Hygiene and Infectious Diseases of Animals, Faculty of Veterinary Medicine, Justus Liebig University Giessen, 35392 Giessen, Germany; (E.P.-B.); (C.E.)
| | | | - Torsten Semmler
- Genome Competence Centre, Robert Koch Institute, 13353 Berlin, Germany (L.T.)
| | - Christa Ewers
- Institute of Hygiene and Infectious Diseases of Animals, Faculty of Veterinary Medicine, Justus Liebig University Giessen, 35392 Giessen, Germany; (E.P.-B.); (C.E.)
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28
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Djoneva L, Lawson J, Rutherford L, Geddes R. Analysis of lower urinary tract signs and bacteriuria in cats with subcutaneous ureteral bypass systems. Vet Rec Open 2023; 10:e69. [PMID: 37534374 PMCID: PMC10393289 DOI: 10.1002/vro2.69] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 05/23/2023] [Accepted: 07/07/2023] [Indexed: 08/04/2023] Open
Abstract
Objectives Distinguishing bacterial cystitis from subclinical bacteriuria is necessary for feline treatment protocols and antimicrobial stewardship. This can be challenging in cats with subcutaneous ureteral bypass (SUB) systems because they may present with lower urinary tract signs without bacteriuria. We investigated the relationship between positive urine culture and lower urinary tract signs in cats with SUBs, including factors associated with each. Methods Clinical records were retrospectively reviewed to identify cats presenting with ureteral obstruction that underwent placement of a SUB device(s). The relationship between a positive urine culture and lower urinary tract signs was determined by chi-squared analysis. Univariable and multivariable logistic regression models were performed to identify factors associated with positive urine cultures and lower urinary tract signs. Results Two hundred and thirty visits were recorded for 61 cats, with 36 of 230 (16%) positive cultures in 21 of 61 (34%) cats. Lower urinary tract signs were documented at 97 of 230 (42%) visits, with 37 of 61 (61%) cats demonstrating lower urinary tract signs at some point. No relationship was found between culture results and lower urinary tract signs. Risk factors for a positive culture were higher urine pH, higher urine white blood cells and the presence of bacteriuria on microscopy. Risk factors for lower urinary tract signs were younger age and being a purebred cat (vs. non-purebred). Conclusions A high proportion of cats with SUBs exhibited sterile lower urinary tract signs, making differentiation between bacterial cystitis and subclinical bacteriuria difficult. This highlights the need for clearer guidelines on when to treat bacteriuria in cats with SUBs.
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Affiliation(s)
- Luba Djoneva
- Royal Veterinary CollegeNorth MymmsHatfieldHertfordshireUK
| | - Jack Lawson
- Royal Veterinary CollegeNorth MymmsHatfieldHertfordshireUK
| | | | - Rebecca Geddes
- Royal Veterinary CollegeNorth MymmsHatfieldHertfordshireUK
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29
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Jariyapamornkoon N, Boonkam P, Suanpairintr N. Assessment of the gradient diffusion method for fosfomycin susceptibility testing in Staphylococcus spp. and Enterococcus spp. isolated from the urine of companion dogs in Thailand. Vet World 2023; 16:2497-2503. [PMID: 38328370 PMCID: PMC10844777 DOI: 10.14202/vetworld.2023.2497-2503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Accepted: 11/28/2023] [Indexed: 02/09/2024] Open
Abstract
Background and Aim The agar dilution method is the approved method for determining the minimum inhibitory concentration (MIC) in fosfomycin susceptibility testing, whereas the broth dilution method is not recommended. This study aimed to investigate the potential of the gradient diffusion method as a more convenient alternative to agar dilution method for MIC evaluation, particularly for the susceptibility testing of Staphylococcus spp. and Enterococcus spp. to fosfomycin. Materials and Methods A total of 194 isolates of Staphylococcus spp. and Enterococcus spp. were collected from urine samples of dogs diagnosed with bacterial cystitis. Bacterial identification and susceptibility to multiple antibiotics were tested using the Vitek 2 automated system. The susceptibility to fosfomycin was compared between agar dilution (reference method) and the gradient diffusion method. We assessed the agreement rates and errors between the two approaches by analyzing the MIC data. Results Staphylococcus pseudintermedius (98.7%) and Enterococcus faecalis (80.0%) exhibited high fosfomycin susceptibility rates, whereas Enterococcus faecium exhibited a lower susceptibility rate (38.5%). The gradient diffusion method demonstrated unacceptably low essential agreement (EA) rates (>90%) but acceptable categorical agreement (CA) rates (≥ 90%) for S. pseudintermedius (83.54% EA and 97.47% CA) and coagulase-negative staphylococci (CoNS) such as Staphylococcus chromogenes, Staphylococcus hominis, and Staphylococcus simulans (85.00% EA and 95.00% CA). Enterococcus spp. had an acceptable EA of 93.75%, but an unacceptably low CA rate of 82.81%, with a minor error rate of 17.19%. No significant errors were observed for Staphylococcus and Enterococcus spp. Conclusion The gradient diffusion method reliably determines MICs and interpretative breakpoints (S, I, R) for S. pseudintermedius. However, its applicability to CoNS and enterococci may be limited due to unacceptable errors.
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Affiliation(s)
- Nattha Jariyapamornkoon
- Department of Agricultural Technology, Faculty of Science and Technology, Thammasat University, Pathum Thani, Thailand
| | - Pongthai Boonkam
- Veterinary Diagnostic Laboratory, Faculty of Veterinary Science, Chulalongkorn University, Bangkok, Thailand
| | - Nipattra Suanpairintr
- Department of Pharmacology, Faculty of Veterinary Science, Chulalongkorn University, Bangkok, Thailand
- Center of Excellence for Food and Water Risk Analysis (FAWRA), Department of Veterinary Public Health, Faculty of Veterinary Science, Chulalongkorn University, Bangkok, Thailand
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30
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Englar RE. Recasting the gold standard - part II of II: communicating healthcare options along a continuum of care. J Feline Med Surg 2023; 25:1098612X231215639. [PMID: 38131202 PMCID: PMC10811761 DOI: 10.1177/1098612x231215639] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Abstract
SERIES OUTLINE This is the second part of a two-part series on spectrum of care that encourages practitioners to tailor case management to the patient along a continuum of acceptable options. Part I defined the spectrum of care and broadened its approach beyond initial cost-of-care considerations. This second article introduces strategies for initiating conversations with clients about their needs, wants and expectations specific to healthcare options and case management decisions. It will explore how open inquiry, reflective listening, transparency and unconditional positive regard facilitate dialogue between providers and their clients as they collaborate on decision-making along a spectrum of care. RELEVANCE Contextual case management prioritizes interventions that are appropriate for both the patient and the client. To identify and explore which healthcare options represent the best fit for those impacted most by medical decisions, veterinarians need to make space for clients to feel comfortable sharing their perspectives. Clients are more likely to be engaged in decision-making when their insight is actively solicited. They have much to share with us as experts about their cat's overall health and wellness needs. Inviting clients to contribute to the consultation and being receptive to hearing what motivates their choices helps us to structure conversations around healthcare options. The ability to communicate healthcare options is as vital as the provision of healthcare, if not more so.
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Affiliation(s)
- Ryane E Englar
- University of Arizona College of Veterinary Medicine, Oro Valley, AZ, USA
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Foster JD, Abouraya M, Papich MG, Muma NA. Population pharmacokinetic analysis of enrofloxacin and its active metabolite ciprofloxacin after intravenous injection to cats with reduced kidney function. J Vet Intern Med 2023; 37:2230-2240. [PMID: 37728198 PMCID: PMC10658592 DOI: 10.1111/jvim.16866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 08/24/2023] [Indexed: 09/21/2023] Open
Abstract
BACKGROUND It is unknown if enrofloxacin accumulates in plasma of cats with reduced kidney function. HYPOTHESIS To determine if enrofloxacin and its active metabolite ciprofloxacin have reduced clearance in azotemic cats. ANIMALS Thirty-four cats hospitalized for clinical illness with variable degree of kidney function. METHODS Prospective study. After enrofloxacin (dose 5 mg/kg) administration to cats, sparse blood sampling was used to obtain 2 compartment population pharmacokinetic results using nonlinear mixed-effects modeling. Plasma enrofloxacin and ciprofloxacin concentrations were measured and summed to obtain the total fluoroquinolone concentration. A model of ciprofloxacin metabolism from enrofloxacin was created and evaluated for covariate effects on clearance, volume of distribution, and the metabolic rate of ciprofloxacin generation from enrofloxacin. RESULTS Body weight was the only covariate found to affect total fluoroquinolone volume of distribution (effect 1.63, SE 0.19, P < .01) and clearance (effect 1.63, SE 0.27, P < .01). Kidney function did not have a significant effect on total fluoroquinolone clearance (median 440.8 mL/kg/h (range 191.4-538.0 mL/kg/h) in cats with normal kidney function, 365.8 mL/kg/h (range 89.49-1092.0 mL/kg/h) in cats with moderate kidney dysfunction, and 308.5 mL/kg/h (range 140.20-480.0 mL/kg/h) in cats with severe kidney dysfunction (P = .64). Blood urea nitrogen concentration influenced the metabolic generation of ciprofloxacin from enrofloxacin (effect 0.51, SE 0.08, P < .01), but other markers of kidney function did not. CONCLUSIONS AND CLINICAL IMPORTANCE Adjustment of enrofloxacin dosage is not indicated for azotemic cats.
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Affiliation(s)
| | | | - Mark G. Papich
- College of Veterinary MedicineNorth Carolina State UniversityRaleighNorth CarolinaUSA
| | - Nancy A. Muma
- Department of Pharmacology and ToxicologyUniversity of KansasLawrenceKansasUSA
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Beaudoin AL, Bollig ER, Burgess BA, Cohn LA, Cole SD, Dear JD, Fellman CL, Frey E, Goggs R, Johnston A, Kreuder AJ, KuKanich KS, LeCuyer TE, Menard J, Reagan KL, Sykes JE, Veir JK, Viviano K, Wayne A, Granick JL. Prevalence of antibiotic use for dogs and cats in United States veterinary teaching hospitals, August 2020. J Vet Intern Med 2023; 37:1864-1875. [PMID: 37526594 PMCID: PMC10473043 DOI: 10.1111/jvim.16814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 07/05/2023] [Indexed: 08/02/2023] Open
Abstract
BACKGROUND Awareness of prescribing practices helps identify opportunities to improve antibiotic use (AU). OBJECTIVES To estimate AU prevalence in dogs and cats in U.S. veterinary teaching hospitals (VTHs) and identify antibiotic drugs commonly prescribed, indications for use, and evidence of bacterial infection. ANIMALS Medical record data were collected from dogs and cats examined at 14 VTHs. METHODS Data were collected from VTH medical records of dogs and cats examined by primary care, urgent care, emergency and critical care, internal medicine, and surgery services on a single day during August 13-September 3, 2020. Data included signalment; clinical service; inpatient or outpatient status; clinical conditions; diagnostic tests; evidence of bacterial infection; intended reason for AU; name and route of antibiotics prescribed. RESULTS Of 883 dogs and cats, 322 (36.5%) were prescribed at least 1 antibiotic. Among 285 antibiotics administered systemically intended for treatment of infection, 10.9% were prescribed without evidence of infection. The most common class of antibiotics presribed for systemic administration was potentiated penicillin for dogs (115/346, 33.3%) and cats (27/80, 33.8%). For dogs and cats, first-generation cephalosporins (93/346, 26.9% and 11/80, 13.8%, respectively) and fluoroquinolones (51/346, 14.7% and 19/80, 23.8%, respectively) was second or third most-prescribed. Common AU indications included skin, respiratory, and urinary conditions, and perioperative use. CONCLUSIONS AND CLINICAL IMPORTANCE Collaborative data collection provides a sustainable methodology to generate national AU prevalence estimates and bring attention to areas requiring additional research and detailed data collection. These efforts can also identify practice improvement opportunities in settings where future veterinarians are trained.
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Affiliation(s)
| | - Emma R. Bollig
- Department of Veterinary Clinical SciencesCollege of Veterinary Medicine, University of MinnesotaSaint PaulMinnesotaUSA
| | - Brandy A. Burgess
- Department of Population HealthCollege of Veterinary Medicine, University of GeorgiaAthensGeorgiaUSA
| | - Leah A. Cohn
- Department of Veterinary Medicine and SurgeryCollege of Veterinary Medicine, University of MissouriColumbiaMissouriUSA
| | - Stephen D. Cole
- Department of PathobiologySchool of Veterinary Medicine, University of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - Jonathan D. Dear
- Department of Medicine and EpidemiologySchool of Veterinary Medicine, University of California‐DavisDavisCaliforniaUSA
| | - Claire L. Fellman
- Department of Clinical SciencesCummings School of Veterinary Medicine, Tufts UniversityGraftonMassachusettsUSA
| | - Erin Frey
- Department of Clinical SciencesCollege of Veterinary Medicine, North Carolina State UniversityRaleighNorth CarolinaUSA
| | - Robert Goggs
- Department of Clinical SciencesCollege of Veterinary Medicine, Cornell UniversityIthacaNew YorkUSA
| | - Andrea Johnston
- Department of Veterinary Clinical SciencesSchool of Veterinary Medicine, Louisiana State UniversityBaton RougeLouisianaUSA
| | - Amanda J. Kreuder
- Department of Veterinary Microbiology and Preventive MedicineCollege of Veterinary Medicine, Iowa State UniversityAmesIowaUSA
| | - Kate S. KuKanich
- Department of Clinical SciencesCollege of Veterinary Medicine, Kansas State UniversityManhattanKansasUSA
| | - Tessa E. LeCuyer
- Department of Biomedical Sciences and PathobiologyVirginia‐Maryland College of Veterinary Medicine, Virginia TechBlacksburgVirginiaUSA
| | - Julie Menard
- Department of Clinical SciencesCollege of Veterinary Medicine, Cornell UniversityIthacaNew YorkUSA
- Present address:
Department of Veterinary Diagnostic and Clinical Sciences, Faculty of Veterinary MedicineUniversity of CalgaryCalgaryAlbertaCanada
| | - Krystle L. Reagan
- Department of Medicine and EpidemiologySchool of Veterinary Medicine, University of California‐DavisDavisCaliforniaUSA
| | - Jane E. Sykes
- Department of Medicine and EpidemiologySchool of Veterinary Medicine, University of California‐DavisDavisCaliforniaUSA
| | - Julia K. Veir
- Department of Clinical SciencesCollege of Veterinary Medicine and Biomedical Sciences, Colorado State UniversityFort CollinsColoradoUSA
- Present address:
Antech DiagnosticsFountain ValleyCaliforniaUSA
| | - Katrina Viviano
- Department of Medical SciencesSchool of Veterinary Medicine, University of Wisconsin‐MadisonMadisonWisconsinUSA
| | - Annie Wayne
- Department of Clinical SciencesCummings School of Veterinary Medicine, Tufts UniversityGraftonMassachusettsUSA
- Present address:
Ethos Veterinary HealthWoburnMassachusettsUSA
| | - Jennifer L. Granick
- Department of Veterinary Clinical SciencesCollege of Veterinary Medicine, University of MinnesotaSaint PaulMinnesotaUSA
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Pinthanon A, Nithitarnwat C, Pintapin C, Siripanee C, Yindee J, Am-In N, Kesdangsakonwut S, Surachetpong S, Prapasarakul N. Rapid identification of canine uropathogens by matrix-assisted laser desorption/ionization-time-of-flight mass spectrometry and the clinical factors that correlated bacterial species and antimicrobial resistance. Vet Res Commun 2023; 47:1457-1469. [PMID: 37036600 DOI: 10.1007/s11259-023-10096-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 03/04/2023] [Indexed: 04/11/2023]
Abstract
Using the matrix-assisted laser desorption/ionization-time-of-flight mass spectrometry (MALDI-TOF MS) method for bacterial diagnosis, rapid urine sample preparation can reduce time relapsing of diagnosis and improve discriminatory power in coinfection cases. We aimed to evaluate rapid urine preparation procedures before MALDI-TOF MS application using dog clinical urine samples in comparison with standard microbiological diagnostic methods by agreement analysis. We determined the frequency and distribution of bacteria and bacterial resistance and their correlations to clinical history. Three experimental procedures comprising direct centrifugation, 10% sodium dodecyl sulfate digestion, and ultrasonic preparation were performed for method validation and sensitivity. Sterile urine containing Escherichia coli and/or Staphylococcus aureus were used as simulated samples. By ultrasonic preparation, the microorganisms could be detected 1.46-1.51 × 105 CFU, which was considered the most suitable technique. This preparation was significantly consistent with the routine method based on data from Hospital Information Systems for 50 urine samples from canine cystitis. By standard protocol, Enterobacteriaceae and Staphylococcus pseudintermedius were found in most of the 155 urine samples with cystitis. Extended-spectrum beta-lactamase-producing Enterobacteriaceae was found in 25-30% of the samples. Imipenem resistance was found in 70% of Acinetobacter baumannii cases; almost all were resistant to second-generation fluoroquinolones and tetracyclines. The most efficient antibiotic for treating bacterial urinary tract infection was amoxicillin plus clavulanic acid. A. baumannii and Pseudomonas aeruginosa were susceptible to pradofloxacin. Prolonged urine catheterization was linked to lower urinary tract infections by Enterobacter spp., which also correlated with chronic kidney disease.
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Affiliation(s)
- Artitaya Pinthanon
- Department of Veterinary Microbiology, Faculty of Veterinary Science, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Chayanan Nithitarnwat
- Department of Veterinary Microbiology, Faculty of Veterinary Science, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Chadaporn Pintapin
- Department of Veterinary Microbiology, Faculty of Veterinary Science, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Chonradee Siripanee
- Department of Veterinary Microbiology, Faculty of Veterinary Science, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Jitrapa Yindee
- Department of Veterinary Microbiology, Faculty of Veterinary Science, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Nutthee Am-In
- Department of Veterinary Obstetrics, Gynaecology and Reproduction, Faculty of Veterinary Science, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Sawang Kesdangsakonwut
- Department of Veterinary Pathology and Veterinary Diagnostic Laboratory, Faculty of Veterinary Science, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Sirilak Surachetpong
- Department of Veterinary Medicine, Faculty of Veterinary Science, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Nuvee Prapasarakul
- Department of Veterinary Microbiology, Faculty of Veterinary Science, Chulalongkorn University, Bangkok, 10330, Thailand.
- Center of Excellence in Diagnostic and Monitoring of Animal Pathogens, Chulalongkorn University, Bangkok, Thailand.
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34
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Ellis C, Odunayo A, Tolbert MK. The use of metronidazole in acute diarrhea in dogs: a narrative review. Top Companion Anim Med 2023; 56-57:100824. [PMID: 37884173 DOI: 10.1016/j.tcam.2023.100824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 10/03/2023] [Accepted: 10/22/2023] [Indexed: 10/28/2023]
Abstract
Acute diarrhea is a common reason for non-wellness veterinary visits in dogs. Treatment for acute diarrhea usually consists of supportive care with nutritional intervention, fluid therapy, anthelmintics, and often an antibiotic - commonly metronidazole in North America. The empirical use of metronidazole for acute diarrhea in dogs has been a common practice in veterinary medicine for many decades; however, recent studies evaluating its use suggest it may be inappropriately utilized in many cases. Herein, we review the evidence evaluating the use of metronidazole and other antibiotics in acute diarrhea in the human and veterinary literature. Recommendations on the use of metronidazole and other antibiotics as well as other therapeutic considerations in the treatment of acute diarrhea are also provided.
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Affiliation(s)
- Connor Ellis
- Department of Small Animal Clinical Sciences, University of Florida, Gainesville, FL, USA
| | - Adesola Odunayo
- Department of Small Animal Clinical Sciences, University of Florida, Gainesville, FL, USA.
| | - M Katherine Tolbert
- Gastrointestinal Laboratory, Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, USA
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35
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Ballash GA, Diaz-Campos D, van Balen JC, Mollenkopf DF, Wittum TE. Previous Antibiotic Exposure Reshapes the Population Structure of Infecting Uropathogenic Escherichia coli Strains by Selecting for Antibiotic Resistance over Urovirulence. Microbiol Spectr 2023; 11:e0524222. [PMID: 37338386 PMCID: PMC10433818 DOI: 10.1128/spectrum.05242-22] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 05/28/2023] [Indexed: 06/21/2023] Open
Abstract
Antibiotic therapy is the standard of care for urinary tract infections (UTIs) caused by uropathogenic Escherichia coli (UPEC). However, previous antibiotic therapy may impart a selective pressure that influences the population structure and pathogenic potential of infecting UPEC strains. Here, we conducted a 3-year study using whole-genome-sequencing analysis and retrospective medical record review to characterize how antibiotic exposure influenced the phenotypic antibiotic resistance, acquired resistome, virulome, and population structure of 88 UTI-causing E. coli strains from dogs. A majority of UTI-associated E. coli strains were from phylogroup B2 and clustered within sequence type 372. Previous antibiotic exposure was associated with a population shift toward UPEC from phylogroups other than the typical urovirulent phylogroup B2. The specific virulence profiles within the accessory virulome that were associated with antibiotic use were elicited by the effect of antibiotics on UPEC phylogenetic structure. Among phylogroup B2, antibiotic exposure increased the quantity of genes within the resistome and the odds of developing reduced susceptibility to at least one antibiotic. Non-B2 UPEC strains harbored a more diverse and greater resistome that conferred reduced susceptibility to multiple antibiotic classes following antibiotic exposure. Collectively, these data suggest that previous antibiotic exposure establishes an environment that provides a selective edge to non-B2 UPEC strains through their diverse and abundant antibiotic resistance genes, despite their lack of urovirulence genes. Our findings highlight the necessity for judicious use of antibiotics as we uncover another mechanism by which antibiotic exposure and resistance can influence the dynamics of bacterial infectious disease. IMPORTANCE Urinary tract infections (UTIs) are one of the most common infections of dogs and humans. While antibiotic therapy is the standard of care for UTIs and other infections, antibiotic exposure may influence the pathogenic profile of subsequent infections. We used whole-genome sequencing and retrospective medical record review to characterize the effect of systemic antibiotic therapy on the resistance, virulence, and population structure of 88 UTI-causing UPEC strains isolated from dogs. Our results indicate that antibiotic exposure alters the population structure of infecting UPEC strains, providing a selective edge for non-B2 phylogroups that harbor diverse and abundant resistance gene catalogues but fewer urovirulence genes. These findings highlight how antibiotic resistance can influence pathogen infection dynamics and have clinical implications for the judicious use of antibiotics for bacterial infections.
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Affiliation(s)
- Gregory A. Ballash
- Department of Veterinary Preventive Medicine, The Ohio State University, Columbus, Ohio, USA
| | - Dubraska Diaz-Campos
- Department of Veterinary Clinical Sciences, The Ohio State University, Columbus, Ohio, USA
| | - Joany C. van Balen
- Department of Veterinary Clinical Sciences, The Ohio State University, Columbus, Ohio, USA
| | - Dixie F. Mollenkopf
- Department of Veterinary Preventive Medicine, The Ohio State University, Columbus, Ohio, USA
| | - Thomas E. Wittum
- Department of Veterinary Preventive Medicine, The Ohio State University, Columbus, Ohio, USA
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36
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Ghisoni G, Foglia A, Sabattini S, Agnoli C, Dondi F, Perfetti S, Marconato L. A Retrospective Clinico-Pathologic Study of 35 Dogs with Urethral Transitional Cell Carcinoma Undergoing Treatment. Animals (Basel) 2023; 13:2395. [PMID: 37508172 PMCID: PMC10376480 DOI: 10.3390/ani13142395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 07/23/2023] [Accepted: 07/23/2023] [Indexed: 07/30/2023] Open
Abstract
Chemotherapy and cyclooxygenase inhibitors (COXi) are primary treatments for canine urethral transitional cell carcinoma (uTCC), a tumor known for its aggressiveness and poor prognosis. This retrospective study aimed to evaluate the clinico-pathological characteristics, treatment modalities, and prognostic factors of 35 dogs with confirmed uTCC that received chemotherapy and COXi. Upon admission, urethral obstruction (UO) and urinary tract infection (UTI) were observed in seven (20%) dogs each. Gemcitabine (n = 20; 57.1%) and vinblastine (n = 10; 28.6%) were commonly used as first-line therapies, with four dogs also receiving radiation therapy. Based on RECIST, one (2.9%) dog achieved complete remission, nine (25.7%) partial remission, 20 (57.14%) showed stable disease, and five (14.3%) progressed. Among dogs with UO, six (85.7%) showed resolution or improvement after the first chemotherapy dose. The median time to local progression was 171 days (range: 107-235), and the median survival time was 333 days (range: 158-508). Dogs with UO upon admission had a higher risk of local progression, while both UO and UTI were associated with an increased risk of overall disease progression and tumor-related death. Additionally, gemcitabine significantly improved metastatic control. This study identified UO and UTI as negative prognostic factors, highlighting the importance of a multimodal approach in managing uTCC.
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Affiliation(s)
- Giulia Ghisoni
- Department of Veterinary Medical Sciences, Alma Mater Studiorum University of Bologna, 40064 Ozzano dell'Emilia, BO, Italy
| | - Armando Foglia
- Department of Veterinary Medical Sciences, Alma Mater Studiorum University of Bologna, 40064 Ozzano dell'Emilia, BO, Italy
| | - Silvia Sabattini
- Department of Veterinary Medical Sciences, Alma Mater Studiorum University of Bologna, 40064 Ozzano dell'Emilia, BO, Italy
| | - Chiara Agnoli
- Department of Veterinary Medical Sciences, Alma Mater Studiorum University of Bologna, 40064 Ozzano dell'Emilia, BO, Italy
| | - Francesco Dondi
- Department of Veterinary Medical Sciences, Alma Mater Studiorum University of Bologna, 40064 Ozzano dell'Emilia, BO, Italy
| | - Simone Perfetti
- Department of Veterinary Medical Sciences, Alma Mater Studiorum University of Bologna, 40064 Ozzano dell'Emilia, BO, Italy
| | - Laura Marconato
- Department of Veterinary Medical Sciences, Alma Mater Studiorum University of Bologna, 40064 Ozzano dell'Emilia, BO, Italy
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37
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Hung CC, Varga C, Reinhart JM, Maddox CW, Dilger RN, Forsythe L, Stevenson AK, Franklin-Guild RJ, Paul NC, Ramachandran A. Assessing the urinary concentration of nitrofurantoin and its antibacterial activity against Escherichia coli, Staphylococcus pseudintermedius, and Enterococcus faecium isolated from dogs with urinary tract infections. Front Vet Sci 2023; 10:1189374. [PMID: 37492434 PMCID: PMC10365272 DOI: 10.3389/fvets.2023.1189374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 06/12/2023] [Indexed: 07/27/2023] Open
Abstract
Nitrofurantoin, a broad-spectrum nitrofuran class antibiotic, is applied as a first-line antibiotic in treating human urinary tract infections (UTIs) due to its great efficacy and high achievable concentration. The interest in using this antibiotic in companion animals has increased due to the growing demand for effective antibiotics to treat UTIs caused by multidrug-resistant bacteria. Currently, the susceptibility interpretations for nitrofurantoin are based on the breakpoints set for humans, while the canine-specific breakpoints are still unavailable. In this study, we assessed the concentration of nitrofurantoin reaching the dog's urine using the recommended oral dosing regimen. In addition, we examined the efficacy of this breakpoint concentration against the common canine UTI pathogens, Escherichia coli, Staphylococcus pseudintermedius, and Enterococcus faecium. Eight experimental beagle dogs were treated with ~5 mg/kg of nitrofurantoin macrocrystal PO 8qh for 7 days. The urine samples were collected via cystocentesis at 2, 4, and 6 h after administration on day 2 and day 7 and used to quantify nitrofurantoin concentrations by ultra-high performance liquid chromatography. The results showed that 26.13-315.87 μg/mL nitrofurantoin was detected in the dogs' urine with a mean and median concentration of 104.82 and 92.75 μg/mL, respectively. Additionally, individual dogs presented with urinary nitrofurantoin concentrations greater than 64 μg/mL for at least 50% of the dosing intervals. This concentration efficiently killed E. coli, and S. pseudintermedius, but not E. faecium strains carrying an MIC90 value equal to 16, 16, and 128 μg/mL, respectively. Taken together, these results suggest that the value of 64 μg/mL may be set as a breakpoint against UTI pathogens, and nitrofurantoin could be an effective therapeutic drug against E. coli and S. pseudintermedius for canine UTIs.
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Affiliation(s)
- Chien-Che Hung
- Veterinary Diagnostic Laboratory, College of Veterinary Medicine, University of Illinois Urbana-Champaign, Urbana, IL, United States
- Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois Urbana-Champaign, Urbana, IL, United States
| | - Csaba Varga
- Department of Pathobiology, College of Veterinary Medicine, University of Illinois Urbana-Champaign, Urbana, IL, United States
| | - Jennifer M. Reinhart
- Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois Urbana-Champaign, Urbana, IL, United States
| | - Carol W. Maddox
- Veterinary Diagnostic Laboratory, College of Veterinary Medicine, University of Illinois Urbana-Champaign, Urbana, IL, United States
- Department of Pathobiology, College of Veterinary Medicine, University of Illinois Urbana-Champaign, Urbana, IL, United States
| | - Ryan N. Dilger
- Department of Animal Science, College of Agriculture, Consumer and Environmental Sciences, University of Illinois Urbana-Champaign, Urbana, IL, United States
| | - Lauren Forsythe
- Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois Urbana-Champaign, Urbana, IL, United States
| | - Amy K. Stevenson
- Veterinary Diagnostic Laboratory, College of Veterinary Medicine, University of Illinois Urbana-Champaign, Urbana, IL, United States
| | - Rebecca J. Franklin-Guild
- Animal Health Diagnostic Center, College of Veterinary Medicine, Cornell University, Ithaca, NY, United States
| | - Narayan C. Paul
- Texas A&M Veterinary Medical Diagnostic Laboratory, College Station, TX, United States
| | - Akhilesh Ramachandran
- Oklahoma Animal Disease Diagnostic Laboratory, College of Veterinary Medicine, Oklahoma State University, Stillwater, OK, United States
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Murray O, Furrow E, Granick J, Merkel L, Lulich J. Safety and efficacy of nightly nitrofurantoin as prophylaxis in dogs with recurrent urinary tract infections: 13 cases (2015-2021). J Small Anim Pract 2023; 64:477-484. [PMID: 36971090 DOI: 10.1111/jsap.13611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 02/06/2023] [Accepted: 03/05/2023] [Indexed: 03/29/2023]
Abstract
OBJECTIVES To report the protocol, efficacy and adverse events in dogs receiving nightly nitrofurantoin therapy as antimicrobial prophylaxis for recurrent urinary tract infections. MATERIALS AND METHODS Retrospective case series of dogs prescribed nitrofurantoin as prophylaxis for recurrent urinary tract infections. Data on urological history, diagnostic investigation, protocol, adverse events and efficacy (through serial urine cultures) were extracted from medical records. RESULTS Thirteen dogs were included. Before therapy, dogs had a median of 3 (range 3 to 7) positive urine cultures in the past year. In all but one dog, standard antimicrobial therapy was given before starting the nightly nitrofurantoin. The nightly nitrofurantoin was then prescribed at a median dose of 4.1 mg/kg orally every 24 hours for a median of 166 days (range 44 to 1740). The median infection-free interval on therapy was 268 days (95% confidence interval: 165 to undefined). Eight dogs had no positive urine cultures while on therapy. Of these, five (three which discontinued and two which remained on nitrofurantoin) had no return of clinical signs or bacteriuria at time of last follow-up evaluation or death, and three had suspected or confirmed bacteriuria 10 to 70 days after discontinuation. Five dogs developed bacteriuria on therapy, four of which were nitrofurantoin-resistant Proteus spp. Most other adverse events were minor; none were considered likely caused by the drug on causality assessment. CLINICAL SIGNIFICANCE Based on this small study group, nightly nitrofurantoin appears well tolerated and might be efficacious prophylaxis for recurrent urinary tract infections in dogs. Infection with nitrofurantoin-resistant Proteus spp. was a common reason for treatment failure.
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Affiliation(s)
- O Murray
- Veterinary Medical Center, University of Minnesota, St Paul, Minnesota, 55108, USA
| | - E Furrow
- Veterinary Medical Center, University of Minnesota, St Paul, Minnesota, 55108, USA
| | - J Granick
- Veterinary Medical Center, University of Minnesota, St Paul, Minnesota, 55108, USA
| | - L Merkel
- Veterinary Medical Center, University of Minnesota, St Paul, Minnesota, 55108, USA
| | - J Lulich
- Veterinary Medical Center, University of Minnesota, St Paul, Minnesota, 55108, USA
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Ylhäinen A, Mölsä S, Grönthal T, Junnila J, Rantala M, Laitinen-Vapaavuori O, Thomson K. A double-blinded randomized placebo-controlled non-inferiority trial protocol for postoperative infections associated with canine pyometra. BMC Vet Res 2023; 19:77. [PMID: 37340459 DOI: 10.1186/s12917-023-03629-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 06/02/2023] [Indexed: 06/22/2023] Open
Abstract
BACKGROUND Pyometra is a common infectious condition, especially in elderly bitches. In addition to an infected uterus, dogs may have concurrent urinary tract infection (UTI). The preferred treatment is surgical removal of the ovaries and uterus, whereupon the general prognosis is excellent. In addition, antimicrobial therapy is frequently prescribed for postoperative treatment. However, no research exists on the benefit of postoperative antimicrobial treatment in uncomplicated canine pyometra. Antimicrobial resistance has become a major challenge in treatment of bacterial infections. Diminishing overuse of antimicrobial agents is essential for controlling the development of antimicrobial resistance in both animals and humans. METHODS This double-blinded, randomized, placebo-controlled two-arm clinical trial is designed to compare the incidence of postoperative infections associated with surgical treatment of uncomplicated pyometra followed by two different treatment protocols. For the study, 150 dogs presenting with an uncomplicated pyometra and that are to undergo surgical treatment will be recruited. Dogs with body weight < 3 or > 93 kg, complicated pyometra, primary disease increasing the risk of infection, or immunosuppressive medication will be excluded. All dogs will receive one dose of sulfadoxine-trimethoprim intravenously as an antimicrobial prophylaxis. Postoperatively, dogs will be randomized to receive either a five-day course of placebo or an active drug, sulfadiazine-trimethoprim orally. During the surgery microbiological samples will be taken from urine and uterine content. The follow-up includes a control visit in 12 days and an interview of the owner 30 days after surgery. If bacteriuria is detected at the time of surgery, a urinary sample will be cultured for bacterial growth at the control visit. The primary outcome is the incidence of a postoperative surgical site infection (SSI), and the secondary outcome is the occurrence of clinical UTI with bacteriuria. Intention-to-treat and per-protocol analyses will be performed to compare outcome incidences between the treatment groups. DISCUSSION Research-based evidence is necessary to create treatment guidelines for judicious use of antimicrobials. The goals of this study are to provide evidence for reducing the use of antimicrobials and targeting the treatment to patients proven to benefit from it. Publishing the trial protocol will increase transparency and promote open science practices.
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Affiliation(s)
- Anna Ylhäinen
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Viikintie 49), P.O. Box 57, Helsinki, FI-00014, Finland
| | - Sari Mölsä
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Viikintie 49), P.O. Box 57, Helsinki, FI-00014, Finland.
| | - Thomas Grönthal
- Animal Health Diagnostics Unit, Finnish Food Authority, Mustialankatu 3, Helsinki, FI-00790, Finland
| | - Jouni Junnila
- EstiMates Oy, Tykistökatu 4, Turku, FI-20520, Finland
| | - Merja Rantala
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Viikintie 49), P.O. Box 57, Helsinki, FI-00014, Finland
| | - Outi Laitinen-Vapaavuori
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Viikintie 49), P.O. Box 57, Helsinki, FI-00014, Finland
| | - Katariina Thomson
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Viikintie 49), P.O. Box 57, Helsinki, FI-00014, Finland
- Evidensia Eläinlääkäripalvelut Oy, Tammiston Kauppatie 29, Vantaa, FI-01510, Finland
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Durr BJ, Ballard LD, Knight AD, Seo KS, Langston VC, Thompson AC, Shivley JM, Brookshire WC. Assessment of accredited veterinary diagnostic laboratory use of breakpoints for canine and feline Escherichia coli infections in the United States and Canada. Front Vet Sci 2023; 10:1178522. [PMID: 37228844 PMCID: PMC10203156 DOI: 10.3389/fvets.2023.1178522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 04/19/2023] [Indexed: 05/27/2023] Open
Abstract
The objective of this study was to assess the use of breakpoints in antibiotic susceptibility testing among veterinary diagnostic laboratories in the United States and Canada. An eight-question survey was conducted via phone and email to determine how often laboratories use breakpoints consistent with published guidelines in wounds, lower urinary tract infections and upper urinary tract infections (pyelonephritis) involving Escherichia coli, both in dogs and cats, for a total of 6 different hypothetical clinical scenarios. Nineteen veterinary diagnostic laboratories that perform antibiotic susceptibility testing on samples from dogs and cats in the United States or Canada and were accredited by the American Association of Veterinary Laboratory Diagnosticians (AAVLD) responded to the survey between January 15th and September 15th, 2022. The overall response rate of laboratories that were not excluded for known lack of dog and cat antibiotic susceptibility testing was 19 of 44 laboratories. Of the 17 respondent laboratories that reported using minimal inhibitory concentration breakpoints, only four laboratories used breakpoints consistent with published guidelines in all six clinical scenarios included in the survey. Our results suggest that there is clinically important variation in what breakpoints laboratories use to determine antibiotic susceptibility, which is of antibiotic stewardship and clinical relevance. Using breakpoints that are too high, too low, or inappropriately reporting "not interpreted" as the interpretive category may result in inappropriate use of antibiotics.
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Affiliation(s)
- Brandon J. Durr
- Department of Clinical Sciences, College of Veterinary Medicine, Mississippi State University, Starkville, MS, United States
| | - Larry D. Ballard
- Department of Pathobiology and Population Medicine, College of Veterinary Medicine, Mississippi State University, Starkville, MS, United States
| | - Angela D. Knight
- Department of Pathobiology and Population Medicine, College of Veterinary Medicine, Mississippi State University, Starkville, MS, United States
| | - Keun-Seok Seo
- Department of Comparative Biomedical Sciences, College of Veterinary Medicine, Mississippi State University, Starkville, MS, United States
| | - Vernon C. Langston
- Department of Clinical Sciences, College of Veterinary Medicine, Mississippi State University, Starkville, MS, United States
| | - Alexis C. Thompson
- Department of Pathobiology and Population Medicine, College of Veterinary Medicine, Mississippi State University, Starkville, MS, United States
| | - Jacob M. Shivley
- Department of Clinical Sciences, College of Veterinary Medicine, Mississippi State University, Starkville, MS, United States
| | - W. Cooper Brookshire
- Department of Clinical Sciences, College of Veterinary Medicine, Mississippi State University, Starkville, MS, United States
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Viitanen SJ, Tuomisto L, Salonen N, Eskola K, Kegler K. Escherichia coli-associated follicular cystitis in dogs: Clinical and pathologic characterization. J Vet Intern Med 2023; 37:1059-1066. [PMID: 37154220 PMCID: PMC10229364 DOI: 10.1111/jvim.16719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 04/07/2023] [Indexed: 05/10/2023] Open
Abstract
BACKGROUND Follicular cystitis is an uncommon inflammatory change in the urinary bladder wall characterized by the formation of tertiary lymphoid structures (TLSs) in the submucosa. OBJECTIVES To characterize clinical and pathologic features of follicular cystitis in dogs and to explore in situ distribution and possible role of Escherichia coli as an associated cause. ANIMALS Eight dogs diagnosed with follicular cystitis and 2 control dogs. METHODS Retrospective descriptive study. Dogs diagnosed with follicular cystitis (macroscopic follicular lesions in the urinary bladder mucosa and histopathologic detection of TLSs in bladder wall biopsies) were identified from medical records. Paraffin embedded bladder wall biopsies were subject to in situ hybridization for E. coli 16SrRNA identification. RESULTS Follicular cystitis was diagnosed in large breed (median weight 24.9 kg, interquartile range [IQR] 18.8-35.4 kg) female dogs with a history of chronic recurrent urinary tract infections (UTIs; median duration of clinical signs 7 months, IQR 3-17 months; median number of previous UTIs 5, IQR 4-6). Positive E. coli 16SrRNA signal was detected within developing, immature and mature TLSs in 7/8 dogs, through submucosal stroma in 8/8 dogs and within the urothelium in 3/8 dogs. CONCLUSIONS AND CLINICAL IMPORTANCE Chronic inflammation associated with an intramural E. coli infection in the urinary bladder wall represents a possible triggering factor for the development of follicular cystitis.
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Affiliation(s)
- Sanna J Viitanen
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland
| | - Laura Tuomisto
- Department of Veterinary Biosciences, Pathology and Parasitology Unit, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland
| | - Nina Salonen
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland
| | - Katariina Eskola
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland
| | - Kristel Kegler
- Department of Veterinary Biosciences, Pathology and Parasitology Unit, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland
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Sun R, Cummings KJ, Beukema A, Hinckley-Boltax AL, Korich JA, Cazer CL. Veterinary Students' Knowledge and Awareness of Antimicrobial Stewardship before and after Clinical Rotations. JOURNAL OF VETERINARY MEDICAL EDUCATION 2023:e20220125. [PMID: 37104468 DOI: 10.3138/jvme-2022-0125] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Abstract
Given the global threat of antimicrobial resistance, it is imperative that veterinary graduates are effective antimicrobial stewards. Veterinary students learn the principles of antimicrobial stewardship explicitly, through pre-clinical coursework, and implicitly, through the cases they each encounter on clinical rotations. We aimed to understand the influence of pre-clinical versus clinical learning on veterinary students' knowledge and awareness of antimicrobial concepts to guide efforts to improve instruction in these areas. To assess knowledge acquisition and to explore student perceptions of antimicrobial stewardship, a standardized online survey was administered to Cornell University veterinary students at two timepoints: in August 2020 before clinical rotations (N = 26 complete responses and N = 24 partial responses) and again in May 2021 after their clinical rotations (N = 17 complete responses and N = 6 partial responses). Overall and section-specific confidence and knowledge scores were calculated, using pairwise deletion for incomplete responses. Students generally had low confidence in antimicrobial topics and correctly answered only half of knowledge questions correctly; they performed the best on antimicrobial resistance knowledge questions. There were no significant differences in knowledge or confidence after clinical rotations. On average, students had only read one antimicrobial stewardship guideline. Students reported that human health care providers contributed more to antimicrobial resistance than veterinarians. In conclusion, graduating veterinary students at our institution have significant knowledge gaps in critical principles that are essential to become antimicrobial stewards. Explicit instruction in antimicrobial stewardship is necessary in the pre-clinical and clinical coursework, and the practical use of antimicrobial stewardship guidelines should be emphasized.
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Affiliation(s)
- Ruinan Sun
- Department of Public and Ecosystem Health, Cornell University College of Veterinary Medicine, Ithaca, NY USA
| | - Kevin J Cummings
- Department of Public and Ecosystem Health, Cornell University College of Veterinary Medicine, Ithaca, NY USA
| | - Andrea Beukema
- Educational Support Services, Cornell University College of Veterinary Medicine, Ithaca, NY USA
| | - Ariana L Hinckley-Boltax
- Department of Comparative Pathobiology, Cummings School of Veterinary Medicine at Tufts University, Grafton, MA USA
| | - Jodi A Korich
- Department of Clinical Sciences, Cornell University College of Veterinary Medicine, Ithaca, NY USA
| | - Casey L Cazer
- Department of Population Medicine & Diagnostic Sciences, Cornell University College of Veterinary Medicine, Ithaca, NY, USA. Department of Public and Ecosystem Health, Cornell University College of Veterinary Medicine, Ithaca, NY USA
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Sutter CM, Dear JD, Fine JR, Pires J, Sykes JE, Segev G, Westropp JL. Evaluation of a rapid immunoassay for bacteriuria in dogs. J Vet Intern Med 2023; 37:1015-1020. [PMID: 37084042 DOI: 10.1111/jvim.16684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Accepted: 03/03/2023] [Indexed: 04/22/2023] Open
Abstract
BACKGROUND The ability to detect bacteriuria in dogs with a point-of-care test might improve medical care and antimicrobial stewardship. HYPOTHESIS AND OBJECTIVE A rapid immunoassay (RIA; RapidBac) will provide acceptable sensitivity and specificity for diagnosis of bacteriuria. ANIMALS Forty-four client-owned dogs with a clinical indication for urinalysis and aerobic bacterial urine culture. METHODS Prospective study. Urine, collected by cystocentesis, was submitted for urinalysis and culture at a diagnostic laboratory. Owners completed an enrollment questionnaire regarding their dogs' clinical signs. The RIA was performed according to the manufacturer's guidelines. Results were compared to culture. RESULTS Forty-four urine specimens were evaluated from 44 dogs. The sensitivity and specificity of the RIA test to detect bacteriuria compared to urine culture were 81.8% (95% CI, 65.7%-97.9%) and 95.5% (95% CI, 86.8%-99.9%), respectively. For cultures yielding ≥103 CFU/mL, sensitivity increased to 90.0% (95% CI, 76.9%-100%) and specificity was similar at 95.2% (95% CI, 86.1%-99.9%). Malodorous urine, bacteriuria, and pyuria were more likely to be present in dogs with positive RIA or urine culture results compared to dogs with negative results. CONCLUSIONS AND CLINICAL IMPORTANCE The RIA was easy to perform and had good sensitivity and excellent specificity in this group of dogs. The RIA might be a useful screening test for decision-making regarding antimicrobial therapy in dogs with a clinical indication for urine culture. Consideration could be given to amending the International Society for Companion Animal Infectious Disease definition of bacterial cystitis as the presence of signs of lower urinary tract disease together with positive culture or a positive RIA.
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Affiliation(s)
- Craig M Sutter
- William R. Pritchard Veterinary Medical Teaching Hospital, University of California, Davis, Davis, California, USA
| | - Jonathan D Dear
- Department of Veterinary Medicine and Epidemiology, University of California, Davis, Davis, California, USA
| | - Jeffrey R Fine
- Department of Veterinary Medicine and Epidemiology, University of California, Davis, Davis, California, USA
| | - Jully Pires
- William R. Pritchard Veterinary Medical Teaching Hospital, University of California, Davis, Davis, California, USA
| | - Jane E Sykes
- Department of Veterinary Medicine and Epidemiology, University of California, Davis, Davis, California, USA
| | - Gilad Segev
- Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Jodi L Westropp
- Department of Veterinary Medicine and Epidemiology, University of California, Davis, Davis, California, USA
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Lavin LE, Maki LC. Antimicrobial use in the surgical treatment of canine pyometra: A questionnaire survey of Arizona-licensed veterinarians. Vet Med Sci 2023; 9:1124-1133. [PMID: 37051761 DOI: 10.1002/vms3.1130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 02/06/2023] [Accepted: 03/03/2023] [Indexed: 04/14/2023] Open
Abstract
BACKGROUND Recent studies and consensus statements in veterinary and human medicine recommend more judicious use of antimicrobials. While guidelines have been provided for some veterinary diseases, others have poorly elucidated guidelines. Postoperative treatment of canine pyometra is a condition with minimal guidelines regarding antimicrobial use. OBJECTIVE To identify and investigate patterns of antimicrobial use following surgically treated canine pyometra. METHODS A 23-question survey, sent to 863 small and mixed animal practitioners, investigated demographics, patterns of antibiotic use, rate of culture submission and participant's recollection of outcomes of surgically treated pyometra cases. Responses were analysed for relationships between demographics, patterns of antibiotic use and culture results to better understand reasoning for antibiotic protocols. RESULTS One hundred and fifty-two responses were received. Overall, 76% of veterinarians stated they always use preoperative and perioperative antibiotics, and 74% stated they always use postoperative antibiotics. A total of 16 different antibiotics were reported. Twelve per cent of respondents regularly submitted a culture. Culture submission was impacted by cost, prior experience, poor owner compliance, result turnaround time and anticipated results. CONCLUSIONS Most respondents always used antibiotics and rarely or never submitted a culture. To optimise patient care, future clinical studies are needed to determine specific guidelines for the use of culture and antibiotics in the treatment of canine pyometra following ovariohysterectomy.
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Affiliation(s)
- Lindsey E Lavin
- Department of Small Animal Surgery, Ocean State Veterinary Specialists, East Greenwich, Rhode Island
| | - Lynn C Maki
- Department of Small Animal Surgery, VetMED Emergency and Specialty Veterinary Hospital, Phoenix, Arizona, United States
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Hammond TN, King RG, Danielson KC. Successful management of pelvic urethral strictures with balloon dilation in 3 cats. J Vet Emerg Crit Care (San Antonio) 2023; 33:371-379. [PMID: 36943170 DOI: 10.1111/vec.13288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 03/08/2022] [Accepted: 04/11/2022] [Indexed: 03/23/2023]
Abstract
OBJECTIVE To describe the successful management of pelvic urethral strictures in 3 young cats (1 after perineal urethrostomy, 1 after a third-time urethral obstruction, and 1 with prolonged lower urinary tract signs post-urethral obstruction) using balloon dilation and a short-term, indwelling urethral catheter. CASE SUMMARIES A 9-month-old neutered male domestic longhair cat with a urethral obstruction and a suspected congenitally narrowed urethra was treated via perineal urethrostomy. The cat later developed acute kidney injury, multidrug-resistant urinary tract infections, and a pelvic urethral stricture. A second case, a 2.3-year-old neutered male domestic shorthair cat, developed a stricture of the pelvic urethra after multiple obstructions and catheterizations. A third case, a 1.2-year-old neutered male domestic shorthair cat, had persistent and prolonged lower urinary tract signs after treatment for a urinary obstruction. The cat also had an abnormally small urethral opening and was ultimately found to have a proximal urethral stricture. The strictures in all 3 cases were successfully treated with a combination of fluoroscopic-guided balloon dilation and short-term indwelling urethral catheterization while managing any present infection. NEW OR UNIQUE INFORMATION PROVIDED To the authors' knowledge, this is the first published case series of successful balloon dilations paired with the use of a short-term indwelling urethral catheter in cats that developed urethral strictures after catheterization due to urinary obstructions. This procedure appears safe and well tolerated and appears to offer a long-term, cost-effective solution to urethral strictures at the level of the pelvis.
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Affiliation(s)
- Tara N Hammond
- Department of Emergency/Critical Care, Tufts Veterinary Emergency Treatment & Specialties, Walpole, Massachusetts, USA
| | - Ryan G King
- Department of Radiology, Tufts Veterinary Emergency Treatment & Specialties, Walpole, Massachusetts, USA
| | - Kelson C Danielson
- Department of Surgery, Tufts Veterinary Emergency Treatment & Specialties, Walpole, Massachusetts, USA
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Lien CJ, Wang SL. The impact of urine storage methods on the results of quantitative bacterial culture in dog and cat. VET MED-CZECH 2023; 68:116-121. [PMID: 37981906 PMCID: PMC10581515 DOI: 10.17221/111/2022-vetmed] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 03/22/2023] [Indexed: 11/21/2023] Open
Abstract
Quantitative bacterial culture (QBC) is the gold standard for determining urinary tract infections. However, the majority of urine samples were sent to a lab for further bacterial culture. Therefore, the storage condition was vital to maintain the quality and accuracy of the urine samples. The main objective of our study was to examine the urine QBC outcomes of (1) immediate culture, (2) culture after urine sample storage at ambient temperature for 24 h, and (3) culture after urine sample storage at 4 °C for 24 hours. There were 49 feline samples and 30 canine samples included in this study. All QBC samples kept at ambient temperature and refrigerator were consistent with immediate QBC in cats. Eight positive results from immediate QBC were in accordance with refrigerated results in dogs. There were ten positive results in the room-temperature sample with two false-positive results. Our study showed that storing conditions at room temperature or refrigeration for 24 h does not impact the results of QBC in cat urine samples. For dog samples, chilled samples have a higher accuracy rate than room temperature samples, although the overall agreement was still satisfactory.
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Affiliation(s)
- Ching-Jung Lien
- Graduate Institute of Veterinary Clinical Sciences, School of Veterinary Medicine, National Taiwan University, Taipei, Taiwan, ROC
| | - Shang-Lin Wang
- Graduate Institute of Veterinary Clinical Sciences, School of Veterinary Medicine, National Taiwan University, Taipei, Taiwan, ROC
- National Taiwan University Veterinary Hospital, National Taiwan University, Taipei, Taiwan, ROC
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47
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Mazda D, Ahamad Azahari IS, Megat Abdul Rani PA, Omar S, Lau SF. Diagnosis and management of rare sequels to feline lower urinary tract disease in two cats. VETERINARY RECORD CASE REPORTS 2023. [DOI: 10.1002/vrc2.514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Affiliation(s)
- Delna Mazda
- Department of Veterinary Clinical Studies, Faculty of Veterinary Medicine Universiti Putra Malaysia (UPM) Serdang Selangor Malaysia
| | - Ikhwan Saufi Ahamad Azahari
- Department of Companion Animal Medicine and Surgery, Faculty of Veterinary Medicine Universiti Putra Malaysia (UPM) Serdang Selangor Malaysia
| | - Puteri Azaziah Megat Abdul Rani
- Department of Companion Animal Medicine and Surgery, Faculty of Veterinary Medicine Universiti Putra Malaysia (UPM) Serdang Selangor Malaysia
| | - Sharina Omar
- Department of Veterinary Pathology and Microbiology, Faculty of Veterinary Medicine Universiti Putra Malaysia (UPM) Serdang Selangor Malaysia
| | - Seng Fong Lau
- Department of Veterinary Clinical Studies, Faculty of Veterinary Medicine Universiti Putra Malaysia (UPM) Serdang Selangor Malaysia
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Gülersoy E, Maden M, Parlak TM, Sayin Z. Comparative evaluation of selected serum and urine biomarkers in cats with interstitial and bacterial cystitis. Vet Clin Pathol 2023; 52:79-87. [PMID: 36345051 DOI: 10.1111/vcp.13174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Accepted: 05/27/2022] [Indexed: 11/10/2022]
Abstract
BACKGROUND Although feline urine is increasingly submitted for bacterial culture and susceptibility testing in veterinary practice, bacterial cystitis (BC) is relatively uncommon compared with feline interstitial cystitis (FIC), which shares similar clinical manifestations. Therefore, an investigation of certain urothelial (glycosaminoglycan [GAG], tissue inhibition metalloproteinase-2 [TIMP-2]), cytokine (interleukin 12 [IL-12]), and neurotrophic factor (nerve growth factor [NGF]) markers may aid diagnosis. OBJECTIVES We aimed to evaluate the diagnostic effectiveness of selected serum/urine biomarkers in the diagnosis of cats with FIC and BC. METHODS Twelve healthy cats (Control group) and 24 cats with feline lower urinary tract disease (FLUTD) were used, and the cats with FLUTD were divided into FIC and BC groups. RESULTS When comparing the three groups, serum GAG, IL-12, NGF, and TIMP-2 concentrations were highest in the FIC group; urine GAG, IL-12, NGF, and TIMP-2 concentrations were higher in the FIC and BC groups than those in the Control group. Serum NGF concentrations were higher in the FIC group than in all other groups. Also, serum GAG, IL-12, NGF, and TIMP-2 concentrations were found to be effective in the differential diagnosis of FIC vs BC. CONCLUSIONS We showed that serum NGF is a candidate biomarker that could be used in the diagnosis and differentiation of FIC. Urine GAG, IL-12, NGF, and TIMP-2 concentrations might be helpful in determining urinary bladder inflammation and/or damage in cats with FIC and BC. ROC analyses revealed that serum and urine biomarkers were effective for diagnosing FIC and that serum biomarkers rather than urine biomarkers were effective for the differential diagnosis of FIC and feline BC.
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Affiliation(s)
- Erdem Gülersoy
- Veterinary Faculty, Department of Internal Medicine, Harran University, Şanlıurfa, Turkey
| | - Mehmet Maden
- Veterinary Faculty, Department of Internal Medicine, Selçuk University, Konya, Turkey
| | - Tuğba Melike Parlak
- Veterinary Faculty, Department of Pharmacology and Toxicology, Selçuk University, Konya, Turkey
| | - Zafer Sayin
- Veterinary Faculty, Department of Microbiology, Selçuk University, Konya, Turkey
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Diabetes Mellitus and the Kidneys. Vet Clin North Am Small Anim Pract 2023; 53:565-580. [PMID: 36854633 DOI: 10.1016/j.cvsm.2023.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2023]
Abstract
The pathomechanisms implicated in diabetic kidney disease in people are present in dogs and cats and, in theory, could lead to renal complications in companion animals with long-standing diabetes mellitus. However, these renal complications develop during a long period, and there is little to no clinical evidence that they could lead to chronic kidney disease in companion animals.
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50
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Ritson K, Bird F, Stefanidis G, Brissot H. The indications, complications and outcomes of dogs undergoing partial penile amputation: 10 cases (2014-2021). J Small Anim Pract 2023; 64:103-110. [PMID: 36376076 DOI: 10.1111/jsap.13564] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 08/10/2022] [Accepted: 09/12/2022] [Indexed: 11/16/2022]
Abstract
OBJECTIVES To report the signalment, indications for surgery, postoperative complications and medium-/long-term outcomes in dogs undergoing partial penile amputation. MATERIALS AND METHODS Retrospective case series. The electronic medical records of a single small animal referral hospital were searched between January 2014 and January 2021 for dogs that underwent a partial penile amputation. Data collected included signalment, presenting clinical signs, indication for partial penile amputation, surgical technique, postoperative complications and outcome. RESULTS Ten dogs were included in the study. Indications for surgery were treatment of preputial neoplasia (n=5), penile neoplasia (n=1), idiopathic paraphimosis (n=3) and chronic urethritis (n=1). Five of five preputial tumours were cutaneous mast cell tumours, and the penile tumour was a squamous cell carcinoma. All dogs recovered uneventfully from surgery with a median postoperative hospitalisation time of 28.8 hours. Two of the three dogs treated for paraphimosis had major postoperative complications requiring further resection of the tip of the penis at 2 weeks and 24 months. Four dogs had minor complications managed without surgical intervention. The outcome was good to excellent in nine of nine dogs for which medium- or long-term follow-up data were available. CLINICAL SIGNIFICANCE In this group of dogs, partial penile amputation, performed with or without concurrent resection of the prepuce, was a well-tolerated surgical procedure with low intraoperative and postoperative complication rates and good functional outcomes. Partial penile amputation should be considered for conditions affecting the distal penis and prepuce.
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Affiliation(s)
- K Ritson
- Willows Veterinary Centre and Referral Service, Highlands Road, Shirley, Solihull, B90 4NH, West Midlands, UK
| | - F Bird
- European Specialist in Small Animal Surgery, Pride Veterinary Centre, Riverside Road, Derby, DE24 8HX, Derbyshire, UK
| | - G Stefanidis
- Vet Clinic S. Stefanidis Protomagias 7 & Aigaiou 5, N. Erythraia, Néa Erithraía, 14671, Greece
| | - H Brissot
- European Specialist in Small Animal Surgery, Azurvet, 769 Avenue Pierre et Marie Curie, Saint-Laurent-du-Var, France
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