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D’Août C, Taylor SS, Gelendi S, Atkinson C, Defauw P. Bacteriuria in Cystocentesis Samples from Cats in the United Kingdom: Prevalence, Bacterial Isolates, and Antimicrobial Susceptibilities. Animals (Basel) 2022; 12:ani12233384. [PMID: 36496905 PMCID: PMC9739958 DOI: 10.3390/ani12233384] [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: 10/07/2022] [Revised: 10/26/2022] [Accepted: 11/29/2022] [Indexed: 12/05/2022] Open
Abstract
Bacterial urinary tract infections (UTIs) have historically been reported to be uncommon in cats; however, recent studies showed a higher prevalence. Bacterial UTIs are one of the most common reasons for the use of antimicrobial drugs in veterinary medicine. Our aim was to investigate the prevalence of positive cultures in urine samples submitted to a UK laboratory for testing, as well as prevalence of bacterial species and their antimicrobial susceptibility to commonly used antibiotics. This was a retrospective analysis of positive cultures from feline urine samples collected by cystocentesis submitted over 14 months (January 2018-February 2019). A total of 2712 samples were reviewed, of which 425 documented a positive culture (15.7%) with a total of 444 bacterial isolates. E. coli (43.7%), other Enterobacterales (26.4%), Enterococcus species (14.9%) and Staphylococcus species (9.2%) were the most commonly isolated bacteria. E. coli most commonly showed resistance to cephalexin (20.7%) and amoxicillin (16.7%). Resistance was most commonly seen against amoxicillin (64.1%) and cephalexin (52.2%) in Enterobacterales. Enterococcus species most commonly showed resistance to trimethoprim/sulfamethoxazole (94.3%). Staphylococcus species most commonly showed resistance to amoxicillin (20%). This study showed significant resistance of bacteria found in feline urine samples in the UK to frequently used antibiotics.
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Affiliation(s)
- Clarisse D’Août
- Internal Medicine Department, Lumbry Park Veterinary Specialists, Selborne Road, Alton GU34 3HL, UK
- Correspondence:
| | - Samantha S. Taylor
- Internal Medicine Department, Lumbry Park Veterinary Specialists, Selborne Road, Alton GU34 3HL, UK
| | - Stefania Gelendi
- Royal (Dick) School of Veterinary Studies, University of Edinburgh, Easter Bush Campus, Midlothian EH25 6RG, UK
| | - Carl Atkinson
- Axiom Veterinary Laboratories Ltd., Manor House, Brunel Rd, Newton Abbott TQ12 4PB, UK
| | - Pieter Defauw
- Internal Medicine Department, Lumbry Park Veterinary Specialists, Selborne Road, Alton GU34 3HL, UK
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Mannion A, McGee W, Feng Y, Shen Z, Buckley-Jordan E, Dzink-Fox JL, Fox JG. Characterization of genotoxin-encoding Escherichia coli isolated from specific-pathogen free cats with impaired fertility. Vet Microbiol 2022; 266:109337. [DOI: 10.1016/j.vetmic.2022.109337] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 12/18/2021] [Accepted: 01/08/2022] [Indexed: 10/19/2022]
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3
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Yu JH, Papich MG, Garcés Torres R, Emerson J, Kinney ME, Helmick K, Crosier A, Sanchez CR, Murray S. Cefovecin pharmacokinetics after single-dose intramuscular administration in cheetahs (Acinonyx jubatus). J Vet Pharmacol Ther 2021; 44:829-835. [PMID: 33778954 DOI: 10.1111/jvp.12969] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Revised: 02/08/2021] [Accepted: 02/27/2021] [Indexed: 11/26/2022]
Abstract
Cefovecin is a third-generation cephalosporin with potential value for use in exotic felids due to its long duration of action. A sparse sampling protocol was implemented with 18 zoo-housed cheetahs (Acinonyx jubatus) to evaluate the pharmacokinetics of cefovecin (Convenia® ) after a single 8 mg/kg intramuscular injection. Blood was collected serially for 15 days following administration, and plasma cefovecin concentrations were determined using high-pressure liquid chromatography with ultraviolet detection. Pharmacokinetic parameters were estimated using population pharmacokinetic methods and non-linear mixed effects modeling (NLME). Cefovecin was well tolerated by all cats, with no adverse effects observed. Peak plasma cefovecin concentration was 84.75 µg/ml, with a mean residence time of 207.9 h and an elimination half-life of 144.1 h (6.00 days). Plasma concentrations of cefovecin were maintained >7 µg/ml in all individuals for the entire study duration (15 days). These concentrations are lower, and the half-life slightly shorter, than the values reported for domestic cats. Cefovecin was highly protein-bound (approximately 99.9%) in cheetah plasma, which is nearly identical to domestic cats. These results indicate that cefovecin is potentially useful as a long-acting antibiotic in cheetahs.
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Affiliation(s)
- Jennifer H Yu
- Global Health Program, Smithsonian's National Zoo and Conservation Biology Institute, Washington, DC, USA
| | - Mark G Papich
- Department of Molecular Biomedical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
| | | | | | | | - Kelly Helmick
- Department of Veterinary Medicine, Smithsonian's National Zoo and Conservation Biology Institute, Front Royal, VA, USA
| | - Adrienne Crosier
- Center for Species Survival, Smithsonian's National Zoo and Conservation Biology Institute, Front Royal, VA, USA
| | | | - Suzan Murray
- Global Health Program, Smithsonian's National Zoo and Conservation Biology Institute, Washington, DC, USA
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Lavin LE, Amore AR, Shaver SL. Urethral obstruction and urolithiasis associated with patent urachus in a 12-week-old kitten. JFMS Open Rep 2020; 6:2055116920909920. [PMID: 32231787 PMCID: PMC7082871 DOI: 10.1177/2055116920909920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Case summary A 12-week-old intact male domestic shorthair kitten presented for dysuria. The patient had a urethral obstruction that was relieved with urinary catheter placement. A cutaneous opening at the umbilicus was identified. Three-view abdominal radiographs and a contrast study revealed a patent urachus with no evidence of urine leakage into the abdomen. An exploratory laparotomy was performed that confirmed a patent urachus, which was excised, and cystic and urethral calculi, which were removed via cystotomy. The patient recovered well from surgery, with a 12 h period of stranguria occurring 2 days postoperatively, attributed to residual inflammation. Calculi analysis revealed struvite stones, likely secondary to infection and inflammation. At the time of writing, 3 months postoperatively, the kitten had one episode of hematuria and inappropriate urination, which resolved with a short course of non-steroidal anti-inflammatory drugs, but had been otherwise been asymptomatic and healthy. Relevance and novel information To our knowledge, this is the first report of urolithiasis and patent urachus in a pediatric feline patient. Based on the occurrence of struvite stones in the presence of a patent urachus in an animal of this age, we suspect that chronic infection and inflammation led to the development of urolithiasis. Correction of the patent urachus resulted in almost complete resolution of clinical signs and no crystal formation was appreciated on recheck urinalysis.
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Affiliation(s)
- Lindsey E Lavin
- Department of Small Animal Specialty Medicine, College of Veterinary Medicine, Midwestern University, Glendale, AZ, USA
| | - Amanda R Amore
- Department of Small Animal Specialty Medicine, College of Veterinary Medicine, Midwestern University, Glendale, AZ, USA
| | - Stephanie L Shaver
- Department of Small Animal Specialty Medicine, College of Veterinary Medicine, Midwestern University, Glendale, AZ, USA
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Abstract
This study was done to investigate epidemiological data and to report causes of lower urinary tract disease in a population of cats presented at the Small Animal Clinic of the University of Veterinary and Pharmaceutical Sciences Brno. Cats presented with lower urinary tract disease signs that had undergone a thorough physical examination and urinalysis (dipstick, urine specific gravity, urine sediment and dipslide urine culture) were included in the study. Urine samples were collected only by cystocentesis or sterile catheterization. Bloodwork, abdominal ultrasound, and abdominal radiographs were performed in 118 (66%), 170 (96%) and 9 (5%) patients, respectively. Cats that were treated with antibiotics or glucocorticoids during an episode of feline lower urinary tract disease (FLUTD) or during the foregoing month and which had undergone perineal urethrostomy or catheterization in private practice, were excluded. The study population consisted of 177 cats. Forty-one (23%) cats were diagnosed with a urethral plug, 26 cats (14%) with a urinary tract infection (UTI), 9 cats (5%) with urolithiasis and 101 cats (57%) with feline idiopathic cystitis (FIC). The cats diagnosed with UTI were significantly older than the cats with FIC, urethral plugs and urolithiasis. Urinary tract infection was diagnosed significantly more often in patients older than 10 years, and in female cats. The diagnosis of urethral plug was made significantly more often in males. Feline idiopathic cystitis and urethral plugs are the most common causes of FLUTD, and the causes are significantly age and sex-related.
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Flaminio KP, Christensen JM, Alshahrani SM, Mohammed SM. Pharmacokinetics after subcutaneous administration of a single dose of cefovecin sodium in African lions (Panthera leo). Am J Vet Res 2019; 80:230-234. [DOI: 10.2460/ajvr.80.3.230] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Burke S, Black V, Sánchez-Vizcaíno F, Radford A, Hibbert A, Tasker S. Use of cefovecin in a UK population of cats attending first-opinion practices as recorded in electronic health records. J Feline Med Surg 2017; 19:687-692. [PMID: 27507842 PMCID: PMC11128814 DOI: 10.1177/1098612x16656706] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Objectives The objective was to use electronic health records to describe the use of cefovecin (Convenia; Zoetis UK), a third-generation long-acting injectable antimicrobial, in a UK population of cats attending first-opinion practices, and to compare the use of Convenia with the licensed uses described on the UK Convenia datasheet. Methods Data were obtained as an Excel database from the Small Animal Veterinary Surveillance Network for all feline consultations containing the word Convenia and/or cefovecin from 1 September 2012 to 23 September 2013 inclusive. Entries were classified according to body system treated, confirmation or suspicion of an abscess, evidence of microbiological evaluation being performed, any concurrent therapies given and whether any reason was given for use of Convenia over alternative antimicrobials. Data were exported to IBM SPSS Statistics and descriptive analysis performed. Results In total, 1148 entries were analysed. The most common body system treated was skin in 553 (48.2%) entries, then urinary (n = 157; 13.7%) and respiratory (n = 112; 9.8%). Microbiological evaluation was recorded in 193 (16.8%) entries, with visible purulent material most commonly cited (in 147 [12.8%] entries). A reason for prescribing Convenia over alternative antimicrobials was given in 138 (12.0%) entries; the most cited was an inability to orally medicate the cat in 77 (55.8%) of these entries. Excluding 131 entries where no body system or multiple body systems were described, the use of Convenia complied with a licensed use in the UK datasheet in 710 (69.8%) of 1017 entries. Conclusions and relevance Most administrations were licensed uses; however, most entries did not describe any microbiological evaluation, or a reason for prescribing Convenia over alternative antimicrobials. Further education of the public and the veterinary profession is needed to promote antimicrobial stewardship in the UK. Health records provide a valuable tool with which to monitor, both locally and at scale, the use of important therapeutics like antimicrobials. Information relevant to decision-making should be recorded in individual animal health records.
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Affiliation(s)
- Sara Burke
- The Feline Centre, Langford Veterinary Services, University of Bristol, Bristol, UK
- Current address: CityVets, Exeter, UK
| | - Vicki Black
- The Feline Centre, Langford Veterinary Services, University of Bristol, Bristol, UK
| | | | - Alan Radford
- Institute of Infection and Global Health, University of Liverpool, Neston, UK
| | - Angie Hibbert
- The Feline Centre, Langford Veterinary Services, University of Bristol, Bristol, UK
| | - Séverine Tasker
- The Feline Centre, Langford Veterinary Services, University of Bristol, Bristol, UK
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8
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Long-lasting concentrations of cefovecin after subcutaneous and intramuscular administration to Patagonian sea lions (Otaria flavescens). Vet J 2016; 208:65-9. [DOI: 10.1016/j.tvjl.2015.09.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2014] [Revised: 09/08/2015] [Accepted: 09/11/2015] [Indexed: 11/18/2022]
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9
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Whitehouse W, Viviano K. Update in feline therapeutics: clinical use of 10 emerging therapies. J Feline Med Surg 2015; 17:220-34. [PMID: 25701861 PMCID: PMC11148892 DOI: 10.1177/1098612x15571879] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/10/2024]
Abstract
PRACTICAL RELEVANCE The field of veterinary medicine is constantly evolving. New medications are being introduced into clinical practice, and novel uses for established medications are frequently being discovered as new information comes to light. CLINICAL CHALLENGES Therapeutic options for our feline patients can be restricted based on inadequate clinical evidence, adverse effects and patient compliance concerns. Additionally, with the reduced availability of commonly used medications in some regions, clinicians are forced to utilize alternatives with which they may have limited experience. AUDIENCE This review article is directed towards primary care veterinarians working with feline patients. The selection of medications discussed is based on many of the clinical challenges commonly encountered in practice. EVIDENCE BASE The evidence for use of some of these medications is limited due to their novelty. Known mechanisms of action, pharmacokinetic and pharmacodynamics data, adverse effects and clinical uses are reviewed where possible, with clinical recommendations made based on the evidence of data available.
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Affiliation(s)
- William Whitehouse
- Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin, 2015 Linden Drive, Madison, WI 53706, USA
| | - Katrina Viviano
- Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin, 2015 Linden Drive, Madison, WI 53706, USA
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Dokuzeylül B, Kahraman BB, Bayrakal A, Siğirci BD, Çelik B, Ikiz S, Kayar A, Or ME. Bacterial species isolated from cats with lower urinary tract infection and their susceptibilities to cefovecin. Ir Vet J 2015; 68:2. [PMID: 25745557 PMCID: PMC4350456 DOI: 10.1186/s13620-015-0030-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2013] [Accepted: 01/12/2015] [Indexed: 12/02/2022] Open
Abstract
Background The aim of this study was to determine the bacterial species recovered from 61 cats with lower urinary tract infection (LUTI), and their susceptibility to cefovecin in vitro. Results The clinical signs and final clinical diagnosis for cats with confirmed LUTI were also reported. After physical examination of the cats, urine samples including ≥5-6 leucocytes in microscopic evaluation were cultured using bacteriological techniques. The isolates were identified by conventional microbiological methods and tested for in vitro susceptibility using the Kirby-Bauer disc diffusion method recommended by the Clinical Laboratory Standards Institute. Bacterial growth was observed in 16 of 61 urine samples. Antimicrobial susceptibility tests showed that 13 of 16 (81%) isolates were susceptible to cefovecin. The most frequently isolated bacterium from cats with signs of lower urinary tract infection, was Escherichia coli. Conclusion Cefovecin was found to be effective in cats with LUTI. Because cefovecin is a new antimicrobial agent in veterinary medicine, there are only few studies about urine culture of cats with LUTI. It is the first study on in vitro activity of cefovecin against bacterial isolates from cats with lower urinary infections in Istanbul, Turkey.
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Affiliation(s)
- Banu Dokuzeylül
- Department of Internal Medicine, Faculty of Veterinary Medicine, Istanbul University, 34320 Avcılar, Istanbul, Turkey
| | - Beren Başaran Kahraman
- Department of Microbiology, Faculty of Veterinary Medicine, Istanbul University, 34320 Avcılar, Istanbul, Turkey
| | - Alper Bayrakal
- Department of Internal Medicine, Faculty of Veterinary Medicine, Istanbul University, 34320 Avcılar, Istanbul, Turkey
| | - Belgi Diren Siğirci
- Department of Microbiology, Faculty of Veterinary Medicine, Istanbul University, 34320 Avcılar, Istanbul, Turkey
| | - Baran Çelik
- Department of Microbiology, Faculty of Veterinary Medicine, Istanbul University, 34320 Avcılar, Istanbul, Turkey
| | - Serkan Ikiz
- Department of Microbiology, Faculty of Veterinary Medicine, Istanbul University, 34320 Avcılar, Istanbul, Turkey
| | - Abdullah Kayar
- Department of Internal Medicine, Faculty of Veterinary Medicine, Istanbul University, 34320 Avcılar, Istanbul, Turkey
| | - M Erman Or
- Department of Internal Medicine, Faculty of Veterinary Medicine, Istanbul University, 34320 Avcılar, Istanbul, Turkey
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11
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Jessen LR, Sørensen TM, Bjornvad CR, Nielsen SS, Guardabassi L. Effect of antibiotic treatment in canine and feline urinary tract infections: a systematic review. Vet J 2014; 203:270-7. [PMID: 25634080 DOI: 10.1016/j.tvjl.2014.12.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2014] [Revised: 12/04/2014] [Accepted: 12/07/2014] [Indexed: 10/24/2022]
Abstract
Urinary tract infection (UTI) is a major reason for antibiotic prescription in small animal practice. Optimal antibiotic treatment strategies have not been established for veterinary species, especially when considering duration of treatment, which is often considerably longer than for human patients with UTI. The aims of this study were (1) to identify and assess evidence related to the efficacy of antibiotic treatment in canine and feline UTIs; and (2) to compare the efficacy of short (<5 days) and standard (≥7 days) duration of antibiotic treatment for canine uncomplicated UTI. An electronic literature search was conducted for publications to 1 May 2014. Fourteen peer-reviewed prospective and controlled studies were retrieved, 10 of which evaluated antibiotic treatment in dogs and four in cats. Of the 14 studies, seven were clinical trials and five of those were randomised controlled trials. Most (12/14) studies were not considered to contribute sufficient evidence to evaluate treatment strategies. There were no clinical studies examining the effect of duration of the same drug. Of the short duration regimens evaluated, the efficacy of 3 day antibiotic therapy with trimethoprim-sulphonamide (females only) or high-dose enrofloxacin in dogs with uncomplicated UTIs was supported by fair evidence, as these treatment strategies were non-inferior to medium duration (10-14 days) therapy with β-lactam antimicrobials. In conclusion, there is little published evidence relating to antibiotic treatment of UTIs in dogs and cats. Well-designed clinical trials focusing on the duration of treatment are warranted to create evidence-based treatment protocols.
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Affiliation(s)
- L R Jessen
- Department of Veterinary Clinical and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Dyrlaegevej 16, 1870 Frederiksberg C, Denmark.
| | - T M Sørensen
- Department of Veterinary Clinical and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Dyrlaegevej 16, 1870 Frederiksberg C, Denmark
| | - C R Bjornvad
- Department of Veterinary Clinical and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Dyrlaegevej 16, 1870 Frederiksberg C, Denmark
| | - S Saxmose Nielsen
- Department of Large Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Groennegaardsvej 8, 1870 Frederiksberg C, Denmark
| | - L Guardabassi
- Department of Veterinary Disease Biology, Faculty of Health and Medical Sciences, University of Copenhagen, Stigboejlen 4, 1870 Frederiksberg C, Denmark
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Dorsch R, von Vopelius-Feldt C, Wolf G, Straubinger RK, Hartmann K. Feline urinary tract pathogens: prevalence of bacterial species and antimicrobial resistance over a 10-year period. Vet Rec 2014; 176:201. [PMID: 25351232 DOI: 10.1136/vr.102630] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
The purpose of this retrospective study was to identify bacterial species in cats with bacterial urinary tract infections (UTIs) and to investigate their antimicrobial susceptibilities over a 10-year period. Three hundred and thirty cultures from 280 cats were included in the study. The mean age of affected cats was 9.9 years; female cats with bacterial UTIs were significantly older than male cats with UTIs. The most common pathogen identified was Escherichia coli (42.3 per cent), followed by Streptococcus species (19.3 per cent), Staphylococcus species (15.6 per cent), Enterococcus species (6.6 per cent) and Micrococcaceae (5.8 per cent). Forty specimens (12.1 per cent) yielded growth of more than one isolate. Streptococcus and Enterococcus isolates were resistant to a significantly higher number of antimicrobial agents than E coli and Staphylococcus species isolates. Applying the formula to select rational antimicrobial therapy, bacterial isolates were most likely to be susceptible to nitrofurantoin, amoxicillin clavulanic acid, enrofloxacin and gentamicin. The antimicrobial impact factor for nitrofurantoin increased significantly over the 10-year period, whereas there was no significant change in antimicrobial impact factors for doxycycline, trimethoprim-sulfamethoxazole, gentamicin, enrofloxacin, cephalothin and amoxicillin clavulanic acid. The detected changes in in vitro antimicrobial efficacy could help to develop hospital-specific guidelines for antimicrobial use to prevent the further development of resistance in feline uropathogens.
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Affiliation(s)
- Roswitha Dorsch
- Clinic of Small Animal Medicine, LMU Munich, Veterinärstr. 13, Munich 80539, Germany
| | | | - Georg Wolf
- Institute for Infectious Diseases and Zoonoses, LMU Munich, Veterinärstr. 13, Munich 80539, Germany
| | - Reinhard K Straubinger
- Institute for Infectious Diseases and Zoonoses, LMU Munich, Veterinärstr. 13, Munich 80539, Germany
| | - Katrin Hartmann
- Clinic of Small Animal Medicine, LMU Munich, Veterinärstr. 13, Munich 80539, Germany
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13
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Freise KJ, Lin TL, Fan TM, Recta V, Clark TP. Evidence-based medicine: the design and interpretation of noninferiority clinical trials in veterinary medicine. J Vet Intern Med 2013; 27:1305-17. [PMID: 24128266 DOI: 10.1111/jvim.12211] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2013] [Revised: 08/08/2013] [Accepted: 08/27/2013] [Indexed: 11/28/2022] Open
Abstract
Noninferiority trials are clinical studies designed to demonstrate that an investigational drug is at least as effective as an established treatment within a predetermined margin. They are conducted, in part, because of ethical concerns of administering a placebo to veterinary patients when an established effective treatment exists. The use of noninferiority trial designs has become more common in veterinary medicine with the increasing number of established veterinary therapeutics and the desire to eliminate potential pain or distress in a placebo-controlled study. Selecting the appropriate active control and an a priori noninferiority margin between the investigational and active control drug are unique and critical design factors for noninferiority studies. Without reliable historical knowledge of the disease response in the absence of treatment and of the response to the selected active control drug, proper design and interpretation of a noninferiority trial is not possible. Despite the appeal of conducting noninferiority trials to eliminate ethical concerns of placebo-controlled studies, there are real limitations and possible ethical conundrums associated with noninferiority trials. The consequences of incorrect study conclusions because of poor noninferiority trial design need careful attention. Alternative trial designs to typical noninferiority studies exist, but these too have limitations and must also be carefully considered.
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Affiliation(s)
- K J Freise
- Nexcyon Pharmaceuticals Inc, Madison, WI
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CEFOVECIN (CONVENIA) FOR THE TREATMENT OF SEPTIC PERITONITIS IN A FEMALE LION (PANTHERA LEO). J Zoo Wildl Med 2012; 43:678-81. [DOI: 10.1638/2012-0038r.1] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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15
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Litster AL, Wu CC, Constable PD. Comparison of the efficacy of amoxicillin-clavulanic acid, cefovecin, and doxycycline in the treatment of upper respiratory tract disease in cats housed in an animal shelter. J Am Vet Med Assoc 2012; 241:218-26. [DOI: 10.2460/javma.241.2.218] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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16
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Sævik BK, Trangerud C, Ottesen N, Sørum H, Eggertsdóttir AV. Causes of lower urinary tract disease in Norwegian cats. J Feline Med Surg 2011; 13:410-7. [PMID: 21440473 DOI: 10.1016/j.jfms.2010.12.012] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2010] [Revised: 12/20/2010] [Accepted: 12/24/2010] [Indexed: 10/18/2022]
Abstract
A study was made on causes of lower urinary tract disease in cats, and to investigate whether demographic data and factors related to husbandry might influence the occurrence of a particular diagnosis. The study was a prospective, descriptive, and analytical study of primary cases of feline lower urinary tract disease (FLUTD) in Norway. Only cats sampled by cystocentesis were included in the present study. Of the 119 cats included, 28.6% were diagnosed with obstructive FLUTD. The majority of cats were diagnosed with feline idiopathic cystitis (FIC) (55.5%). Urethral plugs were the second most common diagnosis (21.0%), whereas bacterial cystitis and urolithiasis each were diagnosed in 11.8%. Nearly one-third (28.6%) of the cats diagnosed with urolithiasis had significant bacteriuria. Thus, significant bacteriuria was diagnosed in a total of 15.1% of the cats. There were no significant differences in the urine specific gravity, pH and amount of epithelial cells in the urine sediment in the different aetiological categories of FLUTD. There was a higher amount of red blood cells in the urine sediment in cats diagnosed with urethral plugs and urolithiasis, whereas cats with bacterial cystitis and urolithiasis had a higher amount of white blood cells in their sediment. Regarding demographic data and factors related to husbandry, cats diagnosed with FLUTD were more often males and kept strictly indoors, when compared with a 'reference population'.
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Affiliation(s)
- Bente K Sævik
- Department of Companion Animal Clinical Sciences, Norwegian School of Veterinary Science, N-0033 Oslo, Norway.
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17
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18
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Litster A, Thompson M, Moss S, Trott D. Feline bacterial urinary tract infections: An update on an evolving clinical problem. Vet J 2009; 187:18-22. [PMID: 20044282 DOI: 10.1016/j.tvjl.2009.12.006] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2009] [Revised: 11/18/2009] [Accepted: 12/05/2009] [Indexed: 11/16/2022]
Abstract
Although feline urine is increasingly submitted for bacterial culture and susceptibility testing as part of a more general diagnostic work-up for a range of presentations in veterinary practice, bacterial urinary tract infections (UTIs) are relatively uncommon due to a variety of physical and immunological barriers to infection. Culture positive urine is most often obtained from older female cats and the clinical history may include hematuria, dysuria and pollakiuria, or the infection may be occult. Urinalysis usually reveals hematuria and pyuria, and Escherichia coli and Gram-positive cocci are cultured most frequently. Most feline UTIs can be successfully treated using oral amoxicillin or amoxicillin/clavulanic acid administered for at least 14days, but the prevalence of antimicrobial resistance amongst infecting bacterial species is a growing concern. There is currently no conclusive information on the safety and efficacy of alternative therapeutic agents for the treatment of feline UTIs.
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Affiliation(s)
- Annette Litster
- Department of Veterinary Clinical Sciences, School of Veterinary Medicine, Purdue University, 625 Harrison St., West Lafayette, IN 47907, USA.
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Dunn K. Selective publication and its impact on clinical knowledge. J Small Anim Pract 2009; 50:1-2. [PMID: 19161507 DOI: 10.1111/j.1748-5827.2008.00724.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Six R, Cleaver DM, Lindeman CJ, Cherni J, Chesebrough R, Papp G, Skogerboe TL, Weigel DJ, Boucher JF, Stegemann MR. Effectiveness and safety of cefovecin sodium, an extended-spectrum injectable cephalosporin, in the treatment of cats with abscesses and infected wounds. J Am Vet Med Assoc 2009; 234:81-7. [PMID: 19119969 DOI: 10.2460/javma.234.1.81] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To evaluate the effectiveness and safety of cefovecin sodium in the treatment of cats with naturally occurring skin infections (abscesses and infected wounds). DESIGN Multicenter (26 sites), randomized, double-blind, controlled clinical trial. ANIMALS Client-owned cats of any breed with naturally occurring skin infections with associated clinical signs and confirmatory bacteriologic culture results. PROCEDURES Cats with clinical signs of skin and soft tissue infection were randomly allocated to receive a single dose of cefovecin (8 mg/kg [3.6 mg/lb], SC) followed by placebo drops administered orally once daily for 14 days or 1 SC placebo injection followed by cefadroxil (22 mg/kg [10 mg/lb], PO, once daily for 14 days). Only one 14-day treatment course was permitted. RESULTS Effectiveness of cefovecin in the treatment of cats with abscesses and infected wounds was similar to that of cefadroxil. At the final assessment on day 28, 97% (86/89) of cefovecin-treated cats and 91% (80/88) of cefadroxil-treated cats were considered treatment successes. There were no serious adverse events or deaths related to treatment. CONCLUSIONS AND CLINICAL RELEVANCE 1 SC injection of 8 mg of cefovecin/kg for the treatment of cats with naturally occurring skin infections (wounds and abscesses) was safe and as effective as cefadroxil administered orally at 22 mg/kg, once daily for 14 days.
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Affiliation(s)
- Robert Six
- Pfizer Animal Health, 7000 Portage Rd, Kalamazoo, MI 49001, USA
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Litster AL, Moss SM, Trott DJ. Urinary tract infections in cats. J Small Anim Pract 2008; 49:548. [PMID: 18844826 DOI: 10.1111/j.1748-5827.2008.00650.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Urinary tract infections in cats. J Small Anim Pract 2008; 49:426. [DOI: 10.1111/j.1748-5827.2008.00644.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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