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Fulton EA, Weir W, Czopowicz M, McBrearty AR. The relationships between sediment findings and culture results and the presence of proteinuria in canine urine samples. J Small Anim Pract 2023; 64:749-758. [PMID: 37632274 DOI: 10.1111/jsap.13669] [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: 01/18/2023] [Revised: 05/10/2023] [Accepted: 07/12/2023] [Indexed: 08/27/2023]
Abstract
OBJECTIVES To assess relationships between urine sediment and microbial culture findings and the presence of proteinuria in canine urine samples, and to assess the change in the percentage of proteinuric samples and urine protein-to-creatinine ratio when urine abnormalities resolve. MATERIALS AND METHODS Canine urine samples collected via cystocentesis and submitted for culture and contemporaneous urinalysis (including urine protein-to-creatinine ratio) were retrospectively identified. Dogs receiving corticosteroids were excluded. Associations between haematuria (red blood cells>5/high-power field), pyuria (white blood cells>5/high-power field), presence of microorganisms on microscopy, active sediment, and positive culture and proteinuria (urine protein-to-creatinine ratio>0.5) were investigated. Patient characteristics were considered possible confounders. In dogs with repeat urinalysis, the associations between active sediment and positive culture resolution on proteinuria and urine protein-to-creatinine ratio were assessed. RESULTS One hundred and ninety-two of 491 samples were proteinuric (39.1%). Age was positively associated with proteinuria. In the multivariable analysis corrected for age, active sediment was the only variable significantly associated with proteinuria (adjusted odds ratio: 2.12; 95% confidence interval: 1.44 to 3.11); however, only 49.8% of samples with active sediment were proteinuric. Neither resolution of active sediment nor positive culture were associated with reduced proportions of proteinuric samples (from 57.9% to 42.1% and from 40.0% to 25.0%, respectively) or significant reductions in urine protein-to-creatinine ratio (median change: -0.16 and -0.14, respectively). CLINICAL SIGNIFICANCE Attributing proteinuria to urinalysis abnormalities or a positive urine culture in canine cystocentesis samples is not supported by our findings, and could result in alternative causes of proteinuria (e.g. renal proteinuria) being overlooked.
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Affiliation(s)
- E A Fulton
- School of Biodiversity, One Health and Veterinary Medicine, The University of Glasgow Small Animal Hospital, 464 Bearsden Road, Glasgow, G61 1QH, Scotland
| | - W Weir
- School of Biodiversity, One Health and Veterinary Medicine, The University of Glasgow Small Animal Hospital, 464 Bearsden Road, Glasgow, G61 1QH, Scotland
| | - M Czopowicz
- Division of Veterinary Epidemiology and Economics, Institute of Veterinary Medicine, Warsaw University of Life Sciences-SGGW, Nowoursynowska 159c, 02-776, Warsaw, Poland
| | - A R McBrearty
- The University of Glasgow Small Animal Hospital and Vets Now, Glasgow, Scotland
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Labelle O, Penninck D, Butty EM, Hahn S, Dunn M. Pseudomembranous cystitis in cats with presumed or confirmed mineralization: A retrospective study of 26 cases (2016-2021). J Vet Intern Med 2023; 37:1806-1814. [PMID: 37497780 PMCID: PMC10472995 DOI: 10.1111/jvim.16819] [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: 01/15/2023] [Accepted: 07/07/2023] [Indexed: 07/28/2023] Open
Abstract
BACKGROUND Pseudomembranous cystitis (PMC) in cats is a recognized disease, but concurrent mineralization is reported rarely and its outcome is poorly described. HYPOTHESIS AND OBJECTIVES Describe a population of cats with PMC and the prevalence of concurrent mineralization. ANIMALS Twenty-six cats with PMC. METHODS Medical records were retrospectively reviewed (January 2016 to December 2021). Cats with an ultrasound diagnosis of PMC were included. Clinicopathologic results, imaging, treatment, and outcome were reviewed. RESULTS All cats were male and 21 (80%) were diagnosed with urethral obstruction (UO). Five cats (23.8%) had positive urine culture (Staphylococcus felis, 3/5; Proteus mirabilis, 2/5) with a median urine pH of 8 (range, 6-9). All cats had ultrasonographic changes suggestive of mineralization. On ultrasound examination, 10 cats (38.5%) had pseudomembranes with acoustic shadowing suggestive of mineralization, 15 (57.7%) had changes indicative of ulceration, and 8 (31%) had changes compatible with of a urachal anomaly. Twenty-two cats received medical treatment, 4 underwent surgery (3 percutaneous cystolithotomy, 1 cystotomy). Twenty cats (77%) survived to discharge. Follow-up ultrasound examination indicated resolution of PMC in 6/7 cats, 4 had persistent hyperechoic bladder lining. Five of 12 cats with follow-up had a relapse of lower urinary tract signs. CONCLUSIONS AND CLINICAL IMPORTANCE Pseudomembranous cystitis was diagnosed mainly in male cats with UO and imaging findings suggestive of mineralization were present in all cases. Frequent negative urine culture suggests a different etiology than encrusting cystitis related to urease-positive bacteria. Good outcomes can be achieved with medical management.
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Affiliation(s)
- Olivier Labelle
- Veterinary Teaching Hospital of the University of Montreal (CHUV)St. HyacintheQuebecCanada
| | - Dominique Penninck
- Tufts Cummings School of Veterinary MedicineNorth GraftonMassachusettsUSA
| | | | | | - Marilyn Dunn
- Veterinary Teaching Hospital of the University of Montreal (CHUV)St. HyacintheQuebecCanada
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Broadbridge C, Williams TL. Evaluation of haem dipstick pad, urine protein, urine pH and urine protein:creatinine ratio results as a marker of bacteriuria in dogs and cats with inactive urine sediment. J Small Anim Pract 2023. [PMID: 37122145 DOI: 10.1111/jsap.13618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 03/13/2023] [Accepted: 03/22/2023] [Indexed: 05/02/2023]
Abstract
OBJECTIVES Evaluation of haem dipstick pad, urine protein, urine pH and urine protein:creatinine ratio results as a marker of bacteriuria in dogs and cats with inactive urine sediment. MATERIALS AND METHODS Cats and dogs with contemporaneous urine dipstick, microscopic sediment analysis and microbiological culture and sensitivity results over a four-year period (2016 to 2020) were retrospectively identified. Dogs and cats with active urine sediments (at least five erythrocytes and/or five leukocytes per high-power field) and/or spermaturia were excluded. Association between urine pH, haem dipstick result, protein dipstick result and urine protein:creatinine ratio with bacteriuria were evaluated using binary logistic regression analysis. Likelihood ratios for bacteriuria were calculated at different diagnostic thresholds. RESULTS A total of 668 and 169 dog and cat urine samples were included. Of these, 166 dogs (25%) had a positive urine culture, whilst only 29 cats (17%) had a positive urine culture. In dogs and cats, any positive haem dipstick result was significantly associated with bacteriuria, although only a ≥4+ haem positive result in dogs was associated with a small increase in the likelihood of a positive urine culture, and positive likelihood ratios did not support the use of haem dipstick results as a screening test for bacteriuria in cats. pH, urine protein:creatinine ratio and protein dipstick results were not associated with bacteriuria. CLINICAL SIGNIFICANCE Our findings provide proof of concept that haem dipstick pad results in dogs with inactive sediment and without spermaturia might be useful as a screening test for bacteriuria, although further studies are required to confirm these findings.
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Affiliation(s)
- C Broadbridge
- Department of Veterinary Medicine, University of Cambridge, Cambridge, UK
| | - T L Williams
- Department of Veterinary Medicine, University of Cambridge, Cambridge, UK
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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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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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Coffey EL, Gomez AM, Burton EN, Granick JL, Lulich JP, Furrow E. Characterization of the urogenital microbiome in Miniature Schnauzers with and without calcium oxalate urolithiasis. J Vet Intern Med 2022; 36:1341-1352. [PMID: 35796316 PMCID: PMC9308445 DOI: 10.1111/jvim.16482] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 06/15/2022] [Indexed: 11/30/2022] Open
Abstract
Background Calcium oxalate (CaOx) uroliths are common in dogs. Humans with CaOx urolithiasis exhibit alterations of the urinary and urogenital microbiomes that might mediate urolith formation. Detection of urogenital microbes associated with CaOx in dogs could inform disease pathophysiology. Objective To identify compositional differences in the urogenital microbiome of Miniature Schnauzers with and without CaOx uroliths. Animals Nineteen midstream, voided urine samples from Miniature Schnauzers with (n = 9) and without (n = 10) a history of CaOx urolithiasis. Methods Analytical cross‐sectional study. Microbial DNA was extracted from previously frozen urine samples and sequenced for the bacterial 16S rRNA V3‐V4 hypervariable regions. Diversity and composition of microbial populations were compared between urolith formers and controls. Results Alpha and beta diversity measures were similar between groups. Five individual bacterial taxa differed in abundance (indicator values >0.5 and P < .05): Acinetobacter, 2 Geobacillus variants, and Hydrogenophaga were overrepresented in the urine of urolith formers, and Sphingopyxis was overrepresented in controls. Two distinct subtypes of urine microbial composition were observed based on beta diversity measures, independent of urolith status, and other clinical variables. Conclusions and Clinical Importance Although we did not detect a difference in the overall urogenital microbial composition between groups, observed differences in individual bacterial taxa might be clinically relevant. For example, Acinetobacter was overrepresented in urolith formers and is associated with CaOx urolithiasis in humans. Two unique clusters of the microbiome were identified, independent of urolith status, which may represent distinct urotypes present in Miniature Schnauzers.
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Affiliation(s)
- Emily L Coffey
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, Saint Paul, Minnesota, USA
| | - Andres M Gomez
- Department of Animal Science, College of Food, Agricultural and Natural Resource Sciences, University of Minnesota, Saint Paul, Minnesota, USA
| | - Erin N Burton
- Department of Veterinary and Biomedical Sciences, College of Veterinary Medicine, University of Minnesota, Saint Paul, Minnesota, USA
| | - Jennifer L Granick
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, Saint Paul, Minnesota, USA
| | - Jody P Lulich
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, Saint Paul, Minnesota, USA
| | - Eva Furrow
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, Saint Paul, Minnesota, USA
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