Serial evaluation of thoracic radiographs and acute phase proteins in dogs with pneumonia

Recognition and Diagnosis of Underlying Disease Processes in Bacterial Pneumonia

Bacterial pneumonia can present in both dogs and cats as either acute or chronic disease, and clinical signs may suggest respiratory or systemic impairment. Aspiration pneumonia, a common form of disease, can be caused by esophageal or laryngeal disease, vomiting, or altered mentation, such as with CNS disease or general anesthesia. Bacterial pneumonia can also develop due to inhaled airway foreign bodies, reduced local immune function, or impaired clearance of respiratory secretions. Rapid identification of the etiology and associated risk factors for pneumonia can help veterinarians develop a targeted therapeutic plan and prevent recurrence of disease.

Blood gases, acid-base, and metabolic alterations in calves with bronchopneumonia diagnosed via clinical signs and thoracic ultrasonography: A cross-sectional study

BACKGROUND

Bronchopneumonia (BP) in calves potentially causes systemic changes.

OBJECTIVES

To describe metabolic, arterial blood gas, and acid-base disorders in calves with BP diagnosed by thoracic ultrasound (TUS), Wisconsin score (WISC), and combinations of WISC and TUS.

ANIMALS

Two hundred thirty-one dairy preweaned dairy calves from 13 dairy farms.

METHODS

Cross-sectional study. Each calf sequentially underwent arterial blood gas evaluation, WISC score, venous sampling, and TUS. Calves were grouped based on a single diagnostic method and combination of WISC and 2 TUS cutoffs (≥1 cm; ≥3 cm) as healthy, upper respiratory tract infection, subclinical BP, and clinical BP.

RESULTS

Oxygenation and acid-base variables were unaffected. Glucose concentration in TUS-affected calves was significantly lower (P < .001) than in healthy calves (median ≥TUS1cm = 5.2 mmol/L 25%-75% interquartile range [IQR] 4.5-6.1,

CONCLUSIONS AND CLINICAL IMPORTANCE

Clinical signs indicate minor systemic disorders compared to TUS. The abnormalities detected by ultrasonographic examination were moderate and did not deviate from normal reference ranges.

Collapse

Key Words

• blood gas analysis
• calves
• clinical signs
• respiratory disease
• thoracic ultrasonography

Collapse

MESH Headings

• Animals
• Cattle
• Cross-Sectional Studies
• Cattle Diseases/diagnostic imaging
• Cattle Diseases/blood
• Bronchopneumonia/veterinary
• Bronchopneumonia/diagnostic imaging
• Bronchopneumonia/blood
• Blood Gas Analysis/veterinary
• Ultrasonography/veterinary
• Female
• Male
• Blood Glucose/analysis

Collapse

Grants

• University of Milan
• University of Milan

Collapse

Affiliation(s)

Antonio Boccardo Dipartimento di Medicina Veterinaria e Scienze Animali (DIVAS)Università degli Studi di MilanoLodiItaly
Vincenzo Ferrulli Dipartimento di Medicina Veterinaria e Scienze Animali (DIVAS)Università degli Studi di MilanoLodiItaly
Giulia Sala Dipartimento di Scienze VeterinarieUniversità degli Studi di PisaSan Piero a GradoItaly
Donatella Scavone Dipartimento di Medicina Veterinaria e Scienze Animali (DIVAS)Università degli Studi di MilanoLodiItaly
Saverio Paltrinieri Dipartimento di Medicina Veterinaria e Scienze Animali (DIVAS)Università degli Studi di MilanoLodiItaly
Laura Filippone Pavesi Dipartimento di Medicina Veterinaria e Scienze Animali (DIVAS)Università degli Studi di MilanoLodiItaly
Davide Pravettoni Dipartimento di Medicina Veterinaria e Scienze Animali (DIVAS)Università degli Studi di MilanoLodiItaly

Collapse

Utility of serum amyloid A in monitoring clinical response to antimicrobial treatment in horses with bacterial pneumonia

BACKGROUND

Serum amyloid A (SAA) is a major acute phase protein in horses which could be a useful tool for assessing clinical response to treatment of bacterial pneumonia in adult horses.

OBJECTIVES

To monitor SAA concentration in response to treatment and identify associations among SAA concentration, WBC and neutrophil counts, and fibrinogen in bacterial pneumonia in adult horses.

ANIMALS

Eighteen adult horses with bacterial pneumonia.

METHODS

Prospective clinical study. Horses hospitalized with bacterial pneumonia were enrolled and SAA concentration and vital signs were assessed daily. SAA concentration was measured by a handheld meter. CBC and plasma fibrinogen were assessed on days 0, 1, and 2, then every 3 days until discharge. Data were not normally distributed and therefore were log transformed. Log-transformed data were analyzed and comparisons were performed on LSMeans by the 2-sided Student's t-test at the 5% level of significance.

RESULTS

Geometric mean SAA concentration on day 0 was 537 μg/mL (SE 383 μg/mL). Geometric mean SAA concentration decreased significantly over time (P = .0001), peaking at day 2 (geomean 1038 μg/mL, SE 261.7 μg/mL) and decreasing until discharge. Plasma concentration of fibrinogen (P = .06), neutrophil count (P = .48), and WBC count (P = .07) did not change significantly over time.

CONCLUSIONS AND CLINICAL IMPORTANCE

SAA concentration decreased significantly over the course of treatment and correlated with clinical improvement of pneumonia whereas fibrinogen, neutrophil, and WBC counts did not.

Change over time and agreement between clinical markers of disease resolution in dogs with aspiration-induced lung injury

BACKGROUND

There is a lack of consensus regarding which markers of disease resolution to prioritise when assessing treatment response in client-owned dogs with aspiration-induced lung injury. This study describes the change over time and the agreement between the clinical markers used to determine disease resolution.

METHODS

Physical examination (PE), owner-reported clinical signs (CS-O), thoracic radiographs (TXR) scores and C-reactive protein (CRP) concentrations were determined at enrolment, after 24, 48 and 72 hours, and after 7, 14 and 28 days.

RESULTS

PE scores were significantly improved at 48 hours, while CRP initially increased (24 hours) and then decreased (48 hours). PE, CS-O and CRP significantly improved earlier (7 days) than TXR (14 days). The median number of days to marker normalisation was 7, 9 and 14 for PE, CRP and CS-O, respectively. Marker agreement was excellent/very good at enrolment and fair/poor during disease recovery.

LIMITATIONS

Analysis did not control for differences aetiology of aspiration or the lack of standardisation in treatment approach.

CONCLUSIONS

PE was the earliest and most consistent marker indicating disease resolution. Serial CRP monitoring (72 hours) may provide an objective marker of early treatment response. Alongside PE normalisation, improvement in CS-O, CRP and TRX may assist in determining disease resolution and guide treatments, including limiting antibiotic exposure in dogs with aspiration-induced lung injury.

Evaluation of Host Constitutive and Ex Vivo Coccidioidal Antigen-Stimulated Immune Response in Dogs with Naturally Acquired Coccidioidomycosis

The early innate immune response to coccidioidomycosis has proven to be pivotal in directing the adaptive immune response and disease outcome in mice and humans but is unexplored in dogs. The objectives of this study were to evaluate the innate immune profile of dogs with coccidioidomycosis and determine if differences exist based on the extent of infection (i.e., pulmonary or disseminated). A total of 28 dogs with coccidioidomycosis (pulmonary, n = 16; disseminated, n = 12) and 10 seronegative healthy controls were enrolled. Immunologic testing was performed immediately, without ex vivo incubation (i.e., constitutive), and after coccidioidal antigen stimulation of whole blood cultures. Whole blood cultures were incubated with a phosphate-buffered solution (PBS) (negative control) or a coccidioidal antigen (rCTS1 (105-310); 10 µg/mL) for 24 h. A validated canine-specific multiplex bead-based assay was used to measure 12 cytokines in plasma and cell culture supernatant. Serum C-reactive protein (CRP) was measured with an ELISA assay. Leukocyte expression of toll-like receptors (TLRs)2 and TLR4 was measured using flow cytometry. Dogs with coccidioidomycosis had higher constitutive plasma keratinocyte chemotactic (KC)-like concentrations (p = 0.02) and serum CRP concentrations compared to controls (p < 0.001). Moreover, dogs with pulmonary coccidioidomycosis had higher serum CRP concentrations than those with dissemination (p = 0.001). Peripheral blood leukocytes from dogs with coccidioidomycosis produced higher concentrations of tumor necrosis factor (TNF)-α (p = 0.0003), interleukin (IL)-6 (p = 0.04), interferon (IFN)-γ (p = 0.03), monocyte chemoattractant protein (MCP)-1 (p = 0.02), IL-10 (p = 0.02), and lower IL-8 (p = 0.003) in supernatants following coccidioidal antigen stimulation when compared to those from control dogs. There was no detectable difference between dogs with pulmonary and disseminated disease. No differences in constitutive or stimulated leukocyte TLR2 and TLR4 expression were found. These results provide information about the constitutive and coccidioidal antigen-specific stimulated immune profile in dogs with naturally acquired coccidioidomycosis.