Suspected side effects of doxycycline use in dogs - a retrospective study of 386 cases

Review canine tuberculosis - An emerging concern

Canine mycobacterial disease was first recognised over 100 years ago but is now an emerging concern. All reported cases of tuberculous disease in dogs have been caused by infection with one of three Mycobacterium tuberculosis-complex (MTBC) organisms (M. tuberculosis, Mycobacterium bovis, and Mycobacterium microti). Molecular PCR and interferon-gamma release assays offer alternative or complementary diagnostic pathways to that of specialist culture, which is limited by availability, sensitivity, and the time it takes to get a result. Optimised triple antimicrobial protocols offer an excellent chance of a successful outcome in dogs where treatment can be considered and is attempted. In this review, the clinical presentation, diagnosis, treatment, and prognosis of canine tuberculosis are discussed.

Effects of doxycycline dose rate and pre-adulticide wait period on heartworm-associated pathology and adult worm mass

BACKGROUND

The American Heartworm Society canine guidelines recommend treatment with doxycycline prior to adulticide administration to reduce levels of Wolbachia and its associated metabolites, which are known to be a leading cause of pulmonary pathology. Studies have determined that doxycycline administered at 10 mg/kg BID for 28 days is an effective dose for eliminating Wolbachia, but what has not been determined is the clinical relevance of this elimination. The current guidelines also recommend a 30-day wait period following administration of doxycycline to allow for clearance of metabolites, such as Wolbachia surface protein, and for further reduction in heartworm biomass before administration of adulticide. Reducing the doxycycline dose and eliminating the wait period may carry practical benefits for the animal, client, and practitioner.

METHODS

To investigate these treatment practices, Dirofilaria immitis adults were surgically transplanted into each of 45 dogs, which were divided into nine study groups of five dogs each. Seventy-five days after transplantation, two groups each were administered 5, 7.5, or 10 mg/kg BID doxycycline orally for 28 days and 6 µg/kg ivermectin monthly, with three untreated groups serving as controls. Study animals were necropsied and examined prior to treatment as well as 30 and 60 days post-treatment.

RESULTS

Mean worm weight was unaffected by dosage but exhibited a significant increase at 30 days and significant decrease at 60 days post-treatment, including in control groups. Histopathology lesion scores did not significantly differ among groups, with the exception of the lung composite score for one untreated group. Liver enzymes, the levels of which are a concern in doxycycline treatment, were also examined, with no abnormalities in alanine aminotransferase or alkaline phosphatase observed.

CONCLUSIONS

No consistent worsening of tissue lesions was observed with or without the AHS-recommended 30-day wait period, nor did reduced dosages of doxycycline lead to worsening of pathology or any change in efficacy in depleting worm weight. Mean worm weight did significantly increase prior to, and decrease following, the wait period. Future work that also includes adulticide treatment (i.e. melarsomine) will study treatment recommendations that may improve both animal health and owner compliance.

Clinical infection of Brucella canis in a companion dog with discospondylitis in the Republic of Korea

A 2-year-old, spayed female, Bichon Frise dog was presented with reluctance to exercise, back pain, and frequent sitting down. Multiple osteolysis, periosteal proliferation, and sclerosis of the vertebral endplates of T11-13 were observed in the radiography, computed tomography, and magnetic resonance imaging. The bacterial culture of the urine specimen, the polymerase chain reaction (PCR) of the blood, and the antibody tests were positive for Brucella canis. Accordingly, discospondylitis caused by B. canis was diagnosed and doxycycline was administered. The clinical signs resolved and the culture and PCR results were negative afterwards. Doxycycline was discontinued after 6 months. The clinical signs recurred 2 weeks later, and the combination treatment of doxycycline and enrofloxacin was initiated. Though no clinical signs were observed after 9 months and the bacterial cultures and PCR were negative, the antibody titre remained at 1 : 200 or more. The dog will continue taking antibiotics until the antibody titre drops. To the best of our knowledge, this is the first case report of a clinical infection of B. canis associated with canine discospondylitis in the Republic of Korea. Although the clinical signs of brucellosis might improve with antibiotic treatment, the disease cannot be cured due to Brucella's various strategies to evade host immune systems. Specifically, it can proliferate and replicate within the host cells, resulting in an environment that makes treatment less effective. Furthermore, owing to its zoonotic potential, owners and veterinarians should consider lifelong management or euthanasia.

The morbidity and the spectrum of applied drugs in shelter cats in the Czech Republic

Maintaining appropriate living conditions and good health of the animals should be one of the main priorities of cat shelters. The aim of this study was to assess the morbidity of shelter cats on the basis of analysis of the shelter health records in terms of the nature and quantity of medicaments and other supportive products administered in two no-kill shelters in the Czech Republic. The subject of the study were the health records of 1,884 cats, which were admitted to the selected shelters from 1.1.2013 to 31.12.2021 and their stay in the shelter was terminated in the monitored period. More than half of all cats whose records were analyzed had at least one health record made during their stay in the shelter. The overall length of stay of cats in the shelter (regardless of the outcome) in which one or more health records were found was significantly longer compared to the length of stay of cats without any health records. The highest number of health records was found in kittens <6 months old. Antibiotics, antiparasitics, and complementary/protective substances were the most used among all administered drugs. Broad-spectrum antibiotics have been administered to cats most often. In terms of classification of antibiotics according to the active substance, the most used antibiotics were penicillins, tetracyclines, and fluoroquinolones. Antibiotics were mostly used to treat diseases related to the upper and lower respiratory tract and their symptoms and gastrointestinal problems. The findings of the study contribute to understanding health problems and approaches to treating the shelter cats.

Application of Moxidectin and Ultrasound-Aided Injection of Melarsomine During the American Heartworm Society Recommended Treatment Protocol in Dirofilaria immitis Infected Dogs

The American Heartworm Society (AHS) recommends the three-dose alternate melarsomine therapeutic regimen, together with a macrocyclic lactone (ML) to reduce new infections and eliminate susceptible larvae and doxycycline against Wolbachia bacteria. Till now, only reports on ivermectin as an ML exist in the frame of this protocol. Between 2014 and 2020, the AHS protocol was used in 44 heartworm-positive dogs. Microfilaremic dogs were pretreated with prednisolone and clopidogrel for 1 week before the first moxidectin application. Moxidectin was applied on the 1st, 30th, 60th, and 90th therapeutic days. On the first day, dexamethasone and chloropyramine were used to avoid potential adverse effects caused by the destroyed microfilariae. During the 1st-28th days, doxycycline 10 mg/kg BID was given with probiotics. Adult heartworms were destroyed with melarsomine on the 60th, 90^th, and 91st days. Butorphanol and dexamethasone were given just before melarsomine injections. The depth of the intramuscular injection site was determined by ultrasound examination of the lumbar muscles. From the 60th day, dalteparin was applied for 10 days to decrease the chance of pulmonary thromboembolism. Moxidectin did not cause adverse reactions, even in microfilaremic dogs. Gastrointestinal side effects of doxycycline were observed in three (6%) dogs, they recovered after symptomatic therapy and by lowering the initial dose to 5 mg/kg BID. Transient anorexia and diarrhea were found in one (2%), and coughing and mild dyspnea in one (2%) animal as systemic post-therapeutic complications of melarsomine. No local side effects were observed in 13 (30%) dogs, mild local side effects occurred in 29 (66%) patients, and severe local swelling in 2 (4%) cases. All dogs recovered clinically by the 120th day and no microfilaremia was seen that time. An antigen test performed in 37/44 animals on the 271st day was also negative in all cases.

Doxycycline pharmacokinetics in mammalian species of veterinary interest – an overview

Doxycycline is a broad-spectrum tetracycline antibiotic widely used in veterinary medicine. The current review aims to summarise the available data about pharmacokinetics in mammalian species of veterinary interest and to indicate the basic strategies for refining dosage regimens in order to use this antibiotic reasonably. Additionally, the available data about population pharmacokinetics are reviewed as this approach exhibits a number of benefits in terms of determination of drug phar­ma­cokinetics, prediction of drug disposition and interpretation of the variations in the pharmacokinetic parameters. Further research with animal species of veterinary interest and pathogens causing diseases in animals is needed to clarify the pharmacokinetics and pharmacodynamics of doxycycline.

2D/2D Heterojunction systems for the removal of organic pollutants: A review

Photocatalysis is considered to be an effective way to remove organic pollutants, but the key to photocatalysis is finding a high-efficiency and stable photocatalyst. 2D materials-based heterojunction has aroused widespread concerns in photocatalysis because of its merits in more active sites, adjustable band gaps and shorter charge transfer distance. Among various 2D heterojunction systems, 2D/2D heterojunction with a face-to-face contact interface is regarded as a highly promising photocatalyst. Due to the strong coupling interface in 2D/2D heterojunction, the separation and migration of photoexcited electron-hole pairs are facilitated, which enhances the photocatalytic performance. Thus, the design of 2D/2D heterojunction can become a potential model for expanding the application of photocatalysis in the removal of organic pollutants. Herein, in this review, we first summarize the fundamental principles, classification, and strategies for elevating photocatalytic performance. Then, the synthesis and application of the 2D/2D heterojunction system for the removal of organic pollutants are discussed. Finally, the challenges and perspectives in 2D/2D heterojunction photocatalysts and their application for removing organic pollutants are presented.

[Use of antimicrobials in acute canine diarrhea - overview of potential risks, indications and alternatives]

In Germany, antibiotics are frequently used in dogs with gastrointestinal disorders such as acute diarrhea. In line with global efforts to limit antibiotic use, this literature review aims to provide a guideline for the rational and judicious use of antibiotics in acute canine diarrhea. Antibiotics can lead to gastrointestinal side effects and may exert a negative influence on the intestinal microbiota in addition to increasing the occurrence of resistant bacteria. There is also evidence that chronic immunological diseases may be triggered by the administration of antibiotics. Therefore, these should not be administered in uncomplicated acute diarrhea without signs of sepsis or systemic inflammatory reaction. In addition, enteropathogenic bacteria usually do not play a role in the etiology of acute diarrhea. For select clinical entities such as acute hemorrhagic diarrhea syndrome, antibiotic therapy should only be recommended in cases displaying signs of bacterial translocation with subsequent sepsis. In the case of parvovirosis, on the other hand, the administration of antibiotics is unavoidable due to the immunological incompetence of the dog caused by the accompanying severe neutropenia.

Effect of chemically modified tetracycline-8 (CMT-8) on hematology, blood chemistry, cytokines and peripheral blood lymphocyte subsets of healthy dogs

Tetracyclines are antibiotics widely used in human and veterinary medicine. Effects on the immune system and inflammatory response, including effects on blood leukocytes proliferation and function and in cytokines synthesis, have been described. Chemically modified tetracyclines (CMT) have lost their antimicrobial activity, but maintain these other properties. This study analyzes the effect of chemically modified tetracycline-8 (CMT-8) on the evolution of complete blood count, blood chemistry, the mRNA expression of selected cytokines and peripheral blood lymphocyte subpopulations distribution in healthy dogs. CMT-8 at a dose of 10 mg/kg once daily was administered per os to six healthy dogs. A control group of five healthy dogs, living in the same conditions than dogs treated with CMT-8, received placebo with an identical therapeutic regimen. When given at the doses used in this study, no side effects of CMT-8 were detected, suggesting a good tolerance and a limited toxicity of the drug. Dogs treated with CMT-8 showed a gradual increase in mean corpuscular hemoglobin. The administration of CMT-8 in healthy dogs did not affect blood mRNA expression of IFN-γ, TNFα, IL-4, IL-6, IL-10, IL-12 p40 and IL-13. However, the lymphocytes expressing class II MHC on their surface decreased during the first two weeks of CMT-8 treatment and subsequently increased for the next three months. Considering the absence of antimicrobial properties of the drug, the effects of CMT-8 detected in this study seem to be unrelated to the classical antimicrobial activity attributed to tetracyclines.

Outpatient Clinical Trial in Dogs With Leptospirosis Treated With Enrofloxacin Hydrochloride-Dihydrate (ENRO-C)

Pharmacokinetics of enrofloxacin HCl-2H2O (enro-C) in dogs and Monte-Carlo simulations against Leptospira spp. prompted a clinical study to treat the clinically apparent phase of this disease. Leptospirosis was diagnosed by real-time PCR from blood, micro-agglutination titers (MAT), clinical signs and blood parameters of the liver and kidney. In order to determine the clinical ability of the participants to diagnose leptospirosis on the first exam and establish an early treatment to avoid excessive organ damage, patients were clinically classified as: high-risk or medium-risk. Forty-five dogs were included in this trial (from 2017 to early 2019). The treatment consisted of IM injections of a 5% aqueous enro-C suspension (10 mg/kg/day) for 10 days, and subsequently enro-C was administered orally for another 7 days in gelatin capsules. Thirty-four high-risk and 11 medium-risk dogs were treated, including 6 puppies (4 high-risk with ages between 6 to 10 months and 2 medium-risk dogs with an average age of 6 and 7 months). Other ages ranged from 1 to 5 years. Fifteen cases had a history of having received prior treatment with other antibiotics, including all puppies. The clinical diagnostic error was 13.5% (7/52 cases), and only one of the misdiagnosed dogs had been classified as a high-risk patient. Three to 5 days after finishing treatment with enro-C, 82.2% of the dogs were negative to real-time PCR from urine samples and 100% negativity was observed on day 30 after treatment, when antibody titrations dropped to 1:100-1:200. Based on the absence of clinical signs, real-time PCR, and MAT titers, all treated dogs were considered as successful treatments. Within 6-24 months of clinical follow-up, no relapses were recorded. Adverse effects were inconsequential. This study represents the first report of a successful treatment of canine leptospirosis using a fluoroquinolone, and due to its efficacy, it is suggested that enro-C be considered as a viable option for the treatment of this disease.

A Suspected Case of Lyme Borreliosis in a Dog from Belgium

A 5-year-old Jack Russell Spaniel was presented in December 2017 to his veterinarian in Belgium for sudden weakness, reluctance to move, and pain. Blood analysis showed no deviations and serum increased levels of B. burgdorferi s.l. antibodies were detected. The dog recovered a few days after the onset of doxycycline treatment. This case illustrates the possible relationship between tick-borne diseases and orthopedic problems.

Effect of sildenafil and pimobendan on intracardiac heartworm infections in four dogs

Four dogs, referred for management of heartworm (HW) disease, were found to have HWs entangled in their tricuspid valve apparatus. None of the dogs were actively hemolyzing or showed signs of acute cardiovascular collapse that would have necessitated emergency transvenous HW extraction, and surgery was not performed at time of presentation. The dogs received pimobendan and sildenafil within 24 h of identifying HW in the tricuspid valve apparatus, and the HW moved to the pulmonary arteries within 2 days in most cases (median 2 days, range 1-14 days). All dogs survived to discharge from the original hospital admission and were subsequently treated with adulticide (melarsomine) without complication. All dogs were HW antigen negative 6 months after their last melarsomine injection. Four dogs appeared to respond positively to medical management aimed at decreasing pulmonary arterial pressure and improving the right ventricular function, but movement of HW out of the heart for other reasons cannot be excluded. This therapeutic option is not advised when dogs with HW disease are presented for acute collapse, ongoing hemolysis, and hypotension as surgical extraction is still considered the best option in these cases. It remains unknown if medical management is a safe option for all dogs with intracardiac HW without clinical signs of caval syndrome. Controlled prospective studies are required to determine the efficacy and safety of this treatment regimen in comparison with surgical extraction.

An update on the treatment of canine monocytic ehrlichiosis (Ehrlichia canis)

Canine monocytic ehrlichiosis (CME), caused by Ehrlichia canis, a gram-negative, obligate intracellular bacterium, is a tick-borne disease of worldwide distribution. Experimentally, the course of E. canis infection can be sequentially divided into acute, subclinical and chronic phases, although distinction of these phases is challenging in the clinical setting. Spontaneous clinical recovery of acutely infected dogs is common; however, dogs at this stage require medical treatment in order to hasten their clinical recovery, and to prevent clinical exacerbation or death. An unpredictable proportion of subclinically infected dogs will eventually develop the chronic, severe form of ehrlichiosis, characterized by aplastic pancytopenia and high mortality. The aims of antimicrobial treatment in CME include the achievement of clinical remission, resolution of the clinicopathologic abnormalities, and eradication of the infection, although the latter is not always feasible or diagnostically confirmable. Treatment of dogs with aplastic pancytopenia should be undertaken with the clear understanding that medical management will require long-term care, will be expensive, and may eventually prove ineffective. This manuscript reviews the current state of knowledge regarding treatment of ehrlichiosis, caused by E. canis infection in dogs, provides expert opinion guidelines for the management of the CME-associated aplastic pancytopenia, and outlines methods for evaluation of treatment outcomes.

Metabolic Abnormalities Detected in Phase II Evaluation of Doxycycline in Dogs with Multicentric B-Cell Lymphoma

Doxycycline has antiproliferative effects in human lymphoma cells and in murine xenografts. We hypothesized that doxycycline would decrease canine lymphoma cell viability and prospectively evaluated its clinical tolerability in client-owned dogs with spontaneous, nodal, multicentric, substage a, B-cell lymphoma, not previously treated with chemotherapy. Treatment duration ranged from 1 to 8 weeks (median and mean, 3 weeks). Dogs were treated with either 10 (n = 6) or 7.5 (n = 7) mg/kg by mouth twice daily. One dog had a stable disease for 6 weeks. No complete or partial tumor responses were observed. Five dogs developed grade 3 and/or 4 metabolic abnormalities suggestive of hepatopathy with elevations in bilirubin, ALT, ALP, and/or AST. To evaluate the absorption of oral doxycycline in our study population, serum concentrations in 10 treated dogs were determined using liquid chromatography tandem mass spectrometry. Serum levels were variable and ranged from 3.6 to 16.6 µg/ml (median, 7.6 µg/ml; mean, 8.8 µg/ml). To evaluate the effect of doxycycline on canine lymphoma cell viability in vitro, trypan blue exclusion assay was performed on canine B-cell lymphoma cell lines (17-71 and CLBL) and primary B-cell lymphoma cells from the nodal tissue of four dogs. A doxycycline concentration of 6 µg/ml decreased canine lymphoma cell viability by 80%, compared to matched, untreated, control cells (mixed model analysis, p < 0.0001; Wilcoxon signed rank test, p = 0.0313). Although the short-term administration of oral doxycycline is not associated with the remission of canine lymphoma, combination therapy may be worthwhile if future research determines that doxycycline can alter cell survival pathways in canine lymphoma cells. Due to the potential for metabolic abnormalities, close monitoring is recommended with the use of this drug in tumor-bearing dogs. Additional research is needed to assess the tolerability of chronic doxycycline therapy.

Canine Monocytic Ehrlichiosis: An Update on Diagnosis and Treatment

Canine monocytic ehrlichiosis (CME) is a tick-borne disease of worldwide distribution. The major causative agent is Ehrlichia canis, a gram-negative, obligate intracellular, pleomorphic bacterium of the genus Ehrlichia, which infects monocytes, macrophages and lymphocytes, forming intracytoplasmic, membrane-bound bacterial aggregates, called morulae. After an incubation period of 8-20 days, the course of E. canis infection, can be sequentially divided into acute, subclinical and chronic phases, although these phases can hardly be distinguished in the clinical setting. Clinical recovery is the typical outcome of acutely infected dogs, entering the subclinical phase, during which they show no or minimal clinical signs and/or mild hematological abnormalities. Immunocompetent dogs may eliminate the infection during the acute or subclinical phases, but an unpredictable proportion of dogs will eventually develop the chronic phase, characterized by aplastic pancytopenia and high mortality, due to septicemia and/or severe bleeding. This article outlines briefly the pathogenesis of CME due to E. canis, and more thoroughly reviews the recent scientific literature pertaining to the diagnosis and treatment of this devastating disease.

Antibiotic susceptibility of bacterial isolates from 502 dogs with respiratory signs

The aim of this study was to investigate the prevalence of bacterial species isolated from bronchoalveolar lavage fluid (BALF) samples taken from dogs with respiratory signs and to determine their antibiotic susceptibility. Clinical cases were included in the study if they showed signs of respiratory disease and data relating to bacterial culture and susceptibility of BALF samples were available. The medical records of 493 privately owned dogs that were presented between January 1989 and December 2011 were evaluated retrospectively. In 35 per cent of samples, no bacteria were cultured. Bacteria isolated from culture-positive samples included Streptococcus species (31 per cent of positive cultures), Enterobacteriaceae (30 per cent, including Escherichia coli (15 per cent)), Staphylococcus species (19 per cent), Pasteurella species (16 per cent) and Pseudomonas species (14 per cent). Bordetella bronchiseptica as a primary respiratory pathogen was isolated in 8 per cent of cases. Enrofloxacin showed the best susceptibility pattern; 86 per cent of all isolates and 87 per cent of Gram-negative bacteria were susceptible to this antibiotic. Amoxicillin/clavulanic acid yielded the best susceptibility pattern in Gram-positive bacteria (92 per cent). Therefore, these antibiotics can be recommended for empirical or first-line treatment in dogs with bacterial lower respiratory tract infections.

Efficacy of rifampicin in the treatment of experimental acute canine monocytic ehrlichiosis

OBJECTIVES

To assess the efficacy of rifampicin in achieving clinical and haematological recovery and clearing infection in dogs with experimentally induced acute monocytic ehrlichiosis.

METHODS

Five Ehrlichia canis-infected Beagle dogs were treated with rifampicin (10 mg/kg/24 h orally for 3 weeks), nine E. canis-infected dogs received no treatment (infected untreated dogs) and two dogs served as uninfected controls. Clinical score, platelet counts, immunofluorescent antibody titres and PCR detection of E. canis-specific DNA in blood, bone marrow and spleen aspirates were evaluated on post-inoculation days 21 (start of rifampicin), 42 (end of rifampicin) and 98 (end of the study).

RESULTS

By day 21 post-inoculation, all infected dogs became clinically ill and thrombocytopenic, seroconverted and were PCR positive in at least one tissue. Clinical scores and antibody titres did not differ between the treated and infected untreated dogs throughout the study. The rifampicin-treated dogs experienced an earlier resolution of their thrombocytopenia (Kaplan-Meier survival plot, P=0.048), and the median platelet counts were significantly higher in the treated compared with the infected untreated dogs on post-inoculation days 42 (P=0.0233) and 98 (P=0.0195). At the end of the study, three treated and six untreated infected dogs remained PCR positive in one tissue each.

CONCLUSIONS

The rifampicin treatment regimen applied in this study hastened haematological recovery, but was inconsistent in eliminating the acute E. canis infection.