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Segev G, Cortellini S, Foster JD, Francey T, Langston C, Londoño L, Schweighauser A, Jepson RE. International Renal Interest Society best practice consensus guidelines for the diagnosis and management of acute kidney injury in cats and dogs. Vet J 2024; 305:106068. [PMID: 38325516 DOI: 10.1016/j.tvjl.2024.106068] [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: 06/11/2023] [Revised: 12/10/2023] [Accepted: 01/19/2024] [Indexed: 02/09/2024]
Abstract
Acute kidney injury (AKI) is defined as an injury to the renal parenchyma, with or without a decrease in kidney function, as reflected by accumulation of uremic toxins or altered urine production (i.e., increased or decreased). AKI might result from any of several factors, including ischemia, inflammation, nephrotoxins, and infectious diseases. AKI can be community- or hospital-acquired. The latter was not previously considered a common cause for AKI in animals; however, recent evidence suggests that the prevalence of hospital-acquired AKI is increasing in veterinary medicine. This is likely due to a combination of increased recognition and awareness of AKI, as well as increased treatment intensity (e.g., ventilation and prolonged hospitalization) in some veterinary patients and increased management of geriatric veterinary patients with multiple comorbidities. Advancements in the management of AKI, including the increased availability of renal replacement therapies, have been made; however, the overall mortality of animals with AKI remains high. Despite the high prevalence of AKI and the high mortality rate, the body of evidence regarding the diagnosis and the management of AKI in veterinary medicine is very limited. Consequently, the International Renal Interest Society (IRIS) constructed a working group to provide guidelines for animals with AKI. Recommendations are based on the available literature and the clinical experience of the members of the working group and reflect consensus of opinion. Fifty statements were generated and were voted on in all aspects of AKI and explanatory text can be found either before or after each statement.
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Affiliation(s)
- Gilad Segev
- Koret School of Veterinary Medicine, The Robert H. Smith Faculty of Agriculture, Food and Environment, Hebrew University of Jerusalem, Israel.
| | - Stefano Cortellini
- Department of Clinical Science and Services, Royal Veterinary College, Hawkshead Lane, North Mymms, Hertfordshire, UK
| | - Jonathan D Foster
- Department of Nephrology and Urology, Friendship Hospital for Animals, Washington DC, USA
| | - Thierry Francey
- Department of Clinical Veterinary Medicine, Vetsuisse Faculty University of Bern, Bern, Switzerland
| | - Catherine Langston
- Veterinary Clinical Science, The Ohio State University, Columbus, OH, USA
| | - Leonel Londoño
- Department of Critical Care, Capital Veterinary Specialists, Jacksonville, FL, USA
| | - Ariane Schweighauser
- Department of Clinical Veterinary Medicine, Vetsuisse Faculty University of Bern, Bern, Switzerland
| | - Rosanne E Jepson
- Department of Clinical Science and Services, Royal Veterinary College, Hawkshead Lane, North Mymms, Hertfordshire, UK
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Ioannou ADF, Tai C, Labato MA, Butty EM. Retrospective evaluation of 22 dogs with leptospirosis treated with extracorporeal renal replacement therapies (2018-2021). J Vet Intern Med 2024; 38:1051-1059. [PMID: 38334229 PMCID: PMC10937474 DOI: 10.1111/jvim.16998] [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: 03/27/2023] [Accepted: 01/19/2024] [Indexed: 02/10/2024] Open
Abstract
BACKGROUND Outcomes of dogs with acute kidney injury secondary to leptospirosis (AKI-L) treated using renal replacement therapies (RRT) are poorly characterized. HYPOTHESIS/OBJECTIVES Describe survival to discharge, short (≤30 days) and long-term (≥6 months) outcomes of AKI-L dogs receiving RRT and determine if there is a significant difference in maximum blood urea nitrogen (maxBUN), maximum creatinine (maxCr), maximum bilirubin (maxBili) and the number of body systems affected between survivors and non-survivors. ANIMALS Twenty-two client-owned dogs with AKI-L receiving RRT. METHODS Retrospective medical record review of dogs with AKI-L that received RRT between 2018 and 2021. RESULTS Sixteen of 22 (73%) dogs survived to discharge. Of the survivors, 13 (81%) were alive >30 days from discharge and 12 (75%) were alive at 6 months from discharge. Factors significantly higher in non-survivors included number of body systems affected (survivors: 1 (19%), 2 (50%), 3 (25%) and 4 (6%) vs non-survivors: 3 (33.3%), and 4 (66.7%); P = .01) and median maxBili (survivors: 1.9 mg/dL; range, 0.1-41.6 vs non-survivors: 21.0 mg/dL; range, 12.3-38.9; P = .02). There was no significant difference in median maxBUN (survivors: 153.0 mg/dL; range, 67-257 vs non-survivors: 185.5 mg/dL; range, 102-218; P = .44) and median maxCr (survivors: 9.8 mg/dL; range, 6.2-15.9 vs non-survivors: 9.8 mg/dL; range, 8.4-13.5; P = .69) between survivors and non-survivors. CONCLUSIONS AND CLINICAL IMPORTANCE Regardless of azotemia severity, dogs with AKI-L receiving RRT have a good survival rate to discharge. The number of body systems affected and hyperbilirubinemia might be associated with worse outcomes.
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Affiliation(s)
- Antonia Da Fonseca Ioannou
- Department of Clinical SciencesTufts University, Cummings School of Veterinary Medicine, Foster Hospital for Small AnimalsNorth GraftonMassachusettsUSA
| | - Carolyn Tai
- Department of Clinical SciencesTufts University, Cummings School of Veterinary Medicine, Foster Hospital for Small AnimalsNorth GraftonMassachusettsUSA
| | - Mary Anna Labato
- Department of Clinical SciencesTufts University, Cummings School of Veterinary Medicine, Foster Hospital for Small AnimalsNorth GraftonMassachusettsUSA
| | - Emmanuelle M. Butty
- Department of Clinical SciencesTufts University, Cummings School of Veterinary Medicine, Foster Hospital for Small AnimalsNorth GraftonMassachusettsUSA
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Sykes JE, Francey T, Schuller S, Stoddard RA, Cowgill LD, Moore GE. Updated ACVIM consensus statement on leptospirosis in dogs. J Vet Intern Med 2023; 37:1966-1982. [PMID: 37861061 PMCID: PMC10658540 DOI: 10.1111/jvim.16903] [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: 09/21/2023] [Accepted: 09/29/2023] [Indexed: 10/21/2023] Open
Abstract
Since publication of the last consensus statement on leptospirosis in dogs, there has been revision of leptospiral taxonomy and advancements in typing methods, widespread use of new diagnostic tests and vaccines, and improved understanding of the epidemiology and pathophysiology of the disease. Leptospirosis continues to be prevalent in dogs, including in small breed dogs from urban areas, puppies as young as 11 weeks of age, geriatric dogs, dogs in rural areas, and dogs that have been inadequately vaccinated for leptospirosis (including dogs vaccinated with 2-serovar Leptospira vaccines in some regions). In 2021, the American College of Veterinary Internal Medicine (ACVIM) Board of Regents voted to approve the topic for a revised Consensus Statement. After identification of core panelists, a multidisciplinary group of 6 experts from the fields of veterinary medicine, human medicine, and public health was assembled to vote on the recommendations using the Delphi method. A draft was presented at the 2023 ACVIM Forum, and a written draft posted on the ACVIM website for comment by the membership before submission to the editors of the Journal of Veterinary Internal Medicine. This revised document provides guidance for veterinary practitioners on disease in dogs as well as cats. The level of agreement among the 12 voting members (including core panelists) is provided in association with each recommendation. A denominator lower than 12 reflects abstention of ≥1 panelists either because they considered the recommendation to be outside their scope of expertise or because there was a perceived conflict of interest.
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Affiliation(s)
- Jane E. Sykes
- Department of Medicine and EpidemiologyUniversity of California, DavisDavisCalifornia95616USA
| | - Thierry Francey
- Department of Clinical Veterinary ScienceVetsuisse Faculty, University of BernBernSwitzerland
| | - Simone Schuller
- Department of Clinical Veterinary ScienceVetsuisse Faculty, University of BernBernSwitzerland
| | - Robyn A. Stoddard
- Bacterial Special Pathogens BranchCenters for Disease Control and PreventionAtlantaGeorgia30333USA
| | - Larry D Cowgill
- Department of Medicine and EpidemiologyUniversity of California, DavisDavisCalifornia95616USA
| | - George E. Moore
- Department of Veterinary AdministrationPurdue UniversityWest Lafayette, Indiana 47907USA
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Helman SK, Tokuyama AFN, Mummah RO, Stone NE, Gamble MW, Snedden CE, Borremans B, Gomez ACR, Cox C, Nussbaum J, Tweedt I, Haake DA, Galloway RL, Monzón J, Riley SPD, Sikich JA, Brown J, Friscia A, Sahl JW, Wagner DM, Lynch JW, Prager KC, Lloyd-Smith JO. Pathogenic Leptospira are widespread in the urban wildlife of southern California. Sci Rep 2023; 13:14368. [PMID: 37658075 PMCID: PMC10474285 DOI: 10.1038/s41598-023-40322-2] [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: 03/29/2023] [Accepted: 08/08/2023] [Indexed: 09/03/2023] Open
Abstract
Leptospirosis, the most widespread zoonotic disease in the world, is broadly understudied in multi-host wildlife systems. Knowledge gaps regarding Leptospira circulation in wildlife, particularly in densely populated areas, contribute to frequent misdiagnoses in humans and domestic animals. We assessed Leptospira prevalence levels and risk factors in five target wildlife species across the greater Los Angeles region: striped skunks (Mephitis mephitis), raccoons (Procyon lotor), coyotes (Canis latrans), Virginia opossums (Didelphis virginiana), and fox squirrels (Sciurus niger). We sampled more than 960 individual animals, including over 700 from target species in the greater Los Angeles region, and an additional 266 sampled opportunistically from other California regions and species. In the five target species seroprevalences ranged from 5 to 60%, and infection prevalences ranged from 0.8 to 15.2% in all except fox squirrels (0%). Leptospira phylogenomics and patterns of serologic reactivity suggest that mainland terrestrial wildlife, particularly mesocarnivores, could be the source of repeated observed introductions of Leptospira into local marine and island ecosystems. Overall, we found evidence of widespread Leptospira exposure in wildlife across Los Angeles and surrounding regions. This indicates exposure risk for humans and domestic animals and highlights that this pathogen can circulate endemically in many wildlife species even in densely populated urban areas.
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Affiliation(s)
- Sarah K Helman
- Department of Ecology and Evolutionary Biology, University of California, Los Angeles, CA, USA.
- Institute of the Environment and Sustainability, University of California, Los Angeles, CA, USA.
| | - Amanda F N Tokuyama
- Department of Ecology and Evolutionary Biology, University of California, Los Angeles, CA, USA
| | - Riley O Mummah
- Department of Ecology and Evolutionary Biology, University of California, Los Angeles, CA, USA
| | - Nathan E Stone
- The Pathogen and Microbiome Institute, Northern Arizona University, Flagstaff, AZ, USA
| | - Mason W Gamble
- Department of Ecology and Evolutionary Biology, University of California, Los Angeles, CA, USA
- Institute of the Environment and Sustainability, University of California, Los Angeles, CA, USA
| | - Celine E Snedden
- Department of Ecology and Evolutionary Biology, University of California, Los Angeles, CA, USA
| | - Benny Borremans
- Department of Ecology and Evolutionary Biology, University of California, Los Angeles, CA, USA
- Evolutionary Ecology Group, Department of Biology, University of Antwerp, Antwerp, Belgium
- Wildlife Health Ecology Research Organization, San Diego, CA, USA
| | - Ana C R Gomez
- Department of Ecology and Evolutionary Biology, University of California, Los Angeles, CA, USA
| | - Caitlin Cox
- Department of Ecology and Evolutionary Biology, University of California, Los Angeles, CA, USA
| | - Julianne Nussbaum
- Department of Ecology and Evolutionary Biology, University of California, Los Angeles, CA, USA
| | - Isobel Tweedt
- Department of Ecology and Evolutionary Biology, University of California, Los Angeles, CA, USA
| | - David A Haake
- Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, USA
- The David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | | | - Javier Monzón
- Natural Science Division, Pepperdine University, Malibu, CA, USA
| | - Seth P D Riley
- Santa Monica Mountains National Recreation Area, National Park Service, Thousand Oaks, CA, USA
| | - Jeff A Sikich
- Santa Monica Mountains National Recreation Area, National Park Service, Thousand Oaks, CA, USA
| | - Justin Brown
- Santa Monica Mountains National Recreation Area, National Park Service, Thousand Oaks, CA, USA
| | - Anthony Friscia
- Department of Integrative Biology and Physiology, University of California, Los Angeles, CA, USA
| | - Jason W Sahl
- The Pathogen and Microbiome Institute, Northern Arizona University, Flagstaff, AZ, USA
| | - David M Wagner
- The Pathogen and Microbiome Institute, Northern Arizona University, Flagstaff, AZ, USA
| | - Jessica W Lynch
- Institute for Society and Genetics, University of California, Los Angeles, CA, USA
| | - Katherine C Prager
- Department of Ecology and Evolutionary Biology, University of California, Los Angeles, CA, USA
| | - James O Lloyd-Smith
- Department of Ecology and Evolutionary Biology, University of California, Los Angeles, CA, USA.
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To A, Davila C, Stroope S, Walton R. Case report: Resolution of oligo-anuric acute kidney injury with furosemide administration in a cat following lily toxicity. Front Vet Sci 2023; 10:1195743. [PMID: 37476822 PMCID: PMC10354244 DOI: 10.3389/fvets.2023.1195743] [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: 03/28/2023] [Accepted: 06/05/2023] [Indexed: 07/22/2023] Open
Abstract
Objective To describe the successful outcome of a case of oligo-anuric acute kidney injury in a cat secondary to lily ingestion. Case summary A 12-week-old intact male domestic short-hair cat weighing 1.64 kg (3.6 lb) presented with a 12-h duration of vomiting and lethargy after exposure to lilies of the genera Lilium species 24 h prior to presentation. Severe azotemia (Creatinine 5.8 mg/dL, BUN > 100 mg/dL) and hyperkalemia (9.36 mmol/L) were noted on the day of presentation. Treatment of hyperkalemia was instituted with calcium gluconate, lactated ringers solution, dextrose, regular short-acting insulin, albuterol, and sodium bicarbonate, Oliguria to anuria was highly suspected based on a lack of urine production 21 h after hospitalization with intravenous fluid administration and a static bladder size. The cat was administered 4 mg/kg of furosemide, and urinated at 6 h following administration and continued to produce over 6 ml/kg/h of urine in the next 24 h. Two days following furosemide administration, the cat's hyperkalemia and azotemia resolved. The cat was discharged after 4 days of hospitalization, and a recheck revealed no persistent azotemia or hyperkalemia. Unique information Anuric acute kidney injury secondary to lily toxicity is associated with a poor prognosis, and the only treatment modality previously described is hemodialysis. The cat in this report was successfully managed with medical intervention and furosemide administration, with complete resolution of the acute kidney injury.
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Affiliation(s)
- An To
- Department of Emergency and Critical Care, Veterinary Centers of America (VCA) West Los Angeles Animal Hospital, Los Angeles, CA, United States
| | - Claudia Davila
- Department of Emergency and Critical Care, Veterinary Centers of America (VCA) West Los Angeles Animal Hospital, Los Angeles, CA, United States
| | - Sarah Stroope
- Department of Emergency and Critical Care, Veterinary Centers of America (VCA) West Los Angeles Animal Hospital, Los Angeles, CA, United States
| | - Rebecca Walton
- Department of Emergency and Critical Care, Veterinary Centers of America (VCA) West Los Angeles Animal Hospital, Los Angeles, CA, United States
- Department of Emergency and Critical Care, Iowa State University, Ames, IA, United States
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6
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Machado IC, Nunes T, Maximino M, Malato J, Tavares L, Almeida V, Sepúlveda N, Gil S. Epidemiologic Factors Supporting Triage of Infected Dog Patients Admitted to a Veterinary Hospital Biological Isolation and Containment Unit. Vet Sci 2023; 10:vetsci10030186. [PMID: 36977225 PMCID: PMC10057909 DOI: 10.3390/vetsci10030186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 02/18/2023] [Accepted: 02/23/2023] [Indexed: 03/06/2023] Open
Abstract
The teaching hospital of the Faculty of Veterinary Medicine at the University of Lisbon hosts a Biological Isolation and Containment Unit (BICU) for the hospitalization of both confirmed and suspected animals of an infectious disease. This study targets the BICU dog population to identify and characterize the most frequent infectious diseases recorded in a 7-year period. Several epidemiologic factors were analyzed for their significance to triage infected cases. During the study period, 534 dogs were admitted, of which 263 (49.3%) had a confirmed infectious disease diagnosis: parvovirosis (49.4%; n = 130); leptospirosis (21.7%; n = 57); multidrug-resistant (MDR) bacterial infection; (10.6%; n = 28), and canine distemper (9.9%; n = 26). Several potential risk factors for these diseases were identified: age under 2 years old (p < 0.001), incomplete vaccination for parvovirosis (p < 0.001), age ≥ 10 years old (p < 0.001), and the presence of concomitant disorders for MDR-infected cases (p = 0.03). Logistic regression models were constructed to classify cases and controls. The sensitivity and specificity estimates were very high (>0.83) for parvovirosis, MDR, and distemper infections. A lower sensitivity (0.77) was obtained for identifying cases with leptospirosis. In conclusion, infectious diseases are frequent, hence, it is essential to decrease their occurrence through effective preventive measures such as vaccination. The constructed logistic models can also help in triaging admitted dogs with a potential infectious disease.
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Affiliation(s)
- Inês Cunha Machado
- Teaching Hospital, Faculty of Veterinary Medicine, University of Lisbon, Av. Universidade Técnica, 1300-477 Lisboa, Portugal
- CIISA—Centre for Interdisciplinary Research in Animal Health, Faculty of Veterinary Medicine, University of Lisbon, Av. Universidade Técnica, 1300-477 Lisboa, Portugal
- Associate Laboratory for Animal and Veterinary Sciences (AL4AnimalS), Av. Universidade Técnica, 1300-477 Lisboa, Portugal
- Faculty of Veterinary Medicine, University of Lisbon, Av. Universidade Técnica, 1300-477 Lisbon, Portugal
| | - Telmo Nunes
- CIISA—Centre for Interdisciplinary Research in Animal Health, Faculty of Veterinary Medicine, University of Lisbon, Av. Universidade Técnica, 1300-477 Lisboa, Portugal
- Associate Laboratory for Animal and Veterinary Sciences (AL4AnimalS), Av. Universidade Técnica, 1300-477 Lisboa, Portugal
- Faculty of Veterinary Medicine, University of Lisbon, Av. Universidade Técnica, 1300-477 Lisbon, Portugal
| | - Miguel Maximino
- Teaching Hospital, Faculty of Veterinary Medicine, University of Lisbon, Av. Universidade Técnica, 1300-477 Lisboa, Portugal
| | - João Malato
- Instituto de Medicina Molecular (IMM), Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, 1649-028 Lisboa, Portugal
- Centro de Estatística e Aplicações da Universidade de Lisboa, Campo Grande, 1749-016 Lisboa, Portugal
| | - Luís Tavares
- CIISA—Centre for Interdisciplinary Research in Animal Health, Faculty of Veterinary Medicine, University of Lisbon, Av. Universidade Técnica, 1300-477 Lisboa, Portugal
- Associate Laboratory for Animal and Veterinary Sciences (AL4AnimalS), Av. Universidade Técnica, 1300-477 Lisboa, Portugal
- Faculty of Veterinary Medicine, University of Lisbon, Av. Universidade Técnica, 1300-477 Lisbon, Portugal
| | - Virgilio Almeida
- CIISA—Centre for Interdisciplinary Research in Animal Health, Faculty of Veterinary Medicine, University of Lisbon, Av. Universidade Técnica, 1300-477 Lisboa, Portugal
- Associate Laboratory for Animal and Veterinary Sciences (AL4AnimalS), Av. Universidade Técnica, 1300-477 Lisboa, Portugal
- Faculty of Veterinary Medicine, University of Lisbon, Av. Universidade Técnica, 1300-477 Lisbon, Portugal
| | - Nuno Sepúlveda
- Centro de Estatística e Aplicações da Universidade de Lisboa, Campo Grande, 1749-016 Lisboa, Portugal
- Faculty of Mathematics and Information Science, Warsaw University of Technology, Koszykowa 75, 00-662 Warsaw, Poland
| | - Solange Gil
- Teaching Hospital, Faculty of Veterinary Medicine, University of Lisbon, Av. Universidade Técnica, 1300-477 Lisboa, Portugal
- CIISA—Centre for Interdisciplinary Research in Animal Health, Faculty of Veterinary Medicine, University of Lisbon, Av. Universidade Técnica, 1300-477 Lisboa, Portugal
- Associate Laboratory for Animal and Veterinary Sciences (AL4AnimalS), Av. Universidade Técnica, 1300-477 Lisboa, Portugal
- Faculty of Veterinary Medicine, University of Lisbon, Av. Universidade Técnica, 1300-477 Lisbon, Portugal
- Correspondence: ; Tel.: +48-351213652800
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Arzamani K, Abdollahpour G, Azimian A, van Belkum A, Ghasemzadeh‐Moghaddam H. High‐level seroprevalence against
Leptospira interrogans
serovars among wild foxes, jackals and stray dogs in the North Khorasan Province, Iran. Vet Med Sci 2022; 8:1915-1921. [PMID: 35840123 PMCID: PMC9514457 DOI: 10.1002/vms3.890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Background Objectives Methods Results Conclusions
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Affiliation(s)
- Kourosh Arzamani
- Vector‐Borne Disease Research Center North Khorasan University of Medical Sciences Bojnurd Iran
| | - Gholamreza Abdollahpour
- Leptospira Research Laboratory Faculty of Veterinary Medicine Department of Internal Medicine University of Tehran Tehran Iran
| | - Amir Azimian
- Department of Pathobiology and Laboratory Sciences North Khorasan University of Medical Sciences Bojnurd Iran
| | - Alex van Belkum
- Open Innovation & Partnerships BaseClear Leiden The Netherlands
| | - Hamed Ghasemzadeh‐Moghaddam
- Vector‐Borne Disease Research Center North Khorasan University of Medical Sciences Bojnurd Iran
- Department of Pathobiology and Laboratory Sciences North Khorasan University of Medical Sciences Bojnurd Iran
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Loane SC, Thomson JM, Williams TL, McCallum KE. Evaluation of symmetric dimethylarginine in cats with acute kidney injury and chronic kidney disease. J Vet Intern Med 2022; 36:1669-1676. [PMID: 35903963 PMCID: PMC9511064 DOI: 10.1111/jvim.16497] [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] [Received: 01/19/2022] [Accepted: 07/07/2022] [Indexed: 11/26/2022] Open
Abstract
Background Serum symmetric dimethylarginine (SDMA) concentrations are considered a biomarker for renal dysfunction in dogs and humans with acute kidney injury (AKI). No studies have assessed SDMA in cats with AKI. Hypothesis/Objectives SDMA correctly identifies cats with azotemic AKI. Animals Fifteen control cats, 22 with novel AKI, 13 with acute on chronic‐AKI (AoC) and 19 with chronic kidney disease (CKD). Methods Retrospective study. Cats with azotemia (serum creatinine concentrations >1.7 mg/dL) were defined as having AKI or CKD based on history, clinical signs, clinicopathological findings and diagnostic imaging, and classified using the International Renal Interest Society (IRIS) grading/staging systems. Serum SDMA concentrations were compared between groups with nonparametric methods, and correlations assessed using Spearman's correlation coefficient. Data are presented as median [range]. Results SDMA concentrations were 11 (8‐21) μg/dL, 36 (9‐170)μg/dL, 33 (22‐75) μg/dL and 25 (12‐69) μg/dL in control, novel AKI, AoC and CKD cats. SDMA concentrations were significantly higher in cats with novel AKI (P < .001), AoC (P < .001) and CKD (P < .01) compared to controls. SDMA concentrations were significantly higher in cats with more advanced AKI (IRIS grade IV‐V) compared to less severe AKI (IRIS grade II). Serum creatinine and SDMA concentrations had a significant correlation in cats with novel AKI (rs = 0.826, n = 22; P < .001) and a significant correlation when all cats across all 4 groups were considered together (rs = 0.837, n = 69; P < .001). Conclusions and Clinical Importance Serum SDMA concentrations are elevated in cats with established AKI (novel and AoC) and CKD, providing evidence for use of SDMA as a biomarker for AKI in cats.
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Affiliation(s)
- Samantha C Loane
- Department of Veterinary Medicine, University of Cambridge, Cambridge, United Kingdom
| | - James M Thomson
- Department of Veterinary Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Timothy L Williams
- Department of Veterinary Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Katie E McCallum
- Department of Veterinary Medicine, University of Cambridge, Cambridge, United Kingdom
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9
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Reagan KL, Deng S, Sheng J, Sebastian J, Wang Z, Huebner SN, Wenke LA, Michalak SR, Strohmer T, Sykes JE. Use of machine-learning algorithms to aid in the early detection of leptospirosis in dogs. J Vet Diagn Invest 2022; 34:612-621. [PMID: 35603565 PMCID: PMC9266510 DOI: 10.1177/10406387221096781] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Leptospirosis is a life-threatening, zoonotic disease with various clinical presentations, including renal injury, hepatic injury, pancreatitis, and pulmonary hemorrhage. With prompt recognition of the disease and treatment, 90% of infected dogs have a positive outcome. Therefore, rapid, early diagnosis of leptospirosis is crucial. Testing for Leptospira-specific serum antibodies using the microscopic agglutination test (MAT) lacks sensitivity early in the disease process, and diagnosis can take >2 wk because of the need to demonstrate a rise in titer. We applied machine-learning algorithms to clinical variables from the first day of hospitalization to create machine-learning prediction models (MLMs). The models incorporated patient signalment, clinicopathologic data (CBC, serum chemistry profile, and urinalysis = blood work [BW] model), with or without a MAT titer obtained at patient intake (=BW + MAT model). The models were trained with data from 91 dogs with confirmed leptospirosis and 322 dogs without leptospirosis. Once trained, the models were tested with a cohort of dogs not included in the model training (9 leptospirosis-positive and 44 leptospirosis-negative dogs), and performance was assessed. Both models predicted leptospirosis in the test set with 100% sensitivity (95% CI: 70.1–100%). Specificity was 90.9% (95% CI: 78.8–96.4%) and 93.2% (95% CI: 81.8–97.7%) for the BW and BW + MAT models, respectively. Our MLMs outperformed traditional acute serologic screening and can provide accurate early screening for the probable diagnosis of leptospirosis in dogs.
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Affiliation(s)
- Krystle L. Reagan
- Department of Medicine and Epidemiology, University of California–Davis, Davis, CA, USA
| | - Shaofeng Deng
- School of Veterinary Medicine, and Department of Mathematics, University of California–Davis, Davis, CA, USA
| | - Junda Sheng
- School of Veterinary Medicine, and Department of Mathematics, University of California–Davis, Davis, CA, USA
| | - Jamie Sebastian
- William R. Pritchard Veterinary Medical Teaching Hospital, University of California–Davis, Davis, CA, USA
| | - Zhe Wang
- William R. Pritchard Veterinary Medical Teaching Hospital, University of California–Davis, Davis, CA, USA
| | - Sara N. Huebner
- William R. Pritchard Veterinary Medical Teaching Hospital, University of California–Davis, Davis, CA, USA
| | - Louise A. Wenke
- William R. Pritchard Veterinary Medical Teaching Hospital, University of California–Davis, Davis, CA, USA
| | - Sarah R. Michalak
- William R. Pritchard Veterinary Medical Teaching Hospital, University of California–Davis, Davis, CA, USA
| | - Thomas Strohmer
- School of Veterinary Medicine, and Department of Mathematics, University of California–Davis, Davis, CA, USA
| | - Jane E. Sykes
- Department of Medicine and Epidemiology, University of California–Davis, Davis, CA, USA
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10
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Ross L. Acute Kidney Injury in Dogs and Cats. Vet Clin North Am Small Anim Pract 2022; 52:659-672. [DOI: 10.1016/j.cvsm.2022.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Griebsch C, Kirkwood N, Ward MP, So W, Weerakoon L, Donahoe S, Norris JM. Emerging leptospirosis in urban Sydney dogs: a case series (2017-2020). Aust Vet J 2022; 100:190-200. [PMID: 35076093 PMCID: PMC9306944 DOI: 10.1111/avj.13148] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Revised: 07/18/2021] [Accepted: 01/02/2022] [Indexed: 11/29/2022]
Abstract
Canine leptospirosis has not been reported in the Sydney dog population since 1976. However, between 2017 and 2020, leptospirosis was confirmed in 17 dogs, five of which were known to hunt rodents. Dogs infected between 2017 and 2019 lived within a 3 km radius in the Inner City of Sydney (n = 11). In 2020, cases emerged across a broader area of Sydney; Inner City (n = 1), Inner West (n = 3), Lower North Shore (n = 1) and Upper North Shore (n = 1). The disease was characterised by severe hepatorenal involvement resulting in an unusually high case fatality rate (88%). In conjunction with supportive clinical signs, diagnosis was confirmed by real‐time PCR on whole blood (n = 1), kidney (n = 1), urine (n = 4), whole blood and urine (n = 9) or by seroconversion (n = 3). Antibody titres determined by Microscopic Agglutination Test (MAT) to Leptospira serovars were measured in 12 dogs: seven were positive for serovar Copenhageni, one was positive for serovar Hardjo, three were negative for all serovars, likely due to insufficient time for seroconversion before death and one had a low positive titre (1/50) for serovars Australis and Robinsoni. This sudden emergence of a highly fatal disease in pet dogs in Sydney has led to the introduction of Leptospira vaccination protocols for dogs living in inner Sydney using a monovalent vaccine containing serovar Copenhageni. The success of this vaccination program will require ongoing research to understand the emergence of leptospirosis in this region and the serovars involved.
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Affiliation(s)
- C Griebsch
- Sydney School of Veterinary Science, University of Sydney, Sydney, New South Wales, 2006, Australia
| | - N Kirkwood
- Sydney School of Veterinary Science, University of Sydney, Sydney, New South Wales, 2006, Australia
| | - M P Ward
- Sydney School of Veterinary Science, University of Sydney, Sydney, New South Wales, 2006, Australia
| | - W So
- Sydney School of Veterinary Science, University of Sydney, Sydney, New South Wales, 2006, Australia
| | - L Weerakoon
- Sydney School of Veterinary Science, University of Sydney, Sydney, New South Wales, 2006, Australia
| | - S Donahoe
- Sydney School of Veterinary Science, University of Sydney, Sydney, New South Wales, 2006, Australia
| | - J M Norris
- Sydney School of Veterinary Science, University of Sydney, Sydney, New South Wales, 2006, Australia
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12
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Raj J, Campbell R, Tappin S. Clinical findings in dogs diagnosed with leptospirosis in England. Vet Rec 2021; 189:e452. [PMID: 34085284 DOI: 10.1002/vetr.452] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
BACKGROUND Leptospirosis is a zoonotic disease of worldwide importance. This study describes the clinical findings and outcome of dogs diagnosed with leptospirosis in England. METHODS Retrospective review of medical records of dogs diagnosed with leptospirosis from a single referral hospital located in Eastern England. RESULTS Thirty-eight dogs met the inclusion criteria. Clinical signs included inappetence (76%), vomiting (68%), lethargy (58%), polydipsia and polyuria (18%) and abdominal pain (16%). Disease manifestations included hepatic and renal involvement (47%), hepatic only (37%), renal only (16%); no dogs were found to have respiratory involvement. Clinicopathological findings at presentation included anaemia (42%), thrombocytopenia (43%), increased alanine transaminase activity (ALT) (66%), hyperbilirubinemia (55%), azotaemia (68%), hypoalbuminaemia (49%) and glucosuria (32%). Seven serovars of Leptospira interrogans or Leptospira kirschneri were detected; the most prevalent was Copenhageni (48%). Seventy-one percent survived to discharge. Dogs in the non-surviving group had a higher creatinine at presentation compared to survivors (p = 0.02). CONCLUSIONS Copenhageni was the most prevalent serovar in this population. This supports the use of a vaccine including this serovar, in this region. Renal involvement was associated with reduced survival to discharge. A hepatic only form was common in this population, and leptospirosis should be included as a differential diagnosis for dogs suffering with a hepatopathy. No cases had significant pulmonary involvement, but ongoing clinical vigilance for this disease manifestation is essential.
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Affiliation(s)
- Jennifer Raj
- Dick White Referrals, Station Farm, London Road, Six Mile Bottom, Cambridgeshire, UK.,Southfields Veterinary Specialists, 1 Bramston Way, Basildon, Essex, UK
| | - Ruth Campbell
- Dick White Referrals, Laboratory, Station Farm, London Road, Six Mile Bottom, Cambridgeshire, UK
| | - Simon Tappin
- Dick White Referrals, Small Animal Internal Medicine, Station Farm, London Road, Six Mile Bottom, Cambridgeshire, UK
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13
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Taylor C, O'Neill DG, Catchpole B, Brodbelt DC. Incidence and demographic risk factors for leptospirosis in dogs in the UK. Vet Rec 2021; 190:e512. [PMID: 34057217 DOI: 10.1002/vetr.512] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 03/15/2021] [Accepted: 05/04/2021] [Indexed: 01/08/2023]
Abstract
OBJECTIVES To estimate the annual incidence risk of leptospirosis diagnosis in practice-attending dogs in the UK during 2016 and identify risk factors for diagnosis. METHODS Incidence of leptospirosis diagnosis in dogs during 2016 was estimated from dogs in primary-care practices from the VetCompass Programme (n = 905,543). A case-control study of laboratory cases (n = 362) versus VetCompass controls explored factors (age, sex, neutering, breed, Kennel Club group, urban-rural location, indices of deprivation) associated with leptospirosis diagnosis through multivariable logistic regression. RESULTS Annual incidence risk of leptospirosis in the VetCompass population was 0.8 cases per 100,000 dogs (0.0008%, 95% CI 9.1 × 10-8 -5.2 × 10-5 ). Adult dogs, especially 1- < 5 years olds (odds ratio [OR] = 0.38, 95% CI 0.27-0.54), and dogs attending urban clinics (OR = 0.26, 95% CI 0.19-0.35) had reduced odds of leptospirosis versus dogs < 1 year old and rural dogs, respectively. Dogs attending clinics in less deprived areas had increased odds of diagnosis (OR = 3.63, 95% CI 2.28-5.78) compared to crossbreds, Cocker Spaniels (OR = 4.25, 95% CI 2.65-6.84), Collies (OR = 3.53, 95% CI 2.22-5.62) and Lurchers (OR = 3.49, 95% CI 1.50-8.11) had increased odds of diagnosis. DISCUSSION Leptospirosis is rarely diagnosed in clinical practice, suggesting that many true cases may be missed. Demographic risk factors identified here may inform the index of suspicion and encourage increased use of confirmatory diagnostic testing.
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Affiliation(s)
- Collette Taylor
- Department of Pathobiology and Population Sciences, The Royal Veterinary College, Hatfield, Herts, UK
| | - Dan G O'Neill
- Department of Pathobiology and Population Sciences, The Royal Veterinary College, Hatfield, Herts, UK
| | - Brian Catchpole
- Department of Pathobiology and Population Sciences, The Royal Veterinary College, Hatfield, Herts, UK
| | - Dave C Brodbelt
- Department of Pathobiology and Population Sciences, The Royal Veterinary College, Hatfield, Herts, UK
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14
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Iverson SA, Levy C, Yaglom HD, Venkat HL, Artus A, Galloway R, Guagliardo SAJ, Reynolds L, Kretschmer MJ, LaFerla Jenni ME, Woodward P, Reindel AA, Tarrant S, Sylvester T, Klein R, Mundschenk P, Sunenshine R, Schafer IJ. Clinical, diagnostic, and epidemiological features of a community-wide outbreak of canine leptospirosis in a low-prevalence region (Maricopa County, Arizona). J Am Vet Med Assoc 2021; 258:616-629. [PMID: 33683958 DOI: 10.2460/javma.258.6.616] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To describe clinical, diagnostic, and epidemiological features of an outbreak of leptospirosis in dogs in Maricopa County, Ariz, from January 2016 through June 2017. ANIMALS 71 case and 281 control dogs. PROCEDURES Cases were classified as confirmed, probable, suspect, or not a case on the basis of medical record data that fulfilled clinical, diagnostic, and epidemiological criteria. Potential exposures were assessed by owner survey. For the case-control investigation, control dogs were recruited through owner completion of a July 2017 survey. Summary statistics and ORs for case dog lifestyle factors were reported. RESULTS 54 dogs were classified as confirmed and 17 as probable cases. For 4 dogs of a household cluster (5 confirmed and 3 probable), the highest microscopic agglutination titer was for serovar Djasiman (Leptospira kirschneri detected by PCR assay), and for 13 dogs of a community outbreak (49 confirmed and 14 probable cases), the highest titer was for serovar Canicola (Leptospira interrogans detected by PCR assay). The 44 case dogs included in the case-control investigation were 7.7 (95% CI, 3.5 to 16.7) and 2.9 times (95% CI, 1.3 to 6.6) as likely as control dogs to have visited dog daycare or to have been kenneled overnight at a boarding facility, respectively, 30 days prior to the onset of clinical signs or diagnosis. CONCLUSIONS AND CLINICAL RELEVANCE Diagnostic and epidemiological findings indicated 2 outbreaks. Transmission where dogs congregated likely propagated the community outbreak. Outbreaks of leptospiral infections can occur in regions of low prevalence, and a dog's exposure to areas where dogs congregate should be considered when making Leptospira vaccination recommendations.
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15
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Dias CS, Paz LN, Solcà MS, Portela RWD, Bittencourt MV, Pinna MH. Kidney Injury Molecule-1 in the detection of early kidney injury in dogs with leptospirosis. Comp Immunol Microbiol Infect Dis 2021; 76:101637. [PMID: 33706047 DOI: 10.1016/j.cimid.2021.101637] [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: 11/27/2020] [Revised: 02/23/2021] [Accepted: 02/24/2021] [Indexed: 11/26/2022]
Abstract
Renal damage, a common feature in canine leptospirosis, ranges from a subclinical affection to kidney dysfunction and death. Chances of recovery can be improved by early intervention. However, traditional biomarkers (serum urea and creatinine) have limited relevance for precocity. Kidney Injury Molecule-1 (KIM-1) is a transmembrane protein upregulated in early stages of tubular injury. This study evaluated the use of urinary KIM-1 to detect early renal injury in naturally occurring canine leptospirosis. This exploratory research included 30 dogs divided into two groups: (1) dogs with leptospirosis (n = 25) and (2) healthy dogs (n = 5). Leptospira sp. infection was diagnosed through urine PCR and/or direct bacteriologic culture and/or serology (single MAT titters ≥800). Additionally, stage of infection was further characterized in acute and subacute phases based on the onset of clinical symptoms from 3 to 7 days. Urinary KIM-1 (uKIM-1) concentrations were measured in both groups with a commercial canine ELISA kit. uKIM-1 levels were statistically different (P < 0.01) between the studied groups, especially in non-azotemic dogs (P = 0.0042). The biomarker showed 88 % sensibility to diagnosis of kidney injury at> 1.49 ng/mL cut-off. Urine KIM-1 was negatively correlated with urine specific gravity (USG) but accompanied histopathological evidence of renal degeneration, necrosis and regeneration processes, extending information on kidney health. Measurement of KIM-1 in the urine of canine patients was able to detect naturally occurring acute and subacute leptospirosis accompanied by tubular injury in early non-azotemic infections.
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Affiliation(s)
- C S Dias
- Bacterial Disease Laboratory, Federal University of Bahia, 500 Adhemar de Barros Av., Salvador, BA 40170-110, Brazil
| | - L N Paz
- Bacterial Disease Laboratory, Federal University of Bahia, 500 Adhemar de Barros Av., Salvador, BA 40170-110, Brazil
| | - M S Solcà
- Department of Preventive Veterinary Medicine and Animal Production of the School of Veterinary Medicine and Zootechny, Federal University of Bahia, 500 Adhemar de Barros Av., Salvador, BA 40170-110, Brazil
| | - R W D Portela
- Laboratory of Immunology and Molecular Biology, Health Science Institute, Federal University of Bahia, Reitor Miguel Calmon Av., Salvador, BA 40140-100, Brazil
| | - M V Bittencourt
- Bacterial Disease Laboratory, Federal University of Bahia, 500 Adhemar de Barros Av., Salvador, BA 40170-110, Brazil
| | - M H Pinna
- Bacterial Disease Laboratory, Federal University of Bahia, 500 Adhemar de Barros Av., Salvador, BA 40170-110, Brazil.
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16
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Putz EJ, Nally JE. Investigating the Immunological and Biological Equilibrium of Reservoir Hosts and Pathogenic Leptospira: Balancing the Solution to an Acute Problem? Front Microbiol 2020; 11:2005. [PMID: 32922382 PMCID: PMC7456838 DOI: 10.3389/fmicb.2020.02005] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 07/29/2020] [Indexed: 12/18/2022] Open
Abstract
Leptospirosis is a devastating zoonotic disease affecting people and animals across the globe. Pathogenic leptospires are excreted in urine of reservoir hosts which directly or indirectly leads to continued disease transmission, via contact with mucous membranes or a breach of the skin barrier of another host. Human fatalities approach 60,000 deaths per annum; though most vertebrates are susceptible to leptospirosis, complex interactions between host species and serovars of Leptospira can yield disease phenotypes that vary from asymptomatic shedding in reservoir hosts, to multi-organ failure in incidental hosts. Clinical symptoms of acute leptospirosis reflect the diverse range of pathogenic species and serovars that cause infection, the level of exposure, and the relationship of the pathogen with the given host. However, in all cases, pathogenic Leptospira are excreted into the environment via urine from reservoir hosts which are uniformly recognized as asymptomatic carriers. Therefore, the reservoir host serves as the cornerstone of persistent disease transmission. Although bacterin vaccines can be used to abate renal carriage and excretion in domestic animal species, there is an urgent need to advance our understanding of immune-mediated host–pathogen interactions that facilitate persistent asymptomatic carriage. This review summarizes the current understanding of host–pathogen interactions in the reservoir host and prioritizes research to unravel mechanisms that allow for colonization but not destruction of the host. This information is required to understand, and ultimately control, the transmission of pathogenic Leptospira.
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Affiliation(s)
- Ellie J Putz
- Infectious Bacterial Diseases Research Unit, National Animal Disease Center, United States Department of Agriculture, Agricultural Research Service, Ames, IA, United States
| | - Jarlath E Nally
- Infectious Bacterial Diseases Research Unit, National Animal Disease Center, United States Department of Agriculture, Agricultural Research Service, Ames, IA, United States
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17
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Altheimer K, Jongwattanapisan P, Luengyosluechakul S, Pusoonthornthum R, Prapasarakul N, Kurilung A, Broens EM, Wagenaar JA, Goris MGA, Ahmed AA, Pantchev N, Reese S, Hartmann K. Leptospira infection and shedding in dogs in Thailand. BMC Vet Res 2020; 16:89. [PMID: 32178664 PMCID: PMC7077098 DOI: 10.1186/s12917-020-2230-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Accepted: 01/03/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Leptospirosis is a widespread zoonosis and has been recognized as a re-emerging infectious disease in humans and dogs, but prevalence of Leptospira shedding in dogs in Thailand is unknown. The aim of this study was to determine urinary shedding of Leptospira in dogs in Thailand, to evaluate antibody prevalence by microscopic agglutination test (MAT) and enzyme-linked immunosorbent assay (ELISA), and to assess risk factors for Leptospira infection. In Northern, Northeastern, and Central Thailand, 273 stray (n = 119) or client-owned (n = 154) dogs from rural (n = 139) or urban (n = 134) areas were randomly included. Dogs that had received antibiotics within 4 weeks prior to sampling were excluded. No dog had received vaccination against Leptospira. Urine was evaluated by real-time polymerase chain reaction (PCR) specific for lipL32 gene of pathogenic Leptospira. Additionally, urine was cultured for 6 months in Ellinghausen-McCullough-Johnson-Harris (EMJH) medium. Antibodies were measured by ELISA and MAT against 24 serovars belonging to 15 serogroups and 1 undesignated serogroup. Risk factor analysis was performed with backwards stepwise selection based on Wald. RESULTS Twelve of 273 (4.4%; 95% confidence interval (CI): 2.0-6.8%) urine samples were PCR-positive. In 1/273 dogs (0.4%; 95% CI: 0.01-1.1%) Leptospira could be cultured from urine. MAT detected antibodies in 33/273 dogs (12.1%; 95% CI: 8.2-16.0%) against 19 different serovars (Anhoa, Australis, Ballum, Bataviae, Bratislava, Broomi, Canicola, Copenhageni, Coxi, Grippotyphosa, Haemolytica, Icterohaemorrhagiae, Khorat, Paidjan, Patoc, Pyrogenes, Rachmati, Saxkoebing, Sejroe). In 111/252 dogs (44.0%; 95% CI: 37.9-50.2%) immunoglobulin M (IgM) and/or immunoglobulin G (IgG) antibodies were found by ELISA. Female dogs had a significantly higher risk for Leptospira infection (p = 0.023). CONCLUSIONS Leptospira shedding occurs in randomly sampled dogs in Thailand, with infection rates comparable to those of Europe and the USA. Therefore, the potential zoonotic risk should not be underestimated and use of Leptospira vaccines are recommended.
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Affiliation(s)
- Kerstin Altheimer
- Clinic of Small Animal Medicine, Centre for Clinical Veterinary Medicine, LMU Munich, Veterinaerstrasse 13, 80539 Munich, Germany
| | - Prapaporn Jongwattanapisan
- Department of Veterinary Medicine, Faculty of Veterinary Science, Chulalongkorn University, Bangkok, Thailand
| | - Supol Luengyosluechakul
- Department of Veterinary Medicine, Faculty of Veterinary Science, Chulalongkorn University, Bangkok, Thailand
| | - Rosama Pusoonthornthum
- Department of Veterinary Medicine, Faculty of Veterinary Science, Chulalongkorn University, Bangkok, Thailand
| | - Nuvee Prapasarakul
- Department of Veterinary Microbiology, Faculty of Veterinary Science, Chulalongkorn University, Bangkok, Thailand
| | - Alongkorn Kurilung
- Department of Veterinary Microbiology, Faculty of Veterinary Science, Chulalongkorn University, Bangkok, Thailand
| | - Els M. Broens
- Department of Infectious Diseases and Immunology, Faculty of Veterinary Medicine, Utrecht University, Utrecht, the Netherlands
| | - Jaap A. Wagenaar
- Department of Infectious Diseases and Immunology, Faculty of Veterinary Medicine, Utrecht University, Utrecht, the Netherlands
- Wageningen Bioveterinary Research, Lelystad, the Netherlands
| | - Marga G. A. Goris
- OIE and National Collaborating Centre for Reference and Research on Leptospirosis, Department of Medical Microbiology, Academic Medical Center, Amsterdam, the Netherlands
| | - Ahmed A. Ahmed
- OIE and National Collaborating Centre for Reference and Research on Leptospirosis, Department of Medical Microbiology, Academic Medical Center, Amsterdam, the Netherlands
| | | | - Sven Reese
- Department of Veterinary Sciences, Institute of Anatomy, Histology and Embryology, LMU Munich, Munich, Germany
| | - Katrin Hartmann
- Clinic of Small Animal Medicine, Centre for Clinical Veterinary Medicine, LMU Munich, Veterinaerstrasse 13, 80539 Munich, Germany
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18
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Smith AM, Arruda AG, Evason MD, Weese JS, Wittum TE, Szlosek D, Stull JW. A cross-sectional study of environmental, dog, and human-related risk factors for positive canine leptospirosis PCR test results in the United States, 2009 to 2016. BMC Vet Res 2019; 15:412. [PMID: 31730465 PMCID: PMC6858729 DOI: 10.1186/s12917-019-2148-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Accepted: 10/20/2019] [Indexed: 12/03/2022] Open
Abstract
Background Canine leptospirosis is a reemerging zoonotic disease concern in North America, and a better understanding of its epidemiology is needed. Wide-scale use and subsequent analyses of polymerase chain reaction (PCR) testing may provide additional insight into leptospirosis. This study aimed to describe temporal trends, to descriptively map, and to identify environmental, dog, and human-level factors associated with positive canine leptospirosis PCR test results in the United States. Results Data obtained from IDEXX Laboratories, Inc. on 40,118 canine leptospirosis PCR tests run in the United States between 2009 and 2016 were evaluated. Climate and socioeconomic (e.g. urban influence, income) data were obtained from public databases. Choropleth maps were created to identify high test-positive proportion areas and a cross-sectional analysis was completed with generalized (univariable, followed by multivariable) mixed logistic regression models accounting for county within state to identify significant predictors for a positive test. Overall test-positive proportion was 5.4% across the United States, with the regional point estimate highest in the southwest (8.1%). In the final multivariable model, the odds of a positive test were greater for male dogs (Odds Ratio [OR] = 1.28) and dogs 0–4 years of age (ORs ranged from 0.35–0.71 for the other age groups). The odds of a positive test were greater for dogs living in areas with wet environmental conditions (OR = 1.24). Season and temperature, as well as the interaction between them, were significant predictors of a positive test. Dogs had a greater probability of testing positive during cool temperatures (< 4 °C) compared to the other temperature categories in the fall season. Conclusions These findings based on PCR testing allow for an improved understanding of factors influencing a positive canine leptospirosis PCR test and will assist targeted education and prevention efforts.
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Affiliation(s)
- Amanda M Smith
- Department of Veterinary Preventive Medicine, College of Veterinary Medicine, The Ohio State University, Columbus, OH, 43210, USA.
| | - Andréia Gonçalves Arruda
- Department of Veterinary Preventive Medicine, College of Veterinary Medicine, The Ohio State University, Columbus, OH, 43210, USA
| | - Michelle D Evason
- Department of Companion Animals and Department of Health Management, Atlantic Veterinary College, University of Prince Edward Island, C1A4P3, Charlottetown, PE, Canada.,Department of Pathobiology, Ontario Veterinary College, Centre for Public Health and Zoonoses, University of Guelph, N1G2W1, Guelph, Ontario, Canada
| | - J S Weese
- Department of Pathobiology, Ontario Veterinary College, Centre for Public Health and Zoonoses, University of Guelph, N1G2W1, Guelph, Ontario, Canada
| | - Thomas E Wittum
- Department of Veterinary Preventive Medicine, College of Veterinary Medicine, The Ohio State University, Columbus, OH, 43210, USA
| | | | - Jason W Stull
- Department of Veterinary Preventive Medicine, College of Veterinary Medicine, The Ohio State University, Columbus, OH, 43210, USA.,Department of Companion Animals and Department of Health Management, Atlantic Veterinary College, University of Prince Edward Island, C1A4P3, Charlottetown, PE, Canada
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LaFerla Jenni M, Woodward P, Yaglom H, Levy C, Iverson SA, Kretschmer M, Jarrett N, Dooley E, Narang J, Venkat H. Knowledge, attitudes, and practices among veterinarians during an outbreak of canine leptospirosis-Maricopa County, Arizona, 2017. Prev Vet Med 2019; 172:104779. [PMID: 31557686 DOI: 10.1016/j.prevetmed.2019.104779] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 09/16/2019] [Accepted: 09/18/2019] [Indexed: 10/26/2022]
Abstract
Leptospirosis, caused by Leptospira spp., is a zoonotic bacterial disease important to both human and animal health. Six pathogenic serovars are currently known to commonly infect and cause disease in dogs in the United States. While canine leptospirosis infection is historically rare in Arizona (≤5 cases reported annually) (ADHS unpublished data) several clusters were reported in Maricopa County (MC) during February 2016-January 2017. Public health initiated an outbreak response and developed a knowledge, attitudes, and practices survey for veterinarians. The goals were to determine awareness and general attitudes about canine leptospirosis and to identify gaps in veterinarians' knowledge in treatment and prevention. We distributed a 40-question self-administered online survey to 1058 Arizona Veterinary Medical Association members, made available during February 9-May 15, 2017. We analyzed the results using Pearson's Chi-squared or Fisher's exact test; a P-value <0.05 was considered statistically significant. We analyzed 202 complete responses. Veterinarians from 10 (66%) of 15 Arizona counties were represented. MC practices were more likely to stock leptospirosis vaccine (80%) than other counties combined (58%) (P = 0.004). The average composite knowledge score was 24.4 out of 38 (range 12-37, median 24); 49% of respondents demonstrated higher knowledge as defined by authors, largely in identification of leptospirosis risk factors (86%) and routes of exposure (73%). Fewer than half (45%) of respondents correctly identified the length of time bacteria can be shed in dogs' urine. Eighty-one percent of respondents demonstrated lower knowledge about clinical signs associated with leptospirosis; only 47% of respondents identified eight clinical signs commonly associated with leptospirosis. Sixty-one percent of MC respondents agreed that leptospirosis is an important canine disease in their geographic area, while only 40% of other county respondents agreed (P=0.03). Seventy percent of respondents identified diagnostic testing options. The majority correctly selected infection-control practices in line with recommendations from 2 national clinical guidelines. More respondents would recommend leptospirosis vaccination if dogs traveled or lived in rural areas (87-96%) than if dogs attended day care or were boarded (63%). We identified opportunities for education, including the local epidemiology of leptospirosis, transmission prevention strategies, vaccine safety, testing, clinical identification, and emerging risk factors. Our findings will help guide the design of educational materials for small animal veterinarians in Arizona regarding recommendations for prevention of animal and human leptospirosis infections; these efforts could also shift the culture of reporting companion animal diseases to improve future One Health collaborations.
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Affiliation(s)
- Margaret LaFerla Jenni
- Public Health Associate Program, Center for State, Tribal, Local and Territorial Support, Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, GA, 30333, USA; Maricopa County Department of Public Health, 4041 N Central Ave, Suite 600, Phoenix, AZ 85012, USA.
| | - Peter Woodward
- Maricopa County Department of Public Health, 4041 N Central Ave, Suite 600, Phoenix, AZ 85012, USA.
| | - Hayley Yaglom
- Arizona Department of Health Services, 150 N 18th Ave Suite 140, Phoenix, AZ, 85007, USA.
| | - Craig Levy
- Maricopa County Department of Public Health, 4041 N Central Ave, Suite 600, Phoenix, AZ 85012, USA.
| | - Sally Ann Iverson
- Maricopa County Department of Public Health, 4041 N Central Ave, Suite 600, Phoenix, AZ 85012, USA; Arizona Department of Health Services, 150 N 18th Ave Suite 140, Phoenix, AZ, 85007, USA; Epidemic Intelligence Service, Division of Scientific Education and Professional Development, Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, GA, 30333, USA.
| | - Melissa Kretschmer
- Maricopa County Department of Public Health, 4041 N Central Ave, Suite 600, Phoenix, AZ 85012, USA.
| | - Nicole Jarrett
- Maricopa County Department of Public Health, 4041 N Central Ave, Suite 600, Phoenix, AZ 85012, USA.
| | - Elizabeth Dooley
- Arizona Department of Health Services, 150 N 18th Ave Suite 140, Phoenix, AZ, 85007, USA.
| | - Jigna Narang
- Maricopa County Department of Public Health, 4041 N Central Ave, Suite 600, Phoenix, AZ 85012, USA.
| | - Heather Venkat
- Arizona Department of Health Services, 150 N 18th Ave Suite 140, Phoenix, AZ, 85007, USA; Career Epidemiology Field Officer Program, Center for Preparedness and Response, Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, GA, 30333, USA.
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20
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Sharun K, Anjana S, Dhivahar M, Ambily VR, Pillai UN. Diagnosis and treatment of canine leptospirosis due to serovar Bataviae—a case report. ACTA ACUST UNITED AC 2019. [DOI: 10.1007/s00580-019-02949-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Cambournac M, Goy-Thollot I, Guillaumin J, Ayoub JY, Pouzot-Nevoret C, Barthélemy A, Bonnet-Garin JM. Acute kidney injury management using intermittent low efficiency haemodiafiltration in a critical care unit: 39 dogs (2012-2015). Acta Vet Scand 2019; 61:17. [PMID: 30971317 PMCID: PMC6457005 DOI: 10.1186/s13028-019-0452-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2017] [Accepted: 03/31/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Veterinary studies describing acute kidney injury (AKI) management using renal replacement therapy (RRT) are limited and have primarily focused on intermittent haemodialysis in North American populations. European data are lacking, although differences in populations, pathogen and toxin exposure and RRT modalities may exist between Europe and North America. The present study reviewed RRT-managed cases from the intensive care unit (ICU) of VetAgro Sup, Lyon, France, for the period 2012-2015. The aims were to describe a 4-h RRT protocol of intermittent low efficiency haemodiafiltration, population characteristics and outcomes in canine AKI cases requiring RRT and to identify prognostic variables. We defined DeltaCreat/h as the difference between the serum creatinine level after RRT treatment N and that before treatment N + 1 divided by the time between treatments (in hours). RESULTS Thirty-nine dogs were included, and 67% were males. The median (range) age, weight, hospitalization length and number of RRT treatments were 4.4 (0.25-15) years, 26.6 (6.7-69) kg, 8 (1-23) days and 3 (1-8) treatments, respectively. The main AKI causes were leptospirosis (74.4%) and nephrotoxins (15.4%). Age (4.0 vs 5.4 years; P = 0.04), admission urine output (0.5 mL/kg/h vs 0 mL/kg/h; P = 0.02) and hospitalization length (10 vs 4 days; P < 0.001) differed between survivors and non-survivors. Hospitalization length [odds ratio (OR) = 0.4], number of treatments (OR = 5.1), serum potassium level on day 2 (OR = 1.9), DeltaCreat/h between the first and second treatments (OR = 1.2), and UOP during hospitalization (OR = 0.2) were correlated with outcome. The main causes of death were euthanasia (44%) and haemorrhagic diatheses (33%). The overall survival rate was 54%, with 55% of survivors discharged with a median creatinine < 240 µmol/L. CONCLUSIONS This is the first description in the veterinary literature of a 4-h protocol of intermittent low efficiency haemodiafiltration to provide RRT in a veterinary critical care unit. While this protocol appears promising, the clinical application of this protocol requires further investigation. Among parameters associated with survival, UOP and DeltaCreat/h between the first and second RRT treatments may be prognostic indicators. The applicability of these parameters to other populations is unknown, and further international, multicentre prospective studies are warranted to confirm these preliminary observations.
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McCallum KE, Constantino-Casas F, Cullen JM, Warland JH, Swales H, Linghley N, Kortum AJ, Sterritt AJ, Cogan T, Watson PJ. Hepatic leptospiral infections in dogs without obvious renal involvement. J Vet Intern Med 2018; 33:141-150. [PMID: 30499209 PMCID: PMC6335520 DOI: 10.1111/jvim.15340] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2017] [Accepted: 10/11/2018] [Indexed: 12/23/2022] Open
Abstract
Background Reports of chronic hepatitis in dogs caused by Leptospira spp. are confined to small case series. Fluorescence in situ hybridization (FISH) allows the identification of spirochetes in liver samples. Consequently, this technique may help elucidate the role of Leptospira spp. in cases of chronic hepatitis. Objectives To describe cases of hepatic leptospirosis in dogs diagnosed by FISH and subsequent polymerase chain reaction (PCR) speciation, with the absence of clinically relevant renal involvement. Animals Ten client‐owned dogs. Methods Retrospective case series from the University of Cambridge presented between 2013 and 2016 or cases consulted by telephone advice during this time period. Cases were selected based on histopathologically confirmed granulomatous hepatitis and leptospiral organisms identified by FISH and PCR speciation (Leptospira interrogans/kirschneri). Results All cases had increased liver enzyme activities, and FISH in combination with PCR speciation‐confirmed infection with L. interrogans/kirschneri. Four dogs underwent repeat liver biopsy, FISH and PCR speciation 4‐15 months after initial presentation and doxycycline treatment with 1 dog undergoing repeat sampling at necropsy. Three dogs that underwent repeat biopsy remained positive for L. interrogans/kirschneri infection. Six dogs were alive at the time of manuscript preparation and 4 dogs were euthanized as a result of progressive liver disease. Conclusions and Clinical Importance The presence of hepatic leptospiral organisms may be associated with chronic granulomatous hepatitis without clinical evidence of renal involvement. Further studies are necessary to elucidate the etiological role of these organisms in the disease.
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Affiliation(s)
- Katie E McCallum
- Department of Veterinary Medicine, University of Cambridge, Cambridge, United Kingdom
| | | | - John M Cullen
- North Carolina State College of Veterinary Medicine, Raleigh, North Carolina
| | - James H Warland
- Department of Haematology, University of Cambridge, NHS Blood & Transplant Donor Centre, Cambridge, United Kingdom
| | - Harry Swales
- Small Animal Teaching Hospital, Leahurst Campus, University of Liverpool, Wirral, United Kingdom
| | | | - Andre J Kortum
- Department of Veterinary Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Alex J Sterritt
- Highcroft Veterinary Group, Whitchurch Veterinary Centre, Bristol, United Kingdom
| | | | - Penny J Watson
- Department of Veterinary Medicine, University of Cambridge, Cambridge, United Kingdom
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Ojeda J, Salgado M, Encina C, Santamaria C, Monti G. Evidence of interspecies transmission of pathogenic Leptospira between livestock and a domestic cat dwelling in a dairy cattle farm. J Vet Med Sci 2018; 80:1305-1308. [PMID: 29962394 PMCID: PMC6115255 DOI: 10.1292/jvms.16-0361] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
A domestic cat dwelling in a dairy cattle farm with haematuria was referred for a physical examination. The examination showed no abnormalities therefore complementary exams were performed. Leukocytosis with neutrophilia, monocytosis and hyperproteinaemia were detected. The urine analysis showed a bacterial infection without ultrasound findings. Serological titers to Leptospira interrogans serovar Pomona and Autumnalis were detected. Molecular analysis demonstrated the presence of Leptospira spp. in urine. The findings were consistent with subclinical leptospirosis. The cattle herd had evidence of Leptospira infection. The microbiological exams confirmed the presence of the Leptospira spp. in urine and serum. According to the evidence presented in this study, cats that dwell within a dairy farm could play a role in the Leptospira infection epidemiologically. The importance of feline leptospirosis must be evaluated with leptospirosis control in livestock.
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Affiliation(s)
- Javier Ojeda
- Veterinary Clinical Sciences Department, Faculty of Veterinary Sciences, Universidad Austral de Chile, Valdivia, 5090000, Chile
| | - Miguel Salgado
- Preventive Veterinary Medicine Department, Faculty of Veterinary Sciences, Universidad Austral de Chile, Valdivia, 5090000, Chile
| | - Carolina Encina
- Preventive Veterinary Medicine Department, Faculty of Veterinary Sciences, Universidad Austral de Chile, Valdivia, 5090000, Chile
| | - Camila Santamaria
- Preventive Veterinary Medicine Department, Faculty of Veterinary Sciences, Universidad Austral de Chile, Valdivia, 5090000, Chile
| | - Gustavo Monti
- Preventive Veterinary Medicine Department, Faculty of Veterinary Sciences, Universidad Austral de Chile, Valdivia, 5090000, Chile
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Segev G, Bruchim Y, Berl N, Cohen A, Aroch I. Effects of fenoldopam on kidney function parameters and its therapeutic efficacy in the management of acute kidney injury in dogs with heatstroke. J Vet Intern Med 2018; 32:1109-1115. [PMID: 29575360 PMCID: PMC5980265 DOI: 10.1111/jvim.15081] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Revised: 12/28/2017] [Accepted: 01/30/2018] [Indexed: 01/11/2023] Open
Abstract
Background Acute kidney injury (AKI) is common in dogs, but evidence of efficacy of its treatment is lacking. Objective To evaluate the efficacy of fenoldopam in the management of AKI. Animals Forty dogs with naturally occurring heatstroke. Methods Dogs were prospectively enrolled and divided into treatment and the placebo groups (fenoldopam, constant rate infusion [CRI] of 0.1 µg/kg/min or saline, respectively). Urine production (UP) was measured using a closed system. Urinary clearances were performed at 4, 12, and 24 hours after presentation to estimate the effect of fenoldopam on UP, glomerular filtration rate (GFR) and sodium fractional excretion (NaFE). Results At presentation, severity of heatstroke, based on a previously developed scoring system, was similar between the study groups, but was significantly worse in nonsurvivors compared with survivors. Fenoldopam administration was not associated with hypotension. Overt AKI was diagnosed, based on the International Renal Interest Society guidelines in 22/40 (55%) of the dogs. Overall, 14/40 dogs (35%) died, with no significant (P = .507) mortality rate difference between the fenoldopam (6/20 dogs; 30%) and placebo (8/20; 40%) groups. The proportion of dogs with AKI did not differ between the fenoldopam and the placebo groups (9/20; 45% versus 13/20; 65%, respectively; P = .204). There were no differences in UP, GFR, and NaFE between the fenoldopam and the placebo groups. Conclusion and Clinical Importance Fenoldopam CRI at 0.1 µg/kg/min did not have a clinically relevant effect on kidney function parameters in dogs with severe heatstroke‐associated AKI.
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Affiliation(s)
- Gilad Segev
- Department of Small Animals Medicine, Koret School of Veterinary Medicine, Hebrew University, Jerusalem, Israel
| | - Yaron Bruchim
- Department of Small Animals Medicine, Koret School of Veterinary Medicine, Hebrew University, Jerusalem, Israel
| | - Noga Berl
- Department of Small Animals Medicine, Koret School of Veterinary Medicine, Hebrew University, Jerusalem, Israel
| | - Adar Cohen
- Department of Small Animals Medicine, Koret School of Veterinary Medicine, Hebrew University, Jerusalem, Israel
| | - Itamar Aroch
- Department of Small Animals Medicine, Koret School of Veterinary Medicine, Hebrew University, Jerusalem, Israel
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Legatti SAM, El Dib R, Legatti E, Botan AG, Camargo SEA, Agarwal A, Barretti P, Paes AC. Acute kidney injury in cats and dogs: A proportional meta-analysis of case series studies. PLoS One 2018; 13:e0190772. [PMID: 29370180 PMCID: PMC5784898 DOI: 10.1371/journal.pone.0190772] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Accepted: 12/15/2017] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Risk of mortality in the setting of acute kidney injury (AKI) in cats and dogs remains unclear. OBJECTIVES To evaluate the incidence of mortality in cats and dogs with AKI based on etiology (i.e. infectious versus non-infectious; receiving dialysis versus conservative treatment). MATERIALS AND METHODS Ovid Medline, EMBASE, and LILACS were searched up to July 2016. Articles were deemed eligible if they were case series studies evaluating the incidence of all-cause mortality in cats and dogs with AKI, regardless of etiology or the nature of treatment. RESULTS Eighteen case series involving 1,201animalsproved eligible. The pooled proportions for overall mortality were: cats53.1% [95% CI 0.475, 0.586; I2 = 11,9%, p = 0.3352]; dogs 45.0% [95% CI 0.33, 0.58; I2 = 91.5%, P < 0.0001]. A non-significant increase in overall mortality risk was found among dialysed animals relative to those managed with conservative treatment, independent of animal type and the etiology of their AKI. The pooled proportions for overall mortality according to etiology, regardless of treatment type, were: AKI due infectious etiology for cats and dogs, 19.2% [95% CI 0.134, 0.258; I2 = 37.7%, P = 0.0982]; AKI due non-infectious etiology for cats and dogs, 59.9% [95% CI 0.532, 0.663; I2 = 51.0%, P = 0.0211]. CONCLUSION Our findings suggest higher rates of overall mortality in cats and dogs with AKI due to non-infectious etiologies relative to infectious etiologies, and showed non-significant differences in terms of higher rates associated with dialysis compared to conservative management. Further investigations regarding optimal time to initiate dialysis and the development of clinical models to prognosticate the course of disease and guide optimal treatment initiation for less severe cases of AKI in cats and dogs is warranted.
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Affiliation(s)
- Sabrina Almeida Moreira Legatti
- Department of Veterinary Hygiene and Public Health, School of Veterinary Medicine and Animal Science, Unesp – Univ Estadual Paulista, Botucatu, São Paulo, Brazil
| | - Regina El Dib
- Department of Anaesthesiology, Botucatu Medical School, Unesp – Univ Estadual Paulista, Botucatu, São Paulo, Brazil
- McMaster Institute of Urology, McMaster University, Hamilton, Ontario, Canada
- * E-mail:
| | - Emerson Legatti
- School of Veterinary Medicine and Animal Science, Unesp – Univ Estadual Paulista, Botucatu, São Paulo, Brazil
| | - Andresa Graciutti Botan
- Institute of Science and Technology, Department of Biosciences and Oral Diagnosis, Unesp – Univ Estadual Paulista, São José dos Campos, São Paulo, Brazil
| | - Samira Esteves Afonso Camargo
- Institute of Science and Technology, Department of Biosciences and Oral Diagnosis, Unesp – Univ Estadual Paulista, São José dos Campos, São Paulo, Brazil
| | - Arnav Agarwal
- Schoolof Medicine, University of Toronto, Toronto, Canada
| | - Pasqual Barretti
- Department of Internal Medicine, Botucatu Medical School, Unesp – Univ Estadual Paulista, Botucatu, São Paulo, Brazil
| | - Antônio Carlos Paes
- Department of Veterinary Hygiene and Public Health, School of Veterinary Medicine and Animal Science, Unesp – Univ Estadual Paulista, Botucatu, São Paulo, Brazil
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Sonet J, Barthélemy A, Goy-Thollot I, Pouzot-Nevoret C. Prospective evaluation of abdominal ultrasonographic findings in 35 dogs with leptospirosis. Vet Radiol Ultrasound 2017; 59:98-106. [DOI: 10.1111/vru.12571] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Revised: 07/01/2017] [Accepted: 08/04/2017] [Indexed: 11/29/2022] Open
Affiliation(s)
- Juliette Sonet
- Diagnostic Imaging Unit, Univ Lyon; VetAgro Sup; F-69280 Marcy l'Etoile France
| | - Anthony Barthélemy
- Intensive Care Unit (SIAMU), Univ Lyon; VetAgro Sup; APCSe F-69280 Marcy l'Etoile France
| | - Isabelle Goy-Thollot
- Intensive Care Unit (SIAMU), Univ Lyon; VetAgro Sup; APCSe F-69280 Marcy l'Etoile France
| | - Céline Pouzot-Nevoret
- Intensive Care Unit (SIAMU), Univ Lyon; VetAgro Sup; APCSe F-69280 Marcy l'Etoile France
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Knöpfler S, Mayer-Scholl A, Luge E, Klopfleisch R, Gruber AD, Nöckler K, Kohn B. Evaluation of clinical, laboratory, imaging findings and outcome in 99 dogs with leptospirosis. J Small Anim Pract 2017; 58:582-588. [DOI: 10.1111/jsap.12718] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Revised: 05/01/2017] [Accepted: 05/29/2017] [Indexed: 11/28/2022]
Affiliation(s)
- S. Knöpfler
- Clinic for Small Animals; Freie Universität Berlin, Oertzenweg 19b; D-14163 Berlin
| | - A. Mayer-Scholl
- Federal Institute for Risk AssessmentDiedersdorfer Weg 1, D-12277 Berlin; Germany
| | - E. Luge
- Federal Institute for Risk AssessmentDiedersdorfer Weg 1, D-12277 Berlin; Germany
| | - R. Klopfleisch
- Institute for Veterinary Pathology; Freie Universität Berlin, Robert-von-Ostertag-Str. 15, D-14163 Berlin; Germany
| | - A. D. Gruber
- Institute for Veterinary Pathology; Freie Universität Berlin, Robert-von-Ostertag-Str. 15, D-14163 Berlin; Germany
| | - K. Nöckler
- Federal Institute for Risk AssessmentDiedersdorfer Weg 1, D-12277 Berlin; Germany
| | - B. Kohn
- Clinic for Small Animals; Freie Universität Berlin, Oertzenweg 19b; D-14163 Berlin
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28
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Bergmann M, Llewellyn JR, Hartmann K. [Diagnosis of leptospirosis in dogs]. TIERARZTLICHE PRAXIS. AUSGABE K, KLEINTIERE/HEIMTIERE 2017; 45:170-177. [PMID: 28513759 DOI: 10.15654/tpk-170039] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Accepted: 03/15/2017] [Indexed: 12/29/2022]
Abstract
Rapid confirmation of the diagnosis leptospirosis is important in order to apply appropriate treatment; in addition, infected dogs are a zoonotic risk. Culture and isolation of living leptospires from blood, urine, or tissues is considered the reference standard of diagnosis. However, sensitivity are low, and leptospires require weeks to months to grow. Therefore, diagnosis of leptospirosis is most commonly based on antibody testing or the detection of Leptospira spp. DNA by PCR. Microscopic agglutination test (MAT) is currently still the recommended confirmatory test for canine leptospirosis, despite its numerous limitations (e. g., negative results in early infection, positive results due to vaccine-associated antibodies). ELISA can differentiate between IgG and IgM antibodies and thus, discriminate current infections from previous vaccination or exposure. Point-of-care tests and in-house-PCR tests have recently been developed for use in private practice allowing easy and immediate diagnosis. However, only few data on sensitivity and specificity of these tests exist so far. A reliable diagnosis can only be established in case of a positive PCR result or a fourfold titre increase in MAT.
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Affiliation(s)
- Michèle Bergmann
- Michèle Bergmann, Medizinische Kleintierklinik, Ludwig-Maximilians-Universität München, Veterinärstraße 13, 80539 München, E-Mail:
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Barthélemy A, Magnin M, Pouzot-Nevoret C, Bonnet-Garin JM, Hugonnard M, Goy-Thollot I. Hemorrhagic, Hemostatic, and Thromboelastometric Disorders in 35 Dogs with a Clinical Diagnosis of Leptospirosis: A Prospective Study. J Vet Intern Med 2016; 31:69-80. [PMID: 27911985 PMCID: PMC5259627 DOI: 10.1111/jvim.14626] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2016] [Revised: 10/11/2016] [Accepted: 11/02/2016] [Indexed: 01/23/2023] Open
Abstract
Background Leptospirosis in dogs is occasionally associated with a hemorrhagic syndrome, the pathophysiology of which is not fully understood. Hypothesis/Objectives To characterize hematologic, hemostatic, and thromboelastometric abnormalities in dogs with leptospirosis and to study their association with hemorrhagic diatheses and outcomes. Animals Thirty‐five client‐owned dogs. Methods A prospective observational single cohort study was conducted. Results from the CBC, coagulation tests (prothrombin, activated partial thromboplastin and thrombin times, fibrinogen, fibrin(ogen) degradation products, and D‐dimer concentrations), rotational thromboelastometry (TEM), signalment, hemorrhagic diatheses, occurrence of disseminated intravascular coagulation (DIC) at admission, and survival to discharge were recorded. Results The most common hematologic and hemostatic abnormalities were anemia (30/35), thrombocytopenia (21/35), and hyperfibrinogenemia (15/35). Eight dogs were diagnosed with DIC. A normal TEM profile was found in 14 dogs, a hypercoagulable profile in 14 dogs, and a hypocoagulable profile in 7 dogs. The 8 dogs with hemorrhagic diatheses at admission had significantly decreased platelet counts (P = .037) and increased D‐dimer concentrations (P = .015) compared with other dogs. Dogs with a hypocoagulable profile exhibited more hemorrhagic diatheses compared with the dogs that had normal and hypercoagulable profiles (P = .049). The mortality rate was lower in dogs with a hypercoagulable profile than in those with a hypocoagulable profile (21% vs 57%; P = .043). Disseminated intravascular coagulation was not a significant prognostic factor. Conclusions and Clinical Importance Thromboelastometric parameters were altered in dogs with both hypercoagulable and hypocoagulable profiles. A hypocoagulable profile was significantly correlated with hemorrhagic diathesis and higher mortality rate.
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Affiliation(s)
- A Barthélemy
- Intensive Care Unit (SIAMU), VetAgro Sup campus vétérinaire de Lyon, Université de Lyon, Marcy l'Etoile, France.,Univ Lyon, VetAgro Sup, APCSe, Marcy l'Etoile, France
| | - M Magnin
- Intensive Care Unit (SIAMU), VetAgro Sup campus vétérinaire de Lyon, Université de Lyon, Marcy l'Etoile, France.,Univ Lyon, VetAgro Sup, APCSe, Marcy l'Etoile, France
| | - C Pouzot-Nevoret
- Intensive Care Unit (SIAMU), VetAgro Sup campus vétérinaire de Lyon, Université de Lyon, Marcy l'Etoile, France.,Univ Lyon, VetAgro Sup, APCSe, Marcy l'Etoile, France
| | | | - M Hugonnard
- Clinic for Small Animal Internal Medicine, USC 1233 Emerging Pathogens and Wild Rodents, VetAgro Sup Campus Vétérinaire de Lyon, Université de Lyon, Marcy l'Etoile, France
| | - I Goy-Thollot
- Intensive Care Unit (SIAMU), VetAgro Sup campus vétérinaire de Lyon, Université de Lyon, Marcy l'Etoile, France.,Univ Lyon, VetAgro Sup, APCSe, Marcy l'Etoile, France
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Hennebelle JH, Sykes JE, Foley J. Risk factors associated with leptospirosis in dogs from Northern California: 2001-2010. Vector Borne Zoonotic Dis 2016; 14:733-9. [PMID: 25325317 DOI: 10.1089/vbz.2014.1624] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The present study was performed to identify risk factors for canine leptospirosis at a tertiary referral institution in northern California from 2001 through 2010 and to describe case characteristics. In this retrospective case-control study, 67 dogs with leptospirosis and 271 controls were evaluated at the William R. Pritchard Veterinary Medical Teaching Hospital (Davis, CA) from March, 2001 , through November, 2010. Medical records of cases and controls were analyzed to identify signalment, exposure history, and clinical signs that increased the risk for a diagnosis of leptospirosis. Among cases, most were vomiting and lethargic and had leukocytosis and azotemia. Total white cell count, neutrophil count, and monocyte count were higher in dogs with leptospirosis, whereas the platelet count was lower. Serum concentrations of urea nitrogen, creatinine, and bilirubin were elevated in dogs with leptospirosis as well. On average, case dogs were hospitalized for 11 days and had hospital bills exceeding $5000. Mortality was 13% of case dogs, with the predominant serovar being Pomona. Dogs with leptospirosis were more likely to reside in the central or south coast (odds ratio [OR]=7.33), Sierra Nevada foothills (OR=4.50), San Francisco Bay area (OR=4.2), and north coast (OR=2.85) of California when compared with controls. Dogs 5-10 years old (OR=3.22) or over 10 years old (OR=2.76) and herding (OR=3.1) or hound breed (OR=4.6) dogs were more likely to have leptospirosis than the control group. Leptospirosis was associated with acute renal failure in older, undervaccinated dogs. The regional distribution, large breed predisposition, and finding of predominantly Pomona serovar suggest wildlife or other contacts as an important route of exposure. Knowledge of risk factors, vaccination history, and clinical signs can increase an index of suspicion for leptospirosis and contribute to improved strategies for prevention of leptospirosis in dogs, understanding of the ecology of the disease for all species, and protection of human health.
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Harkin KR, Hays MP. Variable-number tandem-repeat analysis of leptospiral DNA isolated from canine urine samples molecularly confirmed to contain pathogenic leptospires. J Am Vet Med Assoc 2016; 249:399-405. [DOI: 10.2460/javma.249.4.399] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Arent Z, Frizzell C, Gilmore C, Allen A, Ellis WA. Leptospira interrogans serovars Bratislava and Muenchen animal infections: Implications for epidemiology and control. Vet Microbiol 2016; 190:19-26. [PMID: 27283852 DOI: 10.1016/j.vetmic.2016.05.004] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2015] [Revised: 04/29/2016] [Accepted: 05/12/2016] [Indexed: 11/28/2022]
Abstract
Strains of Leptospira interrogans belonging to two very closely related serovars - Bratislava and Muenchen - have been associated with disease in domestic animals, in particular pigs, but also in horses and dogs. Similar strains have also been recovered from various wildlife species. Their epidemiology is poorly understood. Two hundred and forty seven such isolates, from UK domestic animal and wildlife species, were examined by restriction endonuclease analysis in an attempt to elucidate their epidemiology. A representative sub-sample of 65 of these isolates was further examined by multiple-locus variable-number tandem repeat analysis and 22 by secY sequencing. Ten restriction pattern types were identified. The majority of isolates fell into one of three restriction endonuclease analysis pattern types designated B2a, B2b and M2a. B2a was ubiquitous and was isolated from 10 species and represented the majority of the horse and all dog isolates. B2b was very different, being isolated only from pigs, indicating that this type was maintained by pigs. The pattern M2a was reported for the majority of isolates from pigs but also was common in small rodents isolates. Five restriction pattern types were found only in wildlife suggesting that they are unlikely to pose a disease threat to domestic animals. Multiple-locus variable-number tandem repeat analysis identified six clusters. The REA types B2a and B2b were all found in one MLVA cluster while the majority of the M2a strains examined occurred in another cluster. The secY sequencing detected only one sequence type, clustered with other serovars of Leptospira interrogans.
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Affiliation(s)
- Z Arent
- OIE Leptospira Reference Laboratory, AgriFood and Biosciences Institute, Veterinary Sciences Division, Stoney Road, Stormont, Belfast BT4 3SD, UK; University Centre of Veterinary Medicine JU-UAK, University of Agriculture in Krakow, Al. Mickiewicza 24/28, 30-059 Krakow, Poland.
| | - C Frizzell
- Department of Veterinary Sciences, Queens University Belfast, Stoney Road, Stormont, Belfast BT4 3SD, UK
| | - C Gilmore
- OIE Leptospira Reference Laboratory, AgriFood and Biosciences Institute, Veterinary Sciences Division, Stoney Road, Stormont, Belfast BT4 3SD, UK
| | - A Allen
- OIE Leptospira Reference Laboratory, AgriFood and Biosciences Institute, Veterinary Sciences Division, Stoney Road, Stormont, Belfast BT4 3SD, UK
| | - W A Ellis
- OIE Leptospira Reference Laboratory, AgriFood and Biosciences Institute, Veterinary Sciences Division, Stoney Road, Stormont, Belfast BT4 3SD, UK
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Preyß-Jägeler C, Müller E, Straubinger RK, Hartmann K. Prevalence of antibodies against Borrelia burgdorferi, Anaplasma phagocytophilum, and Leptospira interrogans serovars in Bernese Mountain Dogs. TIERAERZTLICHE PRAXIS AUSGABE KLEINTIERE HEIMTIERE 2016; 44:77-85. [PMID: 27004451 DOI: 10.15654/tpk-140962] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2014] [Accepted: 08/11/2015] [Indexed: 12/17/2022]
Abstract
OBJECTIVE Bernese Mountain Dogs (BMD) have a higher prevalence of Borrelia burgdorferi sensu lato (Bbsl) antibodies than other breeds, but it is not known whether this is the case for other pathogens. Therefore, the aim of the study was to determine the frequency and level of specific antibodies against members of the Bbsl group, Anaplasma phagocytophilum (Ap), and Leptospira (L.) interrogans serovars in BMD and compare the results with those found in dogs of other breeds. MATERIALS AND METHODS A total of 171 healthy BMD and 57 healthy control dogs of other breeds were included in the study. Controls were large dogs (> 30 kg) with long, dark hair coats. A two-tiered testing method consisting of computerized kinetic enzyme-linked immunosorbent assay (KELA) and Western blotting was used for detection of antibodies against Bbsl, an immunofluorescence assay (IFA) was used for detection of antibodies against Ap, and microscopic agglutination test (MAT) for antibodies to 18 different serovars of L. interrogans. RESULTS The prevalence of anti-Bbsl antibodies was significantly higher in BMD (43.3%) than in controls (17.5%) (p < 0.001). Antibodies to Bbsl attributable to vaccination were excluded from the calculation of prevalence. Antibodies to Ap were found in 50.3% of BMD, whereas only 24.6% of the controls dogs were tested positive for Ap (p < 0.001). Antibody titers of the 18 different serovars of L. interrogans antibodies did not differ significantly between BMD and control dogs except for L. copenhageni antibody titers which were higher in BMD. Significantly higher antibody titers to L. canicola (p = 0.003), L. copenhageni (p = 0.005), L. grippothyphosa (p = 0.029) and L. vanderhoedoni (p = 0.035) were seen in BMD compared to control dogs. CONCLUSION AND CLINICAL RELEVANCE BMD had a higher prevalence of anti-Bbsl, anti-L. copenhageni and anti-Ap antibodies than control dogs. Significantly higher antibody titers against L. canicola (p = 0.003), L. copenhageni (p = 0.005), L. grippothyphosa (p = 0.029) and L. vanderhoedoni (p = 0.035) were seen in BMD compared with control dogs, but the reason for this and potential clinical implications are not known.
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Affiliation(s)
- C Preyß-Jägeler
- Christine Preyß-Jägeler, Medizinische Kleintierklinik der Ludwig-Maximilians-Universität München, Veterinärstraße 13, 80539 München, E-Mail:
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Segev G, Langston C, Takada K, Kass PH, Cowgill LD. Validation of a Clinical Scoring System for Outcome Prediction in Dogs with Acute Kidney Injury Managed by Hemodialysis. J Vet Intern Med 2016; 30:803-7. [PMID: 26995335 PMCID: PMC4913579 DOI: 10.1111/jvim.13930] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Revised: 02/24/2016] [Accepted: 02/25/2016] [Indexed: 12/02/2022] Open
Abstract
Background A scoring system for outcome prediction in dogs with acute kidney injury (AKI) recently has been developed but has not been validated. Hypothesis The scoring system previously developed for outcome prediction will accurately predict outcome in a validation cohort of dogs with AKI managed with hemodialysis. Animals One hundred fifteen client‐owned dogs with AKI. Methods Medical records of dogs with AKI treated by hemodialysis between 2011 and 2015 were reviewed. Dogs were included only if all variables required to calculate the final predictive score were available, and the 30‐day outcome was known. A predictive score for 3 models was calculated for each dog. Logistic regression was used to evaluate the association of the final predictive score with each model's outcome. Receiver operating curve (ROC) analyses were performed to determine sensitivity and specificity for each model based on previously established cut‐off values. Results Higher scores for each model were associated with decreased survival probability (P < .001). Based on previously established cut‐off values, 3 models (models A, B, C) were associated with sensitivities/specificities of 73/75%, 71/80%, and 75/86%, respectively, and correctly classified 74–80% of the dogs. Conclusions and Clinical Relevance All models were simple to apply and allowed outcome prediction that closely corresponded with actual outcome in an independent cohort. As expected, accuracies were slightly lower compared with those from the previously reported cohort used initially to develop the models.
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Affiliation(s)
- G Segev
- Koret School of Veterinary Medicine, Hebrew University of Jerusalem, Israel
| | - C Langston
- The Ohio State University Veterinary Medical Center, School of Veterinary Medicine, University of California, Davis, CA
| | - K Takada
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, CA
| | - P H Kass
- Department of Population Heath and Reproduction, University of California, Davis, CA
| | - L D Cowgill
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, CA
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Schuller S, Francey T, Hartmann K, Hugonnard M, Kohn B, Nally JE, Sykes J. European consensus statement on leptospirosis in dogs and cats. J Small Anim Pract 2015; 56:159-79. [PMID: 25754092 DOI: 10.1111/jsap.12328] [Citation(s) in RCA: 158] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2014] [Revised: 10/31/2014] [Accepted: 11/28/2014] [Indexed: 02/03/2023]
Abstract
Leptospirosis is a zoonotic disease with a worldwide distribution affecting most mammalian species. Clinical leptospirosis is common in dogs but appears to be rare in cats. Both dogs and cats, however, can shed leptospires in the urine. This is problematic as it can lead to exposure of humans. The control of leptospirosis, therefore, is important not only from an animal but also from a public health perspective. The aim of this consensus statement is to raise awareness of leptospirosis and to outline the current knowledge on the epidemiology, clinical features, diagnostic tools, prevention and treatment measures relevant to canine and feline leptospirosis in Europe.
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Affiliation(s)
- S Schuller
- Department of Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, 3012 Bern, Switzerland
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Eric Klaasen HL, Adler B. Recent advances in canine leptospirosis: focus on vaccine development. VETERINARY MEDICINE-RESEARCH AND REPORTS 2015; 6:245-260. [PMID: 30101111 PMCID: PMC6067773 DOI: 10.2147/vmrr.s59521] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Leptospirosis is a global infection of humans and animals caused by pathogenic Leptospira spp. Leptospirosis is a major zoonosis, with infection acquired from wild and domestic animals. It is also a significant cause of morbidity, mortality, and economic loss in production and companion animals. Leptospirosis in dogs is prevalent worldwide and as well as a cause of canine disease, it presents a zoonotic risk to human contacts. Canine leptospirosis does not differ greatly from the syndromes seen in other animal species, with hepatic, renal, and pulmonary involvement being the main manifestations. While the pathogenesis of disease is well documented at the whole animal level, the cellular and molecular basis remains obscure. Killed, whole-cell bacterin vaccines are licensed worldwide and have not changed greatly over the past several decades. Vaccine-induced immunity is restricted to serologically related serovars and is generally short-lived, necessitating annual revaccination. The appearance of new serovars as causes of canine leptospirosis requires constant epidemiological surveillance and tailoring of vaccines to cover emerging serovars. At the present time, there is no realistic prospect of alternative, non-bacterin vaccines in the foreseeable future.
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Affiliation(s)
- Henricus Lbm Eric Klaasen
- Global Companion Animals Research and Development, Merck Sharp and Dohme Animal Health, Boxmeer, the Netherlands,
| | - Ben Adler
- Department of Microbiology, Monash University, Clayton, VIC, Australia
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Weingarten MA, Sande AA. Acute liver failure in dogs and cats. J Vet Emerg Crit Care (San Antonio) 2015; 25:455-73. [PMID: 25882813 DOI: 10.1111/vec.12304] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2012] [Accepted: 01/26/2015] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To define acute liver failure (ALF), review the human and veterinary literature, and discuss the etiologies and current concepts in diagnostic and treatment options for ALF in veterinary and human medicine. ETIOLOGY In veterinary medicine ALF is most commonly caused by hepatotoxin exposure, infectious agents, inflammatory diseases, trauma, and hypoxic injury. DIAGNOSIS A patient may be deemed to be in ALF when there is a progression of acute liver injury with no known previous hepatic disease, the development of hepatic encephalopathy of any grade that occurs within 8 weeks after the onset of hyperbilirubinemia (defined as plasma bilirubin >50 μM/L [>2.9 mg/dL]), and the presence of a coagulopathy. Diagnostic testing to more specifically characterize liver dysfunction or pathology is usually required. THERAPY Supportive care to aid the failing liver and compensate for the lost functions of the liver remains the cornerstone of care of patients with ALF. Advanced therapeutic options such as extracorporeal liver assist devices and transplantation are currently available in human medicine. PROGNOSIS The prognosis for ALF depends upon the etiology, the degree of liver damage, and the response to therapy. In veterinary medicine, the prognosis is generally poor.
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Brown N, Segev G, Francey T, Kass P, Cowgill LD. Glomerular filtration rate, urine production, and fractional clearance of electrolytes in acute kidney injury in dogs and their association with survival. J Vet Intern Med 2015; 29:28-34. [PMID: 25594609 PMCID: PMC4858109 DOI: 10.1111/jvim.12518] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2014] [Revised: 09/16/2014] [Accepted: 11/06/2014] [Indexed: 12/02/2022] Open
Abstract
Background Acute kidney injury (AKI) is common in dogs. Few studies have assessed sequential changes in indices of kidney function in dogs with naturally occurring AKI. Objective To document sequential changes of conventional indices of renal function, to better define the course of AKI, and to identify a candidate marker for recovery. Animals Ten dogs with AKI. Methods Dogs were prospectively enrolled and divided into surviving and nonsurviving dogs. Urine production was measured with a closed system for 7 days. One and 24‐hour urinary clearances were performed daily to estimate solute excretion and glomerular filtration rate (GFR). Solute excretion was calculated as an excretion ratio (ER) and fractional clearance (FC) based on both the 1‐ and 24‐hour urine collections. Results Four dogs survived and 6 died. At presentation, GFR was not significantly different between the outcome groups, but significantly (P = .03) increased over time in the surviving, but not in the nonsurviving dogs. Fractional clearance of Na decreased significantly over time (20.2–9.4%, P < .0001) in the surviving, but not in the nonsurviving dogs. The ER and FC of solutes were highly correlated (r, 0.70–0.95). Conclusion and Clinical Impact Excretion ratio might be used in the clinical setting as a surrogate marker to follow trends in solute excretion. Increased GFR, urine production, and decreased FC of Na were markers of renal recovery. The FC of Na is a simple, noninvasive, and cost‐effective method that can be used to evaluate recovery of renal function.
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Affiliation(s)
- N Brown
- Internal Medicine Service, Animal Referral Hospital, Homebush West, NSW, Australia
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Hepatitis and Cholangiohepatitis. SMALL ANIMAL CRITICAL CARE MEDICINE 2015. [PMCID: PMC7184236 DOI: 10.1016/b978-1-4557-0306-7.00115-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Hepatitis is defined as any inflammatory cell infiltrate within the hepatic parenchyma; the term cholangiohepatitis describes the extension of that inflammation to include the intrahepatic bile ducts. Although many causes of hepatitis and cholangiohepatitis have been described in dogs and cats, the cause in many cases remains unknown. A suspicion of hepatitis or cholangiohepatitis may be based on supportive historical, physical examination, and clinicopathologic findings that are similar for most causes of hepatic disease. A diagnosis of hepatitis or cholangiohepatitis is made ultimately via histopathologic evaluation of hepatic tissue. The mechanisms of hepatocellular injury in animals with hepatitis and cholangiohepatitis are poorly understood. Elucidation of these mechanisms may provide the basis for future therapeutic options. Successful treatment of the patient with hepatitis or cholangiohepatitis involves addressing the underlying disease or inciting cause and providing aggressive symptomatic therapy and supportive care.
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Chomel BB. Emerging and Re-Emerging Zoonoses of Dogs and Cats. Animals (Basel) 2014; 4:434-45. [PMID: 26480316 PMCID: PMC4494318 DOI: 10.3390/ani4030434] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2014] [Revised: 07/04/2014] [Accepted: 07/04/2014] [Indexed: 12/25/2022] Open
Abstract
Simple Summary Dogs and cats have been sharing our environment for a long time and as pets they bring major psychological well-being to our modern urbanized society. However, they still can be a source of human infection by various pathogens, including viruses, bacteria, parasites, and fungi. Abstract Since the middle of the 20th century, pets are more frequently considered as “family members” within households. However, cats and dogs still can be a source of human infection by various zoonotic pathogens. Among emerging or re-emerging zoonoses, viral diseases, such as rabies (mainly from dog pet trade or travel abroad), but also feline cowpox and newly recognized noroviruses or rotaviruses or influenza viruses can sicken our pets and be transmitted to humans. Bacterial zoonoses include bacteria transmitted by bites or scratches, such as pasteurellosis or cat scratch disease, leading to severe clinical manifestations in people because of their age or immune status and also because of our closeness, not to say intimacy, with our pets. Cutaneous contamination with methicillin-resistant Staphylococcus aureus, Leptospira spp., and/or aerosolization of bacteria causing tuberculosis or kennel cough are also emerging/re-emerging pathogens that can be transmitted by our pets, as well as gastro-intestinal pathogens such as Salmonella or Campylobacter. Parasitic and fungal pathogens, such as echinococcosis, leishmaniasis, onchocercosis, or sporotrichosis, are also re-emerging or emerging pet related zoonoses. Common sense and good personal and pet hygiene are the key elements to prevent such a risk of zoonotic infection.
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Affiliation(s)
- Bruno B Chomel
- Department of Population Health and Reproduction, School of Veterinary Medicine, University of California, Davis, CA 95616, USA.
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Ball C, Dawson S, Williams N. Leptospira cases and vaccination habits within UK vet-visiting dogs. Vet Rec 2014; 174:278. [PMID: 24570411 DOI: 10.1136/vr.102085] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- C Ball
- Department of Epidemiology and Population Health, University of Liverpool, Institute of Infection and Global Health, Neston, UK
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Lee HS, Levine M, Guptill-Yoran C, Johnson AJ, von Kamecke P, Moore GE. Regional and temporal variations of Leptospira seropositivity in dogs in the United States, 2000-2010. J Vet Intern Med 2014; 28:779-88. [PMID: 24597659 PMCID: PMC4895461 DOI: 10.1111/jvim.12335] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2013] [Revised: 12/30/2013] [Accepted: 01/21/2014] [Indexed: 11/02/2022] Open
Abstract
BACKGROUND Previous studies have reported a seasonal increased risk for leptospirosis, but there is no consistent seasonality reported across regions in the United States. OBJECTIVES To evaluate and compare seasonal patterns in seropositivity for leptospirosis in dogs for 4 US regions (northeast [NE], midwest [MW], south-central [SC], and California-southern west coast [CS]). ANIMALS Forty four thousand nine hundred and sixteen canine serum samples submitted to a commercial laboratory for microscopic agglutination tests (MAT) from 2000 through 2010. METHODS In this retrospective study, positive cases were defined as MAT titers ≥1 : 3,200 for at least one of 7 tested serovars. Four geographic regions were defined, and MAT results were included in regional analyses based on hospital zipcode. A seasonal-trend decomposition method for times series was utilized for the analysis. Monthly variation in the seropositive rate was evaluated using a seasonal cycle subseries plot and logistic regression. RESULTS Two thousand and twelve of 44,916 (4.48%) samples were seropositive. Compared to seropositive rates for February, significantly higher monthly rates occurred during the 2nd half of the year in the MW (OR 3.92-6.35) and NE (OR 2.03-4.80) regions, and only in January (OR 2.34) and December (OR 1.74) in the SC region. Monthly seropositive rates indicative of seasonality were observed earlier in the calendar year for both CS and SC regions. CONCLUSIONS AND CLINICAL IMPORTANCE Seasonal patterns for seropositivity to leptospires differed by geographic region. Although risk of infection in dogs can occur year round, knowledge of seasonal trends can assist veterinarians in formulating differential diagnoses and evaluation of exposure risk.
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Affiliation(s)
- H S Lee
- Department of Comparative Pathobiology, Purdue University, West Lafayette, IN
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Lee HS, Guptill L, Johnson AJ, Moore GE. Signalment changes in canine leptospirosis between 1970 and 2009. J Vet Intern Med 2013; 28:294-9. [PMID: 24372922 PMCID: PMC4857991 DOI: 10.1111/jvim.12273] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2013] [Revised: 10/16/2013] [Accepted: 11/12/2013] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Previous studies have identified large breed, male, outdoor dogs of herding or working groups to be at increased risk for Leptospira infection. Exposure risk factors may change over time, altering the signalment of dogs most commonly diagnosed with leptospirosis. OBJECTIVES The objectives of this study were to evaluate possible signalment changes by decade in canine leptospirosis cases diagnosed at university veterinary hospitals in the United States and Canada using reports to the Veterinary Medical DataBase (VMDB) over a 40-year period (1970-2009). ANIMALS One thousand and ninety-one dogs with leptospirosis diagnosed among 1,659,146 hospital visits. METHODS Hospital prevalence of leptospirosis by decade was determined by age, sex, weight, and breed groups. Multivariable logistic regression models were created to evaluate the association between variables and the odds of disease for each decade. RESULTS Veterinary Medical DataBase hospital prevalence of leptospirosis in dogs, after a marked decrease in the 1970s and low rates in the 1980s, began increasing in the 1990s. Hospital prevalence significantly increased in dogs between 2 and 9.9 years of age (P < .05) and in male dogs (P < .05) in each decade since the 1980s. Among weight groups in the most recent decade (2000-2009), dogs weighing <15 pounds had the greatest odds of being diagnosed with leptospirosis (P = .003). CONCLUSIONS AND CLINICAL IMPORTANCE Hospital prevalence rates by age, weight, sex, and breed groups differed by decade. These changes may reflect changes in exposure risk, Leptospira vaccination practices for dogs, or both.
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Affiliation(s)
- H S Lee
- Department of Comparative Pathobiology, College of Veterinary Medicine, Purdue University, West Lafayette, IN
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Ross LA, Labato MA. Current techniques in peritoneal dialysis. J Vet Emerg Crit Care (San Antonio) 2013; 23:230-40. [PMID: 23566109 DOI: 10.1111/vec.12035] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2012] [Accepted: 02/02/2013] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To provide a current overview of the technique of peritoneal dialysis in dogs and cats. CLINICAL IMPLICATION Peritoneal dialysis is the process by which water and solutes move between blood in the peritoneal capillaries and fluid (dialysate) instilled into the peritoneal cavity, across the semipermeable membrane of the peritoneum. The primary indication for peritoneal dialysis (PD) in animals is for treatment of renal failure to correct water, solute, and acid-base abnormalities and to remove uremic toxins. SUMMARY Peritoneal dialysis is a modality of renal replacement therapy commonly used in human medicine for the treatment of chronic kidney disease and end-stage kidney failure. Peritoneal dialysis utilizes the peritoneum as a membrane across which fluids and uremic solutes are exchanged. Dialysate is instilled into the peritoneal cavity and, through the process of diffusion and osmosis, water, toxins, electrolytes, and other small molecules are allowed to equilibrate.
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Affiliation(s)
- Linda A Ross
- Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA 01536, USA
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Hennebelle JH, Sykes JE, Carpenter TE, Foley J. Spatial and temporal patterns of Leptospira infection in dogs from northern California: 67 cases (2001-2010). J Am Vet Med Assoc 2013; 242:941-7. [PMID: 23517206 DOI: 10.2460/javma.242.7.941] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To conduct an epidemiological analysis of the spatial and temporal distribution of canine leptospirosis cases in northern California and detect spatial clustering in any region. DESIGN Retrospective case-control study. ANIMALS 67 dogs with leptospirosis and 271 control dogs. PROCEDURES Medical records of case and control dogs were reviewed. Spatial coordinates of home addresses of the study population were analyzed visually and statistically via a Cuzick-Edwards test and spatial, temporal, and space-time permutation scan statistics. RESULTS Cases were distributed around the San Francisco Bay region as well as in the Sierra Nevada foothills near Sacramento, Calif, whereas controls were principally distributed along route I-80 between San Francisco and Sacramento, Calif. Clustering was found for the second through sixth nearest neighboring cases via the global spatial cluster test. A local spatial cluster of 30 cases was identified in San Francisco (95% confidence interval, 1.3 to 7.0), and a temporal cluster of 18 cases was identified from May 2003 through May 2004 (95% confidence interval, 1.4 to 6.5). No significant space-time cluster was identified. CONCLUSIONS AND CLINICAL RELEVANCE The use of geographic information systems provided a visual representation of the results of statistical analysis for the location and time at which leptospirosis cases occurred. This useful tool can be used to educate veterinary practitioners and the public about a potentially fatal zoonotic disease and direct vaccination strategies to help prevent disease occurrence.
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Affiliation(s)
- Janemarie H Hennebelle
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California-Davis, Davis, CA 95616, USA
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Klaasen HLBM, van der Veen M, Sutton D, Molkenboer MJCH. A new tetravalent canine leptospirosis vaccine provides at least 12 months immunity against infection. Vet Immunol Immunopathol 2013; 158:26-9. [PMID: 24054091 DOI: 10.1016/j.vetimm.2013.08.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2012] [Revised: 08/02/2013] [Accepted: 08/04/2013] [Indexed: 10/26/2022]
Abstract
A key success factor in the vaccination of dogs against leptospirosis is long term protection against establishment of the renal carrier state, in order to protect other dogs, as well as humans, against this re-emerging zoonotic disease. In this paper, we describe the ability of a new European tetravalent vaccine containing antigen from Leptospira interrogans (sensu lato) serogroups Icterohaemorrhagiae, Canicola, Grippotyphosa and Australis to control infection and renal excretion in dogs at 12 months after vaccination. In order to demonstrate the efficacy of all four vaccine components, four separate challenge studies were performed. For each study two groups of dogs were used (a group receiving the leptospirosis vaccine and a control group). Twelve months after the second vaccination all dogs in the vaccine and control groups were challenged, both intraperitoneally and conjunctivally, using a pathogenic challenge strain from one of four serogroups. Parameters recorded post-challenge were: clinical signs of disease, change in body temperature, total leucocyte count, thrombocyte count, presence of challenge organisms in blood, urine and kidney tissue, and evidence of interstitial nephritis at necropsy four weeks after challenge. The vaccine was able to either prevent or significantly reduce infection following challenge with the strains of all four serogroups. The vaccine was also able to prevent or significantly reduce renal infection following Canicola and Icterohaemorrhagiae challenge, and there was a trend of reduction of renal infection with Australis (serovar Bratislava). In the case of the Grippotyphosa study, challenge led to no detectable renal infection in any dog of the control group. In conclusion, in this study significant protective immunity was achieved in dogs 12 months after a basic vaccination schedule of two doses against strains of serogroups Canicola, Icterohaemorrhagiae, Grippotyphosa and Australis.
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Affiliation(s)
- H L B M Klaasen
- Department of Microbiological R&D, MSD Animal Health, Boxmeer, The Netherlands.
| | - M van der Veen
- Department of Microbiological R&D, MSD Animal Health, Boxmeer, The Netherlands
| | - D Sutton
- Global Marketing Department, MSD Animal Health, Milton Keynes, UK
| | - M J C H Molkenboer
- Department of Global Regulatory Affairs Immunologicals, MSD Animal Health, Boxmeer, The Netherlands
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Li R, Mugford A, Humm K. Acute kidney injury in dogs and cats 2. Management, treatment and outcome. IN PRACTICE 2013. [DOI: 10.1136/inp.f3640] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Eatroff AE, Langston CE, Chalhoub S, Poeppel K, Mitelberg E. Long-term outcome of cats and dogs with acute kidney injury treated with intermittent hemodialysis: 135 cases (1997-2010). J Am Vet Med Assoc 2013; 241:1471-8. [PMID: 23176239 DOI: 10.2460/javma.241.11.1471] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine the long-term outcome for small animal patients with acute kidney injury (AKI) treated with intermittent hemodialysis (IHD). DESIGN Retrospective case series. ANIMALS 42 cats and 93 dogs treated with IHD for AKI. PROCEDURES Medical records of cats and dogs treated with IHD for AKI from January 1997 to October 2010 were reviewed. Standard methods of survival analysis with Kaplan-Meier product limit curves were used. The log-rank, Mann-Whitney, and Kruskal-Wallis tests were used to determine whether outcome, number of IHD treatments, or duration of hospitalization was different when dogs and cats were classified according to specific variables. RESULTS The overall survival rate at the time of hospital discharge was 50% (21/42) for cats and 53% (49/93) for dogs. The overall survival rate 30 days after hospital discharge was 48% (20/42) for cats and 42% (39/93) for dogs. The overall survival rate 365 days after hospital discharge was 38% (16/42) for cats and 33% (31/93) for dogs. For all-cause mortality, the median survival time was 7 days (95% confidence interval, 0 to 835 days) for cats and 9 days (95% confidence interval, 0 to 55 days) for dogs. CONCLUSIONS AND CLINICAL RELEVANCE Cats and dogs with AKI treated with IHD have survival rates similar to those of human patients. Although there was a high mortality rate prior to hospital discharge, those patients that survived to discharge had a high probability of long-term survival.
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Affiliation(s)
- Adam E Eatroff
- Bobst Hospital, The Animal Medical Center, 510 E 62nd St, New York, NY 10065, USA.
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Klaasen HLBM, van der Veen M, Molkenboer MJCH, Sutton D. A novel tetravalent Leptospira bacterin protects against infection and shedding following challenge in dogs. Vet Rec 2013; 172:181. [PMID: 23180149 PMCID: PMC3582088 DOI: 10.1136/vr.101100] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/23/2012] [Indexed: 11/04/2022]
Abstract
Recent evidence based on the current epidemiological situation suggests that vaccines against canine leptospirosis in Europe should be directed against infection with Leptospira interrogans (sensu lato) serogroups Canicola, Icterohaemorrhagiae, Grippotyphosa and Australis. In the eight studies presented here, dogs were vaccinated with Nobivac L4 (MSD Animal Health), a new tetravalent inactivated vaccine containing antigen from four strains representing these four serogroups. The dogs were then challenged, together with unvaccinated control dogs, using heterologous strains from the same four serogroups. In four of the studies, pups without agglutinating antibodies against the four serogroups were vaccinated with Nobivac L4 vaccine. In a further four studies, Nobivac L4 vaccine was given 48 hours after administration of antiserum from vaccinated dogs designed to mimic the serological status of pups with maternally derived antibodies against these serogroups. In all eight studies, vaccine efficacy was assessed in terms of antibody response, clinical signs, fever, thrombocyte count, frequency of positive isolation of challenge organisms from blood, urine and kidney and frequency of interstitial nephritis. The results demonstrate that Nobivac L4 vaccine induces sterile immunity against leptospiraemia and renal infection with strains of serogroups Canicola, Icterohaemorrhagiae and Grippotyphosa, and induces sterile immunity against leptospiraemia with a strain of serogroup Australis. Since sterile immunity was achieved in pups pretreated with antiserum as well, it can be concluded that this vaccine is also likely to be efficacious in the face of maternally derived antibodies in pups from the age of six weeks.
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Affiliation(s)
- H L B M Klaasen
- Department of Microbiological R&D, MSD Animal Health, Wim de Körverstraat 35, Boxmeer 5831 AN, The Netherlands.
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Kavanagh C, Shaw S, Webster CRL. Coagulation in hepatobiliary disease. J Vet Emerg Crit Care (San Antonio) 2012; 21:589-604. [PMID: 22316251 DOI: 10.1111/j.1476-4431.2011.00691.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVE To review the pathogenesis and clinical consequences of coagulation abnormalities accompanying hepatobiliary disorders and to highlight the need for further studies to characterize these derangements and their treatment options in small animal patients. DATA SOURCES Veterinary and human medical literature: original research articles, scientific reviews, consensus statements, and recent texts. SUMMARY The liver plays an important role in the production and clearance of many components of coagulation. A wide range of hemostatic derangements can occur in patients with hepatobiliary disease including alterations in platelet number and function, coagulation factor levels, anticoagulants, vascular endothelial function, and fibrinolysis. As these hemostatic alterations include both pro- and anticoagulation pathways, the net result is often a rebalanced hemostatic system that can be easily disrupted by concurrent conditions resulting in either clinical bleeding or thrombosis. Conventional coagulation tests are inadequate at identifying the spectrum of coagulation alterations occurring in patients with hepatobiliary disease, but their evaluation is necessary to assess bleeding risk and provide prognostic information. A paucity of information exists regarding the treatment of the coagulation derangements in small animals with hepatobiliary disease. Extrapolation from human studies provides some information about potential treatment options, but further studies are warranted in this area to elucidate the best management for coagulation abnormalities in dogs and cats with hepatobiliary disease. CONCLUSION Hepatobiliary disease can have profound effects on coagulation function leading to hypercoagulable or hypocoagulable states. Overall coagulation status with hepatobiliary disease depends on both the type and severity of disease and the presence of associated complications.
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Affiliation(s)
- Carrie Kavanagh
- Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA 01536, USA
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