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Sørensen TM, Scahill K, Ruperez JE, Olejnik M, Swinbourne F, Verwilghen DR, Nolff MC, Baines S, Marques C, Vilen A, Duarte EL, Dias M, Dewulf S, Wichtowska A, Valencia AC, Pelligand L, Broens EM, Toutain PL, Alishani M, Brennan ML, Weese JS, Jessen LR, Allerton F. Antimicrobial prophylaxis in companion animal surgery: A scoping review for European Network for Optimization of Antimicrobial Therapy (ENOVAT) guidelines. Vet J 2024; 304:106101. [PMID: 38490359 DOI: 10.1016/j.tvjl.2024.106101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 03/09/2024] [Accepted: 03/10/2024] [Indexed: 03/17/2024]
Abstract
Surgical antimicrobial prophylaxis (SAP) is widely used to reduce the risk of surgical site infections (SSI), but there is uncertainty as to what the proportion of SSI reduction is. Therefore, it is difficult for surgeons to properly weigh the costs, risks and benefits for individual patients when deciding on the use of SAP, making it challenging to promote antimicrobial stewardship in primary practice settings. The objective of this study was to map the veterinary evidence focused on assessing the effect of SAP on SSI development and in order to identify surgical procedures with some research evidence and possible knowledge gaps. In October 2021 and December 2022, Scopus, CAB Abstracts, Web of Science Core Collection, Embase and MEDLINE were systematically searched. Double blinded screening of records was performed to identify studies in companion animals that reported on the use of SAP and SSI rates. Comparative data were available from 34 out of 39123 records screened including: eight randomised controlled trials (RCT), 23 cohort studies (seven prospective and 16 retrospective) and three retrospective case series representing 12476 dogs and cats in total. Extracted data described peri- or post-operative SAP in nine, and 25 studies, respectively. In the eight RCTs evaluating SAP in companion animals, surgical procedure coverage was skewed towards orthopaedic stifle surgeries in referral settings and there was large variation in SAP protocols, SSI definitions and follow-up periods. More standardized data collection and agreement of SSI definitions is needed to build stronger evidence for optimized patient care.
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Affiliation(s)
- T M Sørensen
- Department of Veterinary Clinical Sciences, University of Copenhagen, Dyrlaegevej 16, Frederiksberg C 1870, Denmark; ESCMID Study Group for Veterinary Microbiology (ESGVM), Basel, Switzerland.
| | - K Scahill
- College of Medicine and Veterinary Medicine, University of Edinburgh, 49 Little France Crescent, Edinburgh EH16 4SB, United Kingdom; Evidensia Södra Djursjukhuset Kungens Kurva, Månskärarvägen 13, Kungens Kurva 14175, Sweden; ESCMID Study Group for Veterinary Microbiology (ESGVM), Basel, Switzerland
| | - J Espinel Ruperez
- College of Veterinary Medicine, Murdoch University, Murdoch, Perth, WA 6150, Australia
| | - M Olejnik
- Department of Fundamental and Preclinical Sciences, Nicolaus Copernicus University, Jurija Gagarina 11, Toruń 87-100, Poland
| | - F Swinbourne
- Lumbry Park Veterinary Specialists, Selborne Rd, Alton GU34 3HL, United Kingdom
| | - D R Verwilghen
- Sydney School of Veterinary Science, University of Sydney, Regimental Dr, Camperdown, NSW 2050, Australia
| | - M C Nolff
- Clinic for Small Animal Surgery, Vetsuisse Faculty, University Zürich, Winterthurerstrasse 260, TFA 01.51, Zürich 8057, Switzerland
| | - S Baines
- Willows Veterinary Centre & Referral Service, Solihull B90 4NH, United Kingdom
| | - C Marques
- Universidade Lusófona de Humanidades e Tecnologias, Campo Grande 376, Lisboa 1749-024, Portugal; Centre for Interdisciplinary Research in Animal Health (CIISA), Faculty of Veterinary Medicine, University of Lisbon, Tapada da Ajuda, Lisboa, Portugal
| | - A Vilen
- AniCura Landskrona Smådjursklinik, Föreningsgatan 165, Landskrona 261 51, Sweden
| | - E L Duarte
- Mediterranean Institute for Agriculture, Environment and Development & Departamento de Medicina Veterinária, Escola de Ciências e Tecnologia, Universidade de Évora, Universidade de Évora, Pólo da Mitra Apartado 94, Évora 7006-554, Portugal; ESCMID Study Group for Veterinary Microbiology (ESGVM), Basel, Switzerland
| | - M Dias
- Mediterranean Institute for Agriculture, Environment and Development & Departamento de Medicina Veterinária, Escola de Ciências e Tecnologia, Universidade de Évora, Universidade de Évora, Pólo da Mitra Apartado 94, Évora 7006-554, Portugal
| | - S Dewulf
- Veterinary Epidemiology Unit, Faculty of Veterinary Medicine, Ghent University, Gebouw D4, Salisburylaan 133, Merelbeke, Ghent 9820, Belgium
| | - A Wichtowska
- Department of Fundamental and Preclinical Sciences, Nicolaus Copernicus University, Jurija Gagarina 11, Toruń 87-100, Poland
| | - A Carranza Valencia
- Department of Clinical Veterinary Medicine, Vetsuisse Faculty, Bern University, Länggassstrasse 120, Bern 3012, Switzerland
| | - L Pelligand
- Dept. Comparative Biomedical Sciences, The Royal Veterinary College, University of London, 4 Royal College St, London NW1 0TU, United Kingdom; ESCMID Study Group for Veterinary Microbiology (ESGVM), Basel, Switzerland
| | - E M Broens
- Faculty of Veterinary Medicine, Utrecht University, Yalelaan 1, Utrecht 3584 CL, the Netherlands; ESCMID Study Group for Veterinary Microbiology (ESGVM), Basel, Switzerland
| | - P L Toutain
- Dept. Comparative Biomedical Sciences, The Royal Veterinary College, University of London, 4 Royal College St, London NW1 0TU, United Kingdom; INTHERES, Université de Toulouse, INRAE, ENVT, 23 Chem. des Capelles Entrée n°1, Toulouse 31300, France
| | - M Alishani
- Department of Veterinary Medicine, Faculty of Agriculture and Veterinary, University of Prishtina "Hasan Prishtina", Prishtina 10 000, Kosovo
| | - M L Brennan
- Centre for Evidence-based Veterinary Medicine, The University of Nottingham, Loughborough LE12 5RD, United Kingdom
| | - J S Weese
- Dept of Pathobiology, Ontario Veterinary College, University of Guelph, 419 Gordon St, Guelph, ON N1G 2W1, Canada
| | - L R Jessen
- Department of Veterinary Clinical Sciences, University of Copenhagen, Dyrlaegevej 16, Frederiksberg C 1870, Denmark; ESCMID Study Group for Veterinary Microbiology (ESGVM), Basel, Switzerland
| | - F Allerton
- Willows Veterinary Centre & Referral Service, Solihull B90 4NH, United Kingdom
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Scahill K, Jessen LR, Prior C, Singleton D, Foroutan F, Ferran AA, Arenas C, Bjørnvad CR, Lavy E, Allerton F, Weese JS, Allenspach K, Guardabassi L, Unterer S, Bodnárová T, Windahl U, Brennan ML, Werner M. Efficacy of antimicrobial and nutraceutical treatment for canine acute diarrhoea: A systematic review and meta-analysis for European Network for Optimization of Antimicrobial Therapy (ENOVAT) guidelines. Vet J 2024; 303:106054. [PMID: 38049062 DOI: 10.1016/j.tvjl.2023.106054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 11/02/2023] [Accepted: 11/29/2023] [Indexed: 12/06/2023]
Abstract
Systemic antimicrobial treatments are commonly prescribed to dogs with acute diarrhoea, while nutraceuticals (prebiotics, probiotics, and synbiotics) are frequently administered as an alternative treatment. The aim of this systematic review and meta-analysis was to assess the effectiveness of antimicrobials and nutraceutical preparations for treatment of canine acute diarrhoea (CAD). The results of this study will be used to create evidence-based treatment guidelines. PICOs (population, intervention, comparator, and outcome) were generated by a multidisciplinary expert panel taking into account opinions from stakeholders (general practitioners and dog owners). The Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology was used to evaluate the certainty of the evidence. The systematic search yielded six randomised controlled trials (RCT) for antimicrobial treatment and six RCTs for nutraceutical treatment meeting the eligibility criteria. Categories of disease severity (mild, moderate, and severe) were created based on the presence of systemic signs and response to fluid therapy. Outcomes included duration of diarrhoea, duration of hospitalization, progression of disease, mortality, and adverse effects. High certainty evidence showed that antimicrobial treatment did not have a clinically relevant effect on any outcome in dogs with mild or moderate disease. Certainty of evidence was low for dogs with severe disease. Nutraceutical products did not show a clinically significant effect in shortening the duration of diarrhoea (based on very low to moderate certainty evidence). No adverse effects were reported in any of the studies.
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Affiliation(s)
- K Scahill
- University of Edinburgh, College of Medicine and Veterinary Medicine, Edinburgh EH16 4SB, UK; Evidensia Södra Djursjukhuset Kungens Kurva, Månskärarvägen 13, Kungens Kurva 14175, Sweden.
| | - L R Jessen
- Department of Veterinary Clinical Science, University of Copenhagen, 1870 Frederiksberg C, Denmark
| | - C Prior
- Willows Veterinary Centre and Referral Centre, Solihull B90 4NH, United Kingdom
| | - D Singleton
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, CH64 7TE, UK
| | - F Foroutan
- Faculty of Health Sciences, McMasters University, ON L8S 4L8, Canada
| | - A A Ferran
- INTHERES, Université de Toulouse, INRAE, ENVT, Toulouse 31076, France
| | - C Arenas
- Internal Medicine Service, AniCura Valencia Sur Hospital Veterinario, Valencia 46460, Spain; VetCT Teleconsulting, Cambridge CB3 0FA, UK
| | - C R Bjørnvad
- Department of Veterinary Clinical Science, University of Copenhagen, 1870 Frederiksberg C, Denmark
| | - E Lavy
- Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Rehovot 76100, Israel
| | - F Allerton
- Willows Veterinary Centre and Referral Centre, Solihull B90 4NH, United Kingdom
| | - J S Weese
- Department of Pathobiology, Ontario Veterinary College, University of Guelph, Guelph, ON N1G2W1, Canada
| | - K Allenspach
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames 50010, IA, USA
| | - L Guardabassi
- Department of Veterinary and Animal Sciences, University of Copenhagen, 1870 Frederiksberg C, Denmark
| | - S Unterer
- Clinic for Small Animal Internal Medicine, Vetsuisse Faculty, University of Zurich, Zurich 8057, Switzerland
| | - T Bodnárová
- Veterinary Clinic Podebrady, Poděbrady 29001, Czech Republic
| | - U Windahl
- Department of Animal Health and Antimicrobial Strategies, National Veterinary Institute (SVA), SE-75189 Uppsala, Sweden
| | - M L Brennan
- Centre for Evidence-based Veterinary Medicine, The University of Nottingham, NG7 2QL, UK
| | - M Werner
- Clinic for Small Animal Internal Medicine, Vetsuisse Faculty, University of Zurich, Zurich 8057, Switzerland
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Jessen LR, Nielsen LN, Kieler IN, Langhorn R, Reezigt BJ, Cirera S. Stability and profiling of urinary microRNAs in healthy cats and cats with pyelonephritis or other urological conditions. J Vet Intern Med 2019; 34:166-175. [PMID: 31721298 PMCID: PMC6979273 DOI: 10.1111/jvim.15628] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Accepted: 09/10/2019] [Indexed: 12/19/2022] Open
Abstract
Background Specific biomarkers of pyelonephritis (PN) in cats are lacking. MicroRNAs (miRNAs) have diagnostic potential in human nephropathies. Objectives To investigate the presence/stability of miRNAs in whole urine of cats and the discriminatory potential of selected urinary miRNAs for PN in cats. Animals Twelve healthy cats, 5 cats with PN, and 13 cats with chronic kidney disease (n = 5), subclinical bacteriuria (n = 3), and ureteral obstructions (n = 5) recruited from 2 companion animal hospitals. Methods Prospective case‐control study. Expression profiles of 24 miRNAs were performed by quantitative PCR (qPCR). Effect of storage temperature (4°C [24 hours], −20°C, and −80°C) was determined for a subset of miRNAs in healthy cats. Results Urinary miR‐4286, miR‐30c, miR‐204, miR4454, miR‐21, miR‐16, miR‐191, and miR‐30a were detected. For the majority of miRNAs tested, storage at 4°C and −20°C resulted in significantly lower miRNA yield compared to storage at −80°C (mean log2fold changes across miRNAs from −0.5 ± 0.4 SD to −1.20 ± 0.4 SD (4°C versus −80°C) and from −0.7 ± 0.2 SD to −1.20 ± 0.3 SD (−20°C versus −80°C)). Cats with PN had significantly upregulated miR‐16 with a mean log2fold change of 1.0 ± 0.4 SD, compared with controls (−0.1 ± 0.2, P = .01) and other urological conditions (0.6 ± 0.3, P = .04). Conclusions Upregulation of miR16 might be PN‐specific, pathogen‐specific (Escherichia coli), or both.
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Affiliation(s)
- Lisbeth R Jessen
- Department of Veterinary Clinical Sciences, University of Copenhagen, Denmark
| | - Lise N Nielsen
- Department of Veterinary Clinical Sciences, University of Copenhagen, Denmark
| | - Ida N Kieler
- Department of Veterinary Clinical Sciences, University of Copenhagen, Denmark
| | - Rebecca Langhorn
- Department of Veterinary Clinical Sciences, University of Copenhagen, Denmark
| | | | - Susanna Cirera
- Department of Veterinary and Animal Sciences, University of Copenhagen, Denmark
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Moberg FS, Langhorn R, Bertelsen PV, Pilegaard LM, Sørensen TM, Bjørnvad CR, Damborg P, Kieler IN, Jessen LR. Subclinical bacteriuria in a mixed population of 179 middle-aged and elderly cats: a prospective cross-sectional study. J Feline Med Surg 2019; 22:678-684. [PMID: 31537165 DOI: 10.1177/1098612x19874141] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Subclinical bacteriuria (SBU) is the presence of bacteria in urine with no clinical evidence of lower urinary tract disease. The aims of this study were to investigate if being overweight and/or obesity predispose cats to SBU, to investigate previously reported risk factors and to determine the prevalence of SBU in a prospectively sampled cohort of middle-aged and elderly cats. METHODS Cats aged ⩾6 years presenting to the University Hospital for Companion Animals in Copenhagen from 2015-2019 for causes unrelated to the lower urinary tract were eligible for enrolment. Body condition scoring was performed on a 9-point scale. Overweight was defined as a body condition score (BCS) ⩾6 and obese as a BCS ⩾8. The correlation between SBU and the variables of sex, healthy/diseased, age, BCS and comorbidities (chronic kidney disease, diabetes mellitus, hyperthyroidism, hepatic disorders and gastrointestinal disease) were analysed by binominal logistic regression. RESULTS In total, 179 cats ranging from 6-20 (median 10) years of age were included. SBU was identified in 11/179 cats (6.1%). Being overweight was not a significant risk factor (overweight/obese odds ratio [OR] 0.3, 95% confidence interval [CI] 0.06-1.6, relative risk [RR] 0.3 [95% CI 0.05-1.3] vs lean; P = 0.2) and neither was obesity compared with lean and overweight cats (P = 0.99). Female sex (OR 6.2 [95% CI 1.3-30], RR 4.7 [95% CI 1.5-12] vs male; P = 0.02) and the presence of hepatic disease (OR 7.5 [95% CI 1.4-39], RR 5.3 [95% CI 1.3-12]; P = 0.02) were significant risk factors. CONCLUSIONS AND RELEVANCE The prevalence of SBU in cats is low, and being overweight/obese was not identified as a predisposing factor. The increased risk associated with hepatic disease has not been previously reported, and further studies are needed to confirm this finding.
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Affiliation(s)
- Frida S Moberg
- Department of Veterinary Clinical Sciences, University of Copenhagen, Frederiksberg, Denmark
| | - Rebecca Langhorn
- Department of Veterinary Clinical Sciences, University of Copenhagen, Frederiksberg, Denmark
| | - Pernille V Bertelsen
- Department of Veterinary Clinical Sciences, University of Copenhagen, Frederiksberg, Denmark
| | - Louise M Pilegaard
- Department of Veterinary Clinical Sciences, University of Copenhagen, Frederiksberg, Denmark
| | - Tina M Sørensen
- Department of Veterinary Clinical Sciences, University of Copenhagen, Frederiksberg, Denmark
| | - Charlotte R Bjørnvad
- Department of Veterinary Clinical Sciences, University of Copenhagen, Frederiksberg, Denmark
| | - Peter Damborg
- Department of Veterinary and Animal Sciences, University of Copenhagen, Frederiksberg, Denmark
| | - Ida N Kieler
- Department of Veterinary Clinical Sciences, University of Copenhagen, Frederiksberg, Denmark
| | - Lisbeth R Jessen
- Department of Veterinary Clinical Sciences, University of Copenhagen, Frederiksberg, Denmark
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Abstract
OBJECTIVES Cardiac troponins are sensitive and specific markers of myocardial injury. However, their reliability in renal disease has been questioned owing to possible renal involvement in troponin elimination. The primary objective of the present study was to examine whether serum cardiac troponin I is elevated in cats with compromised renal function and no clinically relevant structural cardiac disease. A secondary objective was to examine whether cardiac troponin I is measurable in the urine of cats with normal and compromised renal function. METHODS This prospective case-control study included 52 cats (19 with compromised renal function, 19 with primary cardiac disease and 14 healthy controls). For all cats, clinical examination, echocardiography, electrocardiography, blood pressure, complete blood count, biochemistry, serum thyroxine and urinalysis were performed. Cardiac troponin I was measured in the serum and urine of each cat. RESULTS Median (range) serum cardiac troponin I concentrations were 0.052 ng/ml (0.015-0.78 ng/ml) for the renal group, 0.083 ng/ml (0.003-3.27 ng/ml) for the cardiac group and 0.012 ng/ml (0.003-0.14 ng/ml) for the control group. The renal and cardiac groups both had significantly higher serum cardiac troponin I concentrations than the control group, whereas no difference could be detected between the renal and cardiac groups. In the renal group 7/19 cats had measurable urine cardiac troponin I, whereas cardiac troponin I was measurable in the urine of one cat in the cardiac group and two healthy controls. There was no significant correlation between serum and urine cardiac troponin I. CONCLUSIONS AND RELEVANCE Elevated serum cardiac troponin I in cats with compromised renal function may occur without evidence of clinically relevant structural cardiac disease. Moreover, detecting cardiac troponin I in urine is most likely in cats with compromised renal function.
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Affiliation(s)
- Rebecca Langhorn
- Department of Veterinary Clinical Sciences, University of Copenhagen, Frederiksberg, Denmark
| | - Lisbeth R Jessen
- Department of Veterinary Clinical Sciences, University of Copenhagen, Frederiksberg, Denmark
| | - Anne S Kloster
- Department of Veterinary Clinical Sciences, University of Copenhagen, Frederiksberg, Denmark
| | | | - Jørgen Koch
- Department of Veterinary Clinical Sciences, University of Copenhagen, Frederiksberg, Denmark
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Sørensen TM, Bjørnvad CR, Cordoba G, Damborg P, Guardabassi L, Siersma V, Bjerrum L, Jessen LR. Effects of Diagnostic Work-Up on Medical Decision-Making for Canine Urinary Tract Infection: An Observational Study in Danish Small Animal Practices. J Vet Intern Med 2018; 32:743-751. [PMID: 29469943 PMCID: PMC5867017 DOI: 10.1111/jvim.15048] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Revised: 11/07/2017] [Accepted: 12/21/2017] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Clinical signs of urinary tract disease in dogs often lead to prescription of antibiotics. Appropriate diagnostic work-up could optimize treatment and reduce the risk of inappropriate use of antibiotics. HYPOTHESIS/OBJECTIVES To describe and evaluate the impact of diagnostic work-up on decision to treat (DTT) and choice of antibiotic treatment (COT) for dogs presenting with clinical signs of urinary tract disease. ANIMALS One hundred and fifty-one dogs presenting to 52 Danish veterinary practices. METHODS Prospective, observational study. Clinical signs, diagnostic work-up, and prescriptions were recorded. Urine samples were submitted to a reference laboratory for quantitative bacterial culture (QBC) and susceptibility testing. The laboratory results were used as reference for assessing the appropriateness of DTT and COT. RESULTS In the majority of dogs, veterinarians performed dipstick (99%), microscopic examination of urine (80%) and bacterial culture (56%). Fifty-one percent of dogs had urinary tract infection (UTI) based on reference QBC. Appropriate DTT was made for 62% of the dogs, while 36% were over-prescribed and 2% under-prescribed. Inappropriate use of second-line agents was found in 57% of the UTI cases. Performing microscopy-but not culture-significantly impacted DTT (P = 0.039) while no difference was seen in COT (P = 0.67). The accuracy of in-house microscopy and culture were 64.5 and 77%, respectively. CONCLUSIONS AND CLINICAL IMPORTANCE Over-prescription of antibiotics was common among dogs with suspected UTI, regardless of the diagnostic work-up performed. Test inaccuracy under practice conditions and incoherence between diagnostic test results and decision-making both explained inappropriate and unnecessary use of antibiotics.
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Affiliation(s)
- T M Sørensen
- Department of Veterinary Clinical Sciences, University of Copenhagen, Denmark
| | - C R Bjørnvad
- Department of Veterinary Clinical Sciences, University of Copenhagen, Denmark
| | - G Cordoba
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Denmark
| | - P Damborg
- Department of Veterinary and Animal Sciences, University of Copenhagen, Denmark
| | - L Guardabassi
- Department of Veterinary and Animal Sciences, University of Copenhagen, Denmark
| | - V Siersma
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Denmark
| | - L Bjerrum
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Denmark
| | - L R Jessen
- Department of Veterinary Clinical Sciences, University of Copenhagen, Denmark
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Langhorn R, Kieler IN, Koch J, Christiansen LB, Jessen LR. Symmetric Dimethylarginine in Cats with Hypertrophic Cardiomyopathy and Diabetes Mellitus. J Vet Intern Med 2017; 32:57-63. [PMID: 29230874 PMCID: PMC5787200 DOI: 10.1111/jvim.14902] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Revised: 10/30/2017] [Accepted: 11/16/2017] [Indexed: 01/26/2023] Open
Abstract
Background Symmetric dimethylarginine (SDMA) has been increasingly used as a marker of early chronic kidney disease (CKD) in cats, but little is known about the influence of comorbidities on SDMA in this species. Hypothesis Hypertrophic cardiomyopathy (HCM) and diabetes mellitus (DM), independently of CKD, are associated with changes in serum SDMA. Animals Ninety‐four cats (17 with CKD, 40 with HCM, 17 with DM, and 20 healthy controls). Methods Case‐control study. Clinical examination, echocardiography, ECG, blood pressure, CBC, biochemistry, thyroxine, and SDMA measurement were performed. Urinalysis was performed in controls and cats with CKD and DM. Analysis of variance was used to compare overall differences in the log‐transformed SDMA data among groups. A random forest algorithm was applied to explore which clinical and other factors influenced serum SDMA. Results Median (range) serum SDMA for the renal group (positive control) was 19 (10–93) μg/dL, whereas for the control group (negative control), it was 10 (5–15) μg/dL. For the cardiac and diabetic groups, serum SDMA was 9 (4–24) μg/dL and 7 (3–11) μg/dL, respectively. The renal group had significantly higher SDMA concentrations and the diabetic group significantly lower SDMA concentrations compared to all other groups. Conclusions and Clinical Importance Serum SDMA concentrations in cats with HCM were not significantly different from those of healthy control cats. Cats with DM, however, had significantly lower SDMA concentrations than controls, a finding that needs further investigation and should be kept in mind when evaluating renal function of cats with this endocrinopathy.
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Affiliation(s)
- R Langhorn
- Department of Veterinary Clinical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - I N Kieler
- Department of Veterinary Clinical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - J Koch
- Department of Veterinary Clinical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - L B Christiansen
- Department of Veterinary and Animal Sciences, University of Copenhagen, Copenhagen, Denmark
| | - L R Jessen
- Department of Veterinary Clinical Sciences, University of Copenhagen, Copenhagen, Denmark
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Sørensen TM, Jensen AB, Damborg P, Bjørnvad CR, Guardabassi L, Jessen LR. Evaluation of different sampling methods and criteria for diagnosing canine urinary tract infection by quantitative bacterial culture. Vet J 2016; 216:168-73. [PMID: 27687946 DOI: 10.1016/j.tvjl.2016.08.007] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Revised: 08/07/2016] [Accepted: 08/13/2016] [Indexed: 11/25/2022]
Abstract
The use of voided urine specimens for bacteriological culture in dogs is discouraged because contamination from external genitalia could lead to misinterpretation of laboratory results. Quantitative culturing and defining significant bacteriuria could increase the usefulness of voided specimens. However, limited evidence exists for the cut-offs currently recommended. The aim of this study was to evaluate the accuracy of current veterinary cut-off values for significant bacteriuria in voided canine urine. A secondary aim was to investigate if accuracy improved when applying qualitative criteria used in humans. Paired urine specimens were collected by both cystocentesis and voiding, and quantitative bacteriological cultures were performed within the same day. Cystocentesis was used as the reference standard with a cut-off for significant bacteriuria of ≥1000 colony forming units (CFU)/mL. Voided specimens were compared to cystocentesis using: (1) the veterinary cut-off of ≥100,000 CFU/mL; and (2) various cut-offs depending on qualitative criteria (sex, clinical signs and complicating factors), adapted from human guidelines. Ninety-four dogs with suspected urinary tract infection (UTI) were included for analysis. The veterinary cut-off yielded an accuracy of 94% with a sensitivity and specificity of 94% (95% confidence intervals [CI] 0.81, 0.99) and 94% (95% CI 0.86, 0.98), respectively. Applying the human guidelines did not improve overall accuracy (89%), and yielded a sensitivity and specificity of 97% (95% CI 0.86, 1.00) and 86% (95% CI 0.77, 0.92), respectively. The veterinary cut-off value of ≥100,000 CFU/mL for voided urine is appropriate for determining significant bacteriuria in the majority of dogs with suspected UTI if specimens are refrigerated and cultured on the day of collection.
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Affiliation(s)
- T M Sørensen
- Department of Veterinary Clinical and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Dyrlægevej 16, Frederiksberg C 1870, Denmark.
| | - A B Jensen
- Department of Veterinary Clinical and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Dyrlægevej 16, Frederiksberg C 1870, Denmark
| | - P Damborg
- Department of Veterinary Disease Biology, University of Copenhagen, Stigbøjlen 4, Frederiksberg C 1870, Denmark
| | - C R Bjørnvad
- Department of Veterinary Clinical and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Dyrlægevej 16, Frederiksberg C 1870, Denmark
| | - L Guardabassi
- Department of Veterinary Disease Biology, University of Copenhagen, Stigbøjlen 4, Frederiksberg C 1870, Denmark; Department of Biomedical Sciences, Ross University School of Veterinary Medicine, Basseterre, Saint Kitts and Nevis
| | - L R Jessen
- Department of Veterinary Clinical and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Dyrlægevej 16, Frederiksberg C 1870, Denmark
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9
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Jessen LR, Sørensen TM, Bjornvad CR, Nielsen SS, Guardabassi L. Effect of antibiotic treatment in canine and feline urinary tract infections: a systematic review. Vet J 2014; 203:270-7. [PMID: 25634080 DOI: 10.1016/j.tvjl.2014.12.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2014] [Revised: 12/04/2014] [Accepted: 12/07/2014] [Indexed: 10/24/2022]
Abstract
Urinary tract infection (UTI) is a major reason for antibiotic prescription in small animal practice. Optimal antibiotic treatment strategies have not been established for veterinary species, especially when considering duration of treatment, which is often considerably longer than for human patients with UTI. The aims of this study were (1) to identify and assess evidence related to the efficacy of antibiotic treatment in canine and feline UTIs; and (2) to compare the efficacy of short (<5 days) and standard (≥7 days) duration of antibiotic treatment for canine uncomplicated UTI. An electronic literature search was conducted for publications to 1 May 2014. Fourteen peer-reviewed prospective and controlled studies were retrieved, 10 of which evaluated antibiotic treatment in dogs and four in cats. Of the 14 studies, seven were clinical trials and five of those were randomised controlled trials. Most (12/14) studies were not considered to contribute sufficient evidence to evaluate treatment strategies. There were no clinical studies examining the effect of duration of the same drug. Of the short duration regimens evaluated, the efficacy of 3 day antibiotic therapy with trimethoprim-sulphonamide (females only) or high-dose enrofloxacin in dogs with uncomplicated UTIs was supported by fair evidence, as these treatment strategies were non-inferior to medium duration (10-14 days) therapy with β-lactam antimicrobials. In conclusion, there is little published evidence relating to antibiotic treatment of UTIs in dogs and cats. Well-designed clinical trials focusing on the duration of treatment are warranted to create evidence-based treatment protocols.
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Affiliation(s)
- L R Jessen
- Department of Veterinary Clinical and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Dyrlaegevej 16, 1870 Frederiksberg C, Denmark.
| | - T M Sørensen
- Department of Veterinary Clinical and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Dyrlaegevej 16, 1870 Frederiksberg C, Denmark
| | - C R Bjornvad
- Department of Veterinary Clinical and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Dyrlaegevej 16, 1870 Frederiksberg C, Denmark
| | - S Saxmose Nielsen
- Department of Large Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Groennegaardsvej 8, 1870 Frederiksberg C, Denmark
| | - L Guardabassi
- Department of Veterinary Disease Biology, Faculty of Health and Medical Sciences, University of Copenhagen, Stigboejlen 4, 1870 Frederiksberg C, Denmark
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10
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Spodsberg EH, Wiinberg B, Jessen LR, Marschner CB, Kristensen AT. Endogenous fibrinolytic potential in tissue-plasminogen activator-modified thromboelastography analysis is significantly decreased in dogs suffering from diseases predisposing to thrombosis. Vet Clin Pathol 2013; 42:281-90. [DOI: 10.1111/vcp.12068] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Eva H. Spodsberg
- Department of Clinical Veterinary and Animal Sciences; Faculty of Health and Medical Sciences; University Hospital for Companion Animals; University of Copenhagen; Frederiksberg C; Denmark
| | - Bo Wiinberg
- Biopharmaceuticals Research Unit; Novo Nordisk A/S; Måløv; Denmark
| | - Lisbeth R. Jessen
- Department of Clinical Veterinary and Animal Sciences; Faculty of Health and Medical Sciences; University Hospital for Companion Animals; University of Copenhagen; Frederiksberg C; Denmark
| | - Clara B. Marschner
- Department of Clinical Veterinary and Animal Sciences; Faculty of Health and Medical Sciences; University Hospital for Companion Animals; University of Copenhagen; Frederiksberg C; Denmark
| | - Annemarie T. Kristensen
- Department of Clinical Veterinary and Animal Sciences; Faculty of Health and Medical Sciences; University Hospital for Companion Animals; University of Copenhagen; Frederiksberg C; Denmark
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11
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Wiinberg B, Jessen LR, Tarnow I, Kristensen AT. Diagnosis and treatment of platelet hyperactivity in relation to thrombosis in dogs and cats. J Vet Emerg Crit Care (San Antonio) 2012; 22:42-58. [DOI: 10.1111/j.1476-4431.2011.00708.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- Bo Wiinberg
- From the Department of Small Animal Clinical Sciences; Faculty of Life Sciences; University of Copenhagen; DK-1810 Frederiksberg; Denmark
| | - Lisbeth R. Jessen
- From the Department of Small Animal Clinical Sciences; Faculty of Life Sciences; University of Copenhagen; DK-1810 Frederiksberg; Denmark
| | - Inge Tarnow
- Health & Nutrition Division; Chr. Hansen A/S; DK-2970 Hørsholm; Denmark
| | - Annemarie T. Kristensen
- From the Department of Small Animal Clinical Sciences; Faculty of Life Sciences; University of Copenhagen; DK-1810 Frederiksberg; Denmark
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12
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Jessen LR, Wiinberg B, Kjelgaard-Hansen M, Jensen AL, Rozanski E, Kristensen AT. ORIGINAL RESEARCH: Thrombin-activatable fibrinolysis inhibitor activity in healthy and diseased dogs. Vet Clin Pathol 2010; 39:296-301. [DOI: 10.1111/j.1939-165x.2010.00230.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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13
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Jessen LR, Wiinberg B, Jensen AL, Kjelgaard-Hansen M, Jensen KH, Pedersen LB, Kristensen AT. In vitro heparinization of canine whole blood with low molecular weight heparin (dalteparin) significantly and dose-dependently prolongs heparinase-modified tissue factor-activated thromboelastography parameters and prothrombinase-induced clotting time. Vet Clin Pathol 2008; 37:363-72. [DOI: 10.1111/j.1939-165x.2008.00068.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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