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Mandese WW, Suero M, Reynolds PS, Kariyawasam S, Beatty S, Griffin F. Urinalysis and culture results of free-catch urine samples in dogs: a randomised controlled trial. J Small Anim Pract 2024. [PMID: 38622928 DOI: 10.1111/jsap.13730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Revised: 02/05/2024] [Accepted: 03/20/2024] [Indexed: 04/17/2024]
Abstract
OBJECTIVES To evaluate the prevalence of bacterial presence in free-catch urine samples preceded by either a standardised prepped ("clean-catch") protocol versus unprepped (non-cleaned) voiding. MATERIALS AND METHODS The study was a single-centre prospective single-blinded randomised controlled trial. Urine samples were obtained from 100 client-owned dogs presenting for routine evaluation. Dogs were randomly assigned to either the prepped group (preputial or peri-vulvar area cleaned with sterile saline before collection) or the unprepped group (no preliminary cleansing) stratified by sex. Urinalysis and urine culture (blood and MacConkey agar) were performed on all samples. Significant bacterial presence on urine culture was defined as >104 colony forming units (CFU)/mL. RESULTS There were no statistically significant associations between prepped versus unprepped collection method or sex with a urinalysis positive for bacteriuria. However, on culture, significant bacterial growth was almost five times more likely to be associated with males relative to females (odds ratio 4.59, 95% confidence interval 1.61 to 13.10). The probability of finding a positive culture was not statistically associated with prep method (odds ratio 1.43, 95% confidence interval 0.50 to 4.08). CLINICAL SIGNIFICANCE For the majority of dogs without clinical signs of urinary tract infection, free-catch urine collection does not result in significant bacteriuria found on analysis or culture. The presence of bacteria found in free-catch samples may be secondary to sample contamination or subclinical bacteriuria. Sample contamination or subclinical bacteriuria may be more prevalent in male dogs.
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Affiliation(s)
- W W Mandese
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL, 32610-0126, USA
| | - M Suero
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL, 32610-0126, USA
| | - P S Reynolds
- Department of Anesthesiology, Statistics in Anesthesiology Research (STAR) Core, College of Medicine, University of Florida, Gainesville, FL, 32610-0126, USA
| | - S Kariyawasam
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL, 32610-0126, USA
| | - S Beatty
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL, 32610-0126, USA
| | - F Griffin
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL, 32610-0126, USA
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Spear DJ, Crouse ZJ, Kearns SA. Retrospective evaluation of leflunomide as an adjunctive therapy in dogs with non-associative immune-mediated thrombocytopenia: 20 cases (2008-2021). J Small Anim Pract 2024; 65:261-269. [PMID: 38433454 DOI: 10.1111/jsap.13715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 01/22/2024] [Accepted: 02/07/2024] [Indexed: 03/05/2024]
Abstract
OBJECTIVE To describe leflunomide as an adjunctive therapy in the treatment of non-associative immune-mediated thrombocytopenia. MATERIALS AND METHODS A retrospective study of dogs with a diagnosis of non-associative immune-mediated thrombocytopenia treated with leflunomide March 2008 to September 2021 was conducted. Data collected included signalment, clinical signs, physical examination findings and diagnostic testing performed. Medications administered, duration of hospital stay, time to platelet concentration >150×109/L and adverse events during leflunomide therapy were recorded. Relapses within a year of diagnosis were reported. RESULTS A total of 20 client-owned dogs met inclusion criteria. Nineteen of 20 dogs (95%) achieved a platelet concentration >150×109/L with leflunomide and prednisone combination therapy and four dogs (21.1%) relapsed during treatment or shortly after treatment. Adverse effects included diarrhoea (n=5), mild lymphopenia (n=9) and mild intermittent anaemia (n=1). A single dog developed hepatotoxicity presumed to be secondary to leflunomide therapy that resolved after drug discontinuation. One dog was treated for aspiration pneumonia during treatment. Two dogs were euthanased while receiving leflunomide. CLINICAL SIGNIFICANCE Length of hospitalisation, time to platelet recovery, treatment response and relapse rate were comparable with alternative treatment protocols. Most adverse effects did not require leflunomide dose adjustment; however, two dogs died while undergoing leflunomide treatment and there is compelling evidence that one of these dogs experienced fatal infection secondary to immune-suppression. Hepatotoxicity remains a known complication of leflunomide treatment and serial biochemistry testing is recommended.
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Affiliation(s)
- D J Spear
- Department of Internal Medicine, Massachusetts Veterinary Referral Hospital, Woburn, MA, 01801, USA
- Department of Internal Medicine, Angell Animal Medical Center, Boston, MA, 02130, USA
| | - Z J Crouse
- Department of Internal Medicine, Angell Animal Medical Center, Boston, MA, 02130, USA
| | - S A Kearns
- Department of Internal Medicine, Angell Animal Medical Center, Boston, MA, 02130, USA
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3
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Harrer J, Fejös C, Zablotski Y, Hirschberger J, Wolf G, Rieger A, Mayer C, Dorsch R. Bacterial urinary tract infection and subclinical bacteriuria in dogs receiving antineoplastic chemotherapy. J Vet Intern Med 2022; 36:1005-1015. [PMID: 35524488 PMCID: PMC9151473 DOI: 10.1111/jvim.16410] [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: 07/22/2021] [Revised: 03/07/2022] [Accepted: 03/08/2022] [Indexed: 11/30/2022] Open
Abstract
Background Immunosuppressive treatment with glucocorticoids and cyclosporine increases the risk for positive urine cultures (PUCs) in dogs. Objective To investigate the prevalence and incidence of PUC in dogs diagnosed with cancer and treated with antineoplastic chemotherapy while distinguishing between subclinical bacteriuria (SB) and urinary tract infection (UTI). Animals Forty‐six client‐owned dogs with nonurogenital cancer treated with antineoplastic chemotherapy. Methods Prospective observational longitudinal clinical study. Dogs in which a urine culture was performed before the start of and at least once during antineoplastic chemotherapy were included. A McNemar's test was used to investigate if the prevalence of PUC increased during antineoplastic chemotherapy. Positive urine cultures were categorized into SB and UTI and multiple PUCs from the same dog and category were grouped together as 1 episode of PUC. Results Urine culture was positive in 21/185 urine samples in 8/46 dogs. Antineoplastic chemotherapy did not influence the prevalence of PUC (P = 1.00), which was 11% (5/46 dogs; 95% confidence interval: 5‐23%) before the start of and 13% (6/46 dogs; 95% confidence interval: 6‐26%) during antineoplastic chemotherapy. Eight dogs had 10 episodes of PUC; 7/10 episodes were classified as SB, and in 3/10 episodes UTI (chronic prostatitis, prostatic abscess, and emphysematous cystitis) was diagnosed. Escherichia coli was the most common pathogen, isolated in 9/10 episodes. Conclusions and Clinical Importance We did not find evidence that antineoplastic chemotherapy is a major predisposing factor for the development of PUC. Most dogs with PUC had SB.
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Affiliation(s)
- Julia Harrer
- Clinic of Small Animal Internal Medicine, Centre for Clinical Veterinary Medicine, Ludwig-Maximilian-University, Munich, Germany
| | - Csilla Fejös
- Clinic of Small Animal Internal Medicine, Centre for Clinical Veterinary Medicine, Ludwig-Maximilian-University, Munich, Germany
| | - Yury Zablotski
- Clinic of Small Animal Internal Medicine, Centre for Clinical Veterinary Medicine, Ludwig-Maximilian-University, Munich, Germany
| | - Johannes Hirschberger
- Clinic of Small Animal Internal Medicine, Centre for Clinical Veterinary Medicine, Ludwig-Maximilian-University, Munich, Germany
| | - Georg Wolf
- Department of Veterinary Sciences, Institute of Infectious Diseases and Zoonoses, Faculty of Veterinary Medicine, Ludwig-Maximilian-University, Munich, Germany
| | - Alexandra Rieger
- Department of Veterinary Sciences, Institute of Veterinary Pathology, Faculty of Veterinary Medicine, Ludwig-Maximilian-University, Munich, Germany
| | - Christian Mayer
- Department of Veterinary Sciences, Institute of Veterinary Pathology, Faculty of Veterinary Medicine, Ludwig-Maximilian-University, Munich, Germany
| | - Roswitha Dorsch
- Clinic of Small Animal Internal Medicine, Centre for Clinical Veterinary Medicine, Ludwig-Maximilian-University, Munich, Germany
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Bruet V, Mosca M, Briand A, Bourdeau P, Pin D, Cochet-Faivre N, Cadiergues MC. Clinical Guidelines for the Use of Antipruritic Drugs in the Control of the Most Frequent Pruritic Skin Diseases in Dogs. Vet Sci 2022; 9:vetsci9040149. [PMID: 35448647 PMCID: PMC9030482 DOI: 10.3390/vetsci9040149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 03/13/2022] [Accepted: 03/15/2022] [Indexed: 12/10/2022] Open
Abstract
Pruritus is a common clinical sign in many skin disorders and is currently the main complaint in canine dermatology. Pruritic skin diseases can affect the quality of life of dogs and their owners. Several families of antipruritic drugs are available to help control pruritus in dogs. The aim of this review is to help practitioners select the most appropriate symptomatic treatment in the most frequent situations of dermatological pruritus in dogs. The molecules reviewed here are systemic and topical glucocorticoids, antihistamines, ciclosporin, oclacitinib and lokivetmab. A level of evidence (1, 2 or 3) has been established according to a detailed algorithm for each individual study in the literature published between 1990 and March 2021. The guidelines result from evidence grading using the strength of recommendation taxonomy (SoRT) and clinical recommendations using a thorough methodology.
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Affiliation(s)
- Vincent Bruet
- Veterinary Dermatology Referral Services, 44100 Nantes, France;
| | - Marion Mosca
- Université de Lyon, VetAgro Sup, Interactions Cells Environment, UPSP 2016.A104, 69280 Marcy l’Etoile, France; (M.M.); (D.P.)
| | - Amaury Briand
- Department of Dermatology, Ecole Nationale Vétérinaire d’Alfort, 94700 Maisons-Alfort, France; (A.B.); (N.C.-F.)
| | - Patrick Bourdeau
- Department of Clinical Sciences, ENVN (Oniris) Université de Nantes, 44307 Nantes, France;
| | - Didier Pin
- Université de Lyon, VetAgro Sup, Interactions Cells Environment, UPSP 2016.A104, 69280 Marcy l’Etoile, France; (M.M.); (D.P.)
| | - Noëlle Cochet-Faivre
- Department of Dermatology, Ecole Nationale Vétérinaire d’Alfort, 94700 Maisons-Alfort, France; (A.B.); (N.C.-F.)
- UMR BIPAR, Laboratoire de Santé Animale, 94700 Maisons-Alfort, France
| | - Marie-Christine Cadiergues
- Department of Clinical Sciences, Université de Toulouse, ENVT, 31076 Toulouse, France
- INFINITy, Université de Toulouse, Inserm, CNRS, UPS, 31059 Toulouse, France
- Correspondence: ; Tel.: +33-561-193268
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5
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Teh H. A review of the current concepts in canine urinary tract infections. Aust Vet J 2021; 100:56-62. [PMID: 34775603 DOI: 10.1111/avj.13127] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 09/27/2021] [Indexed: 12/01/2022]
Abstract
Traditionally, urinary tract infections (UTIs) have been categorised as either uncomplicated or complicated in veterinary medicine, with treatment differing for the two categories. In human medicine, there is an additional category: Asymptomatic bacteriuria, which is the presence of bacteriuria without symptoms of infection. Escherichia coli (E.coli) is the most common bacterial species involved in UTIs in dogs. Clinical signs can be absent in dogs with complicated UTIs, and this has been likened to asymptomatic bacteriuria (ASB) in people and has been termed subclinical bacteriuria (SBU) with the treatment recommendations for SBU in dogs have been adapted from human recommendations. There is a shift in the current treatment of UTIs to help minimise the development of antimicrobial resistance. Routine screening of dogs with conditions that may predispose them to UTIs has been discouraged as has the treatment of SBU. This has been due to the increase in antimicrobial resistance (AMR).
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Affiliation(s)
- H Teh
- Translational Research and Clinical Trial Study Group, U-Vet Werribee Animal Hospital, Werribee, Victoria, Australia
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6
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Perry KM, Lynch AM, Caudill A, Vigani A, Roberston JB, Vaden S. Clinical features, outcome, and illness severity scoring in 32 dogs with urosepsis (2017-2018). J Vet Emerg Crit Care (San Antonio) 2021; 32:236-242. [PMID: 34730876 DOI: 10.1111/vec.13158] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 08/14/2020] [Accepted: 09/05/2020] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To describe the clinical features, outcome, and utility of illness severity scoring in dogs diagnosed with urosepsis. DESIGN Retrospective study (2017-2018). SETTING University teaching hospital. ANIMALS Thirty-two dogs diagnosed with urosepsis secondary to pyometra, prostatitis, or pyelonephritis. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS Urosepsis was identified in 32 dogs, consisting of 9 of 32 (28.1%) with pyometra, 7 of 32 (21.8%) with prostatitis, and 16 of 32 (50%) with pyelonephritis. In total, 28 (87.5%) dogs survived to discharge, with the following group-specific survival rates: pyometra, 9 of 9 (100%); prostatitis, 5 of 7 (71.4%); and pyelonephritis, 14 of 16 (87.5%). Positive bacterial cultures were obtained in 27 of 32 (84.1%) dogs. The most commonly implicated pathogens were Escherichia coli (14/37 [37.8%]), Klebsiella pneumoniae (8/37 [21.6%]), and Staphylococcus pseudintermedius (6/37 [16.2%]). Multiple organ dysfunction syndrome (MODS) was identified in 21 of 32 dogs (65.6%). Although the presence of MODS was not different between survivors and nonsurvivors (P = 0.6), nonsurvivors had more dysfunctional organs (P = 0.04). Nonsurvivors also had higher Acute Patient Physiology and Laboratory Evaluation (APPLEFAST ) scores compared to survivors (P = 0.01). CONCLUSIONS Survival of dogs with urosepsis was good and may be higher than for other sources of sepsis. Compared to survivors, nonsurvivors had more dysfunctional organs and higher illness severity scores, which may be helpful in the assessment and management of dogs with urosepsis.
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Affiliation(s)
- Kayla M Perry
- Department of Clinical Sciences, North Carolina State University, Raleigh, North Carolina, USA
| | - Alex M Lynch
- Department of Clinical Sciences, North Carolina State University, Raleigh, North Carolina, USA
| | - Alexander Caudill
- Department of Clinical Sciences, North Carolina State University, Raleigh, North Carolina, USA
| | - Alessio Vigani
- Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - James B Roberston
- Department of Clinical Sciences, North Carolina State University, Raleigh, North Carolina, USA
| | - Shelly Vaden
- Department of Clinical Sciences, North Carolina State University, Raleigh, North Carolina, USA
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Methylprednisolone Induces Extracellular Trap Formation and Enhances Bactericidal Effect of Canine Neutrophils. Int J Mol Sci 2021; 22:ijms22147734. [PMID: 34299355 PMCID: PMC8304006 DOI: 10.3390/ijms22147734] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 07/11/2021] [Accepted: 07/13/2021] [Indexed: 12/15/2022] Open
Abstract
Methylprednisolone is a glucocorticoid and can negatively influence immune defense mechanisms. During bacterial infections in the dog, neutrophils infiltrate infected tissue and mediate antimicrobial effects with different mechanisms such as phagocytosis and neutrophil extracellular trap (NET) formation. Here, we investigated the influence of methylprednisolone on canine NET formation and neutrophil killing efficiency of Gram positive and Gram negative bacteria. Therefore, canine blood derived neutrophils were treated with different concentrations of methylprednisolone over time. The survival factor of Staphylococcus pseudintermedius, Streptococcus canis or Escherichia coli was determined in presence of stimulated neutrophils. Additionally, free DNA and nucleosomes as NET marker were analyzed in supernatants and neutrophils were assessed for NET formation by immunofluorescence microscopy. Methylprednisolone concentrations of 62.5 and 625 µg/mL enhanced the neutrophil killing of Gram positive bacteria, whereas no significant influence was detected for the Gram negative Escherichia coli. Interestingly, higher amounts of free DNA were detected under methylprednisolone stimulation in a concentration dependency and in the presence of Streptococcus canis and Escherichia coli. The nucleosome release by neutrophils is induced by bacterial infection and differs depending on the concentration of methylprednisolone. Furthermore, immunofluorescence microscopy analysis identified methylprednisolone at a concentration of 62.5 µg/mL as a NET inducer. In summary, methylprednisolone enhances NET-formation and time-dependent and concentration-dependent the bactericidal effect of canine neutrophils on Gram positive bacteria.
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8
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Machado L, de Oliveira MC, Barbieri CR, Riboldi CI, Leotti VB, González FHD, Valle SDF, Siqueira FM, Pöppl ÁG. Clinical and microbiological characterization of subclinical bacteriuria and sporadic bacterial cystitis in dogs with spontaneous hypercortisolism. Comp Immunol Microbiol Infect Dis 2021; 75:101624. [PMID: 33609989 DOI: 10.1016/j.cimid.2021.101624] [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: 07/19/2020] [Revised: 01/27/2021] [Accepted: 02/05/2021] [Indexed: 12/25/2022]
Abstract
Study's aims were to characterize subclinical bacteriuria (SB) and sporadic bacterial cystitis (SBC) in dogs with spontaneous hypercortisolism (HC). Prospective cross-sectional design divided patients as newly diagnosed (n = 27), poorly controlled (n = 21), well controlled (n = 34), and controls (n = 19). Urine culture positive results were identified by MALDI-TOF and submitted to antibiogram. Escherichia coli was the most common microorganism (36%). The majority of positive cultures in HC were SB (12.2%). All 4.1% SBC cases were in well controlled HC cases. Bacteriuria correlated with low urine specific gravity and low lymphocyte count. HC degree of control correlated with leukocyturia. SB/SBC cases were treated based in antimicrobial susceptibility leading to microbiological cure in 75% of HC cases. Persistent infections occurred only in SB cases, all by E. coli which became more resistant. SB/SBC prevalence in canine HC is actually lower. Further evidence for current ISCAID guideline contraindication for SB treatment due to HC were provided.
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Affiliation(s)
- Letícia Machado
- Veterinary Sciences Post-Graduation Program, Federal University of Rio Grande do Sul, Av. Bento Gonçalves 9090, Porto Alegre, Rio Grande do Sul, CEP 91540-000, Brazil
| | - Milena Cleff de Oliveira
- Faculty of Veterinary Medicine, Federal University of Rio Grande do Sul, Av. Bento Gonçalves 9090, Porto Alegre, Rio Grande do Sul, CEP 91540-000, Brazil
| | - Cláudia Ruga Barbieri
- Faculty of Veterinary Medicine, Federal University of Rio Grande do Sul, Av. Bento Gonçalves 9090, Porto Alegre, Rio Grande do Sul, CEP 91540-000, Brazil
| | - Camila Impérico Riboldi
- Faculty of Veterinary Medicine, Federal University of Rio Grande do Sul, Av. Bento Gonçalves 9090, Porto Alegre, Rio Grande do Sul, CEP 91540-000, Brazil
| | - Vanessa Bielefeldt Leotti
- Department of Statistics, Mathematics and Statistics Institute, Federal University of Rio Grande do Sul, Av. Bento Gonçalves 9500, Porto Alegre, Rio Grande do Sul, CEP 91540-000, Brazil
| | - Félix Hilário Díaz González
- Veterinary Sciences Post-Graduation Program, Federal University of Rio Grande do Sul, Av. Bento Gonçalves 9090, Porto Alegre, Rio Grande do Sul, CEP 91540-000, Brazil; Department of Veterinary Clinical Pathology, School of Veterinary Medicine, Federal University of Rio Grande do Sul, Av. Bento Gonçalves 9090, Porto Alegre, Rio Grande do Sul, CEP 91540-000, Brazil
| | - Stella de Faria Valle
- Veterinary Sciences Post-Graduation Program, Federal University of Rio Grande do Sul, Av. Bento Gonçalves 9090, Porto Alegre, Rio Grande do Sul, CEP 91540-000, Brazil; Department of Veterinary Clinical Pathology, School of Veterinary Medicine, Federal University of Rio Grande do Sul, Av. Bento Gonçalves 9090, Porto Alegre, Rio Grande do Sul, CEP 91540-000, Brazil
| | - Franciele Maboni Siqueira
- Veterinary Sciences Post-Graduation Program, Federal University of Rio Grande do Sul, Av. Bento Gonçalves 9090, Porto Alegre, Rio Grande do Sul, CEP 91540-000, Brazil; Department of Veterinary Clinical Pathology, School of Veterinary Medicine, Federal University of Rio Grande do Sul, Av. Bento Gonçalves 9090, Porto Alegre, Rio Grande do Sul, CEP 91540-000, Brazil
| | - Álan Gomes Pöppl
- Veterinary Sciences Post-Graduation Program, Federal University of Rio Grande do Sul, Av. Bento Gonçalves 9090, Porto Alegre, Rio Grande do Sul, CEP 91540-000, Brazil; Department of Animal Medicine, School of Veterinary Medicine, Federal University of Rio Grande do Sul, Av. Bento Gonçalves 9090, Porto Alegre, Rio Grande do Sul, CEP 91540-000, Brazil.
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Narayanan L, Mulligan C, Durso L, Thames B, Thomason J, Fellman C, Mackin A, Wills R, Archer T. Recovery of T-cell function in healthy dogs following cessation of oral cyclosporine administration. Vet Med Sci 2020; 6:277-282. [PMID: 31914237 PMCID: PMC7397919 DOI: 10.1002/vms3.230] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 10/30/2019] [Accepted: 12/08/2019] [Indexed: 11/30/2022] Open
Abstract
Cyclosporine is a potent immunosuppressive agent used to treat immune‐mediated disorders in dogs. Secondary infections sometimes necessitate withdrawal of cyclosporine, but it is not known how long it takes for the immune system to recover after cessation of cyclosporine. Our goal was to utilize a validated RT‐qPCR assay in dogs to assess recovery time of the T‐cell cytokines IL‐2 and IFN‐γ after discontinuation of cyclosporine. Six healthy dogs were given oral cyclosporine (10 mg/kg every 12 hr) for 1 week, with samples collected for measurement of cytokine gene expression prior to treatment, and on the last day of therapy. Cyclosporine was then discontinued, and samples were collected daily for an additional 7 days. Results revealed that there was a significant difference in cytokine expression when comparing pre‐treatment and immediate post‐treatment values, corresponding to marked suppression of T‐cell function. There was no significant difference between pre‐treatment values for either cytokine when compared with any day during the recovery period. Cytokine expression, evaluated as a percentage of pre‐treatment baseline samples, demonstrated progressing return of T‐cell function after drug cessation, with full recovery seen in all dogs by Day 4 of the recovery period.
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Affiliation(s)
- Lakshmi Narayanan
- Department of Clinical Sciences, Mississippi State University College of Veterinary Medicine, Mississippi State, MS, USA
| | - Charlee Mulligan
- Department of Clinical Sciences, Mississippi State University College of Veterinary Medicine, Mississippi State, MS, USA
| | - Lisa Durso
- Department of Clinical Sciences, Mississippi State University College of Veterinary Medicine, Mississippi State, MS, USA
| | - Brittany Thames
- Department of Clinical Sciences, Mississippi State University College of Veterinary Medicine, Mississippi State, MS, USA
| | - John Thomason
- Department of Clinical Sciences, Mississippi State University College of Veterinary Medicine, Mississippi State, MS, USA
| | - Claire Fellman
- Department of Clinical Sciences, Mississippi State University College of Veterinary Medicine, Mississippi State, MS, USA
| | - Andrew Mackin
- Department of Clinical Sciences, Mississippi State University College of Veterinary Medicine, Mississippi State, MS, USA
| | - Robert Wills
- Department of Pathobiology and Population Medicine, Mississippi State University College of Veterinary Medicine, Mississippi State, MS, USA
| | - Todd Archer
- Department of Clinical Sciences, Mississippi State University College of Veterinary Medicine, Mississippi State, MS, USA
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Johnstone T. A clinical approach to multidrug-resistant urinary tract infection and subclinical bacteriuria in dogs and cats. N Z Vet J 2019; 68:69-83. [PMID: 31707934 DOI: 10.1080/00480169.2019.1689196] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Multidrug-resistant bacteria are increasingly isolated from the urinary tract of pets, particularly those that suffer from concurrent conditions, have been hospitalised, or were treated with antimicrobials in the recent past. Many of the multidrug-resistant bacteria encountered are resistant to all commonly used oral antibiotics. This poses both a therapeutic dilemma in the individual pet and a threat to public health. This article begins with an overview of multidrug resistance in organisms that are commonly isolated from the urinary tract of pets. This is followed by a proposed clinical approach to managing multidrug-resistant urinary bacteria, which summarises current knowledge regarding appropriate sampling and analysis, reviews the current guidelines regarding appropriate antimicrobial use and discusses treatment options that might be considered. The article highlights several shortcomings of the current knowledge to be considered when planning future clinical research and developing policies.
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Affiliation(s)
- T Johnstone
- Translational Research and Animal Clinical Trial Study Group, U-Vet Animal Hospital, Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Werribee, Australia
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11
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McGovern DA, Gaschen F, Habil D, Roy A. Antimicrobial Susceptibility Patterns and Clinical Parameters in 208 Dogs with Positive Urine Cultures (2012-2014). J Am Anim Hosp Assoc 2019; 55:306-313. [PMID: 31525091 DOI: 10.5326/jaaha-ms-6796] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Urinary tract infections (UTI) occur commonly in dogs, and gram-negative enteric bacteria are the most prevalent pathogens. Clinical parameters, urinalysis, and urine culture and sensitivity results were retrieved from the medical records of 208 dogs with positive urine cultures over a 3 yr period at the Louisiana State University Veterinary Teaching Hospital. Several groups were defined including dogs presented for primary care versus referred cases; simple UTI, complicated UTI, and pyelonephritis; dogs pretreated with antimicrobials; and dogs having an indwelling catheter in place prior to sampling. Nearly 80% of dogs had complicated UTI. Of all dogs, 70% had no documented clinical signs of lower urinary tract disease (LUTD), with 68% of them showing hematuria and/or pyuria. Based on clinical signs or urinalysis, 19% of all dogs had no evidence of lower UTI. In dogs without LUTD signs the most common comorbidities were immunosuppressive treatment and severely restricted mobility (23%). Chronic recurring UTI were present in 19% of dogs with LUTD signs. Distribution of bacterial species was comparable with the existing literature and not significantly different between clinical subgroups. Isolates from dogs pretreated with antimicrobials showed decreased susceptibility to enrofloxacin. The prevalence of multidrug-resistant Escherichia coli and Staphylococcus spp. was moderate (29%).
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Affiliation(s)
- Diana A McGovern
- From Affiliated Veterinary Specialists, Orlando, Florida (D.A.M.); Department of Veterinary Clinical Sciences (F.G.), and Department of Pathobiological Sciences (A.R.), Louisiana State University School of Medicine, Baton Rouge, Louisiana
| | - Frédéric Gaschen
- From Affiliated Veterinary Specialists, Orlando, Florida (D.A.M.); Department of Veterinary Clinical Sciences (F.G.), and Department of Pathobiological Sciences (A.R.), Louisiana State University School of Medicine, Baton Rouge, Louisiana
| | - Dr Habil
- From Affiliated Veterinary Specialists, Orlando, Florida (D.A.M.); Department of Veterinary Clinical Sciences (F.G.), and Department of Pathobiological Sciences (A.R.), Louisiana State University School of Medicine, Baton Rouge, Louisiana
| | - Alma Roy
- From Affiliated Veterinary Specialists, Orlando, Florida (D.A.M.); Department of Veterinary Clinical Sciences (F.G.), and Department of Pathobiological Sciences (A.R.), Louisiana State University School of Medicine, Baton Rouge, Louisiana
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12
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Weingart C, Thielemann D, Kohn B. Primary immune-mediated haemolytic anaemia: a retrospective long-term study in 61 dogs. Aust Vet J 2019; 97:483-489. [PMID: 31454853 DOI: 10.1111/avj.12875] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2019] [Revised: 07/16/2019] [Accepted: 07/22/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The objective of this study is to describe the course of disease of dogs with primary immune-mediated haemolytic anaemia (pIMHA) with an observation period longer than 90 days in regard to clinical signs, laboratory results and treatment response. MATERIAL AND METHODS Clinical records between January 2003 and December 2011 were reviewed. Diagnosis of pIMHA was based on the presence of haemolytic anaemia with a packed cell volume of <0.35 L/L, a positive Coombs' test and/or erythrocyte agglutination, spherocytosis and exclusion of an underlying disease. Included were dogs which could be monitored for more than 90 days after initial presentation. RESULTS Sixty-one dogs with pIMHA were included. The initial packed cell volume ranged from 0.08 to 0.30 L/L (median 0.16). Immunosuppressive treatment included prednisolone in all the cases; 32 dogs successively received cyclosporine (28), cyclophosphamide (5), leflunomide (2) or human intravenous immunoglobulins (2) in addition. In 33/61 dogs, the drugs were discontinued 67-3372 days (median 334) after beginning of therapy; in 28 dogs, the drug dosage was reduced, but not discontinued until the end of the study. Three dogs developed immune-mediated thrombocytopenia (days 132, 156 and 680). The observation period ranged from 96 to 4147 days (median 628). A total of 22.9% (14/61) of the dogs developed a relapse after 94-3972 days (median 517). Five dogs were euthanased due to a relapse after 96-1188 days (median 628). CLINICAL SIGNIFICANCE Long-term prognosis in dogs with pIMHA is favourable. However, a relapse can occur after many years. Relapse was the most common cause of death in dogs with pIMHA that survive more than 90 days.
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Affiliation(s)
- C Weingart
- Freie Universität Berlin, Faculty of Veterinary Medicine, Clinic for Small Animals, Berlin, Germany
| | - D Thielemann
- Freie Universität Berlin, Faculty of Veterinary Medicine, Clinic for Small Animals, Berlin, Germany
| | - B Kohn
- Freie Universität Berlin, Faculty of Veterinary Medicine, Clinic for Small Animals, Berlin, Germany
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13
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Swann JW, Garden OA, Fellman CL, Glanemann B, Goggs R, LeVine DN, Mackin AJ, Whitley NT. ACVIM consensus statement on the treatment of immune-mediated hemolytic anemia in dogs. J Vet Intern Med 2019; 33:1141-1172. [PMID: 30847984 PMCID: PMC6524099 DOI: 10.1111/jvim.15463] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Accepted: 02/06/2019] [Indexed: 01/07/2023] Open
Abstract
Immune‐mediated hemolytic anemia (IMHA) causes severe anemia in dogs and is associated with considerable morbidity and mortality. Treatment with various immunosuppressive and antithrombotic drugs has been described anecdotally and in previous studies, but little consensus exists among veterinarians as to the optimal regimen to employ and maintain after diagnosis of the disease. To address this inconsistency and provide evidence‐based guidelines for treatment of IMHA in dogs, we identified and extracted data from studies published in the veterinary literature. We developed a novel tool for evaluation of evidence quality, using it to assess study design, diagnostic criteria, explanation of treatment regimens, and validity of statistical methods. In combination with our clinical experience and comparable guidelines for humans afflicted with autoimmune hemolytic anemia, we used the conclusions of this process to make a set of clinical recommendations regarding treatment of IMHA in dogs, which we refined subsequently by conducting several iterations of Delphi review. Additionally, we considered emerging treatments for IMHA in dogs and highlighted areas deserving of future research. Comments were solicited from several professional bodies to maximize clinical applicability before the recommendations were submitted for publication. The resulting document is intended to provide clinical guidelines for management of IMHA in dogs. These guidelines should be implemented pragmatically, with consideration of animal, owner, and veterinary factors that may vary among cases.
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Affiliation(s)
- James W Swann
- Kennedy Institute of Rheumatology, University of Oxford, Oxford, United Kingdom
| | - Oliver A Garden
- School of Veterinary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Claire L Fellman
- Cummings School of Veterinary Medicine, Tufts University, North Grafton, Massachusetts
| | - Barbara Glanemann
- Royal Veterinary College, University of London, London, United Kingdom
| | - Robert Goggs
- College of Veterinary Medicine, Cornell University, Ithaca, New York
| | - Dana N LeVine
- College of Veterinary Medicine, Iowa State University, Ames, Iowa
| | - Andrew J Mackin
- College of Veterinary Medicine, Mississippi State University, Mississippi State, Mississippi
| | - Nathaniel T Whitley
- Davies Veterinary Specialists, Manor Farm Business Park, Huntingdon, United Kingdom
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14
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International Society for Companion Animal Infectious Diseases (ISCAID) guidelines for the diagnosis and management of bacterial urinary tract infections in dogs and cats. Vet J 2019; 247:8-25. [PMID: 30971357 DOI: 10.1016/j.tvjl.2019.02.008] [Citation(s) in RCA: 170] [Impact Index Per Article: 34.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Revised: 02/19/2019] [Accepted: 02/21/2019] [Indexed: 02/08/2023]
Abstract
Urinary tract disease is a common clinical presentation in dogs and cats, and a common reason for antimicrobial prescription. This document is a revision and expansion on the 2011 Antimicrobial Use Guidelines for Treatment of Urinary Tract Disease in Dogs and Cats, providing recommendations for diagnosis and management of sporadic bacterial cystitis, recurrent bacterial cystitis, pyelonephritis, bacterial prostatitis, and subclinical bacteriuria. Issues pertaining to urinary catheters, medical dissolution of uroliths and prophylaxis for urological procedures are also addressed.
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Abstract
"Urinary tract infection (UTI) is a common diagnosis in companion animal practice and is responsible for a significant proportion of antimicrobial use in veterinary medicine. The veterinary community has begun to follow the standards of care in human medicine and shift its definition of an UTI based on culture results and toward the presence of lower urinary tract symptoms. An improved understanding of the pathophysiology of UTI, risk factors for clinical disease, and the implementation of more reliable in-house diagnostic testing can lead to improved outcomes for patients and reduce inappropriate treatment. Investigation of antibiotic-sparing therapies holds some promise as well."
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Affiliation(s)
- Julie K Byron
- Veterinary Clinical Sciences, The Ohio State University, Columbus, OH 43210, USA.
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Abstract
Canine atopic dermatitis (AD) is one of the most common inflammatory skin diseases in dogs. The pathogenesis is complex and not completely understood. Many therapeutic options are available; however, because of cost, side effects, or a long lag phase, new compounds are constantly produced. This article provides a comprehensive review of the latest compounds for the treatment of canine AD. In addition, a brief review of new studies on conventional medications is provided. For a successful long-term therapeutic approach, it is important to considerate the status of the disease, as well as the patients' and their owners' needs.
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Affiliation(s)
- Domenico Santoro
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, 2015 Southwest 16th Avenue, Gainesville, FL 32610, USA.
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17
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Widmer G, Ferrer L, Favrot C, Paps J, Huynh K, Olivry T. Glucocorticosteroids and ciclosporin do not significantly impact canine cutaneous microbiota. BMC Vet Res 2018; 14:51. [PMID: 29471815 PMCID: PMC5824610 DOI: 10.1186/s12917-018-1370-y] [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] [Received: 03/23/2017] [Accepted: 02/14/2018] [Indexed: 12/16/2022] Open
Abstract
Background As prednisone and ciclosporin can have immunosuppressive effects and have been considered potential predisposing factors for skin infections, we investigated the impact of these drugs on the diversity of the cutaneous microbiota, the abundance of Malassezia and infection with Papillomaviruses. Results Six atopic, asymptomatic Maltese-beagle dogs were treated with ciclosporin for one month and then with prednisone for another month, with a one-month wash-out between treatments. The dogs were sampled on the abdomen and pinna before and after each treatment using a swab. Samples for Papillomavirus detection were obtained with cytobrush sticks. The bacterial microbiota was characterized using 16S amplicon high-throughput sequencing. Malassezia populations were quantified with nested real-time PCR targeting the ribosomal internal transcribed spacer 1. The diversity and composition of cutaneous microbiota was not impacted in a detectable manner by any of the treatments. As observed for the bacterial microbiota, Malassezia populations were not affected by treatment. Three dogs were positive for Papillomavirus at more than one timepoint, but an association with treatment was not apparent. Conclusions Ciclosporin and prednisone at doses used for the treatment of atopic dermatitis do not impact the canine cutaneous microbiota in a detectable manner. Electronic supplementary material The online version of this article (10.1186/s12917-018-1370-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Giovanni Widmer
- Department of Infectious Diseases and Global Health, Cummings School of Veterinary Medicine at Tufts University, 200 Westboro Road, North Grafton, MA, USA.
| | - Lluís Ferrer
- Department of Clinical Sciences, Cummings School of Veterinary Medicine at Tufts University, 200 Westboro Road, North Grafton, MA, USA
| | - Claude Favrot
- Clinic for Small Animal Internal Medicine, Vetsuisse Faculty, University of Zürich, Winterthurerstrasse 260, -8057, Zürich, CH, Switzerland
| | - Judy Paps
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, 1060 William Moore Drive, Raleigh, NC, 27607, USA
| | - Kevin Huynh
- Department of Infectious Diseases and Global Health, Cummings School of Veterinary Medicine at Tufts University, 200 Westboro Road, North Grafton, MA, USA
| | - Thierry Olivry
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, 1060 William Moore Drive, Raleigh, NC, 27607, USA
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18
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Thornton LA, Burchell RK, Burton SE, Lopez-Villalobos N, Pereira D, MacEwan I, Fang C, Hatmodjo AC, Nelson MA, Grinberg A, Velathanthiri N, Gal A. The Effect of Urine Concentration and pH on the Growth of Escherichia Coli in Canine Urine In Vitro. J Vet Intern Med 2018; 32:752-756. [PMID: 29469957 PMCID: PMC5866962 DOI: 10.1111/jvim.15045] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Revised: 11/11/2017] [Accepted: 12/19/2017] [Indexed: 11/28/2022] Open
Abstract
Background Lower urinary tract infections are common in dogs, and Escherichia coli is the most common bacterial pathogen isolated. The literature has conflicting evidence regarding the inhibitory effects of urine concentration and pH on E. coli growth. Hypothesis/Objectives To determine the effect of different pH and urine concentrations on E. coli growth in vitro. Animals Voided urine samples from 10 apparently healthy spayed female dogs were used. Methods A matrix of 9 urine specific gravity (USG; 1.010, 1.020, and 1.030) and pH (5.5, 7.0, and 8.5) combinations was prepared by diluting and titrating filtered voided urine samples. Three E. coli isolates were obtained from urine of female dogs with signs of lower urinary tract infection and cultured at different urine pH and USG combinations in wells of a microtiter plate. The number of E. coli colony‐forming units (CFU) per mL of urine was calculated after aerobic incubation of the urine at 37°C for 18 hours, and statistically compared. Results Significant differences were identified in the mean log CFU/mL among different combinations of pH and USG. The lowest log CFU/mL were observed in alkaline concentrated urine (pH 8.5 and USG 1.030). Conclusions and Clinical Importance Escherichia coli in vitro growth was higher in neutral to acidic and diluted urine compared to alkaline and concentrated urine. The impact of non‐alkalizing diluting diets on the incidence of E. coli lower urinary tract infections should be further explored.
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Affiliation(s)
- L A Thornton
- School of Veterinary Sciences, Massey University, Palmerston North, Manawatu-Wanganui, New Zealand
| | - R K Burchell
- School of Veterinary Sciences, Massey University, Palmerston North, Manawatu-Wanganui, New Zealand
| | - S E Burton
- School of Veterinary Sciences, Massey University, Palmerston North, Manawatu-Wanganui, New Zealand
| | - N Lopez-Villalobos
- School of Veterinary Sciences, Massey University, Palmerston North, Manawatu-Wanganui, New Zealand
| | - D Pereira
- School of Veterinary Sciences, Massey University, Palmerston North, Manawatu-Wanganui, New Zealand
| | - I MacEwan
- School of Veterinary Sciences, Massey University, Palmerston North, Manawatu-Wanganui, New Zealand
| | - C Fang
- School of Veterinary Sciences, Massey University, Palmerston North, Manawatu-Wanganui, New Zealand
| | - A C Hatmodjo
- School of Veterinary Sciences, Massey University, Palmerston North, Manawatu-Wanganui, New Zealand
| | - M A Nelson
- School of Veterinary Sciences, Massey University, Palmerston North, Manawatu-Wanganui, New Zealand
| | - A Grinberg
- School of Veterinary Sciences, Massey University, Palmerston North, Manawatu-Wanganui, New Zealand
| | - N Velathanthiri
- School of Veterinary Sciences, Massey University, Palmerston North, Manawatu-Wanganui, New Zealand
| | - A Gal
- School of Veterinary Sciences, Massey University, Palmerston North, Manawatu-Wanganui, New Zealand
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19
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Lockwood SL, Schick AE, Lewis TP, Newton H. Investigation of subclinical bacteriuria in cats with dermatological disease receiving long-term glucocorticoids and/or ciclosporin. Vet Dermatol 2017; 29:25-e12. [PMID: 28833821 DOI: 10.1111/vde.12480] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/27/2017] [Indexed: 11/27/2022]
Affiliation(s)
| | - Anthea E. Schick
- Dermatology for Animals; 86 West Juniper Lane Gilbert AZ 85233 USA
| | - Thomas P. Lewis
- Dermatology for Animals; 86 West Juniper Lane Gilbert AZ 85233 USA
| | - Heide Newton
- Dermatology for Animals; 2933 North Campbell Ave Tucson AZ 85719 USA
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20
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Simpson AC, Schissler JR, Rosychuk RA, Moore AR. The frequency of urinary tract infection and subclinical bacteriuria in dogs with allergic dermatitis treated with oclacitinib: a prospective study. Vet Dermatol 2017; 28:485-e113. [PMID: 28513001 DOI: 10.1111/vde.12450] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/26/2017] [Indexed: 02/03/2023]
Affiliation(s)
- Andrew C. Simpson
- Department of Clinical Sciences; College of Veterinary Medicine and Biomedical Sciences; Colorado State University; 300 West Drake Road Fort Collins CO 80525 USA
| | - Jennifer R. Schissler
- Department of Clinical Sciences; College of Veterinary Medicine and Biomedical Sciences; Colorado State University; 300 West Drake Road Fort Collins CO 80525 USA
| | - Rod A.W. Rosychuk
- Department of Clinical Sciences; College of Veterinary Medicine and Biomedical Sciences; Colorado State University; 300 West Drake Road Fort Collins CO 80525 USA
| | - A Russell Moore
- Department of Microbiology, Immunology, and Pathology; College of Veterinary Medicine and Biomedical Sciences; Colorado State University; 311 Diagnostic Medical Center 300 West Drake Fort Collins CO 80524 USA
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21
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Park KM, Nam HS, Hussein KH, Woo HM. Surgical management of vesicoureteral reflux with recurrent urinary tract infection after renal transplantation in a dog. J Am Vet Med Assoc 2016; 248:309-14. [PMID: 26799110 DOI: 10.2460/javma.248.3.309] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
CASE DESCRIPTION A 3-year-old male Cocker Spaniel renal transplant recipient was readmitted 39 weeks after transplantation because of acute clinical signs of pollakiuria, intermittent vomiting, decreased appetite, lethargy, and mild fever. CLINICAL FINDINGS Hydronephrosis and hydroureter were observed with ultrasonography and contrast cystography, and a diagnosis of vesicoureteral reflux (VUR) was made. Urinary tract infection (UTI) caused by Escherichia coli was also diagnosed on the basis of results of urine culture. TREATMENT AND OUTCOME Despite treatment of the UTI with an appropriate antimicrobial for 6 weeks, the VUR persisted and the UTI recurred 9 weeks after cessation of antimicrobial treatment. Therefore, surgical correction by means of revision extravesicular ureteroneocytostomy was performed. Both VUR and hydronephrosis resolved after surgery. No recurrences of clinical signs of urinary tract complications were observed during the subsequent 22-month follow-up period. CLINICAL RELEVANCE Results suggested that ureteral reimplantation with an extravesicular technique incorporating a long submucosal tunnel may be an effective treatment for VUR when medical management fails in canine renal transplant recipients with recurrent UTIs.
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22
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Swann JW, Skelly BJ. Canine autoimmune hemolytic anemia: management challenges. VETERINARY MEDICINE-RESEARCH AND REPORTS 2016; 7:101-112. [PMID: 30050843 PMCID: PMC6055891 DOI: 10.2147/vmrr.s81869] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Immune-mediated hemolytic anemia is one of the most common manifestations of canine immune-mediated disease, yet treatment regimens remain nonstandardized and, in some cases, controversial. The main reason for this, as for most diseases in veterinary medicine, is the lack of large-scale placebo-controlled trials so that the efficacy of one treatment over another can be established. Most of the evidence used for treatment comes from retrospective studies and from personal preference and experience, and because of this, treatment regimens tend to vary among institutions and individual clinicians. Management of immune-mediated hemolytic anemia includes immunosuppression, thromboprophylaxis, and supportive care measures to help prevent and treat concurrent conditions.
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Affiliation(s)
- James W Swann
- Queen Mother Hospital for Animals, The Royal Veterinary College, Hatfield, Hertfordshire
| | - Barbara J Skelly
- Department of Veterinary Medicine, University of Cambridge, Cambridge, UK,
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23
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Wong C, Epstein SE, Westropp JL. Antimicrobial Susceptibility Patterns in Urinary Tract Infections in Dogs (2010-2013). J Vet Intern Med 2015; 29:1045-52. [PMID: 26133165 PMCID: PMC4895361 DOI: 10.1111/jvim.13571] [Citation(s) in RCA: 76] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2014] [Revised: 04/21/2015] [Accepted: 05/14/2015] [Indexed: 11/27/2022] Open
Abstract
Background Urinary tract infections (UTIs) are common in dogs. The responsible bacterial populations have evolved with increasing resistance to many antimicrobials. Objective To characterize the antimicrobial susceptibility patterns of canine urinary tract isolates over a 51‐month period. Animals One thousand six hundred and thirty‐six bacterial isolates from 1,028 dogs. Methods Aerobic bacterial isolate growth and susceptibility data from urine cultures of dogs were identified, retrospectively. Medical records were reviewed to obtain signalment, comorbidities, and antimicrobial use in the previous 30 days. The UTIs were further categorized as uncomplicated, complicated, or pyelonephritis. Results Common bacterial isolates identified were Escherichia coli (52.5%), Staphylococcus spp. (13.6%), and Enterococcus spp. (13.3%). In vitro susceptibility among all isolates varied for commonly prescribed antimicrobials (amoxicillin [59%], amoxicillin/clavulanic acid [76%], cephalexin [66%], enrofloxacin [74%] and trimethoprim‐sulfamethoxazole [86%]). For all antimicrobials tested (except aminoglycosides), in vitro susceptibility was higher in uncomplicated versus complicated infections (P < .05). Uncomplicated infection isolate susceptibility rates remained ≤90% for PO administered antimicrobials. Administration of amoxicillin, doxycycline, and enrofloxacin, but not amoxicillin/clavulanic acid in the previous 30 days was associated with resistance to that antimicrobial. Multidrug resistant isolates of E. coli and Staphylococcus spp. were more common in dogs with complicated than uncomplicated UTIs (36% versus 21%, P < .0001). Conclusions and Clinical Importance In vitro susceptibility was highly variable and no PO administered antimicrobial had >90% efficacy among isolates tested. Multidrug resistance was frequent among isolates tested suggesting that routine culture and susceptibility testing is indicated. Previously prescribed antimicrobials may affect empirical choices made pending susceptibility testing.
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Affiliation(s)
- C Wong
- William R. Pritchard Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California, Davis, CA
| | - S E Epstein
- Department of Veterinary Surgical and Radio-logical Sciences, School of Veterinary Medicine, University of California, Davis, CA
| | - J L Westropp
- Department of Veterinary Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, CA
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Dowling SR, Webb J, Foster JD, Ginn J, Foy DS, Trepanier LA. Opportunistic fungal infections in dogs treated with ciclosporin and glucocorticoids: eight cases. J Small Anim Pract 2015; 57:105-109. [PMID: 25988822 DOI: 10.1111/jsap.12367] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2014] [Revised: 02/05/2015] [Accepted: 03/09/2015] [Indexed: 12/01/2022]
Abstract
Glucocorticoids are the standard of care for the treatment of immune-mediated disorders, and ciclosporin is increasingly being used off-label as an adjunct immunosuppressive drug in dogs. However, opportunistic infections can develop during combination immunosuppressive regimens. This case series describes atypical fungal infections in eight dogs treated with immunosuppressive dosages of glucocorticoids and ciclosporin. The median duration of combined treatment prior to the identification of fungal infection was 31 (range, 13 to 201) days, although two dogs received glucocorticoids for prolonged periods prior to the addition of ciclosporin. The estimated prevalence of serious fungal infections with this drug combination appears to be low (approximately 1 · 67%), but these infections led directly or indirectly to death or euthanasia in five of eight (63%) dogs. These cases highlight the need for frequent clinical monitoring of dogs receiving immunosuppressive dosages of glucocorticoids and ciclosporin.
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Affiliation(s)
- S R Dowling
- Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, WI, 53706, USA
| | - J Webb
- Department of Pathobiological Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, WI, 53706, USA
| | - J D Foster
- Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, WI, 53706, USA
| | - J Ginn
- Department of Internal Medicine, Wheat Ridge Animal Hospital, Wheat Ridge, CO, 80033, USA
| | - D S Foy
- Department of Internal Medicine, Wheat Ridge Animal Hospital, Wheat Ridge, CO, 80033, USA
| | - L A Trepanier
- Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, WI, 53706, USA
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25
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Wan SY, Hartmann FA, Jooss MK, Viviano KR. Prevalence and clinical outcome of subclinical bacteriuria in female dogs. J Am Vet Med Assoc 2015; 245:106-12. [PMID: 24941394 DOI: 10.2460/javma.245.1.106] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine the prevalence of subclinical bacteriuria and its natural clinical course over a 3-month period in healthy female dogs. DESIGN Observational, prospective, cross-sectional study. ANIMALS 101 healthy client-owned female dogs. PROCEDURES In all dogs, screening clinicopathologic tests and bacteriologic culture of urine were performed. In culture-positive dogs, subclinical bacteriuria was confirmed by 2 positive culture results within 2 weeks and dogs were reevaluated at 3 months. RESULTS The prevalence of subclinical bacteriuria in healthy female dogs was 9 of 101 (8.9%). Three-month follow-up data were available for 8 of 9 dogs with subclinical bacteriuria. Four dogs had persistent bacteriuria, and 4 had transient bacteriuria. No dogs with subclinical bacteriuria developed clinical signs during the 3-month observation period. Subclinical bacteriuria was diagnosed in 6 of 51 (12%) young and middle-aged dogs and 3 of 50 (6.0%) senior and geriatric dogs. No significant difference was found in the prevalence of subclinical bacteriuria with age. CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that subclinical bacteriuria is a nonprogressive condition in healthy female dogs and can be persistent or transient. No significant difference in the prevalence of subclinical bacteriuria in young and middle-aged dogs versus senior and geriatric dogs was detected. No dogs with subclinical bacteriuria developed clinical signs requiring antimicrobial treatment during the 3-month observation period. Healthy female dogs with subclinical bacteriuria may be a population of dogs in which antimicrobial treatment is unnecessary.
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Affiliation(s)
- Stephanie Y Wan
- Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin, Madison, WI 53706
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Atencia S, Papakonstantinou S, Leggett B, McAllister H, Mooney CT. Systemic fungal infection in a dog: a unique case in Ireland. Ir Vet J 2014; 67:17. [PMID: 25132957 PMCID: PMC4134465 DOI: 10.1186/2046-0481-67-17] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2014] [Accepted: 07/21/2014] [Indexed: 11/29/2022] Open
Abstract
A three year old male entire Staffordshire bull terrier was referred to University College Dublin Veterinary Hospital, with a two week history of fever, inflammation of the right hock, lameness on the right hindlimb, peripheral lymphadenopathy and gastrointestinal signs (vomiting and diarrhoea). For the preceding three months the dog had been treated for atopic dermatitis with oral ciclosporin (5 mg/kg, PO, q 24 hours). Cytological analysis of the affected lymph nodes demonstrated fungal-like organisms predominantly contained within macrophages. Subsequent fungal culture and microscopic identification confirmed the presence of a Byssochlamys sp. This fungus is a saprophytic organism which has been associated with mycotoxin production. It has not previously been identified as a cause of systemic infection in animals or humans. Ciclosporin was discontinued, and a second generation triazole, voriconazole prescribed at a dose of 6 mg/kg for the first two doses, and continued at 3 mg/kg every 12 hours for six months. There was an excellent response. Follow-up examination five weeks after treatment was completed confirmed remission of the disease. The dog remains alive and well three years later. The present case represents an unusual fungal infection in a dog secondary to immunosuppressive therapy with ciclosporin. Such a possibility should be considered in animals presenting with signs consistent with systemic infection when receiving immunosuppressive medication.
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Affiliation(s)
- Sabela Atencia
- Department of Small Animal Clinical Studies, University Veterinary Hospital, University College Dublin, Belfield, Dublin Dublin 4, Ireland
| | - Stratos Papakonstantinou
- Biobest Laboratories Ltd. 6 Charles Darwin House, The Edinburgh Technopole, Milton Bridge, Nr Penicuik EH26 0PY, Scotland
| | - Bernadette Leggett
- Department of Microbiology, University Veterinary Hospital, University College Dublin, Belfield, Dublin Dublin 4, Ireland
| | - Hester McAllister
- Department of Diagnostic Imaging, University Veterinary Hospital, University College Dublin, Belfield, Dublin Dublin 4, Ireland
| | - Carmel T Mooney
- Department of Small Animal Clinical Studies, University Veterinary Hospital, University College Dublin, Belfield, Dublin Dublin 4, Ireland
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27
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Nuttall T, Reece D, Roberts E. Life-long diseases need life-long treatment: long-term safety of ciclosporin in canine atopic dermatitis. Vet Rec 2014; 174 Suppl 2:3-12. [PMID: 24682696 PMCID: PMC3995266 DOI: 10.1136/vr.102471] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Ciclosporin (Atopica; Novartis Animal Health) has been licensed for canine atopic dermatitis (AD) since 2002. Adverse events (AEs) have been reported in 55 per cent of 759 dogs in 15 clinical trials, but are rare in pharmacovigilance data (71.81 AEs/million capsules sold). Gastrointestinal reactions were most common, but were mild and rarely required intervention. Other AEs were rare (≤1 per cent in clinical trials; <10/million capsules sold). Hirsutism, gingival hyperplasia and hyperplastic dermatitis were rarely significant and resolved on dose reduction. Ciclosporin decreases staphylococcal and Malassezia infections in AD, and at the recommended dose is not a risk factor for other infections, neoplasia, renal failure or hypertension. The impact on glucose and calcium metabolism is not clinically significant for normal dogs. Concomitant treatment with most drugs is safe. Effects on cytochrome P450 and MDR1 P-glycoprotein activity may elevate plasma ciclosporin concentrations, but short-term changes are not clinically significant. Monitoring of complete blood counts, urinalysis or ciclosporin levels is not justified except with higher than recommended doses and/or long-term concurrent immunosuppressive drugs. Ciclosporin is not a contraindication for killed (including rabies) vaccines, but the licensed recommendation is that live vaccination is avoided during treatment. In conclusion, ciclosporin has a positive risk-benefit profile for the long-term management of canine AD.
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Affiliation(s)
- Tim Nuttall
- Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Easter Bush Campus, Roslin, UK
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Abstract
Cyclosporine is an immunomodulatory medication that is efficacious and approved for atopic dermatitis in dogs and allergic dermatitis in cats; it has also been used to successfully manage a variety of immune-mediated dermatoses in dogs and cats. This article reviews the use of cyclosporine in veterinary dermatology including its mechanism of action, pharmacokinetics, drug interactions, side effects, and relevant clinical updates. Dermatologic indications including atopic/allergic dermatitis, perianal fistulas, sebaceous adenitis, and other immune-mediated skin diseases are discussed.
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