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Leisewitz AL, Mrljak V, Dear JD, Birkenheuer A. The Diverse Pathogenicity of Various Babesia Parasite Species That Infect Dogs. Pathogens 2023; 12:1437. [PMID: 38133320 PMCID: PMC10746086 DOI: 10.3390/pathogens12121437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 11/30/2023] [Accepted: 12/05/2023] [Indexed: 12/23/2023] Open
Abstract
Babesia species infect a very wide range of mammal hosts across the globe, and zoonotic infections are of growing concern. Several species of the Babesia genus infect dogs, and some of these cause significant morbidity and mortality. The Apicomplexan parasite resides within the red cell and infections result in direct damage to the host through intra- and extravascular hemolysis. An exuberant inflammatory response by the host to some species of Babesia parasites also results in significant collateral damage to the host. Canine infections have been the subject of many studies as the well-being of these companion animals is increasingly threatened by the spread of tick vectors and an increasingly mobile dog population. There are currently no widely available and effective vaccines, and effective treatment can be challenging. Understanding disease pathogenesis underlies the development of new treatments. The varying pathogenicity of the various Babesia parasite species that infect dogs offers an opportunity to explore the molecular basis for the wide range of diseases caused by infection with this parasite genus. In this review, we focus on what has been reported about the clinical presentation of Babesia-infected dogs in an attempt to compare the severity of disease caused by different Babesia species.
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Affiliation(s)
- Andrew L. Leisewitz
- Companion Animal Clinical Studies, Faculty of Veterinary Science, University of Pretoria, Pretoria 0110, South Africa
- Department of Clinical Sciences, College of Veterinary Medicine, Auburn University, Auburn, AL 36849, USA
| | - Vladimir Mrljak
- Clinic for Internal Diseases, Faculty of Veterinary Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Jonathan D. Dear
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, CA 95616, USA
| | - Adam Birkenheuer
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC 27607, USA
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Matula E, Mastrocco A, Prittie J, Weltman J, Keyserling C. Microorganism colonization of peripheral venous catheters in a small animal clinical setting. J Vet Emerg Crit Care (San Antonio) 2023; 33:509-519. [PMID: 37585353 DOI: 10.1111/vec.13328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 06/16/2022] [Accepted: 06/30/2022] [Indexed: 08/18/2023]
Abstract
OBJECTIVE To compare the incidence of microorganism colonization of peripheral venous catheters (PVCs) placed in the Emergency Department (ED) to those placed in a routine preoperative setting. The relationship between catheter tip colonization and patient urgency (as assessed by triage priority) was also evaluated. DESIGN Prospective, observational study from January 2021 to October 2021. SETTING Emergency room and clinical areas of a large, urban, tertiary referral center. ANIMALS Three hundred dogs and 94 cats with a PVC in place for a minimum of 24 hours were enrolled in the study. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS Two hundred and eighty-eight PVCs were placed in the ED and 106 were placed preoperatively. The overall colonization rate was 10.4% (41/394). Sixteen bacterial and 1 fungal genera were cultured. Eight of these bacterial genera (25/51 [49%] bacterial isolates) were resistant to at least 1 antimicrobial class. Twenty-nine of 288 (10.1%) catheters positive for colonization were placed in the ED, whereas 12 of 106 (11.3%) were placed preoperatively. There was no association between microorganism growth on catheters and clinical area of catheter placement. There was also no association between ED patient urgency and positive catheter tip culture. No significant risk factors were identified predisposing to colonization of PVCs. CONCLUSIONS The overall incidence of microorganism colonization of PVCs in this study population was equivalent to, or lower than, previously reported in veterinary literature. There was no statistical difference between the catheters placed in the ED and those placed for routine surgical procedures. Patient urgency did not affect the incidence of positivity of peripheral catheter tip cultures.
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Affiliation(s)
- Erica Matula
- Emergency and Critical Care, The Animal Medical Center, New York, New York, USA
| | - Alicia Mastrocco
- Emergency and Critical Care, The Animal Medical Center, New York, New York, USA
| | - Jennifer Prittie
- Emergency and Critical Care, The Animal Medical Center, New York, New York, USA
| | - Joel Weltman
- Emergency and Critical Care, The Animal Medical Center, New York, New York, USA
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Fitzgerald WR, Cave NJ, Yozova ID. Clinical parameters at time of admission as prognostic indicators in cats presented for trauma to an emergency centre in New Zealand: a retrospective analysis. J Feline Med Surg 2022; 24:1294-1300. [PMID: 36018375 PMCID: PMC10812375 DOI: 10.1177/1098612x221115674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVES The aims of this study were to describe the clinical features of cats presented for trauma in a first-opinion and referral teaching hospital in New Zealand, and to determine the relationship between those features and outcome. METHODS The electronic medical records of cats presented for trauma to the Massey University Pet Emergency Centre between September 2013 and January 2019 were examined, from which the signalment, clinical parameters and patient outcomes were extracted. Cases were assigned an Animal Trauma Triage (ATT) score and Modified Glasgow Coma Scale (MGCS) score. Variables were selected for inclusion in a logistic regression model to predict survival, and backward elimination was used to find the minimal significant model. RESULTS In total, 530 cats met the inclusion criteria. The cause of injury was not known in the majority of cases (38.0%). The most common location of injury was the hindlimbs/pelvis/tail (n = 247; 41%), and skin lacerations/abrasions were the most common specific injury. Multivariate analysis revealed altered mentation (odds ratio [OR] 0.31, P = 0.029), hypothermia (rectal temperature <37.8°C [<100.04°F]; OR 0.45, P = 0.015) and an ATT score ⩾5 (OR 0.13, P <0.001) to be statistically significantly associated with mortality. CONCLUSIONS AND RELEVANCE Altered mentation and hypothermia are easily measurable perfusion parameter abnormalities associated with mortality in cats presenting with trauma. The ATT score appears to be an accurate prognostic indicator in cats presenting with trauma in New Zealand. These results highlight the importance of incorporating a hands-on triage examination in each cat that presents as an emergency after trauma.
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Affiliation(s)
| | - Nick J Cave
- School of Veterinary Science-Ta¯wharau Ora, Massey University, Palmerston North, Manawatu, New Zealand
| | - Ivayla D Yozova
- School of Veterinary Science-Ta¯wharau Ora, Massey University, Palmerston North, Manawatu, New Zealand
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Weltman JG, Prittie JE. The influence of a fast-track service on case flow and client satisfaction in a high-volume veterinary emergency department. J Vet Emerg Crit Care (San Antonio) 2021; 31:608-618. [PMID: 34297884 DOI: 10.1111/vec.13073] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Revised: 09/20/2019] [Accepted: 11/13/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To assess the benefit of a fast-track service in the emergency department of a large, high-volume veterinary hospital. DESIGN Prospective, observational, clinical study. SETTING Emergency department of an urban, tertiary referral veterinary hospital. ANIMALS All animals presented to the emergency department between April 1 and April 30 in 2017 and 2018 were eligible for inclusion. Only patients seen on days in 2017 corresponding to those days of 2018 during which the fast-track service was available were studied. MEASUREMENT AND MAIN RESULTS Triage case logs were collected and reviewed for April 2017 (prefast-track) and 2018 (fast-track). The fast-track service was launched as a pilot program in April 2018 to provide expedited care to low acuity patients presented to the emergency department. The median number of daily emergency department cases did not differ between 2017 (45, range 26-64) and 2018 (47, range 38-64; P = 0.3). The median time from presentation until first discussion with a doctor for low acuity cases was lower in April 2017 (29 min, range 1-163) than in April 2018 (24 min, range 1-100; P < 0.001). This reduction in wait time was observed despite a 40% increase in low acuity case presentations in 2018. Wait times for high acuity patients did not differ between study periods. The number of cases that left without being seen was higher in April 2017 compared to April 2018 (77 and 45 cases, respectively P < 0.001). CONCLUSIONS Implementation of a fast-track service reduced wait time for low acuity cases without adversely impacting wait times for sicker patients and led to a reduction in clients leaving without being seen. By introducing the fast-track service in a large volume veterinary hospital, limited resources can be distributed to improve speed of care, case flow, and client satisfaction in the emergency department.
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Affiliation(s)
- Joel G Weltman
- Department of Emergency and Critical Care, Animal Medical Center, 510 E. 62 St, New York, New York, 10065, United States of America
| | - Jennifer E Prittie
- Department of Emergency and Critical Care, Animal Medical Center, 510 E. 62 St, New York, New York, 10065, United States of America
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Gori E, Pierini A, Bartolomeo E, Ceccherini G, Pasquini A, Marchetti V. Serum Total Thyroxine Evaluation in Critically Ill Feline Patients. Vet Sci 2021; 8:21. [PMID: 33514056 PMCID: PMC7911658 DOI: 10.3390/vetsci8020021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 12/28/2020] [Accepted: 01/21/2021] [Indexed: 11/20/2022] Open
Abstract
This retrospective case control study compared serum total thyroxine (tT4) concentrations in hospitalized critical cats (CCs) and non-hospitalized cats with non-thyroidal chronic diseases (chronic group, CG) and evaluated the relationship between the serum tT4 concentration of CCs and systemic inflammation (systemic inflammatory response syndrome (SIRS)), disease severity (Acute Patient Physiologic and Laboratory Evaluation (APPLEfast)), and prognosis. Cats with previously suspected or diagnosed thyroid disease were excluded. Serum tT4 was evaluated in surplus serum samples at the time of admission for CCs and CGs. The APPLEfast score of the CC group was calculated at admission. The systemic inflammatory response syndrome (SIRS) in CCs was determined using proposed criteria. Cats were divided into survivors and non-survivors according to the discharge outcome. Forty-nine cats were retrospectively included. Twenty-seven cats died during hospitalization. The CG group was composed of 37 cats. The CC group showed a significantly lower tT4 compared to the CG group (1.3 ± 0.7 vs. 2 ± 0.9; p < 0.0001). Among SIRS, APPLEfast, and tT4, only tT4 was associated with mortality (p = 0.04). The tT4 cut-off point for mortality was 1.65 μg/dL (sensitivity 81%, specificity 57%, odds ratio (OR) 5.6). Twenty-five cats (51%) had SIRS that was not associated with tT4. Non-thyroidal illness syndrome can occur in critically ill cats and the evaluation of tT4 in hospitalized cats could add prognostic information.
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Affiliation(s)
| | - Alessio Pierini
- Veterinary Teaching Hospital “Mario Modenato”, Department of Veterinary Sciences, University of Pisa, Via Livornese Lato monte, San Piero a Grado, 56122 Pisa, Italy; (E.G.); (E.B.); (G.C.); (A.P.); (V.M.)
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Lightfoot KL, Burford JH, England GCW, Bowen IM, Freeman SL. Mixed methods investigation of the use of telephone triage within UK veterinary practices for horses with abdominal pain: A Participatory action research study. PLoS One 2020; 15:e0238874. [PMID: 32966300 PMCID: PMC7510986 DOI: 10.1371/journal.pone.0238874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 08/25/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Telephone triage is an integral part of modern patient care systems in human medicine, and a key component of veterinary practice care systems. There is currently no published research on telephone triage within the veterinary profession. OBJECTIVE To investigate current approaches to telephone triage of horses with abdominal pain (colic) in veterinary practice and develop new resources to support decision-making. STUDY DESIGN Participatory action research using mixed-methods approach. METHODS An online survey assessed current approaches to telephone triage of horses with colic in UK veterinary practices. Structured group and individual interviews were conducted with four equine client care (reception) teams on their experiences around telephone triage of colic. Evidence-based resources, including an information pack, decision flow chart and recording form, were developed and implemented within the practices. Participant feedback was obtained through interviews six months after implementation of the resources. RESULTS There were 116 participants in the online survey. Management and client care staff (53/116) felt less confident giving owner advice (p<0.01) and recognising critical indicators (p = 0.03) compared to veterinary surgeons and nurses (63/116). Thirteen themes were identified in the survey relating to owner advice; exercise and owner safety were most frequently mentioned, but conflicting guidance was often given. Fourteen client care staff were interviewed. They were confident recognising colic during a telephone conversation with an owner and identified the most common signs of critical cases as sweating and recumbency. The new resources received positive feedback; the decision flow chart and information on critical indicators were identified as most useful. After resource implementation, there was an increase in confidence in recognising critical cases and giving owners advice. MAIN LIMITATIONS Limited sample population. CONCLUSIONS This study described existing approaches to telephone triage, identified variations in advice given, and worked with client care teams to develop new resources to aid decision-making.
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Affiliation(s)
- Katie L. Lightfoot
- School of Veterinary Medicine and Science, University of Nottingham, Loughborough, Leicestershire, United Kingdom
| | - John H. Burford
- School of Veterinary Medicine and Science, University of Nottingham, Loughborough, Leicestershire, United Kingdom
| | - Gary C. W. England
- School of Veterinary Medicine and Science, University of Nottingham, Loughborough, Leicestershire, United Kingdom
| | - I. Mark Bowen
- School of Veterinary Medicine and Science, University of Nottingham, Loughborough, Leicestershire, United Kingdom
| | - Sarah L. Freeman
- School of Veterinary Medicine and Science, University of Nottingham, Loughborough, Leicestershire, United Kingdom
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Williams JM, Jones D, Thornton C. Owners' perception of veterinary medical emergencies. Vet Rec 2017; 181:vetrec-2016-104050. [PMID: 28724641 DOI: 10.1136/vr.104050] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/13/2017] [Indexed: 11/04/2022]
Affiliation(s)
- J M Williams
- Department of Animal and Land Sciences, Hartpury University Centre, Hartpury College, Gloucester GL19 3BE, UK
| | - D Jones
- Department of Veterinary Nursing, Hartpury University Centre, Hartpury College, Gloucester GL19 3BE, UK
| | - C Thornton
- Department of Veterinary Nursing, Hartpury University Centre, Hartpury College, Gloucester GL19 3BE, UK
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Affiliation(s)
- Emma Donnelly
- Vets Now Referrals123‐145 North StreetGlasgowG3 7DAUK
| | - Daniel Lewis
- Vets Now Referrals123‐145 North StreetGlasgowG3 7DAUK
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Chan DL. Triage 2.0: re-evaluation of early patient assessment. J Vet Emerg Crit Care (San Antonio) 2013; 23:487-8. [PMID: 24016343 DOI: 10.1111/vec.12104] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Daniel L Chan
- Department of Clinical Science and Services, The Royal Veterinary College, University of London, United Kingdom
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