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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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Farrell S, Bagcigil AF, Chaintoutis SC, Firth C, Aydin FG, Hare C, Maaland M, Mateus A, Vale AP, Windahl U, Damborg P, Timofte D, Singleton D, Allerton F. A multinational survey of companion animal veterinary clinicians: How can antimicrobial stewardship guidelines be optimised for the target stakeholder? Vet J 2024; 303:106045. [PMID: 38000694 DOI: 10.1016/j.tvjl.2023.106045] [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: 06/29/2023] [Revised: 10/03/2023] [Accepted: 11/20/2023] [Indexed: 11/26/2023]
Abstract
Antimicrobial stewardship initiatives are widely regarded as a cornerstone for ameliorating the global health impact of antimicrobial resistance. Within companion animal health, such efforts have largely focused on development and dissemination of antimicrobial stewardship guidelines (ASGs). However, there have been few attempts to understand veterinarian attitudes towards and knowledge of ASGs or to determine how awareness regarding ASGs might best be increased. An online survey regarding ASGs was formulated for veterinarians who treat companion animals. The survey was distributed across 46 European and associated countries between 12 January and 30 June, 2022. In total, 2271 surveys were completed, with 64.9% of respondents (n = 1474) reporting awareness and usage of at least one ASG. Respondents from countries with greater awareness of ASGs tended to report more appropriate use of antimicrobials (Spearman's rank coefficient = 0.6084, P ≤ 0.001), with respondents from countries with country-specific ASGs tending to score highest across both awareness and appropriate use domains. Respondents prioritised guidance around antimicrobial choice (82.0%, n = 1863), duration of treatment (66.0%, n = 1499), and dosage (51.9%, n = 1179) for inclusion in future ASGs, with 78.0% (n = 1776) of respondents preferring ASGs to be integrated into their patient management system. Awareness of ASGs and their use in companion animal veterinary practice appears to be greater than previously reported, with respondents tending to report antimicrobial prescription decision making broadly in line with current clinical recommendations. However, further initiatives aimed at maximising accessibility to ASGs both within countries and individual veterinary practices are recommended.
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Affiliation(s)
- S Farrell
- Department of Computer Science, Durham University, Durham, UK
| | - A F Bagcigil
- Department of Microbiology, Faculty of Veterinary Medicine, Istanbul University-Cerrahpaşa, Istanbul, Turkey
| | - S C Chaintoutis
- Diagnostic Laboratory, Department of Clinical Sciences, School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 11 Stavrou Voutyra str., Thessaloniki, Greece
| | - C Firth
- Unit of Veterinary Public Health and Epidemiology, University of Veterinary Medicine, Veterinaerplatz 1, 1210 Vienna, Austria
| | - F G Aydin
- Ankara University, Faculty of Veterinary Medicine, Department of Pharmacology and Toxicology, 06070 Altindag/Ankara, Turkey
| | - C Hare
- Department of Veterinary Medicine, University of Cambridge, Madingley Road, Cambridge CB3 0ES, UK
| | - M Maaland
- Department of Production Animal Clinical Sciences, Norwegian University of Life Sciences, 4325 Sandnes, Norway
| | - A Mateus
- World Organisation for Animal Health, 12 Rue de Prony, 75017 Paris, France
| | - A P Vale
- School of Veterinary Medicine, University College Dublin, UCD Belfield, Dublin, Ireland
| | - U Windahl
- Swedish National Veterinary Institute, 75189 Uppsala, Sweden
| | - P Damborg
- Department of Veterinary and Animal Sciences, University of Copenhagen, Stigbøjlen 4, 1870 Frederiksberg, Denmark
| | - D Timofte
- Department of Veterinary Anatomy Physiology and Pathology, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Leahurst Campus, Neston CH64 7TE, UK
| | - D Singleton
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, UK
| | - F Allerton
- Willows Veterinary Centre and Referral Service, part of Linnaeus Veterinary Limited, Highlands Road, Shirley, Solihull B90 4NH, UK.
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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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Steagall PV, Pelligand L, Page S, Granick JL, Allerton F, Bęczkowski PM, Weese JS, Hrček AK, Queiroga F, Guardabassi L. The 2023 World Small Animal Veterinary Association (WSAVA): List of essential medicines for cats and dogs. J Small Anim Pract 2023; 64:731-748. [PMID: 37807906 DOI: 10.1111/jsap.13673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 09/07/2023] [Indexed: 10/10/2023]
Affiliation(s)
- P V Steagall
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, QC, Canada
- Department of Veterinary Clinical Sciences, Centre for Animal Health and Welfare, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Hong Kong, SAR, China
| | - L Pelligand
- The Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, AL9 7TA, UK
| | - S Page
- Advanced Veterinary Therapeutics, Newtown, NSW, Australia
- Honorary Associate, Sydney School of Veterinary Science, Faculty of Science, University of Sydney, Sydney, NSW, Australia
| | - J L Granick
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, Saint Paul, MN, USA
| | - F Allerton
- Willows Veterinary Centre & Referral Service, Highlands Road Shirley, Solihull, West Midlands, B90 4NH, UK
| | - P M Bęczkowski
- Department of Veterinary Clinical Sciences, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Hong Kong, SAR, China
| | - J S Weese
- Department of Pathobiology and Centre for Public Health and Zoonoses, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
| | | | - F Queiroga
- Animal and Veterinary Research Centre (CECAV), University of Trás-os-Montes and Alto Douro, Vila Real, Portugal
- Associate Laboratory for Animal and Veterinary Sciences (AL4AnimalS), University of Trás-os-Montes and Alto Douro, Vila Real, Portugal
- Center for the Study of Animal Sciences, CECA-ICETA, University of Porto, Porto, Portugal
| | - L Guardabassi
- Department of Veterinary and Animal Sciences, University of Copenhagen, Frederiksberg, Denmark
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Work M, Scudder C, Bergum Hjellegjerde K, Dunning M, Gajanayake I, Kent A, Tintle L, Sparks T, Allerton F. A survey on Shar Pei autoinflammatory disease in the United Kingdom. J Small Anim Pract 2023; 64:401-408. [PMID: 36978210 DOI: 10.1111/jsap.13602] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 11/03/2022] [Accepted: 01/16/2023] [Indexed: 03/30/2023]
Abstract
OBJECTIVES To characterise the fever episodes attributed to Shar Pei autoinflammatory disease and to identify common diagnostic and management strategies in the United Kingdom. A secondary objective was to determine risk factors associated with Shar Pei autoinflammatory disease fever episodes. METHODS A retrospective survey was performed to characterise episodes of Shar Pei autoinflammatory disease fever and to identify commonly used treatments in affected dogs. Clinical data were collected from owners and veterinarians. Frequencies of previously proposed risk factors (skin thickness and folding, muzzle conformation) and comorbid conditions were compared between dogs that had exhibited fever episodes consistent with Shar Pei autoinflammatory disease and those who had not. RESULTS At least one episode of fever attributed to Shar Pei autoinflammatory disease was reported in 52 of 106 (49%) Shar Pei. Nine other dogs had fever episodes consistent with Shar Pei autoinflammatory disease reported by their owners but not by veterinarians. Median rectal temperature at presentation for Shar Pei autoinflammatory disease fever was 40.1°C [104.2°F] (39.9 to 41.3°C [103.8 to 106.3°F]) and owners reported associated hyporexia (n=33, 63%) and vomiting (n=8, 15%) more frequently than veterinary records (n=22, 42% and n=0, 0%, respectively). The median number of veterinary appointments for Shar Pei autoinflammatory disease was two per dog (1 to 15) while owners reported a median of four episodes per dog per year. None of the assessed phenotypic variants or comorbidities were significantly associated with exhibiting Shar Pei autoinflammatory disease fever episodes. CLINICAL SIGNIFICANCE Episodes of Shar Pei autoinflammatory disease fever were reported approximately twice as frequently by owners compared to veterinary records, suggesting the burden of this condition may be underestimated by veterinarians. Specific risk factors for Shar Pei autoinflammatory disease fever were not identified.
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Affiliation(s)
- M Work
- Willows Veterinary Centre and Referral Service, Solihull, UK
| | - C Scudder
- Southfields Veterinary Specialists, Essex, UK
- Royal Veterinary College, Potters Bar, Hertfordshire, UK
| | | | - M Dunning
- Willows Veterinary Centre and Referral Service, Solihull, UK
| | - I Gajanayake
- Willows Veterinary Centre and Referral Service, Solihull, UK
| | - A Kent
- Willows Veterinary Centre and Referral Service, Solihull, UK
| | - L Tintle
- Wurtsboro Veterinary Clinic, Wurtsboro, New York, USA
| | - T Sparks
- Waltham Petcare Science Institute, Leicestershire, UK
| | - F Allerton
- Willows Veterinary Centre and Referral Service, Solihull, UK
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Ravicini S, Kent A, Dunning M, Baines S, Clarke S, Allerton F. Description and outcome of dogs with primary immune-mediated polyarthritis: 73 cases (2012-2017). J Small Anim Pract 2023; 64:142-148. [PMID: 36321528 DOI: 10.1111/jsap.13565] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 06/18/2022] [Accepted: 08/12/2022] [Indexed: 11/18/2022]
Abstract
OBJECTIVES To provide a description of primary idiopathic immune-mediated polyarthritis, including long-term outcome and relapse rates, for dogs starting treatment with corticosteroids alone or corticosteroids with a second immunosuppressant. MATERIALS AND METHODS Medical records were reviewed between January 2012 and December 2017 to identify dogs diagnosed with primary immune-mediated polyarthritis. Data including signalment, clinicopathological findings, type and duration of treatment, relapse and outcome were recorded. RESULTS Seventy-three dogs were included. Fifty-four dogs were started on corticosteroid monotherapy (an additional immunosuppressant was introduced later in 27/54 dogs) and 19 dogs were treated with multi-modal immunosuppression from the outset. Ninety-five percent (69/73) of dogs responded favourably to therapy although death was attributed to immune-mediated polyarthritis in 19% (14/73) of dogs. Relapse of clinical signs was reported in 53% (39/73) dogs (31/39 while on treatment), with multiple relapses observed in 17 dogs. Complete cure (permanent withdrawal of immunosuppressive medication) was achieved in 46 dogs (63%). Overall, 81% of dogs had a well-managed disease for an extended timeframe (≥1131 days). Fourteen of 19 (74%) dogs that started treatment with multi-modal immunosuppression and 32 of 54 (59%) started on corticosteroids alone achieved a complete cure. CLINICAL SIGNIFICANCE This study provides extended follow-up information for a large cohort of dogs with primary immune-mediated polyarthritis. Immunosuppressive therapy was discontinued in the majority of dogs but disease-associated mortality remains high.
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Affiliation(s)
- S Ravicini
- Washington State University, College of Veterinary Medicine, Pullman, WA, USA
| | - A Kent
- Willows Veterinary Centre and Referral Service, Solihull, West Midlands, UK
| | - M Dunning
- Willows Veterinary Centre and Referral Service, Solihull, West Midlands, UK.,School of Veterinary Medicine and Science, University of Nottingham, Nottingham, UK
| | - S Baines
- Willows Veterinary Centre and Referral Service, Solihull, West Midlands, UK
| | - S Clarke
- Willows Veterinary Centre and Referral Service, Solihull, West Midlands, UK
| | - F Allerton
- Willows Veterinary Centre and Referral Service, Solihull, West Midlands, UK
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Work M, Allerton F, Griffin S, Kent A. Percutaneous-endoscopic rendezvous cholangiography with biliary stent placement in a dog with extra-hepatic biliary duct obstruction. J Small Anim Pract 2021; 63:416-420. [PMID: 34658028 DOI: 10.1111/jsap.13442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 09/07/2021] [Accepted: 09/19/2021] [Indexed: 11/28/2022]
Abstract
A middle-aged male springer spaniel was presented for investigation of acute vomiting, lethargy and icterus. Marked distension of the gall bladder and common bile duct was evident at ultrasound due to obstruction by mineralised intraluminal material. After 48 hours of hospitalisation with intravenous fluid therapy, analgesia and antimicrobial therapy, intervention was deemed necessary to relieve the obstruction. A percutaneous-endoscopic rendezvous approach was used to achieve placement of a pigtail stent into the distal common bile duct, successfully relieving the obstruction. Serial biochemistry measurements postprocedure confirmed marked improvements in serum bilirubin. The patient remains clinically well 24 months postprocedure, and all hepatic enzyme activities have normalised. Based on the literature search performed, this is the first successful application of this technique in the management of canine extrahepatic biliary duct obstruction.
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Affiliation(s)
- M Work
- Willows Veterinary Centre and Referral Service, Highlands Road, Shirley, Solihull, B90 4NH, UK
| | - F Allerton
- Willows Veterinary Centre and Referral Service, Highlands Road, Shirley, Solihull, B90 4NH, UK
| | - S Griffin
- Willows Veterinary Centre and Referral Service, Highlands Road, Shirley, Solihull, B90 4NH, UK
| | - A Kent
- Willows Veterinary Centre and Referral Service, Highlands Road, Shirley, Solihull, B90 4NH, UK
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Barker L, Tivers MS, Kathrani A, Allerton F, Powell R, Stam L, Black V. Serological markers of gluten sensitivity in Border terriers with gall bladder mucocoeles. J Small Anim Pract 2020; 61:630-636. [PMID: 32845530 DOI: 10.1111/jsap.13211] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 06/17/2020] [Accepted: 07/03/2020] [Indexed: 12/12/2022]
Abstract
OBJECTIVES To evaluate serological markers of gluten sensitivity in conjunction with cholecystokinin measurement in Border terriers with gall bladder mucocoeles. MATERIALS AND METHODS Medical records from two referral hospitals were obtained between 2011 and 2019 to identify Border terriers with gall bladder mucocoeles, non-Border terriers with gall bladder mucocoeles and control Border terriers with non-biliary diseases. Enzyme-linked immunosorbent assays were performed on stored fasted serum samples for anti-gliadin IgG, anti-canine transglutaminase-2-IgA autoantibodies and cholecystokinin. Statistical analysis was performed using the Kruskall-Wallis test to identify differences between the groups. RESULTS Fifteen Border terriers with gall bladder mucocoeles, 17 non-Border terriers with gall bladder mucocoeles and 14 control Border terriers with non-biliary diseases were recruited. Median transglutaminase-2-IgA autoantibodies in Border terriers with gall bladder mucocoeles was 0.73 (range: 0.18 to 1.67), which was significantly greater than in control Border terriers at 0.41 (0.07 to 1.14). Median cholecystokinin concentration in Border terriers with gall bladder mucocoeles was 13 pg/mL (6 to 45 pg/mL), which was significantly lower than in control Border terriers at 103 pg/mL (9 to 397 pg/mL). There was no difference in the anti-gliadin IgG between these groups. There was no difference observed in the non-Border terriers with gall bladder mucocoeles with either of the other groups. CLINICAL SIGNIFICANCE Reduced cholecystokinin and increased transglutaminase-2-IgA autoantibodies was detected in Border terriers with gall bladder mucocoeles; which is in part homologous to gall bladder disease identified in human coeliac disease. The results suggest an immunological disease with impaired cholecystokinin release may be affecting gall bladder motility and possibly contributing to mucocoele formation in Border terriers.
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Affiliation(s)
- L Barker
- Bristol Veterinary School, University of Bristol, Langford, Bristol, BS40 5DU, UK
| | - M S Tivers
- Paragon Veterinary Referrals, Wakefield, WF1 2DF, UK
| | - A Kathrani
- Royal Veterinary College, Hertfordshire, AL9 7TA, UK
| | - F Allerton
- Willows Veterinary Referrals, Solihull, B90 4NH, UK
| | - R Powell
- SYNLAB-VPG, Manor Farm Business Park, Hertfordshire, SG5 3HR, UK
| | - L Stam
- SYNLAB-VPG, Manor Farm Business Park, Hertfordshire, SG5 3HR, UK
| | - V Black
- Bristol Veterinary School, University of Bristol, Langford, Bristol, BS40 5DU, UK
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Allerton F, Jeffery N. Prescription rebellion: reduction of antibiotic use by small animal veterinarians. J Small Anim Pract 2020; 61:148-155. [PMID: 31943224 DOI: 10.1111/jsap.13098] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Accepted: 11/20/2019] [Indexed: 01/25/2023]
Affiliation(s)
- F Allerton
- Willows Veterinary Centre and Referral Service, Highlands Road, Shirley, Solihull, West Midlands, B90 4NH, UK
| | - N Jeffery
- Department of Small Animal Clinical Sciences, Texas A&M University, 4474 TAMU, College Station, Texas, 77843, USA
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Girod M, Allerton F, Vangrinsven E, Tutunaru AC, de Marchin J, Gómez-Fernández-Blanco C, Ruiz-Nuño A, Wojnicz A, Farnir F, Gommeren K, Peeters D. CSF omeprazole concentration and albumin quotient following high dose intravenous omeprazole in dogs. Res Vet Sci 2019; 125:266-271. [PMID: 31326702 DOI: 10.1016/j.rvsc.2019.07.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 09/23/2018] [Revised: 06/09/2019] [Accepted: 07/10/2019] [Indexed: 10/26/2022]
Abstract
Clinical signs of syringomyelia and hydrocephalus occur secondary to cerebrospinal fluid (CSF) accumulation within the central nervous system. Omeprazole is recommended to treat these conditions despite little evidence of its capacity to decrease CSF production in the dog. Studies into new treatments are hampered by difficulties in measuring CSF production. The albumin quotient (QAlb), the ratio between CSF and serum albumin concentrations, may reflect CSF production and any decrease in CSF production should be associated with an increase in QAlb. The primary objective of this study was to determine CSF omeprazole concentration after administration of a high intravenous dose of omeprazole and to evaluate its impact on QAlb in the dog. The second aim was to validate QAlb as a surrogate marker of CSF production. Eighteen dogs were included in this prospective crossover placebo-controlled study. Each dog received omeprazole (10 mg/kg), acetazolamide (50 mg/kg) combined with furosemide (1 mg/kg) and saline. Blood and CSF samples were obtained on day 0 and then every 7 days, one hour after drug administration. Omeprazole concentrations (2.0 ± 0.4 μmol/L) reached in CSF after high dose omeprazole were lower than the concentrations previously described as decreasing CSF production in dogs. There was no significant increase in QAlb following administration of acetazolamide/furosemide, prohibiting validation of QAlb as a surrogate marker for CSF production. Several dogs presented transient mild side effects after injection of acetazolamide/furosemide. High dose omeprazole was well tolerated in all dogs.
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Affiliation(s)
- M Girod
- Department of Clinical Sciences, Faculty of Veterinary Medicine, University of Liège, Quartier Vallée 2, avenue de Cureghem 3, B44, 4000 Liège, Belgium.
| | - F Allerton
- Department of Clinical Sciences, Faculty of Veterinary Medicine, University of Liège, Quartier Vallée 2, avenue de Cureghem 3, B44, 4000 Liège, Belgium
| | - E Vangrinsven
- Department of Clinical Sciences, Faculty of Veterinary Medicine, University of Liège, Quartier Vallée 2, avenue de Cureghem 3, B44, 4000 Liège, Belgium
| | - A C Tutunaru
- Department of Clinical Sciences, Faculty of Veterinary Medicine, University of Liège, Quartier Vallée 2, avenue de Cureghem 3, B44, 4000 Liège, Belgium
| | - J de Marchin
- Labocit, Citadelle Hospital, Boulevard du 12ème de ligne, 1, 4000 Liège, Belgium
| | - C Gómez-Fernández-Blanco
- Department of Clinical Sciences, Faculty of Veterinary Medicine, University of Liège, Quartier Vallée 2, avenue de Cureghem 3, B44, 4000 Liège, Belgium
| | - A Ruiz-Nuño
- Servicio Farmacología Clínica, Hospital Universitario de la Princesa, planta 7ª, Diego de León, 62, 28006 Madrid, Spain
| | - A Wojnicz
- Servicio Farmacología Clínica, Hospital Universitario de la Princesa, planta 7ª, Diego de León, 62, 28006 Madrid, Spain
| | - F Farnir
- Department of Clinical Sciences, Faculty of Veterinary Medicine, University of Liège, Quartier Vallée 2, avenue de Cureghem 3, B44, 4000 Liège, Belgium
| | - K Gommeren
- Department of Clinical Sciences, Faculty of Veterinary Medicine, University of Liège, Quartier Vallée 2, avenue de Cureghem 3, B44, 4000 Liège, Belgium
| | - D Peeters
- Department of Clinical Sciences, Faculty of Veterinary Medicine, University of Liège, Quartier Vallée 2, avenue de Cureghem 3, B44, 4000 Liège, Belgium
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11
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Allerton F, Swinbourne F, Barker L, Black V, Kathrani A, Tivers M, Henriques T, Kisielewicz C, Dunning M, Kent A. Gall bladder mucoceles in Border terriers. J Vet Intern Med 2018; 32:1618-1628. [PMID: 30079451 PMCID: PMC6189338 DOI: 10.1111/jvim.15249] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Revised: 04/30/2018] [Accepted: 05/24/2018] [Indexed: 12/27/2022] Open
Abstract
Background Gall bladder mucoceles (GBM) are a leading cause of biliary disease in dogs with several breeds, including the Shetland Sheepdog, American Cocker Spaniel, Chihuahua, Pomeranian, and Miniature Schnauzer apparently predisposed. Objective To determine risk factors, clinical features, and response to treatment of GBM in Border terriers (BT). Animals Medical records of 99 dogs (including 51 BT) with an ultrasonographic (±histopathologic) diagnosis of GBM from three referral centers in the United Kingdom were collected. A control group of 87 similar‐aged BT with no ultrasonographic evidence of gall bladder disease was selected for comparison. Method Retrospective case‐control study. Odds ratios were calculated to establish breed predisposition. Signalment, presence of endocrine disease, clinicopathologic results, and outcome were compared between the BT, other breeds, and control BTs. Results The odds of identifying a GBM in a BT in this hospital population was 85 times that of all other breeds (95% confidence interval 56.9‐126.8). BT had similar clinical signs and clinicopathologic changes to other breeds with GBM. There was no evidence that endocrinopathies were associated with GBM in BT. Clinical Significance A robust breed predisposition to GBM is established for the BT.
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Affiliation(s)
- F Allerton
- Willows Veterinary Centre and Referral Service, Highlands Road, Shirley, Solihull, B90 4NH, The United Kingdom
| | - F Swinbourne
- Willows Veterinary Centre and Referral Service, Highlands Road, Shirley, Solihull, B90 4NH, The United Kingdom
| | - L Barker
- Bristol Veterinary School, University of Bristol, Langford, Bristol, BS40 5DU, The United Kingdom
| | - V Black
- Bristol Veterinary School, University of Bristol, Langford, Bristol, BS40 5DU, The United Kingdom
| | - A Kathrani
- Bristol Veterinary School, University of Bristol, Langford, Bristol, BS40 5DU, The United Kingdom
| | - M Tivers
- Bristol Veterinary School, University of Bristol, Langford, Bristol, BS40 5DU, The United Kingdom
| | - T Henriques
- Pride Veterinary Centre, Riverside Road, Derby, DE24 8HX, The United Kingdom
| | - C Kisielewicz
- Pride Veterinary Centre, Riverside Road, Derby, DE24 8HX, The United Kingdom
| | - M Dunning
- School of Veterinary Medicine and Science, University of Nottingham, Sutton Bonington, Leicestershire, The United Kingdom
| | - A Kent
- Willows Veterinary Centre and Referral Service, Highlands Road, Shirley, Solihull, B90 4NH, The United Kingdom
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12
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Girod M, Allerton F, Gommeren K, Tutunaru A, de Marchin J, Van Soens I, Ramery E, Peeters D. Evaluation of the effect of oral omeprazole on canine cerebrospinal fluid production: A pilot study. Vet J 2016; 209:119-24. [DOI: 10.1016/j.tvjl.2015.10.045] [Citation(s) in RCA: 10] [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] [Received: 10/24/2014] [Revised: 10/18/2015] [Accepted: 10/19/2015] [Indexed: 10/22/2022]
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