Clinical course and radiographic resolution of pneumonia in dogs treated with a shorter versus longer course of antimicrobials: a randomized, double-masked, placebo-controlled study.

OBJECTIVE: To describe clinical and radiographic outcomes in dogs with uncomplicated pneumonia receiving a shorter (2-week) versus longer (4-week) duration of antimicrobial therapy. ANIMALS: 30 client-owned dogs with radiographic evidence of pneumonia. METHODS: Dogs were randomly assigned to either a 2-week course of antimicrobials followed by a 2-week course of placebo medication (2-week group) or a 4-week course of antimicrobials (4-week group). All study investigators and owners were masked to the treatment group. Dogs were reevaluated at 12 ± 2 days and again at 28 ± 2 days for a physical examination and thoracic radiography. Standard documentation at visits included owner-reported clinical signs, nurse-acquired history, the clinician's physical examination, the number of affected lung lobe segments, and the global radiographic severity scores assigned. Outcomes investigated included the persistence of clinical and radiographic signs of pneumonia. RESULTS: 28 dogs (93.3%) experienced complete resolution of clinical signs by the first visit, and no dogs in either group experienced relapse of clinical signs during the study period. Eighteen of 30 dogs (60%) and 25 of 30 dogs (83%) experienced complete resolution of radiographic lesions at the first and second study visits, respectively. The remaining 5 dogs (17%) had either stable (4 dogs) or continued (1 dog) improvement in radiographic lesions. CLINICAL RELEVANCE: Resolution of clinical and radiographic signs followed similar courses in dogs with uncomplicated pneumonia receiving a 2-week course of antimicrobials compared to a 4-week course. Clinical signs may be more useful for guiding discontinuation of antimicrobial therapy for pneumonia than radiographic signs.

Clinical differences in enterococcal bacteriuria compared with other bacteriuria in cats.

OBJECTIVES: The clinical differences between Enterococcus species bacteriuria compared with other bacteria has been reported in a small number of cats. The objective of this study was to compare a large number of cats with Enterococcus species bacteriuria to cats with other bacteriuria and determine the clinical differences. It was hypothesized that enterococcal bacteriuria would be associated with subclinical bacteriuria and polymicrobial infections more than other bacteriuria, and that when local or systemic comorbidities were present, enterococcal bacteriuria would be more common. METHODS: This retrospective case-control study compared case cats with enterococcal bacteriuria to control cats with other bacteriuria. Cats with enterococcal bacteriuria were age, year and weight matched with 1-2 control cats with any other bacteriuria. RESULTS: Lower urinary tract clinical signs were statistically significantly more common in controls (n = 38/77 [49%]) compared with Enterococcus cases (n = 12/47 [25%]; P = 0.01). Specifically, control cats (n = 20/77 [26%]) were statistically significantly more likely to have gross hematuria compared with Enterococcus case cats (n = 3/47 [6%]; P = 0.01). Enterococcus cases were statistically significantly more likely to have a polymicrobial infection compared with controls (odds ratio 5.84, 95% confidence interval 1.33-34.70; P = 0.01). CONCLUSIONS AND RELEVANCE: Enterococcus species are associated with subclinical bacteriuria and polymicrobial urinary tract infections in cats vs other bacteriuria.

Fluoxetine-induced urinary retention in a cat.

Case summary: A 2-year-old neutered male domestic shorthair cat presented for a history of several weeks of infrequent urination and hyporexia progressing to anorexia. The cat had been normal prior to being placed on fluoxetine to treat inter-cat aggression, after which it began to display weight loss, hyporexia and abnormal urination habits. The cat had been seen by various veterinary hospitals previously and treated for suspected feline lower urinary tract disease. When the patient still had urinary retention despite perineal urethrostomy surgery, it was presented for ongoing care. Contrast urethrogram showed a mild questionable proximal ureteral narrowing, but other diagnostics were unremarkable. The patient was trialed on various medications, including alpha-antagonists, cholinergics, non-steroidal anti-inflammatory drugs and different analgesics with no improvement, but would reproducibly urinate only following administration of midazolam intravenously. Ultimately, the cat began urinating normally following the discontinuation of fluoxetine. The cat was urinating normally upon discharge, and when it presented for another complaint several months later, its weight, appetite and urination habits were normal. Relevance and novel information: Fluoxetine is a commonly utilized medication in behavioral medicine. Despite its common use and reports of urinary retention secondary to this medication in humans, this potential side effect is not reported in various veterinary pharmacologic textbooks or the veterinary literature. To our knowledge, this is the first report in veterinary medicine to describe urinary retention suspected to be secondary to prolonged administration of fluoxetine at an excessive dose.

Prevalence of naturally occurring non-AB blood type incompatibilities in cats and influence of crossmatch on transfusion outcomes.

BACKGROUND: Recognition of the feline red blood cell (RBC) antigen Mik and the presence of naturally occurring anti-Mik antibodies resulting in acute hemolytic transfusion reactions prompted the recommendation to perform a crossmatch before a cat's first RBC transfusion, but this guideline has not yet become a standard practice. OBJECTIVE: To determine the prevalence of naturally occurring non-AB alloantibodies detectable by tube crossmatch, and to compare transfusion outcomes in cats with and without a crossmatch performed. ANIMALS: Three hundred cats that received an RBC transfusion, with or without a major crossmatch performed. METHODS: Retrospective study. RESULTS: Major crossmatch incompatibilities were documented in 23 of 154 transfusion-naive cats (14.9%) and in 15 of 55 previously transfused cats (27%; P = 0.042). Type-specific packed RBCs (pRBCs) were administered to 167 and 82 cats with and without a crossmatch, respectively. Median volume of pRBCs administered during the first transfusion was 5.3 mL/kg (range, 2.4-18 mL/kg). Median change in PCV scaled to dose of pRBCs was +0.8%/mL/kg; administration of crossmatch-compatible pRBCs was not associated with a greater increase in PCV. Febrile transfusion reactions occurred more often in cats that received non-crossmatched (10.1%) compared to crossmatched (2.5%) pRBCs (P = 0.022). Seventy-six percent of cats that received pRBC transfusions survived to hospital discharge. A crossmatch was not associated with improved survival to discharge or at 30 or 60 days posttransfusion. CONCLUSIONS AND CLINICAL IMPORTANCE: The prevalence of naturally occurring non-AB incompatibilities is sufficiently high to justify the recommendation to perform a crossmatch before all (including the first) RBC transfusions in cats.