[AntibioticScout.ch: A decision supporting tool for antimicrobial stewardship: application to companion animal medicine]. / AntibioticScout.ch: Eine Entscheidungshilfe für den umsichtigen Einsatz von antimikrobiellen Wirkstoffen: Anwendung in der Kleintiermedizin.

INTRODUCTION: Bacterial resistances to antimicrobial drugs pose serious public health challenges. The observed increase of resistances is attributed to the uncontrolled, massive and often unnecessary administration of antibiotics both in human and veterinary medicine. To support the responsible use of antimicrobials in animals and help veterinarians selecting the most suitable antimicrobial drugs, we developed the AntibioticScout.ch as a comprehensive decision supporting tool providing online access to the current knowledge of rational antibiotic prescription practices. User-friendly search functions allow for the fast and efficient retrieval of information that is structured in this database by animal species, organ systems and therapeutic indications. In addition, an online form allows to report treatment failures in order to identify problematic cases as well as ensuing risks and take appropriate mitigation measures. The present report describes the workflow of this decision support system applied to the prudent use of antimicrobials in companion animal medicine.

INTRODUCTION: Les résistances bactériennes face aux substances antimicrobiennes placent le système de santé face à de grands défis. L'augmentation des résistances est attribuée à une utilisation mal dirigée, massive et souvent inutile d'antibiotiques tant en médecine humaine qu'en médecine vétérinaire. Afin d'encourager une utilisation responsable des substances antimicrobiennes en médecine vétérinaire et pour soutenir les vétérinaires lors du choix de l'antibiotique adapté, on a créé, avec AntibioticScout. ch, une aide à la décision de grande envergure qui permet de recourir à chaque instant aux principes de prescription reconnus de la médecine fondée sur les faits (Evidence Based Medicine). La banque de données est structurée par espèces animales, systèmes d'organes et indications et un moteur de recherche intuitif garantit de trouver rapidement et efficacement les informations. D'autre part un formulaire en ligne pour l'annonce d'une inefficacité est proposé afin de reconnaitre les cas à problèmes et les risques en vue d'améliorer l'aide au diagnostic. La présente contribution pour but de démontrer l'utilisation d'AntibioticScout pour un usage prudent des antibiotiques en médecine des petits animaux.

[Digitization in Swiss veterinary practices]. / Stand der Digitalisierung in Schweizer Tierarztpraxen.

INTRODUCTION: Data on the digitization in Swiss veterinary practices and clinics were collected in a survey from June 2017 to the end of December 2017. Data of 171 practices contributed to the survey. Animal records were filed in 96.5% with a practice management program. Nine out of ten practices operate an x-ray machine whereof 70% digitally record the radiographs. While a moderate diversity of practice management systems is used, numerous different radiographic recording, archiving and viewing systems are utilized. Data exchange with other practices and owners preferably takes place via e-mail, followed by upload servers and digital data carriers. Data protection receives less attention in veterinary medicine than in comparison to human medicine. A protected data exchange platform coupled with AMICUS and ANIS is under construction via standardized DICOM (https://www.dicomstandard.org/current/) and HL7 (https://www.hl7.org/) interfaces.

INTRODUCTION: De juin 2017 à fin décembre 2017, des données relative à la digitalisation ont été collectées dans le cadre d'une enquête auprès de cabinets et cliniques vétérinaires suisses. Au total, 171 pratiques ont participé à l'enquête. 96,5% conservent les antécédents du patient avec un programme de gestion. Neuf cabinets sur dix utilisent un appareil à rayons X, dont 70% enregistrent numériquement les images. Bien que la variété des systèmes de gestion soit modérée, elle est riche en ce qui concerne l'enregistrement, l'archivage et la visualisation des images. L'échange de données avec d'autres pratiques et propriétaires se fait de préférence par courrier électronique, suivi de serveurs de téléchargement et de supports de données numériques. En comparaison avec la médecine humaine, la protection des données a beaucoup moins d'importance en médecine vétérinaire. Afin de pouvoir effectuer l'échange de données numériques de manière pratique, une plate-forme d'échange de données sécurisée couplée à AMICUS et à ANIS via DICOM normalisé (https://www.dicomstandard.org/current/) et HL7 (https://www.hl7.org/) est en construction.

A prospective study on canine atopic dermatitis and food-induced allergic dermatitis in Switzerland.

Canine atopic dermatitis sensu stricto and food-induced allergic dermatitis are common canine skin conditions, which are often considered clinically undistinguishable. Several attempts have been made to describe populations of atopic dogs and determine breed predisposition but the results were often biased by the use of hospital populations as control group. The present study aims to describe a population of Swiss atopic and food-allergic dogs and to compare it with a data set representing more than 85% of all Swiss dogs. The study, which was carried out during 1 year in several practices and teaching hospital in Switzerland, describes a group of 259 allergic dogs, determines breed predisposition for atopic dermatitis and food-induced allergic dermatitis, compares the clinical signs and features of both conditions, and outlines the clinical picture of five frequently affected breeds.

[Delta(9)-tetrahydrocannabinol and the opioid receptor agonist piritramide do not act synergistically in postoperative pain]. / Keine synergistische Wirkung der Kombination von Delta(9)-Tetrahydrocannabinol und Piritramid bei postoperativen Schmerzen.

BACKGROUND: It is concluded from animal experiments that cannabinoid receptor and mu-opioid receptor agonists act synergistically with respect to antinociception. In order to demonstrate this effect under clinical conditions, we conducted a randomized double blind trial with patients after radical prostatectomy. PATIENTS AND METHODS: From the evening before the operation until the morning of the second postoperative day, all patients received eight oral doses of either placebo or 5 mg Delta(9)-tetrahydrocannabinol (dronabinol). Postoperatively patients had access to patient-controlled analgesia with the micro-opioid agonist piritramide for 48 h. We expected patients receiving dronabinol to require significantly less piritramide compared to patients on placebo. RESULTS: The consumption of piritramide was recorded in 100 patients after radical retropubic prostatectomy with regional lymphadenectomy. Patients in the placebo group consumed 74 mg (median), interquartile range (IQR) 44-90 mg, patients in the verum group consumed 54 mg (median) IQR 46-88 mg. The difference between groups was not statistically significant. Plasma concentrations of Delta(9)-THC were measurable in all patients in the verum group. The levels (median) were 1.5 ng/ml (IQR 0.6-2.3), 1.3 ng/ml (IQR 0.5-2.2) and 1.9 ng/ml (IQR 0.8-2.7) on the day of operation, the first and second postoperative day, respectively. CONCLUSION: We found neither a synergistic nor even an additive antinociceptive interaction between Delta(9)-tetrahydrocannabinol and the micro-opioid agonist piritramide in a setting of acute postoperative pain.

Ultrasonography of the parathyroid glands as an aid in differentiation of acute and chronic renal failure in dogs.

OBJECTIVE: To evaluate whether determination of parathyroid gland size by use of ultrasonography is helpful in differentiating acute renal failure (ARF) from chronic renal failure (CRF) in dogs. DESIGN: Prospective study. ANIMALS: 20 dogs with renal failure in which serum creatinine concentration was at least 5 times the upper reference limit. Seven dogs had ARF, and 13 dogs had CRF. Twenty-three healthy dogs were used as controls. PROCEDURE: Dogs were positioned in dorsal recumbency for ultrasonographic examination of the ventral portion of the neck, A 10-MHz linear-array high-resolution transducer was used. The size of the parathyroid gland was determined by measuring the maximal length of the gland on the screen when it was imaged in longitudinal section. For comparison among groups, the longest linear dimension of any of the parathyroid glands of each dog was used. RESULTS: Size of the parathyroid glands in the control dogs varied from 2.0 to 4.6 mm (median, 3.3 mm). In the dogs with ARF, gland size ranged from 2.4 to 4.0 mm (median, 2.7), which was not significantly different from controls. In dogs with CRF, the glands were more distinctly demarcated from the surrounding thyroid tissue, than those of controls and dogs with ARF. Sizes ranged from 3.9 to 8.1 mm (median, 5.7 mm), which was significantly larger, compared with controls and dogs with ARF. CONCLUSIONS AND CLINICAL RELEVANCE: In dogs with severe azotemia, ultrasonographic examination of the parathyroid glands was helpful in differentiating ARF from CRF Size of the parathyroid glands appeared to be related to body weight.

Leeching as initial treatment in a cat with polycythaemia vera.

Polycythaemia vera was diagnosed in a three-year-old domestic shorthaired cat referred because of seizures and a high packed cell volume (PCV). Laboratory examination revealed severe erythrocytosis (PCV 79 per cent). Diagnosis was reached by excluding causes for relative and secondary absolute polycythaemia. As phlebotomy proved impossible for initial treatment due to hyperviscosity, four leeches were used to suck blood and the PCV was consequently reduced to 64 per cent. A further 24 hours later, when bleeding at the sites of sucking had stopped, the PCV was 56 per cent. Long-term management of the condition was achieved with hydroxyurea (100 mg/cat once daily) and intermittent phlebotomy. Initial treatment using leeches in cases of polycythaemia vera is a simple, non-invasive, well tolerated and effective method where phlebotomy is not possible.

Epidermal dysplasia and Malassezia infection in two West Highland White Terrier siblings: an inherited skin disorder or reaction to severe Malassezia infection?

Two 9-month-old West Highland White Terrier siblings were referred to our clinic with pruritus, alopecia and lichenification. Cytological examination of Scotch tape strippings revealed Malassezia organisms and cocci. Skin biopsy specimens showed epidermal dysplasia. Treatment included bathing with a 2% miconazole/chlorhexidine-containing shampoo, orally administered ketoconazole (5 mg kg-1, every 12 h) and cloxacillin (25 mg kg-1 every 8 h). Six weeks later, the dermal infection had resolved and there was hair regrowth. However, the dogs were still moderately pruritic. Intradermal allergy testing was positive for house dust mites, storage mites and Malassezia. Immunotherapy was initiated, and treatment with ketoconazole and cloxacillin was stopped. Skin biopsies, which were performed in both dogs 4 months after the first presentation, revealed mild superficial perivascular dermatitis. The remaining mild facial pruritus was easily controlled with topical treatment. These two cases indicate that epidermal dysplasia might be an inflammatory or hypersensitivity reaction to the Malassezia infection or a result of excessive self-trauma, rather than a congenital keratinization disorder.

Radiotherapy in three suspect cases of feline thymoma.

Radiation therapy for three cases of suspect feline thymoma is described. The thymoma was controlled for 4 years in case no. 1. Case no. 2 responded well to radiation therapy but was euthanized after 2 months because of a nasal adenocarcinoma. Case no. 3 continues to do well more than 8 months after radiotherapy. Difficulties in diagnosing feline thymomas are discussed, and biological behavior as well as different treatment modalities of feline and human thymomas are compared.

A modified biopsy technique to improve histopathological evaluation of avian skin.

Skin biopsies are a viable diagnostic tool in avian dermatology, however, the thinness of avian skin makes it difficult to prevent rolling and contraction of skin biopsy specimens during collection and fixation. The difficulty orienting such rolled samples during processing ultimately interferes with the establishment of a histopathological diagnosis. We describe a modified skin biopsy procedure for obtaining avian skin biopsy specimens. In this technique nontranslucent self-adhesive tape (Scotch tape) was attached to skin biopsy sites before obtaining skin biopsies using a standard skin biopsy punch instrument. A total of 23 skin biopsy specimens were obtained: 15 from nonfeathered skin of 12 normal Hispaniolan parrots, 3 from feathered skin of 2 normal birds and 5 from feathered skin of 3 psittacines presented for pathologic feather-picking. All 23 skin specimens consistently adhered to the tape during the biopsy procedure. The specimens were fixed in 10% neutral phosphate-buffered formalin. During processing, no curling or rolling of specimens occurred, and all specimens could be easily orientated for correct trimming and subsequent histopathological evaluation. The tape technique did not produce any appreciable artefacts. Remnants of the tape were microscopically evident above the stratum corneum assuring that none of the stratum corneum was lost during processing. Obtaining avian skin biopsy specimens using this modified tape technique is easy and ensures flat fixation of the skin biopsy specimens, which later allows trimming at right angles, and through the longitudinal diameter of feather follicles for accurate histopathologic evaluation.