RESUMEN
OBJECTIVES: Cat Friendly Practices (CFPs) were compared with non-CFP control practices to determine whether CFPs had an increased proportion of clinical visits, number of visits per cat per year and inclusion of diagnostic testing. To measure diagnostic testing behavior, the numbers and types of tests analyzed and clinically relevant findings were compared. METHODS: In a retrospective analysis comparing CFPs and non-CFPs, clinic financial data and associated diagnostic tests from a commercial laboratory for 2018 and 2021 were analyzed. Data were stratified based on visit type and included revenue per visit type, revenue per patient, the number of visits per year and the proportion of visits that included diagnostic testing. Analyses of clinical findings for June 2021 to June 2022 examined clinical findings associated with biochemistry, complete blood count, urinalysis and thyroid testing categories at diagnostic patient visits, the proportion of clinical visits in which each finding was observed, the volume of testing categories as a proportion of clinical visits, and the proportion of diagnostic visits with one, two, three or four testing categories. RESULTS: The average revenue per feline visit and visits that included diagnostic testing were higher at CFPs. There was no difference in the proportion of wellness visits; however, CFPs had higher mean visits per year per patient. CFPs performed diagnostic testing at 12% more clinical visits, and had higher annual revenue per feline patient for all visits and for visits including diagnostic testing. CFPs had higher odds of patients having >1 visit that included bloodwork or urinalysis. They were more likely to include all four testing categories and less likely to include only one category at a diagnostic visit. CFPs identified a higher number of cats with clinical findings. CONCLUSIONS AND RELEVANCE: CFPs exhibited unique diagnostic testing behavior by performing more diagnostic tests more frequently and identifying a higher number of cats with abnormal findings.
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Enfermedades de los Gatos , Urinálisis , Gatos , Animales , Estudios Retrospectivos , Urinálisis/veterinaria , Enfermedades de los Gatos/diagnósticoRESUMEN
A validated second-generation SNAP 4Dx Plus (Idexx) incorporates new peptides for improved detection of antibodies against Anaplasma and Ehrlichia tick-borne pathogens in dogs. We compared the first- and second-generation SNAP 4Dx Plus using dogs naturally infected with Anaplasma or Ehrlichia species, or dogs seroreactive by an E. canis indirect fluorescent antibody test (IFAT). The second-generation immunoassay was more sensitive than the first-generation for dogs infected with A. phagocytophilum (51.1% and 29.2%, respectively), A. platys (63.6% and 35.3%, respectively), E. canis (96.2% and 88.3%, respectively), or E. ewingii (73.7% and 70.8%, respectively), and for dogs seroreactive by E. canis IFAT (87.3% and 83.9%, respectively). The second-generation immunoassay detected significantly more Anaplasma- or Ehrlichia-infected dogs that were Anaplasma (p < 0.001) or Ehrlichia (p = 0.031) seroreactive, respectively, than did the first-generation test. When Ehrlichia seroreactivity by E. canis IFAT and both immunoassays was compared, significantly more E. canis-infected dogs were seroreactive by E. canis IFAT than the first-generation (p = 0.006) but not the second-generation (p = 0.125) immunoassay. Significantly more E. ewingii-infected dogs were seroreactive by the first- (p = 0.011) and second-generation (p = 0.049) immunoassays than the E. canis IFAT. Medical records available for 7 dogs that were Anaplasma seroreactive by the second-generation but not the first-generation immunoassay revealed case management decisions that might have been different with an immediate anaplasmosis diagnosis, including earlier doxycycline therapy and less hospitalization. The second-generation SNAP 4Dx Plus test offered improved serologic detection of Anaplasma and Ehrlichia in naturally infected dogs.
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Anaplasmosis , Enfermedades de los Perros , Ehrlichiosis , Animales , Perros , Ehrlichia/genética , Anaplasma , Ehrlichiosis/diagnóstico , Ehrlichiosis/veterinaria , Sistemas de Atención de Punto , Anticuerpos Antibacterianos , Anaplasmosis/diagnóstico , Inmunoensayo/veterinaria , Reacción en Cadena de la Polimerasa/veterinaria , Enfermedades de los Perros/diagnóstico , Ehrlichia canisRESUMEN
BACKGROUND: Canine vector-borne disease (CVBD) has been an area of increasing interest in Europe over the last few decades, and there have been changes in the prevalence and distribution of many of these diseases. Monitoring CVBD infections in Europe is often done by individual countries, but aggregated data for the European countries are helpful to understand the distribution of CVBDs. METHODS: We used an extensive retrospective database of results from point-of-care rapid enzyme-linked immunosorbent assay (ELISA) tests on dogs across Europe to identify distribution and seropositivity in animals tested for selected CVBDs (Anaplasma spp., Ehrlichia spp., Borrelia burgdorferi, Leishmania spp., and Dirofilaria immitis) from 2016 through 2020. Geographic distribution of positive tests and relative percent positive values were mapped by the Nomenclature of Territorial Units for Statistics classification for regions with sufficient test results for reporting. RESULTS: A total of 404,617 samples corresponding to 1,134,648 canine results were available from dogs tested in 35 countries over the 5-year study period. Over this period the number of test results per year increased whereas test positivity decreased. Leishmania spp. had the largest increase in total test results from 25,000 results in 2016 to over 60,000 results in 2020. Test positivity for Leishmania spp. fell from 13.9% in 2016 to 9.4% in 2020. Test positivity fell for Anaplasma spp. (7.3 to 5.3%), Ehrlichia spp. (4.3 to 3.4%), and Borrelia burgdorferi (3.3 to 2.4%). Dirofilaria immitis test positivity trended down with a high of 2.7% in 2016 and low of 1.8% in 2018. Leishmania spp. test positivity was highest in endemic areas and in several non-endemic countries with low numbers of test results. Co-positivity rates were significantly higher than expected for all pathogen test positive pairs except for Ehrlichia spp. with Borrelia burgdorferi and D. immitis with Borrelia burgdorferi. CONCLUSIONS: This study represents the largest data set on CVBD seropositivity in Europe to date. The increase in the number of test results and decreasing test positivity over the study period may reflect changes in testing behavior and increased screening of healthy animals. The Europe-wide mapping of CVBD provides expected test positivity that can help inform veterinarians' decisions on screening and improve prevention and identification of these important, sometimes zoonotic, diseases.
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Anaplasmosis , Borrelia burgdorferi , Dirofilaria immitis , Dirofilariasis , Enfermedades de los Perros , Ehrlichiosis , Enfermedad de Lyme , Enfermedades Transmitidas por Vectores , Anaplasma , Anaplasmosis/epidemiología , Animales , Dirofilariasis/epidemiología , Enfermedades de los Perros/epidemiología , Perros , Ehrlichia , Ehrlichiosis/epidemiología , Ehrlichiosis/veterinaria , Enfermedad de Lyme/epidemiología , Enfermedad de Lyme/veterinaria , Estudios Retrospectivos , Estudios Seroepidemiológicos , ZoonosisRESUMEN
Ehrlichiosis is a common vector-borne disease caused by Ehrlichia spp. This retrospective matched cohort study was performed to determine if dogs with Ehrlichia spp. antibodies had an increased incidence of chronic kidney disease (CKD). Exposure to Ehrlichia spp. was defined as having an Ehrlichia spp. antibody-positive result recorded at any point in their available patient history. The outcome of CKD was defined as concurrent increased symmetric dimethylarginine (>14 µg/dL) and creatinine (>1.5 mg/dL) for a minimum of 25 days with inappropriate urine specific gravity (<1.030). Patients were matched using propensity score matching to control for age, geography, and breed. A total of 22,440 patients and controls in E canis-endemic regions of the United States were used in this analysis. Contingency tables were used to compare dogs with and without exposure to Ehrlichia spp.-infected ticks and CKD outcome. The relative risk of CKD for patients exposed to ticks carrying Ehrlichia spp. was found to be 2.12 (95% confidence interval [1.35-3.15], p < 0.0006). This study identified that testing positive for Ehrlichia spp. antibodies in E canis-endemic regions is associated with higher incidence of CKD in dogs.