Antibiotic Use in Dental Care of Dogs, Cats, and Rabbits in Sweden.

Antimicrobial resistance is one of the largest threats to global health. In society as well as in healthcare facilities, antimicrobial resistance is rapidly increasing with the main reason being overuse and misuse of antibiotics combined with inadequate infection prevention. For humans, dental care accounts for about 10% of all antibiotic prescriptions, making it an important target for antibiotic stewardship interventions. Corresponding figures for veterinary care are currently lacking but dental disease is frequently diagnosed in small animals. An important first step in the work towards prudent use of antibiotics is to understand antibiotic prescription habits and through that estimate the adherence to veterinary antibiotic guidelines as well as the need for education, training, and improved policies. The aim of this article is to present the results of a multicentre point prevalence survey sent to Swedish IVC Evidensia practices during autumn 2021 to recognize the use of antibiotics associated with dental treatments in dogs, cats, and rabbits. During the study period, 4.4% of the dental patients in Swedish IVC Evidensia small animal veterinary practices received antibiotics. The most used antibiotics prescribed were ampicillin, amoxicillin, and clindamycin indicating an overall high level of compliance to veterinary dental guidelines. This article demonstrates that Swedish veterinarians use antibiotics prudently in small animal dentistry and the results may be used as a future global benchmark.

A controlled study on gastrointestinal nematodes from two Swedish cattle farms showing field evidence of ivermectin resistance.

BACKGROUND: Anthelmintic resistance (AR) is an increasing problem for the ruminant livestock sector worldwide. However, the extent of the problem is still relatively unknown, especially for parasitic nematodes of cattle. The effect of ivermectin (IVM) (Ivomec inj.®, Merial) was investigated in Swedish isolates of gastrointestinal nematode (GIN) populations showing signs of AR in the field to further characterise the AR status by a range of in vivo and in vitro methods. METHODS: Three groups, each of 11 calves, were infected with an equal mixture of third stage larvae (L3) of Cooperia oncophora and Ostertagia ostertagi. Group A was inoculated with an IVM-susceptible laboratory isolate and groups B and C with isolates originating from 'resistant' cattle farms. Faecal egg counts (FEC) were monitored from 0 to 45 days post infection (d.p.i.), and L3 were harvested continuously for larval migration inhibition testing (LMIT) and species-specific PCR (ITS2). At 31 d.p.i., one calf from each group was necropsied and adult worms were recovered pre-treatment. At 35 d.p.i., calves from all groups were injected with IVM at the recommended dose (0.2 mg/kg bodyweight). At 45 d.p.i., another two animals from each group were sacrificed and established gastrointestinal worms were collected and counted. RESULTS: A few animals in all three groups were still excreting eggs (50-150 per g faeces) 10 days post IVM injection. However, there was no significant difference in the FEC reductions in groups A (95%; 95% CI 81-99), B (98%; 92-100) and C (99%; 97-100) between 35 and 44 d.p.i. Furthermore, LMIT showed no significant difference between the three groups. Approximately 100 adult O. ostertagi were found in the abomasum of one calf (group B), whereas low to moderate numbers (400-12 200) of C. oncophora remained in the small intestine of the calves in all three groups at 45 d.p.i. PCR on L3 harvested from faecal samples up to 10 days post treatment showed a ratio of 100% C. oncophora in the calves inoculated with isolates A and B, whereas C also had 8% O. ostertagi. CONCLUSIONS: Overall, this experiment showed that the animals were successfully treated according to the Faecal egg count reduction test (FECRT) standard (≥ 95% reduction). However, several adult worms of the dose-limiting species C. oncophora demonstrably survived the IVM treatment.

PGP expression in Cooperia oncophora before and after ivermectin selection.

The aim of this study was to investigate genetic selection and P-glycoprotein (PGP) expression in three different isolates of Cooperia oncophora before treatment and after ivermectin (IVM) injection. Adult parasites were recovered from nine calves experimentally infected with the isolates represented by one IVM susceptible laboratory isolate, and two field isolates showing signs of phenotypic macrocyclic lactone resilience according to the faecal egg count reduction test. Five males and five females per isolate were examined both pre- and post-IVM treatment giving a total of 60 worms. A sequence from C. oncophora (Con-pgp) was identified, showing 83% similarity to Pgp-9 of Caenorhabditis elegans. Primers specific to putative Con-pgp-9 mRNA were designed, generating a 153-bp PCR product. Total RNA was prepared from all worms, and Con-pgp-9 expression was measured by quantitative real-time reverse transcription PCR. Our results showed that mean PGP concentrations were four to five times higher in female as compared to male worms. No significant differences in gene expression between experimental groups pre- and post-IVM selection were detected. However, PGP gene expression tended to be increased by IVM treatment in male worms (p = 0.091), with 70% higher mean expression in treated than in untreated male worms. Amplified fragment length polymorphism analysis did not demonstrate any bottleneck effect within the different isolates post-treatment. The total mean gene diversity values were 0.158 and 0.153 before and after treatment, respectively. Inbreeding coefficient in subpopulations compared to total population F(ST) was 0.0112, suggesting no genetic differentiation between or within the investigated isolates in relation to treatment. In conclusion, comparison of Con-pgp-9 expression showed no significant difference before and after treatment, but some tendency towards increasing expression in male worms.

Limited efficacy of pour-on anthelmintic treatment of cattle under Swedish field conditions.

A study on the effect of topical macrocyclic lactones (ML) against gastrointestinal nematodes (GIN) in Swedish first season grazing cattle (FSG) was performed during the grazing seasons of 2009 and 2010. Herds were recruited through farming press and both dairy and beef cattle farms were invited. A questionnaire revealed that 64% of participating farmers dewormed their animals in previous years, and of these 76% used topical formulations with ML. Four to six weeks after turnout, 107 (2009) and 64 (2010) farmers sent in individual faecal samples from 6-10 FSG. Faecal egg counts (FEC) were determined by the FECPAK®-method in 2009 and the McMaster-method in 2010, when also larvae were cultured. Average FEC of ⩾100 eggs per gram faeces (EPG) was seen in 39% of the herds in 2009 and 42% in 2010 and with arithmetic means of 258 ± 110 and 252 ± 350 EPG, respectively. Interestingly, FSG in dairy and beef herds had similar mean FEC. In herds with mean FEC of ⩾100 EPG, farmers dewormed all FSG in the tested grazing group with ivermectin (IVM) or doramectin (DOR) pour-on. In 2009, 33 (31%), and in 2010, 26 (40%) of the herds were retested 7-16 days post treatment. Mean reduction was 89% and 88%, respectively, and in only 12 (36%) and 10 (38%) herds it was ⩾95%. Beef herds had mean reductions similar to those of the dairy herds. No significant difference (P = 0.66) in reduction was seen between the groups treated with three different pour-on formulations, nor was there any correlation between the previous year's usage of anthelmintics and the efficacy. Larvae from post-treatment cultures analysed in 2010 with a species-specific ITS2 qPCR showed that Cooperia oncophora was the predominant species after deworming. Four (15%) groups also harboured surviving Ostertagia ostertagi post treatment.

Dexamethasone treatment interferes with the pharmacokinetics of ivermectin in young cattle.

An experiment was carried out to study the possible interaction between dexamethasone (DXM) treatment and the efficacy of ivermectin (IVM) treatment in young cattle. Two groups, each of seven calves, were experimentally inoculated with an equal mixture containing 15,000 third stage larvae of Cooperia oncophora and Ostertagia ostertagi each, and with no history of being resistant to any anthelmintics. However, in this study C. oncophora was unexpectedly classified as IVM-resistant according to the outcome from the faecal egg count reduction test (FECRT). Blood parameters and faecal egg counts (FEC) were monitored from 0 to 35 days post infection (d.p.i.). The calves in one group received intramuscular injections of short and long-term acting DXM at 22 and 24 d.p.i., respectively. The other group remained as a control. Three days post patency (24 d.p.i.) both groups were injected subcutaneously with IVM (Merial) at the recommended dose (0.2mg/kg). A significant difference (p<0.001) in FEC patterns was observed between groups. Although both groups still excreted eggs (100-200 eggs per gram faeces) 11 days post anthelmintic treatment, the control group had a significantly higher reduction between 23 and 35 d.p.i. (p=0.025). After 35 days, four animals per group were euthanized, and worms in the gastrointestinal tract were counted. No O. ostertagi were found in the abomasums, but low to high numbers (800-6200) of C. oncophora remained in the small intestines in both groups. Overall, these findings indicated that there was an interaction between the efficacy of IVM and DXM treatment. As significantly lower plasma levels of IVM were observed in the DXM group, we conclude that the impaired efficacy of ivermectin was most likely due to the altered pharmacokinetics.