The MARS PETCARE BIOBANK protocol: establishing a longitudinal study of health and disease in dogs and cats.

BACKGROUND: The veterinary care of cats and dogs is increasingly embracing innovations first applied to human health, including an increased emphasis on preventative care and precision medicine. Large scale human population biobanks have advanced research in these areas; however, few have been established in veterinary medicine. The MARS PETCARE BIOBANK™ (MPB) is a prospective study that aims to build a longitudinal bank of biological samples, with paired medical and lifestyle data, from 20,000 initially healthy cats and dogs (10,000 / species), recruited through veterinary hospitals over a ten-year period. Here, we describe the MPB protocol and discuss its potential as a platform to increase understanding of why and how diseases develop and how to advance personalised veterinary healthcare. METHODS: At regular intervals, extensive diet, health and lifestyle information, electronic medical records, clinicopathology and activity data are collected, genotypes, whole genome sequences and faecal metagenomes analysed, and blood, plasma, serum, and faecal samples stored for future research. DISCUSSION: Proposed areas for research include the early detection and progression of age-related disease, risk factors for common conditions, the influence of the microbiome on health and disease and, through genome wide association studies, the identification of candidate loci for disease associated genetic variants. Genomic data will be open access and research proposals for access to data and samples will be considered. Over the coming years, the MPB will provide the longitudinal data and systematically collected biological samples required to generate important insights into companion animal health, identifying biomarkers of disease, supporting earlier identification of risk, and enabling individually tailored interventions to manage disease.

Estimation of defined daily doses of antimicrobials for dogs and cats treated for bacterial cystitis.

Objective: To calculate prescribed daily doses (PDDs) for selected antimicrobials and evaluate application of defined daily doses (DDDs) using an antimicrobial purchasing dataset. Animals: Data from dogs and cats treated for bacterial cystitis at a veterinary practice network were evaluated. Procedure: A dataset containing antimicrobial prescriptions for dogs and cats diagnosed with bacterial cystitis was evaluated. Median dose and frequency and median weight of treated animals were used to calculate PDDs. To account for differences in use between dogs and cats, an adjusted DDD was calculated based on adjustment for proportional use in dogs versus cats. Results: PDDs for dogs and cats were determined and adjusted DDDs were calculated and applied to an antimicrobial purchasing dataset from 886 veterinary clinics, demonstrating the difference between mass-based and DDD data. Conclusions: DDDs can be estimated using prescription datasets, accounting for differences in weights (between and within species) and relative use between dogs and cats. These can be applied to broader (sales, purchase) datasets to provide a more detailed understanding of how antimicrobials are used. Clinical relevance: DDDs could be a useful measure for assessing mass-based antimicrobial use datasets as part of antimicrobial stewardship surveillance efforts.

Objectif: Calculer les doses quotidiennes prescrites (PDDs) pour certains antimicrobiens et évaluer l'application de doses quotidiennes définies (DDDs) à l'aide d'un ensemble de données d'achat d'antimicrobiens. Animaux: Les données de chiens et de chats traités pour une cystite bactérienne dans un réseau de pratiques vétérinaires ont été évaluées. Procédure: Un ensemble de données contenant des prescriptions d'antimicrobiens pour les chiens et les chats diagnostiqués avec une cystite bactérienne a été évalué. La dose et la fréquence médianes et le poids médian des animaux traités ont été utilisés pour calculer les PDDs. Pour tenir compte des différences d'utilisation entre les chiens et les chats, une DDD ajustée a été calculée sur la base d'un ajustement pour une utilisation proportionnelle chez les chiens par rapport aux chats. Résultats: Les PDDs pour les chiens et les chats ont été déterminées et les DDDs ajustées ont été calculés et appliqués à un ensemble de données d'achat d'antimicrobiens provenant de 886 cliniques vétérinaires, démontrant la différence entre les données basées sur la masse et les données DDD. Conclusions: Les DDD peuvent être estimées à l'aide d'ensembles de données de prescription, en tenant compte des différences de poids (entre et au sein des espèces) et de l'utilisation relative entre les chiens et les chats. Celles-ci peuvent être appliquées à des ensembles de données plus larges (ventes, achats) pour fournir une compréhension plus détaillée de la façon dont les antimicrobiens sont utilisés. Pertinence clinique: Les DDDs pourraient être une mesure utile pour évaluer les ensembles de données sur l'utilisation massive d'antimicrobiens dans le cadre des efforts de surveillance de la gestion des antimicrobiens.(Traduit par Dr Serge Messier).

Retrospective analysis of risk factors, clinical features, and prognostic indicators for urolithiasis in guinea pigs: 158 cases (2009-2019).

OBJECTIVE: To investigate risk factors, clinical features, and prognostic indicators in guinea pigs with urolithiasis. ANIMALS: 158 guinea pigs with urolithiasis. PROCEDURES: Medical records of an exotics animal specialty service were searched, identifying guinea pigs with urolithiasis. Signalment, clinical data, and outcomes were recorded. Variables of interest were analyzed for statistical associations with outcome. RESULTS: Overall, 54.4% (86/158) of animals survived to discharge. Median survival time was 177 days. Females (53.2%; 84/158) were more common than males (46.8%; 74/158). Males were presented younger (mean age, 3.64 years) than females (4.41 years). In 81 of 154 (52.5%) cases, animals were presented with primary urinary concerns, while 73 (47.5%) presented for nonurinary primary concerns. Females more commonly presented with distal urinary tract urolithiasis (63/84; 75%) but fared better overall with a longer median survival time (1,149 days) than males (59 days). Surgical intervention was not a risk factor for nonsurvival; however, increased age (> 4.1 years), male sex, anorexia, weight loss, and lower rectal temperature (< 37.2 °C) on presentation were associated with nonsurvival. Reoccurrence was noted in 13.9% (22/158) of cases, at an average of 284 days. CLINICAL RELEVANCE: Urolithiasis should always be considered a differential diagnosis for any unwell guinea pig. In particular, distal urinary tract urolithiasis should be considered in females. A poorer prognosis was associated with older, male guinea pigs, and those displaying anorexia, weight loss, and hypothermia. The need for surgical intervention should not confer a poorer outcome. Further studies are needed to determine specific risk factors and identify possible preventative measures.

Incidence and severity of short-term incisional complications after intraoperative local infiltration of liposomal bupivacaine in dogs.

OBJECTIVE: To report the incidence of short-term incisional complications in dogs receiving intraoperative local infiltration of liposomal bupivacaine. STUDY DESIGN: Retrospective study. ANIMALS: Client-owned dogs (n = 218). METHODS: Medical records were searched for dogs whose surgical site was infiltrated with liposomal bupivacaine. Records were reviewed for complications within 20 days postoperatively. Cases were categorized by: (1) surgical wound classification (clean, clean-contaminated, contaminated); (2) labeled versus off-label use in orthopedic surgery - stifle surgery to address cranial cruciate ligament (CCL) disease versus other orthopedic procedures; and (3) orthopedic versus soft-tissue surgery. RESULTS: Complications were documented in 43/218 (19.7%) records, including 27/218 (12.4%) complications that resolved spontaneously or with topical treatment. The incidence of short-term incisional complications did not differ between surgical wound classifications (P = 0.55) or between labeled versus off-label use in orthopedic surgery (P = 0.21). Complications seemed more common after soft-tissue procedures (32/123; 26.0%) than orthopedic procedures (11/95; 11.6%) (P < 0.01). CONCLUSION: Surgical wound classification or type of orthopedic procedure did not seem to influence incisional complications of infiltrated surgical sites. Complications were more common after soft-tissue procedures than orthopedic procedures. CLINICAL SIGNIFICANCE: Infiltration of surgical sites with liposomal bupivacaine seems safe in a broader range of orthopedic procedures than currently labeled. The results also justify further investigation in soft-tissue surgery.

Toceranib phosphate in the management of canine insulinoma: A retrospective multicentre study of 30 cases (2009-2019).

BACKGROUND: Insulinomas are the most common tumour of the endocrine pancreas in dogs. These malignant tumours have a high metastatic rate and limited chemotherapeutic options. The multi-receptor tyrosine kinase inhibitor sunitinib malate has benefit in the treatment of metastatic insulinoma in people. Toceranib phosphate, an analogous veterinary agent, may provide benefit for dogs. METHODS: A retrospective study describing the extent and duration of clinical outcomes and adverse events (AEs) in dogs diagnosed with insulinoma and receiving toceranib. RESULTS: Records for 30 dogs diagnosed with insulinoma and having received toceranib were identified from a medical record search of five university and eight referral hospitals. The median progression-free interval and overall survival time were 561 days (95% confidence interval (CI): [246, 727 days]) and 656 days (95% CI: [310, 1045 days]), respectively. Of the dogs for which the canine Response evaluation criteria for solid tumours tool could be applied, the majority (66.7%) showed either a complete response, partial response or stable disease. Time to clinical progression was associated with prior intervention and type of veterinary practice. Larger dogs were at increased risk for disease progression and death. No novel AEs were reported. CONCLUSIONS: Most dogs diagnosed with insulinoma and receiving toceranib appeared to have a clinical benefit. Randomised, prospective studies are needed to better elucidate and objectively quantify the potential effect and survival benefit of toceranib therapy for management of insulinoma in dogs.

Evaluation of bexagliflozin in cats with poorly regulated diabetes mellitus.

The aim of this study was to investigate the effect of bexagliflozin on glycemic control in poorly regulated diabetic cats and to evaluate for adverse events associated with this medication. Sodium-glucose cotransporter 2 inhibitors are a newer class of drugs used in the management of humans with type 2 diabetes mellitus. The objective of this study was to evaluate the effect of the orally administered drug, bexagliflozin in a group of poorly regulated diabetic cats over a 4-week study period. Five client-owned cats with poorly controlled diabetes mellitus receiving insulin therapy were enrolled. Bexagliflozin was administered once daily. Serum fructosamine, serum biochemistry profile, and 10-hour blood glucose curves were assessed at baseline (Day 0), Day 14, and Day 28. All cats had a significant reduction in insulin dose requirement (P = 0.015) and insulin was discontinued in 2 cats. There was a significant decrease in blood glucose concentration obtained from blood glucose concentration curves during the study period (P = 0.022). Serum fructosamine decreased in 4 of the 5 cats with a median decrease of 152 µmol/L (range: 103 to 241 µmol/L), which was not statistically significant (P = 0.117). No cats had any documented episodes of hypoglycemia. Adverse effects were mild. The addition of bexagliflozin significantly improved diabetic management in this group of cats.

Le but de cette étude était d'étudier l'effet de la bexagliflozine sur la maitrise de la glycémie chez les chats diabétiques mal régulés et d'évaluer les événements indésirables associés à ce médicament. Les inhibiteurs du cotransporteur sodium-glucose 2 sont une nouvelle classe de médicaments utilisés dans la prise en charge des personnes atteintes de diabète de type 2. L'objectif de cette étude était d'évaluer l'effet du médicament administré par voie orale, la bexagliflozine, dans un groupe de chats diabétiques mal régulés sur une période d'étude de 4 semaines. Cinq chats appartenant à des clients atteints de diabète sucré mal maitrisé et recevant une insulinothérapie ont été inclus. La bexagliflozine a été administrée une fois par jour. La fructosamine sérique, le profil biochimique sérique et les courbes de glycémie sur 10 heures ont été évalués au départ (jour 0), au jour 14 et au jour 28. Tous les chats ont présenté une réduction significative de la dose d'insuline requise (P = 0,015) et l'insuline a été interrompue chez deux chats. Il y avait une diminution significative de la concentration de glucose dans le sang obtenue à partir des courbes de concentration de glucose dans le sang au cours de la période d'étude (P = 0,022). La fructosamine sérique a diminué chez 4 des 5 chats avec une diminution médiane de 152 µmol/L (plage : 103 à 241 µmol/L), ce qui n'était pas statistiquement significatif (P = 0,117). Aucun chat n'a eu d'épisodes documentés d'hypoglycémie. Les effets indésirables étaient légers. L'ajout de bexagliflozine a considérablement amélioré la gestion du diabète dans ce groupe de chats.(Traduit par Docteur Serge Messier).

A multicenter study of antimicrobial prescriptions for cats diagnosed with bacterial urinary tract disease.

OBJECTIVES: The aim of this study was to evaluate initial antimicrobial therapy in cats diagnosed with upper or lower bacterial urinary tract infections at veterinary practices in the USA and Canada. METHODS: Electronic medical records from a veterinary practice corporation with clinics in the USA and Canada were queried between 2 January 2016 and 3 December 2018. Feline patient visits with a diagnosis field entry of urinary tract infection, cystitis and pyelonephritis, as well as variation of those names and more colloquial diagnoses such as kidney and bladder infection, and where an antimicrobial was prescribed, were retrieved. RESULTS: Prescription data for 5724 visits were identified. Sporadic cystitis was the most common diagnosis (n = 5051 [88%]), with 491 (8.6%) cats diagnosed with pyelonephritis and 182 (3.2%) with chronic or recurrent cystitis. Cefovecin was the most commonly prescribed antimicrobial for all conditions, followed by amoxicillin-clavulanic acid. Significant differences in antimicrobial drug class prescribing were noted between practice types and countries, and over the 3-year study period. For sporadic cystitis, prescription of amoxicillin-clavulanic acid increased significantly and cefovecin decreased between 2016 and 2018, and 2017 and 2018, while fluoroquinolone use increased between 2017 and 2018. CONCLUSIONS AND RELEVANCE: The results indicate targets for intervention and some encouraging trends. Understanding how antimicrobials are used is a key component of antimicrobial stewardship and is required to establish benchmarks, identify areas for improvement, aid in the development of interventions and evaluate the impact of interventions or other changes.

Low incidence of postoperative nausea, vomiting, regurgitation, and aspiration pneumonia in geriatric dogs receiving maropitant, famotidine, and fentanyl as part of an anesthesia protocol.

OBJECTIVE: To determine the incidence of and potential risk factors for postoperative regurgitation and vomiting (PORV), postoperative nausea and vomiting (PONV), and aspiration pneumonia in geriatric dogs using premedication with maropitant and famotidine, intraoperative fentanyl, and postoperative fentanyl as part of an anesthetic protocol. ANIMALS: 105 client-owned geriatric dogs that underwent general anesthesia for a major surgical procedure between January 2019 and March 2020. PROCEDURES: Medical records were reviewed to collect data on signalment, historical gastrointestinal signs, American Society of Anesthesiologists (ASA) score, indication for surgery, duration of anesthesia and surgery, patient position during surgery, mode of ventilation, and perioperative administration of maropitant, famotidine, anticholinergics, opioids, colloidal support, NSAID, corticosteroids, and appetite stimulants. The incidence of postoperative regurgitation, vomiting, nausea, and aspiration pneumonia was calculated, and variables were each analyzed for their association with these outcomes. RESULTS: 2 of 105 (1.9%) dogs regurgitated, 1 of 105 (1.0%) dogs developed aspiration pneumonia, 4 of 105 (3.8%) dogs exhibited nausea, and no dogs vomited. Identified possible risk factors included older age (≥ 13 years old) for postoperative regurgitation, regurgitation for postoperative aspiration pneumonia, and high ASA score (≥ 4) for both regurgitation and aspiration pneumonia. CONCLUSIONS AND CLINICAL RELEVANCE: The use of an antiemetic protocol including maropitant, famotidine, and fentanyl in geriatric dogs resulted in very low incidences of PORV, PONV, and aspiration pneumonia. Future prospective studies are warranted to further evaluate and mitigate postoperative risks.

Retrospective comparison of three antivenoms for the treatment of dogs with crotalid envenomation.

OBJECTIVE: To retrospectively compare clinical outcomes associated with 3 commercially available antivenom products (2 F[ab']2 products and 1 IgG product) in dogs with crotalid envenomation. ANIMALS: 282 dogs with evidence of crotalid envenomation treated with antivenom at a single high-volume private emergency facility in southwestern Arizona from 2014 to 2018. PROCEDURES: Data were collected on all dogs regarding signalment, coagulation test results, snakebite characteristics, type and number of units of antivenom received (1 of 3 products), survival to hospital discharge (yes or no), and complications following discharge. Survival rates and other variables were compared among antivenoms by means of bivariable analyses. RESULTS: 271 of 282 (96.1%) dogs survived to discharge; 11 (3.9%) were euthanized or died in the hospital. No significant difference in survival rates was found among the 3 antivenom products. Infusion reaction rates were higher for the IgG product than for each F(ab')2 product. A higher percentage of dogs treated with the IgG product (vs either F[ab']2 product) received only 1 unit of antivenom. Variables associated with a lower probability of survival included older age and lower body weight, thoracic (vs other) location of snakebites, and presence of an antivenom infusion reaction. CONCLUSIONS AND CLINICAL RELEVANCE: Given that survival rates were high for all 3 antivenom products, clinicians may consider other factors when selecting an antivenom, such as preference for a fractionated versus whole immunoglobulin product, risk of infusion reaction, cost, shelf life, availability, ease of use and administration, species of crotalids used for antivenom production, approval by federal regulatory bodies, and clinical preference.

Evaluation of antimicrobial prescriptions in dogs with suspected bacterial urinary tract disease.

BACKGROUND: Antimicrobials are commonly used to treat urinary tract disease in dogs. Understanding antimicrobial use is a critical component of antimicrobial stewardship efforts. HYPOTHESIS/OBJECTIVES: To evaluate antimicrobial prescriptions for dogs diagnosed with acute cystitis, recurrent cystitis, and pyelonephritis. ANIMALS: Dogs prescribed antimicrobials for urinary tract disease at veterinary practices in the United States and Canada. MATERIALS AND METHODS: A retrospective review of antimicrobial prescriptions was performed. RESULTS: The main clinical concerns were sporadic bacterial cystitis (n = 6582), recurrent cystitis (n = 428), and pyelonephritis (n = 326). Amoxicillin/clavulanic acid (2702, 41%), cefpodoxime (1024, 16%), and amoxicillin (874, 13%) were most commonly prescribed for sporadic bacterial cystitis. The median prescribed duration was 12 days (range, 3-60 days; interquartile range [IQR], 4 days). Shorter durations were used in 2018 (median, 10 days; IQR, 4 days) compared to both 2016 and 2017 (both median, 14 days; IQR, 4 days; P ≤ .0002). Amoxicillin/clavulanic acid (146, 33%), marbofloxacin (95, 21%), and cefpodoxime (65, 14%) were most commonly used for recurrent cystitis; median duration of 14 days (range, 3-77 days; IQR, 10.5 days). Amoxicillin/clavulanic acid (86, 26%), marbofloxacin (56, 17%), and enrofloxacin (36, 11%) were most commonly prescribed for pyelonephritis; however, 93 (29%) dogs received drug combinations. The median duration of treatment was 14 days (range, 3-77 days; IQR, 11 days). CONCLUSIONS AND CLINICAL IMPORTANCE: Decreases in duration and increased use of recommended first-line antimicrobials were encouraging. Common drug choices and durations should still be targets for antimicrobial stewardship programs that aim to optimize antimicrobial use, concurrently maximizing patient benefits while minimizing antimicrobial use and use of higher tier antimicrobials.

Survival time of juvenile dogs with oral squamous cell carcinoma treated with surgery alone: A Veterinary Society of Surgical Oncology retrospective study.

OBJECTIVE: To report the signalment, staging, surgical treatment, and survival time of juvenile dogs treated surgically for oral squamous cell carcinoma (OSCC). STUDY DESIGN: Retrospective study. ANIMALS OR SAMPLE POPULATION: Twenty-five dogs, <2 years of age with OSCC treated with surgery. METHODS: Cases were solicited from the Veterinary Society of Surgical Oncology. Data retrieved included sex, breed, age, weight, clinical signs, tumor location, preoperative diagnostics and staging, histopathological diagnosis with margin evaluation, disease-free interval, and date and cause of death. A minimum follow-up time of 3 months was required for inclusion. RESULTS: Eighteen dogs were <12 months of age, and seven were <24 months. Various breeds were represented, with a mean body weight of 22.3 ± 14.4 kg. No dogs had evidence of metastatic disease prior to surgery. All dogs underwent partial maxillectomy or mandibulectomy. Histological margins were complete in 24 dogs and incomplete in one. No dogs had evidence of metastatic disease or tumor recurrence. The median follow-up time was 1556 days (92 to 4234 days). All dogs were alive at the last follow-up except for one documented death, due to dilated cardiomyopathy. Median disease-specific survival time was not reached. CONCLUSION: The prognosis after wide surgical excision of OSCC in juvenile dogs was excellent. CLINICAL SIGNIFICANCE: OSCC in juvenile dogs can be effectively treated with surgery alone.