Factors associated with clinical interpretation of tracheal wash fluid from dogs with respiratory disease: 281 cases (2012-2017).

BACKGROUND: Clinicians face several dilemmas regarding tracheal washes (TWs) for the diagnosis of respiratory disease, including method and prediction of bacterial growth from cytology results. OBJECTIVE: To compare cytology and culture of endotracheal and transtracheal washes and identify factors associated with discordancy and bacterial growth. ANIMALS: Two hundred forty-five dogs with respiratory disease. METHODS: Retrospective study. Tracheal wash submissions were included if cellularity was sufficient for cytologic interpretation and aerobic cultures were performed. Collection technique, cytology, bacterial growth, and antibiotic history were analyzed. RESULTS: Fewer transtracheal specimens (9/144, 6.3%) were excluded for hypocellularity than endotracheal (28/174, 16.1%); otherwise, results were similar and were combined. Of 281 specimens with cellularity sufficient for interpretation, 97 (34.5%) had bacteria on cytology and 191 (68.0%) had bacterial growth. Cytology positive/culture negative discordancy was uncommon (8/97, 8%). Cytology negative/culture positive discordancy was frequent (102/184, 55.4%), but occurred less often (28/184, 14.2%) when only 1+ growth or greater was considered positive. Oropharyngeal contamination was associated with bacterial growth, but not discordancy. No association was found between antibiotic administration and bacterial growth. CONCLUSIONS AND CLINICAL IMPORTANCE: Endotracheal wash fluid, in particular, should be screened for gross mucus or turbidity to maximize the likelihood of an adequate specimen. Otherwise, endotracheal and transtracheal specimens were similar. Presence of bacteria on cytology was a good predictor of any growth, while their absence was a good predictor of the absence of growth of 1+ or more. Recent antibiotic usage should not discourage TW culture if there is compelling reason to avoid delay.

Effect of a struvite dissolution diet in cats with naturally occurring struvite urolithiasis.

OBJECTIVES: The aim of the study was to determine the efficacy of the low struvite relative supersaturation diet in dissolution of feline struvite cystoliths. METHODS: This was a prospective, open-label, two-center study. Twelve client-owned cats were enrolled based on the radiographic appearance of their uroliths and urinalysis parameters. Cats were fed the test diet exclusively for up to 56 days. Cats were radiographed every other week until radiographic evidence of dissolution occurred or the end of the study period was reached. Cats with radiographically apparent uroliths at the end of the study period underwent cystotomy for stone retrieval and analysis. RESULTS: Nine of the 12 cats completed the study. Eight experienced radiographic dissolution; seven of these had complete dissolution within the first month of treatment. One cat, whose owner declined cystotomy after partial dissolution at day 56, had complete radiographic resolution at 70 days of treatment. Two calcium oxalate urolith cores were removed from a cat that had partial radiographic dissolution. CONCLUSIONS AND RELEVANCE: The test diet was successful in dissolving suspected struvite cystoliths. As this diet is suitable for maintenance feeding of adult cats, it may be a suitable choice for long-term prevention of feline struvite urolithiasis.

Reversible myelosuppression suspected to be secondary to linezolid in a cat with infected subcutaneous ureteral bypass systems.

CASE SUMMARY: A 5-year-old castrated male domestic shorthair cat was presented for a multidrug-resistant Enterococcus faecium urinary tract infection within its bilateral subcutaneous ureteral bypass systems. After considerable consultation, the cat was treated with oral linezolid (10 mg/kg q12h) for two separate 2-week courses over 5 weeks. Over this time period, the cat became progressively neutropenic and thrombocytopenic, but was otherwise clinically stable. Upon cessation of the linezolid, the bicytopenia resolved within 12 days. RELEVANCE AND NOVEL INFORMATION: The reversible myelosuppression in this case is suspected to be secondary to linezolid administration. While previously reported in people, this effect has not been reported at therapeutic doses in veterinary species. This report demonstrates the potential for adverse drug reaction development in cats treated with prolonged linezolid therapy and highlights the need for extreme caution when utilizing linezolid in patients with renal insufficiency. Linezolid is the only drug currently approved by the Food and Drug Administration to treat vancomycin-resistant enterococci infections in people; however, resistance to this antibiotic appears to be increasing. Multidrug-resistant organisms continue to be a real global public health threat in both human and veterinary medicine. Third-tier antibiotics should only be considered under extreme circumstances and after considerable consultation with a specialist. Please note that the authors of this manuscript followed American Veterinary Medical Association policies on stewardship and International Society for Companion Animal Infectious Diseases guidelines, and do not promote or encourage the use in daily practice.

Successful treatment of Corynebacterium urealyticum encrusting cystitis with systemic and intravesical antimicrobial therapy.

A 6-year-old Saint Bernard dog was diagnosed with encrusting cystitis caused by Corynebacterium urealyticum. The infection persisted despite the prolonged use of antimicrobials and surgical debridement of the urinary bladder. Resolution occurred following intravenous vancomycin, urine acidification, and intravesical gentamicin. The challenges involved in the treatment of encrusting cystitis are described.

Réussite du traitement d'une cystite incrustante àCorynebacterium urealyticumà l'aide d'une thérapie antimicrobienne systémique et intravésicale. Un chien Saint Bernard âgé de 6 ans a été diagnostiqué avec une cystite incrustante causée par Corynebacterium urealyticum. L'infection a persisté malgré l'usage prolongé d'antimicrobiens et du débridement chirurgical de la vessie urinaire. La résolution s'est produite après l'administration intraveineuse de vancomycine, l'acidification de l'urine et de la gentamicine intravésicale. Les difficultés entourant le traitement d'une cystite incrustante sont décrites.(Traduit par Isabelle Vallières).

Association between excess body weight and urine protein concentration in healthy dogs.

BACKGROUND: Markedly overweight people can develop progressive proteinuria and kidney failure secondary to obesity-related glomerulopathy (ORG). Glomerular lesions in dogs with experimentally induced obesity are similar to those in people with ORG. OBJECTIVES: The aim of this study was to evaluate if urine protein and albumin excretion is greater in overweight and obese dogs than in dogs of ideal body condition. METHODS: Client-owned dogs were screened for underlying health conditions. These dogs were assigned a body condition score (BCS) using a 9-point scoring system. Dogs with a BCS of ≥ 6 were classified as being overweight/obese, and dogs with a BCS of 4 or 5 were classified as being of ideal body weight. The urine protein:creatinine ratio (UPC) and urine albumin:creatinine ratio (UAC) were then determined, and compared between 20 overweight/obese dogs and 22 ideal body weight control dogs. RESULTS: Median UPC (0.04 [range, 0.01-0.14; interquartile range, 0.07]) and UAC (0.41 [0-10.39; 3.21]) of overweight/obese dogs were not significantly different from median UPC (0.04 [0.01-0.32; 0.07]) and UAC (0.18 [0-7.04; 1.75]) in ideal body weight dogs. CONCLUSIONS: Clinicopathologic abnormalities consistent with ORG were absent from overweight/obese dogs in this study.