European multicenter study on antimicrobial resistance in bacteria isolated from companion animal urinary tract infections.

BACKGROUND: There is a growing concern regarding the increase of antimicrobial resistant bacteria in companion animals. Yet, there are no studies comparing the resistance levels of these organisms in European countries. The aim of this study was to investigate geographical and temporal trends of antimicrobial resistant bacteria causing urinary tract infection (UTI) in companion animals in Europe. The antimicrobial susceptibility of 22 256 bacteria isolated from dogs and cats with UTI was determined. Samples were collected between 2008 and 2013 from 16 laboratories of 14 European countries. The prevalence of antimicrobial resistance of the most common bacteria was determined for each country individually in the years 2012-2013 and temporal trends of bacteria resistance were established by logistic regression. RESULTS: The aetiology of uropathogenic bacteria differed between dogs and cats. For all bacterial species, Southern countries generally presented higher levels of antimicrobial resistance compared to Northern countries. Multidrug-resistant Escherichia coli were found to be more prevalent in Southern countries. During the study period, the level of fluoroquinolone-resistant E. coli isolated in Belgium, Denmark, France and the Netherlands decreased significantly. A temporal increase in resistance to amoxicillin-clavulanate and gentamicin was observed among E. coli isolates from the Netherlands and Switzerland, respectively. Other country-specific temporal increases were observed for fluoroquinolone-resistant Proteus spp. isolated from companion animals from Belgium. CONCLUSIONS: This work brings new insights into the current status of antimicrobial resistance in bacteria isolated from companion animals with UTI in Europe and reinforces the need for strategies aiming to reduce resistance.

Short Treatment of 42 Days with Oral GS-441524 Results in Equal Efficacy as the Recommended 84-Day Treatment in Cats Suffering from Feline Infectious Peritonitis with Effusion-A Prospective Randomized Controlled Study.

In the past, feline infectious peritonitis (FIP) caused by feline coronavirus (FCoV) was considered fatal. Today, highly efficient drugs, such as GS-441524, can lead to complete remission. The currently recommended treatment duration in the veterinary literature is 84 days. This prospective randomized controlled treatment study aimed to evaluate whether a shorter treatment duration of 42 days with oral GS-441524 obtained from a licensed pharmacy is equally effective compared to the 84-day regimen. Forty cats with FIP with effusion were prospectively included and randomized to receive 15 mg/kg of GS-441524 orally every 24h (q24h), for either 42 or 84 days. Cats were followed for 168 days after treatment initiation. With the exception of two cats that died during the treatment, 38 cats (19 in short, 19 in long treatment group) recovered with rapid improvement of clinical and laboratory parameters as well as a remarkable reduction in viral loads in blood and effusion. Orally administered GS-441524 given as a short treatment was highly effective in curing FIP without causing serious adverse effects. All cats that completed the short treatment course successfully were still in complete remission on day 168. Therefore, a shorter treatment duration of 42 days GS-441524 15 mg/kg can be considered equally effective.

[Urinalysis in dogs and cats, part 1: physical and chemical urinalysis]. / Die Urinuntersuchung bei Hund und Katze, Teil 1: Physikalische und chemische Urinuntersuchung.

The urinalysis of dogs and cats is an important part of the diagnostic evaluation of urinary tract diseases as well as for the identification of systemic diseases. A routine urinalysis consists of a physical and chemical examination of the urine as well as an examination of the urine sediment. Various urine collection methods (free-catch, catheterization, cystocentesis) are available. Each method has multiple advantages and disadvantages. The appropriate method must be chosen individually for each patient depending on the emphasis of the examination. The urine should ideally be examined within 30 minutes of collection as it is prone to change due to time and storage. Physical examination of the urine consists of the determination of urine color, clarity, and specific gravity which provides information regarding the concentration of the urine. The latter is determined by refractometry and needs to be interpreted in the context of the hydration status of the patient. Chemical examination of the urine consists of the determination of the pH value and the presence of blood/hemoglobin/myoglobin, protein, glucose, bilirubin, urobilinogen, nitrite, and ketones. The use of commercially available urine dipsticks is common. These must be stored and used according to the manufacturer's instructions and when interpreting the results, veterinary aspects need to be taken into consideration. The physical and chemical examinations of the urine represent rapid and readily performable methods that provide important information for the diagnosis or the exclusion of numerous diseases.

[Urinalysis in dogs and cats, part 2: Urine sediment analysis]. / Die Urinuntersuchung bei Hund und Katze, Teil 2: Urinsedimentanalyse.

Examination of the urine sediment is part of a routine urinalysis and is undertaken in order to identify insoluble particles in the urine. This procedure is mainly used in the context of diagnostic evaluation of urinary tract diseases, but may also be useful for the diagnosis of systemic diseases and intoxications. Analysis of fresh urine is recommended as changes in cell morphology, cell lysis and in vitro crystal formation may occur in the course of its storage. Manual urine sediment analysis is still performed in many veterinary practices. Native wet-mount preparations are suitable for the identification and quantification of urine sediment particles. The examination of stained wet-mount preparations or air-dried smears may be necessary to further differentiate cells and to identify bacteria. For several years, automatic urine sediment analyzers have been available in veterinary medicine. These save considerable time and staff resources, however verification of the automatically generated results by an experienced observer remains necessary. Urine sediment particles that are frequently identified and clinically relevant include red blood cells, white blood cells, different types of epithelial cells, crystals, and casts as well as bacteria. Furthermore, parasite eggs, fungal hyphae, lipid droplets, spermatozoa, fibres, hair, mucus, plant parts or environmental contaminations may be found in the urine sediment and result in a complication of the result interpretation.

Serum amyloid A in cats with renal azotemia.

Background and Aim: The concentration of the feline acute-phase protein serum amyloid A (SAA) increases in cats with acute inflammatory diseases. However, it is unclear whether SAA concentration increases in cats with azotemic kidney disease or whether it can aid in differentiating acute kidney injury (AKI) from chronic kidney disease (CKD). Similarly, whether SAA concentration can be used as a prognostic marker is also unclear. Therefore, this study aimed to evaluate the SAA concentrations in cats with azotemic kidney disease and determine whether SAA concentrations can be used to differentiate between AKI, CKD, and "acute on CKD" (AoC). In addition, we evaluated whether SAA concentration could serve as a prognostic parameter. Moreover, we determined the correlations between SAA concentration and temperature; creatinine, urea, and albumin concentrations; leukocyte count; and urine protein/creatinine (UP/C). Materials and Methods: Forty-eight client-owned azotemic cats (creatinine >250 µmol/L) were included in this prospective study. Cats with pre- and post-renal azotemia were excluded from the study. The causes of azotemia were differentiated into AKI, CKD, and AoC. The SAA concentrations were analyzed through turbidimetric immunoassay at the time of admission. Data were analyzed using the Mann-Whitney U, Kruskal-Wallis, Chi-Square, Fisher's exact, and Spearman correlation tests. p ≤ 0.05 was considered statistically significant. Results: Serum amyloid A concentration increased in 5/12 cats with AKI, 7/22 cats with CKD, and 9/14 cats with AoC (p = 0.234). The median SAA concentration in cats with AKI, CKD, and AoC whose SAA concentration was ≥5 mg/L was 174 mg/L (10-281 mg/L), 125 mg/L (6-269 mg/L), and 143 mg/L (7-316 mg/L), respectively (p = 0.697), with no significant differences observed between the groups. The median SAA concentration did not differ significantly between survivors (125 mg/L, 10-316 mg/L) and non-survivors (149 mg/L, 6-281 mg/L; p = 0.915) with SAA concentration ≥5 mg/L. Conclusion: Serum amyloid A concentration increased in 44% of the cats with azotemia. However, it cannot be used to differentiate AKI from CKD or as a prognostic marker. Serum amyloid A concentration was correlated with neutrophil count, albumin concentration, and UP/C, and the presence of comorbidities may influence SAA concentration.

Hemostatic and thromboelastographic parameters in dogs with renal azotemia.

Background and Aim: Humans and dogs with azotemia can develop coagulation disorders. Therefore, this study aimed to evaluate the coagulation profiles and thromboelastographic parameters in dogs with acute kidney injury (AKI) and chronic kidney disease (CKD). Materials and Methods: In this prospective study, 31 client-owned dogs with renal azotemia (creatinine >220 µmol/L) were enrolled. Clinical signs of hemostatic disorders, complete blood count, coagulation profile, D-dimers, thromboelastography, and 28-day survival data were obtained and analyzed using the t-test, Mann-Whitney U test, and Chi-square test. Statistical significance was set at p < 0.05. Results: Seventeen dogs with AKI, 10 with CKD, and four with acute-on-chronic kidney injury (AoC) were enrolled. Ten dogs (AKI, 8/17; CKD, 2/10) had thrombocytopenia. Prothrombin time was prolonged in four dogs with AKI and longer in dogs with AKI than in dogs with CKD (p = 0.004). The activated partial thromboplastin time was prolonged in 23 dogs (AKI, 14/17; CKD, 7/10; AoC, 3/4) and was longer in azotemic dogs than in healthy control dogs (p = 0.003). Thromboelastographic tracings were hypocoagulable in three dogs with AKI and hypercoagulable in 16 dogs (AKI 4/17, CKD 9/10, AoC 3/4). The thromboelastographic values for maximum amplitude (p < 0.001) and global clot strength (p < 0.001) were lower in dogs with AKI than in those with CKD. Conclusion: Hypercoagulable thromboelastographic tracings were observed in dogs with CKD, whereas coagulation times were prolonged in dogs with AKI. However these findings should be validated by further studies.

Long-term follow-up of cats in complete remission after treatment of feline infectious peritonitis with oral GS-441524.

OBJECTIVES: Feline infectious peritonitis (FIP), a common disease in cats caused by feline coronavirus (FCoV), is usually fatal once clinical signs appear. Successful treatment of FIP with oral GS-441524 for 84 days was demonstrated recently by this research group. The aim of this study was to evaluate the long-term outcome in these cats. METHODS: A total of 18 successfully treated cats were followed for up to 1 year after treatment initiation (9 months after completion of the antiviral treatment). Follow-up examinations were performed at 12-week intervals, including physical examination, haematology, serum biochemistry, abdominal and thoracic ultrasound, FCoV ribonucleic acid (RNA) loads in blood and faeces by reverse transciptase-quantitative PCR and anti-FCoV antibody titres by indirect immunofluorescence assay. RESULTS: Follow-up data were available from 18 cats in week 24, from 15 cats in week 36 and from 14 cats in week 48 (after the start of treatment), respectively. Laboratory parameters remained stable after the end of the treatment, with undetectable blood viral loads (in all but one cat on one occasion). Recurrence of faecal FCoV shedding was detected in five cats. In four cats, an intermediate short-term rise in anti-FCoV antibody titres was detected. In total, 12 cats showed abdominal lymphadenomegaly during the follow-up period; four of them continuously during the treatment and follow-up period. Two cats developed mild neurological signs, compatible with feline hyperaesthesia syndrome, in weeks 36 and 48, respectively; however, FCoV RNA remained undetectable in blood and faeces, and no increase in anti-FCoV antibody titres was observed in these two cats, and the signs resolved. CONCLUSIONS AND RELEVANCE: Treatment with GS-441524 proved to be effective against FIP in both the short term as well as the long term, with no confirmed relapse during the 1-year follow-up period. Whether delayed neurological signs could be a long-term adverse effect of the treatment or associated with a 'long FIP syndrome' needs to be further evaluated.

[Role of systemic infections in canine kidney diseases]. / Rolle systemischer Infektionen bei Nierenerkrankungen des Hundes.

Kidney diseases represent a common problem as well as a frequent cause of death in dogs. Infectious agents may be responsible for glomerulopathies and acute kidney injuries. Many infections commonly associated with the development of immune complex glomerulonephritis in central and southern Europe are important as travel-associated diseases in Germany. These include leishmaniosis, dirofilariosis, and ehrlichiosis. Rarely, anaplasmosis, hepatozoonosis, Lyme disease as well as babesiosis caused by small Babesia spp. are detected as cause of canine immune complex glomerulonephritis in Germany. Leptospirosis, canine infectious hepatitis, and babesiosis caused by large Babesia spp. may be responsible for the development of acute kidney injuries associated with tubulointerstitial nephritis. Therefore, further diagnostics aiming at identifying potentially causative infectious agents in dogs with renal disease is important for both prognosis and therapy of the patient.

Ultrasonographic assessment of the caudal vena cava diameter in cats during blood donation.

OBJECTIVES: Ultrasonography of the caudal vena cava (CVC) has been previously established to assess fluid status in dogs but not in cats. The aim of this study was to determine CVC diameter changes during feline blood donation. METHODS: Inter- and intra-observer variability were assessed in 11 client-owned cats. Minimal and maximal CVC diameters were assessed longitudinally in the subxiphoid view (SV) and right paralumbar view (PV), and transversely in the right hepatic intercostal view (HV). Eighteen client-owned, healthy, anaesthetised cats were evaluated during 21 blood donation procedures of 10 ml/kg in the same anatomical locations before (T0) and after (T1) blood donation, and after volume resuscitation with 30 ml/kg lactated Ringer's solution (T2). The CVC index was calculated. RESULTS: Intra-observer variability was acceptable for all probe positions, except for the HV, whereas inter-observer variability was considered unacceptable for all probe positions. Complete measurements were obtained during 21 blood donations at T0, T1 and T2 at the SV, during 18/21 blood donations at the HV and during 16/21 blood donations at the PV. At the SV, the minimal CVC diameter between T1 and T2 (P <0.001), and the maximal CVC diameter between T0 and T1 and between T1 and T2 (P <0.001) were significantly different. At the HV, the minimal vertical diameter, maximal vertical diameter and minimal horizontal diameter were different between all timepoints (P <0.001). The maximal horizontal diameter was different between T1 and T2 (P = 0.002). At the PV, both diameters were different between all timepoints (P <0.001). The CVC index was not different between timepoints. CONCLUSION AND RELEVANCE: Significant probe position dependent CVC diameter changes with marked overlap were observed before and after blood donation, and after fluid bolus. No absolute CVC diameter could be used to indicate hypovolaemia. Ultrasonographic assessment of the feline CVC is highly operator-dependent. The CVC index is not useful in cats.

Comparison of the Anvajo Vet Fluidlab 1 urine sediment analyzer to manual microscopy and Idexx SediVue analysis for analysis of urine samples from cats and dogs.

The Vet Fluidlab 1 (Anvajo), a new urine sediment analyzer for use in veterinary medicine, uses holographic microscopy to detect urine sediment particles in uncentrifuged urine. We compared the performance of the Fluidlab to manual microscopy and Idexx SediVue analysis for the detection of RBC, WBC, epithelial cells (EC), struvite crystals (STR), all crystals (CRY), and casts (CST) in urine samples from cats and dogs. The performance of the Fluidlab for the detection of bacteria was compared to bacterial culture. We included 624 urine samples from feline (238; 38%) and canine (386; 62%) patients; 227 samples had been submitted for bacterial culturing. The sensitivity of the Fluidlab compared to manual microscopy was 92.1% for RBC, 90.1% for WBC, 87.5% for EC, 67.6% for STR, 53.9% for CRY, and 12.5% for CST. Specificity was >97% for STR and CST, 90.0% for CRY, 78.4% for WBC, 59.4% for EC, and 55.1% for RBC. Sensitivities and specificities of the Fluidlab for analytes compared to manual microscopy were found to be similar to those obtained by the Fluidlab compared to SediVue analysis. Miscellaneous materials (e.g., lipid droplets, sperm, cell detritus) seemed to be the main reason for the high false-positive rate in RBC and EC classification by the Fluidlab. Detection of bacteria by the Fluidlab compared to bacterial culture had a sensitivity of 89.8% and a specificity of 72.3%. The performance of the Fluidlab is acceptable for the detection of WBC and bacteria; sensitivity for the detection of CRY and CST, and specificity for the detection of RBC and EC, require improvement.

Bacterial urinary tract infection and subclinical bacteriuria in dogs receiving antineoplastic chemotherapy.

BACKGROUND: Immunosuppressive treatment with glucocorticoids and cyclosporine increases the risk for positive urine cultures (PUCs) in dogs. OBJECTIVE: To investigate the prevalence and incidence of PUC in dogs diagnosed with cancer and treated with antineoplastic chemotherapy while distinguishing between subclinical bacteriuria (SB) and urinary tract infection (UTI). ANIMALS: Forty-six client-owned dogs with nonurogenital cancer treated with antineoplastic chemotherapy. METHODS: Prospective observational longitudinal clinical study. Dogs in which a urine culture was performed before the start of and at least once during antineoplastic chemotherapy were included. A McNemar's test was used to investigate if the prevalence of PUC increased during antineoplastic chemotherapy. Positive urine cultures were categorized into SB and UTI and multiple PUCs from the same dog and category were grouped together as 1 episode of PUC. RESULTS: Urine culture was positive in 21/185 urine samples in 8/46 dogs. Antineoplastic chemotherapy did not influence the prevalence of PUC (P = 1.00), which was 11% (5/46 dogs; 95% confidence interval: 5-23%) before the start of and 13% (6/46 dogs; 95% confidence interval: 6-26%) during antineoplastic chemotherapy. Eight dogs had 10 episodes of PUC; 7/10 episodes were classified as SB, and in 3/10 episodes UTI (chronic prostatitis, prostatic abscess, and emphysematous cystitis) was diagnosed. Escherichia coli was the most common pathogen, isolated in 9/10 episodes. CONCLUSIONS AND CLINICAL IMPORTANCE: We did not find evidence that antineoplastic chemotherapy is a major predisposing factor for the development of PUC. Most dogs with PUC had SB.

Clinical Follow-Up and Postmortem Findings in a Cat That Was Cured of Feline Infectious Peritonitis with an Oral Antiviral Drug Containing GS-441524.

This is the first report on a clinical follow-up and postmortem examination of a cat that had been cured of feline infectious peritonitis (FIP) with ocular manifestation by successful treatment with an oral multicomponent drug containing GS-441524. The cat was 6 months old when clinical signs (recurrent fever, lethargy, lack of appetite, and fulminant anterior uveitis) appeared. FIP was diagnosed by ocular tissue immunohistochemistry after enucleation of the affected eye. The cat was a participant in a FIP treatment study, which was published recently. However, 240 days after leaving the clinic healthy, and 164 days after the end of the 84 days of treatment, the cured cat died in a road traffic accident. Upon full postmortem examination, including histopathology and immunohistochemistry, there were no residual FIP lesions observed apart from a generalized lymphadenopathy due to massive lymphoid hyperplasia. Neither feline coronavirus (FCoV) RNA nor FCoV antigen were identified by quantitative reverse transcription polymerase chain reaction (RT-qPCR) and immunohistochemistry, respectively, in any tissues or body fluids, including feces. These results prove that oral treatment with GS-441524 leads to the cure of FIP-associated changes and the elimination of FCoV from all tissues.

Fecal Feline Coronavirus RNA Shedding and Spike Gene Mutations in Cats with Feline Infectious Peritonitis Treated with GS-441524.

As previously demonstrated by our research group, the oral multicomponent drug Xraphconn® containing GS-441524 was effective at curing otherwise fatal feline infectious peritonitis (FIP) in 18 feline coronavirus (FCoV)-infected cats. The aims of the current study were to investigate, using samples from the same animals as in the previous study, (1) the effect of treatment on fecal viral RNA shedding; (2) the presence of spike gene mutations in different body compartments of these cats; and (3) viral RNA shedding, presence of spike gene mutations, and anti-FCoV antibody titers in samples of 12 companion cats cohabitating with the treated cats. Eleven of the eighteen treated FIP cats (61%) were shedding FCoV RNA in feces within the first three days after treatment initiation, but all of them tested negative by day 6. In one of these cats, fecal shedding reoccurred on day 83. Two cats initially negative in feces were transiently positive 1-4 weeks into the study. The remaining five cats never shed FCoV. Viral RNA loads in feces decreased with time comparable with those in blood and effusion. Specific spike gene mutations linked to systemic FCoV spread were consistently found in blood and effusion from treated FIP cats, but not in feces from treated or companion cats. A new mutation that led to a not yet described amino acid change was identified, indicating that further mutations may be involved in the development of FIP. Eight of the twelve companion cats shed FCoV in feces. All but one of the twelve companion cats had anti-FCoV antibodies. Oral treatment with GS-441524 effectively decreased viral RNA loads in feces, blood, and effusion in cats with FIP. Nonetheless, re-shedding can most likely occur if cats are re-exposed to FCoV by their companion cats.

Decrease of Trefoil factor 2 in cats with feline idiopathic cystitis.

OBJECTIVE: To obtain new insights into aetiological backgrounds, and to search for diagnostic biomarkers by assessing the difference in urinary proteins between cats with spontaneous feline idiopathic cystitis (FIC) and healthy controls. MATERIALS AND METHODS: Urine supernatants of 18 cats with FIC and 18 healthy control cats, and bladder biopsies of two FIC diseased cats and four healthy controls were included in the study. The Bradford method was used to determine protein quantity in urine supernatants. Urine was separated by two-dimensional (2-D) gel electrophoresis. Selected protein spots were excised from two-dimensional gels and analysed with tandem mass spectrometry. Validation of Trefoil factor 2 expression was realized with Western blot and immunohistochemistry. Western blot signal intensities were quantified with image quant software. RESULTS: Eleven differentially expressed protein spots were identified between the 2-D gels of cats with FIC and control cats. Ten spots (only visible in the FIC gel) were identified as albumin and one spot (only visible in the control gel) was identified as Trefoil factor 2.Using quantification of Western blot signal intensities and immunohistochemistry a decrease in Trefoil factor 2 (TFF2) in cats with FIC could be revealed for the first time. CONCLUSION: Deficiency in TFF2 possibly leads to impaired repairing abilities and immune response of the urothelium. The result could be a greater susceptibility to injury, inflammation and relapse. Therefore TFF2 deficiency might be an important event in FIC pathogenesis. Detection of a decrease in urinary TFF2 could serve as diagnostic biomarker, facilitating diagnosis. As FIC can serve as an animal model for human painful bladder syndrome/interstitial cystitis, the findings of this study might also be valuable for interstitial cystitis research and should be further investigated.

[Cystoscopic-guided laser ablation for treatment of ectopic ureteroceles in 2 female dogs]. / Zystoskopiegeführte Laserablation zur Korrektur ektopischer Ureterozelen bei 2 Hündinnen.

Two female intact Labrador Retriever dogs (6 and 3 months of age, respectively) presented with a history of urinary incontinence. In both dogs, abdominal ultrasound revealed evidence of a unilateral ectopic ureterocele. Diagnosis of ureteral ectopia was established urethrocystoscopically by visualization of the ureteral orifice in the urethra, and an intramural course was confirmed via retrograde contrast fluoroscopy. Ectopic ureteral orifices were stenotic in both dogs. Cystoscopic- and fluoroscopic-guided laser ablation of the ectopic ureter were performed with a Hol:YAG laser. Following the procedure, both dogs were fully continent without any medical treatment. Cystoscopic- guided laser ablation of ureteroceles was effective and safe in these 2 dogs. Thus, this minimally invasive technique for the treatment of ectopic ureteroceles provides an alternative to surgical intervention.

Curing Cats with Feline Infectious Peritonitis with an Oral Multi-Component Drug Containing GS-441524.

Feline infectious peritonitis (FIP) caused by feline coronavirus (FCoV) is a common dis-ease in cats, fatal if untreated, and no effective treatment is currently legally available. The aim of this study was to evaluate efficacy and toxicity of the multi-component drug Xraphconn® in vitro and as oral treatment in cats with spontaneous FIP by examining survival rate, development of clinical and laboratory parameters, viral loads, anti-FCoV antibodies, and adverse effects. Mass spectrometry and nuclear magnetic resonance identified GS-441524 as an active component of Xraphconn®. Eighteen cats with FIP were prospectively followed up while being treated orally for 84 days. Values of key parameters on each examination day were compared to values before treatment initiation using linear mixed-effect models. Xraphconn® displayed high virucidal activity in cell culture. All cats recovered with dramatic improvement of clinical and laboratory parameters and massive reduction in viral loads within the first few days of treatment without serious adverse effects. Oral treatment with Xraphconn® containing GS-441524 was highly effective for FIP without causing serious adverse effects. This drug is an excellent option for the oral treatment of FIP and should be trialed as potential effective treatment option for other severe coronavirus-associated diseases across species.

[Bacterial urinary tract infection and subclinical bacteriuria in the dog: a current review]. / Bakterielle Harnwegsinfektion und subklinische Bakteriurie des Hundes: eine aktuelle Übersicht.

Bacterial urinary tract infection (UTI) is a common clinical presentation in dogs and a frequent reason for the prescription of antimicrobial drugs. UTI refers to adherence, multiplication and persistence of an infectious agent within the urogenital system. This causes an associated inflammatory response as well as the pertaining clinical signs. Depending on the site of infection, UTI's may be classified as bacterial cystitis, prostatitis or pyelonephritis. In contrast, subclinical bacteriuria (SB) is defined as the presence of a significant number of bacteria in the urine of an individual not showing clinical signs referrable to UTI. UTI's typically occur as a consequence of ascending pathogen migration from the host's own fecal or distal urogenital microbial flora. The most commonly isolated pathogen in cases of UTI and SB is Escherichia coli. The diagnosis is based on clinical signs and the results of urine examination and culture. The recently revised guidelines of the International Society for Companion Animal Infectious Diseases provide detailed recommendations for diagnosis and management of different forms of bacterial UTI's in dogs. Adherence to treatment guidelines will improve treatment success and is imperative in avoiding further deterioration of the antimicrobial resistance situation.

Recurrence rate and long-term course of cats with feline lower urinary tract disease.

OBJECTIVES: Feline lower urinary tract disease (FLUTD) causes clinical signs such as stranguria, pollakiuria, haematuria, vocalisation and periuria, and is often associated with recurring episodes. The primary objective of this study was to survey the long-term course of cats presenting with FLUTD in terms of recurrence rate and mortality. METHODS: Data from cats that were presented with lower urinary tract signs from 2010 to 2013 were collected by telephone interview with cat owners, using a questionnaire. The observation period ranged from the first presentation due to FLUTD to the telephone interview or the cat's death. Data on diagnoses, recurrence of clinical signs and disease-free intervals, as well as implementation and impact of prophylactic measures (PMs), were collected and compared between groups with different aetiologies. RESULTS: The study included 101 cats. Fifty-two cats were diagnosed with feline idiopathic cystitis, 21 with urolithiasis and 13 with bacterial urinary tract infection; 15 had no definitive diagnosis. Of the 86 cats with a known diagnosis, the recurrence rate was 58.1%, with no significant difference between groups. Twenty-one cats had one relapse, 12 had two relapses, 10 had three and seven had four to eight relapses within a median observation period of 38 months (range 0.5-138 months). Fourteen cats suffered from different causes of FLUTD at different episodes. Mortality due to FLUTD among all 101 cats was 5.0%. The recurrence rate in cats with urolithiasis receiving at least two PMs was significantly lower than the recurrence rate in those without PMs (P = 0.029). CONCLUSIONS AND RELEVANCE: More than half of the cats with FLUTD presented with two or more recurrent episodes irrespective of the identified aetiology. Cats should be thoroughly investigated at each presentation as it cannot be presumed that the cause of FLUTD is the same at different episodes. The mortality due to FLUTD is lower than previously reported.

Influence of preanalytic and analytic variables in canine and feline urine specific gravity measurement by refractometer.

Urine specific gravity (USG), which is usually measured by refractometry, is an important indicator of renal concentrating ability. Few studies have evaluated refractometers with separate scales for canine and feline urine. Variables such as protein content or storage time may influence the USG. We compared the effects of measuring USG with a refractometer with single or separate scales for canine and feline urine, investigated inter- and intra-observer variability, and measured agreement between whole urine and supernatant. We evaluated the correlation between USG and osmolality, the influence of urinary protein on USG and osmolality, and the impact of storage time up to 6 mo. We examined 252 canine and 126 feline samples. Bland-Altman analysis revealed higher USG values of the single-scale refractometer than the dual-scale refractometer, with a mean difference (bias) of < 0.001 for canine and 0.003 for feline specimens. Inter- and intra-observer variability were acceptable. Good agreement was shown between USG of whole urine and supernatant. Correlations between USG and osmolality were excellent (0.98-0.99, p < 0.001). Proteinuria up to 1 g/L had no major impact on USG or osmolality. Storage time had no significant effect on USG. The difference between the refractometers is clinically irrelevant, and the use of a refractometer with separate feline and canine scales is unnecessary. Whole urine and supernatant stored up to 6 mo can both be used for USG measurement. The influence of proteinuria <1 g/L on USG and osmolality is negligible.

Cats shedding pathogenic Leptospira spp.-An underestimated zoonotic risk?

Shedding of DNA of pathogenic Leptospira spp. has been documented in naturally infected cats in several countries, but urinary shedding of infectious Leptospira spp. has only recently been proven. The climate in Southern Chile is temperate rainy with high annual precipitations which represents ideal preconditions for survival of Leptospira spp., especially during spring and summer. The aims of this study were to investigate shedding of pathogenic Leptospira spp. in outdoor cats in Southern Chile, to perform molecular characterization of isolates growing in culture, and to assess potential risk factors associated with shedding. Urine samples of 231 outdoor cats from rural and urban areas in southern Chile were collected. Urine samples were investigated for pathogenic Leptospira spp. by 4 techniques: qPCR targeting the lipL32 gene, immunomagnetic separation (IMS)-coupled qPCR (IMS-qPCR), direct culture and IMS-coupled culture. Positive urine cultures were additionally confirmed by PCR. Multilocus sequence typing (MLST) was used to molecularly characterize isolates obtained from positive cultures. Overall, 36 urine samples (15.6%, 95% confidence interval (CI) 11.4-20.9) showed positive results. Eighteen (7.8%, 95% CI 4.9-12.1), 30 (13%, 95% CI 9.2-18), 3 (1.3%, 0.3-3.9) and 4 cats (1.7%; 95% CI 0.5-4.5) were positive in qPCR, IMS-qPCR, conventional culture, and IMS-coupled culture, respectively. MLST results of 7 culture-positive cats revealed sequences that could be assigned to sequence type 17 (6 cats) and sequence type 27 (1 cat) corresponding to L. interrogans (Pathogenic Leptospira Subgroup 1). Shedding of pathogenic Leptospira spp. by cats might be an underestimated source of infection for other species including humans. The present study is the first one reporting growth of leptospires from feline urine in culture in naturally infected cats in South-America and characterisation of culture-derived isolates. So far, very few cases of successful attempts to culture leptospires from naturally infected cats are described worldwide.