Abstract
OBJECTIVE
While the clinical utility of next-generation DNA sequencing (NGS) as a diagnostic tool for infections in humans and traditional pets has been demonstrated, there is a lack of data regarding its utility for exotic animals. For exotic patients, traditional culturing is especially challenging for anaerobic and fungal pathogens. Therefore, diagnosis often relies on PCR, which provides a high degree of sensitivity and specificity, although it targets only a predetermined, finite pathogen panel. NGS provides the same benefits as PCR, while also offering de novo identification and quantification of all bacteria and fungi present in a clinical sample, including novel pathogen discovery.
PROCEDURES
Clinical samples from 78 exotic animal patients were collected simultaneously for conventional culture testing and NGS analysis. Results provided by each laboratory were compared for the presence and absence of bacterial and fungal pathogens and commensals.
RESULTS
Results showed large bacterial and fungal species diversity in the study cohort and a lack of sensitivity of microbial culture testing. Culture failed to grow 15% of putative bacterial and 81% of putative fungal pathogens that were identified by NGS. The probability of a “no growth” diagnosis was 14% higher for bacteria and 49% higher for fungi with culture versus NGS testing if fungal culture was conducted.
CLINICAL RELEVANCE
Culture testing failed to diagnose a substantial number of both bacterial and fungal pathogens, which were detected by NGS. This highlights the limitations of traditional culture-based testing and displays the clinically advanced utility of NGS-based diagnostics in exotic animal medicine.
Abstract
OBJECTIVE
To determine if urine electrolyte assessments can be used to monitor the adequacy of mineralocorticoid therapy in dogs with hypoadrenocorticism (HA).
ANIMALS
29 dogs with naturally occurring glucocorticoid- and mineralocorticoid-deficient HA.
PROCEDURES
Urine sodium and potassium concentrations, sodium-to-potassium ratios, sodium-to-creatinine ratios, and potassium-to-creatinine (K:Cr) ratios were evaluated in dogs with newly diagnosed HA that were treated with desoxycorticosterone pivalate (DOCP). Dogs underwent measurements of urine and serum sodium, potassium, and creatinine concentrations and plasma renin activities twice monthly for up to 3 months. Regression analyses and calculation of coefficients of determination (R 2) were performed to investigate potential associations between urine and serum variables. Urine variables also were compared between dogs considered to be undertreated or overtreated based on plasma renin activities.
RESULTS
Urine K:Cr ratios were significantly associated with serum potassium concentrations 10 to 14 days (P = .002) and 30 days (P = .027) after the initial DOCP injection, but R 2 values were only 0.35 and 0.17, respectively. Urine K:Cr ratios (median [IQR]) also were higher in dogs that were overtreated with DOCP (1.3 [0.7 to 2.3]) as compared to those dogs that were undertreated with DOCP (0.8 [0.5 to 0.9]) at 10 to 14 days after the initial DOCP injection (P = .039) but not at 30 days after the initial injection. Other urine variables were not significantly different between undertreated and overtreated dogs.
CLINICAL RELEVANCE
Measures of urine electrolytes were not useful for assessing the adequacy of mineralocorticoid therapy in HA dogs that were treated with DOCP.
Abstract
OBJECTIVE
The lactulose-to-mannitol ratio test is a test to assess the disorders associated with gut permeability. The test requires an oral administration of the mixture of lactulose and mannitol and urine collection. The urinary ratio of lactulose to mannitol is an indicator of intestinal permeability. Due to the complexity of urine collection in animal studies, plasma exposure ratios of lactulose to mannitol compared to their urinary concentration ratios were evaluated following an oral administration of the sugar mixture in pigs.
ANIMALS
10 pigs were orally dosed with a solution of lactulose and mannitol mixture.
PROCEDURES
Plasma samples were collected at predose, 10 and 30 minutes and 2, 4, and 6 hours postdosing, and cumulated urinary samples were collected at 6 hours for liquid chromatography–mass spectrometry analysis. The ratios of pharmacokinetic parameters of lactulose to mannitol and the plasma sugar ratios at a single time point or the mean values of several time points were compared to their urinary sugar ratios.
RESULTS
The results revealed that the lactulose-to-mannitol ratios of AUC0–6h, AUCextrap, and Cmax were correlated to the urinary sugar ratios, and the plasma sugar ratios of a single time point at 2, 4, or 6 hours and the mean values of those time points were also appropriate to replace their urinary ratios in pigs.
CLINICAL RELEVANCE
Following an oral administration of lactulose and mannitol mixture, blood collection, and assay can be an option for assessing intestinal permeability, especially in animal studies.
Abstract
OBJECTIVE
To determine the diagnostic utility of a smartphone-based ECG device (Alivecor KardiaMobile) in awake bonobos (Pan paniscus).
ANIMALS
7 adult bonobos in human care.
PROCEDURES
Bonobos were trained with positive reinforcement to hold 1 finger from each hand onto the KardiaMobile sensors for 30 seconds to obtain an ECG reading. Ten ECG tracings were recorded from each bonobo and evaluated by a veterinarian, a veterinary cardiologist, and a human cardiologist for tracing quality, tracing length, heart rate, identification of P-waves, and presence and quantification of premature ventricular or atrial contractions.
RESULTS
6 of the 7 bonobos were trained within 21 weeks to allow the collection of 10 diagnostic quality ECG tracings. The average heart rate recorded was 87 bpm (range = 60 to 118 bpm). Potential abnormalities identified by the KardiaMobile included premature ventricular contractions in 2 male bonobos and 1 premature atrial contraction in another male. There was strong agreement by reviewers in all ECG parameters except for the identification of P-waves.
CLINICAL RELEVANCE
The Alivecor KardiaMobile device has diagnostic utility as a screening tool for use in bonobos in human care. The training was accomplished to yield diagnostic ECG readings of acceptable duration in awake bonobos. Given the prevalence of cardiovascular disease in great apes, this technology may identify a subset of great apes who may benefit from early intervention and treatment in an effort to delay the progression of cardiac disease.
Abstract
OBJECTIVE
The objective of this study was to report clinical outcomes of horses with naturally occurring full-thickness skin lacerations treated with an amorphous silicate dressing. We hypothesized that wounds treated with an amorphous silicate dressing would have minimal complications and lesion resolution without formation of exuberant granulation tissue.
ANIMALS
11 client-owned horses.
PROCEDURES
Clinical records of 11 horses with distal limb wounds treated with an amorphous silicate dressing were collected from participating veterinarians across the US. Wound healing progression was monitored by the veterinarian and owners.
RESULTS
None of the wounds required granulation bed debridement following treatment with topical amorphous silicate dressing. There were no complications associated with the treatment. The size of wounds varied from 5 to 20 cm in length with a median of 10 cm and from 2 to 15 cm in width with a median of 5 cm. Time to resolution varied greatly from 14 to 126 days with a median of 49 days. There was a moderate positive correlation between healing time (days) and area of the wound. All referring veterinarians and owners were satisfied with the healing of the wounds treated with the amorphous silicate dressing.
CLINICAL RELEVANCE
Treatment of equine distal limb wounds with an amorphous silicate dressing may reduce development of exuberant granulation tissue and the need for surgical debridement.
Abstract
OBJECTIVE
To identify associations between admission variables, Animal Trauma Triage (ATT) score, and Modified Glasgow Coma Scale (MGCS) score with need for transfusion or surgical interventions and survival to discharge in cats with bite wounds.
ANIMALS
1,065 cats with bite wounds.
PROCEDURES
Records of cats with bite wounds were obtained from the VetCOT registry from April 2017 to June 2021. Variables included point of care laboratory values, signalment, weight, illness severity scores, and surgical intervention. Associations between admission parameters, terciles of MGCS, quantiles of ATT scores, and death or euthanasia were assessed using univariable and multivariable logistic regression analysis.
RESULTS
872 cats (82%) survived to discharge, while 170 (88%) were euthanized and 23(12%) died. In the multivariable model, age, weight, surgical treatment, ATT and MGCS scores were associated with nonsurvival. For every 1 year of age, odds of nonsurvival increased by 7% (P = .003) and for every 1 kg of body weight, odds of nonsurvival decreased by 14% (P = .005). Odds of dying increased with lower MGCS and higher ATT scores (MGCS: 104% [95% CI, 116% to 267%; P < .001]; ATT: 351% [95% CI, 321% to 632%; P < .001). Odds of dying decreased by 84% (P < .001) in cats that underwent surgery versus those that did not.
CLINICAL RELEVANCE
This multicenter study indicated association of higher ATT and lower MGCS with worse outcome. Older age increased the odds of nonsurvival, while each kilogram increase in bodyweight decreased odds of nonsurvival. To our knowledge, this study is the first to describe associations of age and weight with outcome in feline trauma patients.
Abstract
Antibiotic recommendations for treating skin infections have been published many times in the past 30 years. Prior to 2000, the recommendations focused on the use of β-lactam antibiotics, such as cephalosporins, amoxicillin-clavulanate, or β-lactamase stable penicillins. These agents are still recommended, and used, for wild-type methicillin-susceptible strains of Staphylococcus spp. However, since the mid-2000s there has been an increase in methicillin-resistant Staphylococcus spp (MRSP). The increase among S pseudintermedius in animals coincided with the increase in methicillin-resistant S aureus that was observed in people near the same time. This increase led veterinarians to reevaluate their approach to treating skin infections, particularly in dogs. Prior antibiotic exposure and hospitalization are identified as risk factors for MRSP. Topical treatments are more often used to treat these infections. Culture and susceptibility testing is performed more often, especially in refractory cases, to identify MRSP. If resistant strains are identified, veterinarians may have to rely on antibiotics that were previously used uncommonly for skin infections, such as chloramphenicol, aminoglycosides, tetracyclines, and human-label antibiotics such as rifampin and linezolid. These drugs carry risks and uncertainties that must be considered before they are routinely prescribed. This article will discuss these concerns and provide veterinarians guidance on the treatment of these skin infections.
