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- Author or Editor: Jennifer L. Granick x
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Abstract
Objective—To determine demographic characteristics of dogs from the upper Midwest infected with Anaplasma phagocytophilum and identify clinical and clinicopathologic abnormalities and response to treatment.
Design—Retrospective case series and owner telephone survey.
Animals—34 dogs with granulocytic anaplasmosis.
Procedures—Records were reviewed for information on signalment, history, physical examination findings, clinicopathologic and serologic findings, and treatment. Owners were contacted by telephone within 4 months after dogs were discharged.
Results—Median age was 8 years. Distribution of month of diagnosis was bimodal, with 15 dogs examined during May or June and 11 others examined during October or November. Camping and hiking were the most frequently reported tick exposure activities. Lethargy (25/34) and anorexia (21/34) were the most common initial complaints, fever was the most common clinical sign (27/32), and thrombocytopenia was the most common clinicopathologic abnormality (21/22). Fifteen of 20 dogs were seropositive for antibodies against A phagocytophilum. Doxycycline was prescribed for 31 dogs, and clinical signs and fever resolved within 3 to 5 days. Median time for platelet count to return to reference limits was 7 days. No owners reported clinical sequelae when contacted after dogs were discharged.
Conclusions and Clinical Relevance—Results suggested that granulocytic anaplasmosis should be suspected in dogs in endemic areas examined because of fever, lethargy, or thrombocytopenia, especially in dogs examined during the late spring or early fall. Treatment with doxycycline was successful in resolving clinical signs and thrombocytopenia.
Abstract
OBJECTIVE
To evaluate the knowledge, attitudes, and practices toward antibiotic use among board-certified veterinary dentists.
SAMPLE
104 veterinarians board certified by the American Veterinary Dental College.
METHODS
A 30-question survey was generated from an online platform and sent via email listserv to board-certified veterinary dentists. Responses were examined to identify patterns or correlations among the variables of interest.
RESULTS
There were 104 board-certified veterinary dentists who responded. The majority reported using prophylactic intraoperative antibiotics sparingly for dental procedures and predominately for patients with historic endocarditis or on immunosuppressive doses of steroids. For healthy patients, they reported that antibiotics are often prescribed during jaw fracture repair, maxillectomy/mandibulectomy, and treatment of stage 4 periodontal disease or periapical lucencies. Knowledge of antibiotic resistance and evidence-based antibiotic use were not significantly different between different practice sectors (academia vs private practice) or dependent on the duration of board certification. Dentists who did not believe antibiotics used postoperatively reduce local postoperative infection rates were less likely to prescribe injectable intraoperative antibiotics for the prevention of postoperative infection. No other variables were associated with the likelihood of prescribing intraoperative antibiotics. More than 95% of veterinary dentists surveyed agreed that specific antibiotic use guidelines for veterinary dentistry would help reduce inappropriate use of antibiotics.
CLINICAL RELEVANCE
There are differences among veterinary dentists regarding which procedures and patient-specific comorbidities they believe necessitate the use of prophylactic antibiotics. The development of a consensus statement and prospective studies of current antibiotic use are important next steps to improving antibiotic stewardship in veterinary dentistry.
Abstract
CASE DESCRIPTION
An 8-year-old 36.3-kg (79.9-lb) spayed female Rottweiler was evaluated because of anorexia and vomiting.
CLINICAL FINDINGS
Extrahepatic biliary obstruction (EHBO) secondary to pancreatitis was suspected on the basis of results from serum biochemical analyses, CT, and cytologic examination.
TREATMENT AND OUTCOME
Only marginal improvement was observed after 24 hours of traditional medical management; therefore, novel continual biliary drainage was achieved with ultrasonographically and fluoroscopically guided placement of a percutaneous transhepatic cholecystostomy drainage (PCD) catheter. Within 24 hours after PCD catheter placement, the dog was eating regularly, had increased intestinal peristaltic sounds on abdominal auscultation, no longer required nasogastric tube feeding, and had decreased serum total bilirubin concentration (7.7 mg/dL, compared with 23.1 mg/dL preoperatively). Bile recycling was performed by administering the drained bile back to the patient through a nasogastric tube. The PCD remained in place for 5 weeks and was successfully removed after follow-up cholangiography confirmed bile duct patency.
CLINICAL RELEVANCE
Transhepatic PCD catheter placement provided fast resolution of EHBO secondary to pancreatitis in the dog of the present report. We believe that this minimally invasive, interventional procedure has the potential to decrease morbidity and death in select patients, compared with traditional surgical options, and that additional research is warranted regarding clinical use, safety, and long-term results of this procedure in veterinary patients, particularly those that have transient causes of EHBO, are too unstable to undergo more invasive biliary diversion techniques, or have biliary diseases that could benefit from palliation alone.
