Microbial flora and antimicrobial susceptibility patterns from dogs with otitis media

This study evaluated the middle ear microbial flora and antimicrobial susceptibility patterns from dogs with otitis media. Antimicrobial susceptibility patterns were obtained on 164 micro-organisms from 107 ears of 82 dogs with otitis media that presented to Louisiana State University over a 12-year period. The most common micro-organisms isolated were Staphylococcus intermedius (26.8%), Pseudomonas aeruginosa (23.2%), β-haemolytic streptococcus (12.8%), Proteus spp. (11.0%) and Staphylococcus epidermidis (8.5%). Antimicrobial susceptibility testing was performed on all isolates employing the disk diffusion method (Kirby-Bauer). Minimum inhibitory concentration (MIC) testing for enrofloxacin and ciprofloxacin was performed on 10 of the 18 P. aeruginosa isolates found to be resistant to enrofloxacin on Kirby-Bauer. Of these isolates, 6 (60%) were susceptible, 1 (10%) was intermediate and 3 (30%) were resistant to enrofloxacin. Eight of these isolates (80%) were susceptible to ciprofloxacin, 1 (10%) showed intermediate susceptibility and 1 (10%) was resistant.     

Interpreting culture and susceptibility data in critical care: perks and pitfalls

Problem – The need for immediate, effective antimicrobial therapy in the critical care patient must be tempered by approaches which simultaneously minimize emergence of antimicrobial resistance. Ideally, therapy will successfully resolve clinical signs of infection, while eradicating infecting pathogens such that the risk of resistance is avoided. Increasing limitations associated with empirical antimicrobial choices direct the need for culture and susceptibility data as a basis of therapy. Even so, such in vitro data should be utilized within its limitations. Objectives – To demonstrate the attributes and limitations of patient and population culture and susceptibility (pharmacodynamic) data in the selection of antimicrobial drugs and to demonstrate the design of individualized dosing regimens based on integration of pharmacodynamic (PD) and pharmacokinetic (PK) data. Diagnosis – Limitations in culture and susceptibility testing begin with sample collection and continue through drug selection and dose design. Among the challenges in interpretation is discrimination between pathogens and commensals. Properly collected samples are critical for generation of data relevant to the patient's infection. Data are presented as minimum inhibitory concentrations (MICs). The MIC facilitate selection of the most appropriate drug, particularly when considered in the context of antimicrobial concentrations achieved in the patient at a chosen dose. Integration of MIC data with key PK data yields the C_max:MIC important to efficacy of concentration‐dependent drugs and T>MIC, which guides use of time‐dependent drugs. These indices are then used to design dosing regimens that are more likely to kill all infecting pathogens. In the absence of patient MIC data, population data (eg, MIC₉₀) may serve as a reasonable surrogate. Conclusions – Properly collected, performed, and interpreted culture and susceptibility data are increasingly important in the selection of and design of dosing regimens for antimicrobial drugs. Integration of PK and PD data as modified by host and microbial factors supports a hit hard, exit fast approach to therapy that will facilitate efficacy while minimizing resistance.     

Orbital abscess bacterial isolates and in vitro antimicrobial susceptibility patterns in dogs and cats

Objective To determine bacterial populations, in vitro antimicrobial susceptibility patterns, and sources of microorganisms for dogs and cats with orbital abscess. Animals studied In total, 34 dogs and 7 cats with orbital abscess participated in the study. Procedure Medical records of dogs and cats with a clinical diagnosis of orbital abscess, confirmed by cytologic or histopathologic evaluation of orbital specimens, were reviewed from the years 1990 to 2007. Animal signalment, presumptive source of microorganisms and mechanism of orbital introduction, bacterial isolates, and aerobic bacterial in vitro antimicrobial susceptibility test results were recorded. Percentages of susceptible aerobic bacterial isolates were compared among antimicrobials. Results Twenty dogs and five cats had positive culture results. The most frequent bacterial genera isolated from dogs were Staphylococcus, Escherichia, Bacteroides, Clostridium and Pasteurella. The most frequent bacterial genera isolated from cats were Pasteurella and Bacteroides. Aerobic bacterial isolates from dogs had the highest percentage of susceptibility to amikacin, ceftiofur, gentamicin, imipenem, ticarcillin and trimethoprim–sulfamethoxazole. Aerobic bacterial isolates from dogs had the lowest percentage of susceptibility to ampicillin, clindamycin, erythromycin and penicillin. Antimicrobial resistance was uncommon among feline aerobic bacterial isolates. The most commonly identified routes of orbital bacteria introduction were extension from adjacent anatomical structures, penetrating exogenous trauma, and foreign bodies. Conclusions Mixed aerobic and anaerobic bacterial infections of the orbit occur commonly in dogs and cats. On the basis of aerobic and anaerobic bacterial isolates and in vitro susceptibility testing of aerobic bacterial isolates, cephalosporins, extended‐spectrum penicillins, potentiated‐penicillins and carbapenems are recommended for initial antimicrobial therapy of orbital abscess in dogs and cats.     

Association between quantitative bacterial culture of bronchoalveolar lavage fluid and antibiotic requirement in dogs with lower respiratory tract signs

BackgroundHistorically, positive bacterial cultures from the lower respiratory tract (LRT) have been considered clinically relevant when quantitative bacterial cultures of bronchoalveolar lavage fluid (BALF) were >1700 colony forming units (cfu)/mL. However, this threshold might not accurately predict a requirement for antibiotics.ObjectivesTo study whether quantitative BALF bacterial culture results were predictive of antibiotic requirement in dogs with LRT signs.AnimalsThirty‐three client‐owned dogs.MethodsCross‐sectional study. Dogs with positive quantitative bacterial culture of BALF were included. Dogs were divided into 2 groups, depending on whether they had a LRT infection requiring antibiotics (LRTI‐RA) or LRT disease not requiring antibiotics (LRTD‐NRA), based on thoracic imaging features, presence of intracellular bacteria on BALF cytology, and response to treatment. Predictive effect of cfu/mL and BALF total nucleated cell count (TNCC) on antibiotic requirement, adjusting for ongoing or prior antibiotic therapy and age, were studied using logistic regression.ResultsTwenty‐two and 11 dogs were included in the LRTI‐RA and LRTD‐NRA groups, respectively. The cfu/mL was not significantly predictive of antibiotic requirement, independent of ongoing or prior antibiotic treatment and age (LRTI‐RA: median, 10 000 cfu/mL; range, 10‐3 × 10⁸; LRTD‐NRA: median, 10  000 cfu/mL; range, 250‐1.3 × 10⁹; P = .27). The TNCC was not significantly predictive of antibiotic requirement when only dogs with bronchial disease were considered (LRTI‐RA: median, 470 cells/μL; range, 240‐2260; LRTD‐NRA: median, 455 cells/μL; range, 80‐4990; P = .57).Conclusion and Clinical ImportanceThe cfu/mL is an inappropriate measure for determining whether antibiotics are of benefit in dogs with LRT signs.     

A clinical approach to multidrug-resistant urinary tract infection and subclinical bacteriuria in dogs and cats

ABSTRACT

Multidrug-resistant bacteria are increasingly isolated from the urinary tract of pets, particularly those that suffer from concurrent conditions, have been hospitalised, or were treated with antimicrobials in the recent past. Many of the multidrug-resistant bacteria encountered are resistant to all commonly used oral antibiotics. This poses both a therapeutic dilemma in the individual pet and a threat to public health. This article begins with an overview of multidrug resistance in organisms that are commonly isolated from the urinary tract of pets. This is followed by a proposed clinical approach to managing multidrug-resistant urinary bacteria, which summarises current knowledge regarding appropriate sampling and analysis, reviews the current guidelines regarding appropriate antimicrobial use and discusses treatment options that might be considered. The article highlights several shortcomings of the current knowledge to be considered when planning future clinical research and developing policies.     

Comparison of microbial isolates and susceptibility patterns from the external ear canal of dogs with otitis externa

Otic exudate was obtained from 33 dogs with otitis externa for cytopathology and culture. Two samples were taken from the same location in the external ear canal, for a total of 100 samples. Thirty-six (36%) samples isolated only a single organism, of which 21 (21%) were Malassezia spp. Two organisms were present in 23 (23%) of the samples. Cultures of the two samples agreed in 40 (80%) of the 50 pairs. Cytopathology agreed with culture results only 68% of the time. Cytopathology and culture may not be as definitive as previously assumed because of apparent variability of the microbial population within the external canal.     

Measurement of respiratory system compliance and respiratory system resistance in healthy dogs undergoing general anaesthesia for elective orthopaedic procedures

Objective The aim of this study was to investigate normal values for the dynamic compliance of the respiratory system (Crs) and respiratory system resistance (Rrs) in mechanically ventilated anaesthetized dogs.Study design Prospective clinical study.Animals Forty healthy dogs undergoing elective orthopaedic surgery. Body weight was (mean ± SD) 26.8 ± 10.7 kg (range: 1.9–45.0 kg), age 4.7 ± 2.9 years (range: 0.1–10.6 years).Methods Dogs were premedicated with acepromazine and methadone administered intramuscularly and anaesthesia induced with propofol intravenously. After endotracheal intubation the dog's lungs were connected to an appropriate breathing system depending on body weight and isoflurane in oxygen administered for maintenance of anaesthesia. The lungs were ventilated mechanically with variables set to maintain normocapnia (end‐tidal carbon dioxide concentration 4.7–6.0 kPa). Peak inspiratory pressure, Crs, Rrs, tidal volume, respiratory rate and positive end‐expiratory pressure were recorded at 5, 30, 60, 90 and 120 minutes after start of mechanical ventilation. Cardiovascular variables were recorded at time of collection of respiratory data.Results General additive modeling revealed the following relationships: Crs = [0.895 × body weight (kg)] + 8.845 and Rrs = [?0.0966 × body weight (kg)] + 6.965. Body weight and endotracheal tube diameter were associated with Crs (p <0.001 and p =0.002 respectively) and Rrs (p = 0.017 and p =0.002 respectively), body weight being linearly related to Crs and inversely to Rrs.Conclusion and clinical relevance Body weight was linearly related to Crs while Rrs has an inverse linear relationship with body weight in mechanically ventilated dogs. The derived values of Crs and Rrs may be used for monitoring of lung function and ventilation in healthy dogs under anaesthesia.     

Treatment of problem behaviour in dogs and cats by castration and progestagen administration: A review

Summary

Treatment of problem behaviour in companion animals by castration and progestagen administration is reviewed. In male dogs castration is effective in eliminating roaming and, to a lesser extent, mounting, urine marking and intermale agression. Spraying, roaming and fighting behaviour in cats disappear almost completely after castration. In the latter species prepubertal castration does not seem to be more effective in preventing this problem behaviour than postpubertal castration is in eliminating it.

In dogs, intermale aggression, urine marking, mounting and roaming have been treated successfully with progestagens; in cats the same treatment has been successful in decreasing fighting and roaming. There are no reports on the ethical aspects or on adverse side effects of castration. For progestagens a wide range of undesirable side effects have been described. The results of both castration and progestagen therapy differ in the various studies. The underlying mechanism(s) of progestagen influence on behaviour are not understood. Therefore, future research on this topic is necessary.     

Management of liver disease in dogs and cats

Ampicillin or amoxicillin is a good initial choice for treatment of liver disease involving bacteria. Cephalosporins, among other antibiotics, can be used with aminoglycosides for a broad-spectrum effect. Metronidazole may benefit patients with hepatic encephalopathy. Tetracycline, penicillins and cephalosporins are good choices for biliary disease. Corticosteroids are indicated for chronic active hepatitis, cholangiohepatitis, immune-mediated hepatopathy, and hepatic lymphosarcoma and mast-cell tumors. D-penicillamine is used to treat hepatic Cu toxicosis. Colchicine has been used to combat hepatic fibrosis. Lactulose is used in long-term management of hepatic encephalopathy. Diuretics and a low-Na diet help control ascites. Cimetidine is used to control GI ulcers. Anabolic steroids help reverse protein catabolism. Acetylcysteine is an antidote for acetaminophen toxicity. Use of hetacillin, chloramphenicol, lincomycin, sulfonamides, erythromycin, acetaminophen and methyltestosterone should be avoided in patients with liver disease.