VSPN AOW : Prevalence and clinical o... |
Prevalence and clinical outcome of subclinical bacteriuria in female dogs.J Am Vet Med Assoc. July 2014;245(1):106-12.1 Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin, Madison, WI 53706.
AbstractObjective-To determine the prevalence of subclinical bacteriuria and its natural clinical course over a 3-month period in healthy female dogs. Design-Observational, prospective, cross-sectional study. Animals-101 healthy client-owned female dogs. Procedures-In all dogs, screening clinicopathologic tests and bacteriologic culture of urine were performed. In culture-positive dogs, subclinical bacteriuria was confirmed by 2 positive culture results within 2 weeks and dogs were reevaluated at 3 months. Results-The prevalence of subclinical bacteriuria in healthy female dogs was 9 of 101 (8.9%). Three-month follow-up data were available for 8 of 9 dogs with subclinical bacteriuria. Four dogs had persistent bacteriuria, and 4 had transient bacteriuria. No dogs with subclinical bacteriuria developed clinical signs during the 3-month observation period. Subclinical bacteriuria was diagnosed in 6 of 51 (12%) young and middle-aged dogs and 3 of 50 (6.0%) senior and geriatric dogs. No significant difference was found in the prevalence of subclinical bacteriuria with age. Conclusions and Clinical Relevance-Results suggested that subclinical bacteriuria is a nonprogressive condition in healthy female dogs and can be persistent or transient. No significant difference in the prevalence of subclinical bacteriuria in young and middle-aged dogs versus senior and geriatric dogs was detected. No dogs with subclinical bacteriuria developed clinical signs requiring antimicrobial treatment during the 3-month observation period. Healthy female dogs with subclinical bacteriuria may be a population of dogs in which antimicrobial treatment is unnecessary.
Companion NotesProspective, observational, cross-sectional study on the prevalence and clinical outcome of subclinical bacteriuria in female dogs
Study design - introduction on subclinical bacteriuria - asymptomatic bacteriuria in human medicine: - transient or persistent, benign condition that doesn't require treatment - in healthy pre- and postmenopausal women - defined as the following - presence of ≥ 105 CFUs/mL of a single bacterial pathogen - in 2 consecutive midstream urine specimens - without symptoms of lower urinary tract infection - estimated prevalence increases with age - 5% in pre-menopausal women - 25% in women > 65 years old - ≥ 50% in women > 80 years of age - commonly isolated uropathogens include the following: - Escherichia coli, most common - Klebsiella spp - Enterococcus spp - Staphylococcus spp - in canine medicine: - lower urinary tract infection is common in female dogs - similar distribution of uropathogens and risk factors as in humans - however, subclinical bacteriuria is not a widely recognized condition - bacteriuria is a common indication for antimicrobials - subclinical bacteriuria reported in both sex:M and sex:F dogs as early as 1972 - dogs with the following recognized to have subclinical bacteriuria: - diabetes mellitus - puppies with parvovirus infections - inflammatory skin disorders treated with cyclosporine - obese adult dogs - dogs with positive urine culture with above conditions usually treated - International Society for Companion Animal Infectious Diseases guidelines - recent guidelines for treatment of urinary tract disease in cats and dogs - treatment may be unnecessary in animals with subclinical bacteriuria - extrapolated from human studies - there's growing concern for better use of antimicrobials in veterinary medicine - study population: dogs recruited at University of Wisconsin from 05/11-11/12 - 101 healthy, female, pet dogs belonging to faculty, staff and students - dogs had no signs of lower urinary tract disease - urgency to urinate - dysuria - pollakiuria - stranguria - hematuria - malodorous urine - periuria - 107 dogs were screened and 101 were enrolled (2 were lost to followup) - 2 dogs had Capillaria spp in urine sediment - procedure: - screening clinicopathologic tests and bacteriologic culture of urine performed - blood and urine collected - initial urine sample collected via clean, midstream voided sample - in culture-positive dogs the following was performed: - subclinical bacteriuria confirmed by 2 positive cultures within 2 weeks - urine collected by cystocentesis - rule out any false-positives from initial screening culture - from secondary urogenital contamination - initial culture results confirmed in all cases - further testing to rule out predisposing conditions for bacteruria (incontinence, diabetes, urolithiasis etc) - dogs reevaluated at 3 months - to assess if bacteriuria was transient or persistent - diagnosis of subclinical bacteriuria - positive 2nd bacteriologic culture of urine collected by cystocentesis - at 7- to 14-day follow-up evaluation - no clinical signs of lower urinary tract disease present
Results - prevalence of subclinical bacteriuria in healthy females: 8.9% (9 of the 101) - 3 month followup available for 8 of the 9 dogs with subclinical bacteriuria - 4 had persistent bacteriuria - 4 had transient bacteriuria - none of the dogs developed clinical signs during the 3 month followup - history & signalment of the dogs with sub-clinical bacteriuria - 6 of 51 (12%) young and middle-aged dogs - 3 of 50 (6.0%) senior and geriatric dogs - not significantly different from percentage in younger dogs - culture results - in the young and middle-aged dogs - E coli, 1 - Enterococcus faecalis, 1 - Staphylococcus pseudintermedius, 3 - Streptococcus canis, 1 - in the senior and geriatric dogs - E coli, 1 - Enterococcus faecalis, 1 - Klebsiella spp, 1 - detection of bacteria by urine sediment analysis - 4 of the 9 dogs with subclinical bacteriuria - 2 of 92 dogs without subclinical bacteriuria - pyuria (> 5 WBC/hpf) - 5 of 9 dogs with subclinical bacteriuria - 14 of 92 dogs without subclinical bacteriuria - > 100,000 CFUs/mL isolated in 7 of the 9 dogs with subclinical bacteriuria - senior and geriatric dogs had significantly different laboratory parameters - as compared to young and middle-aged dogs - lower Hct - median in senior and geriatric dogs: 49% - median in young and middle-aged dogs: 51% - higher platelet count - median in senior and geriatric dogs: 308 x 103/µl - median in young and middle-aged dogs: 245 x 103/µl - higher serum alanine aminotransferase activities - median in senior and geriatric dogs: 58 U/L - median in young and middle-aged dogs: 41 U/L - higher alkaline phosphatase activities - median in senior and geriatric dogs: 76 U/L - median in young and middle-aged dogs: 43 U/L - lower urine specific gravity - median in senior and geriatric dogs: 1.033 - median in young and middle-aged dogs: 1.039
"In the interest of the advancement of antimicrobial stewardship, the authors do not recommend empirical or routine treatment of subclinical bacteriuria in healthy female dogs. However, if subclinical bacteriuria is detected in a healthy female dog, clinical monitoring is recommended, including serial bacteriologic culture of urine, to determine whether subclinical bacteriuria is transient, persistent, or progressive and to intervene as indicated."
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VSPN AOW : Prevalence and clinical o... |
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