Resolution of anuric acute kidney injury in a dog with multiple organ dysfunction syndrome

Hoareau, Guillaume L.; Epstein, Steven E; Palm, Carrie A.; Ybarra, Winnie L.; Jandrey, Karl E.; Cowgill, Larry D

doi:10.1111/vec.12248

Cited by 5 publications

(3 citation statements)

References 42 publications

(75 reference statements)

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“…It can result from hypovolemia, hypotension, and direct kidney injury. It is characterized by increased serum creatinine levels and decreased urinary output (Hoareau et al 2014). In humans, AKI has been documented in 47% of patients with a clinical diagnosis of sepsis, being a public health concern.…”

Section: Discussionmentioning

confidence: 99%

Clinical and microbiological characteristics of dogs in sepsis in an academic veterinary hospital in the north of Paraná

2020

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Sepsis is a life-threatening organ dysfunction caused by a patient’s unregulated response to an infectious process. In veterinary medicine, the exact incidence of sepsis is unknown. Early recognition of sepsis in critically ill patients is essential for rapid and effective therapeutic intervention. The present study aimed to apply the criteria of an adapted sepsis assessment protocol based on the Second International Consensus Definition for Sepsis and Septic Shock or Sepsis-2 of human medicine, in canine patients with suspected systemic inflammatory response syndrome (SIRS) and/or organ dysfunction, and to identify infectious agents as well as their antimicrobial resistance profile in the focus of infection, in the bloodstream and colonizing the rectal mucosa. Patients were evaluated for survival and severity of sepsis. Of the 37/42 dogs that met the sepsis criteria, six presented septic shock, 26 (70.2%) had at least two signs of SIRS, and sepsis with organ dysfunction was diagnosed in 27 (73%) dogs. The primary dysfunctions observed were decreased level of consciousness in 21/37 (56.8%), hyperlactatemia in 19/37 (51.4%), and hypoalbuminemia in 18/37 (48.6%). Two or more SIRS signs associated with hypotension and hypoalbuminemia were related to more than half of the deaths. The most frequent infectious focus was skin and soft tissue in 20/37 (54%), followed by organs and cavities in 8/37 (21.6%). The survival rate was 56.7%. Blood culture confirmed bacteremia in nine patients (24.3%), with a predominance of Gram-positive microorganisms (Staphylococcus intermedius, Streptococcus spp.) in 66.6% of dogs and one yeast (Candida glabrata). The most frequent bacteria in the focus of infection were gram-negative bacteria (46.2%), mainly Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa, in 19.5%, 14.6%, and 12.1%, respectively. We observed colonization by gram-negative bacteria such as E. coli-ESBL (31.5%), K. pneumoniae-ESBL (15.7%), and P. aeruginosa (15.7%), and the presence of ESBL bacteria was more associated with death when compared with other microorganisms. Vancomycin-resistant Enterococcus (VRE) were isolated from rectal mucosa in four dogs. Gram-negative microorganisms were the most frequent in both infections and colonization, and most of them were resistant to fluoroquinolones, sulfonamides, tetracyclines, and cephalosporins. Based on this information, it can be concluded that mortality due to sepsis in dogs was high. Due to the presence of multi-resistant bacteria, the use of antimicrobials should be judicious, suggesting the implementation of the same precautions used in human hospitals to prevent the spread of multi-resistant microorganisms.

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Section: Discussionmentioning

confidence: 99%

Clinical and microbiological characteristics of dogs in sepsis in an academic veterinary hospital in the north of Paraná

2020

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“…Ускладнюючим фактором виступає в'язка структура фібрину, який може викликати повну механічну обструкцію уретри або утруднювати сечовипускання (Flores-Mireles et al, 2016). Проходить зворотня реабсорбція сечі через сечоводи до нирок та виникає гостра ниркова недостатність (Hoareau et al, 2014).…”

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Bacterial urocystitis in dogs and cats (classification, pathogenesis, causative agents, treatment, and prevention)

Martyniv

2024

SMLNUVMB

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Diseases of the urinary system are a common problem for small animals. Most often, pathological changes in the urinary bladder and urethra are registered in dogs and cats. In particular, urocystitis ranks first in the list of diseases of the lower urinary tract. The etiology of urocystitis can have a different genesis - infectious and non-infectious. Infectious urocystitis is divided into primary and secondary, which depends on the way of penetration of the uropathogen into the body. They have the same characteristics (bacterial pathogen, pathogenesis, clinical signs) as other infectious diseases, but no clear nosological classification exists. Most often, the causative agents of infectious urocystitis are bacteria that live on the body of animals as conditionally pathogenic microflora. These include escherichia, enterococci, corynebacteria, staphylococci, streptococci, proteus, and pseudomonads. Under favorable conditions, such as urolithiasis, immunosuppression, neoplasia, or congenital or acquired anatomical and functional defects of the urethra and bladder, these bacteria penetrate the urinary canal and begin to multiply uncontrollably there, which leads to the emergence of an infectious inflammatory process. Secondary bacterial urocystitis is more dangerous than primary ones, as constant relapses of the disease characterize their course. The final process of this disease is usually urosepsis. Therefore, according to various authors, the only effective therapy method for secondary infectious urocystitis is using antibiotics to which the pathogen is sensitive. This leads to antibiotic resistance of the bacterial microflora in the patient's body. The emergence of resistance of pathogens to antimicrobial agents makes further treatment of this pathology impossible. Preventive measures, proposed in various publications, ensure only the continuation of the remission of the disease. These measures cannot stop the recurrence of bacterial urocystitis and its irreversible consequences. Due to the cyclic nature of the pathogenetic process, dogs and cats suffering from secondary infectious urocystitis are classified as terminal patients. Alternative solutions to this problem have not yet been proposed. Analysis of literature data indicates that infectious urocystitis occurs more often as a complication of primary pathology. Still, after eliminating the initial cause, they play a vital role in the body of sick animals. Therefore, scientists' research should be directed to developing and implementing therapeutic measures and means that would neutralize bacterial agents without causing them to become resistant to antibiotics. The article describes the mechanisms of infection by uropathogens through the distal part of the urinary system and possible favorable factors that are the key to this process. The frequency of the disease occurrence in cats and dogs is given according to species, age, and sex. Issues of approach and treatment of bacterial urocystitis and related complications are highlighted. Based on the obtained data, an analysis was carried out, and a perspective vector was formed for further scientific research, which would eliminate the problem of this disease in small animals.

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“…Supportive care, close monitoring of organ function, and intensive care nursing are needed to manage MODS [6]. The respiratory, cardiovascular, gastrointestinal, renal, hepatic, coagulation, and nervous systems are generally affected in dogs with MODS [4, 5], and multiorgan failure due to this condition is associated with mortality in both humans and dogs [4, 7, 8].…”

Section: Introductionmentioning

confidence: 99%

Global brain ischemia in a dog with concurrent multiorgan dysfunction syndrome after bite wound trauma

2019

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Background Bite wounds are one of the most common traumatic injuries in dogs and depending on their severity, location, etc., urgent care including antibiotic therapy may be necessary. Serious complications can result from these injuries, such as multiple organ dysfunction syndrome (MODS), as well as a generalized reduction in cerebral perfusion, e.g. during cardiac arrest, shock, or severe hypotension that may cause global brain ischemia (GBI). Case presentation A 5-year-old spayed female Maltese dog was presented with generalized seizures, ataxia, and obtunded mentation. The dog was injured by severe bite wounds that penetrated its abdomen and had received blood transfusions, antibiotic therapy (including metronidazole and cefazoline) and underwent emergency surgery 4 days before its visit. Based on a clinical examination, intracranial hypoxic damage with elevated intra-cranial pressure and MODS were highly suspected, and GBI was confirmed following magnetic resonance imaging. Increased signal intensity diffusely distributed in the olfactory bulb and frontal, temporal, and parietal grey matter was evident on the T2-weighted and fluid attenuated inversion recovery transverse images, along with corresponding high signal intensity observed on diffusion weighted imaging. During the 10-month follow-up period, the clinical signs gradually improved, but intermittent circling and cognitive dysfunction deficits remained. Conclusions GBI should be included among the differential diagnoses in case of any peracute non-progressive neurological dysfunction that occurs with episodes of hypotension or hypoxia. The abnormal signal intensity observed on diffusion weighted imaging was a useful indicator for diagnosing this condition. Long-term medical management with antibiotics and anti-convulsant and anti-oxidant therapies were considered to be helpful in managing the GBI concurrent with MODS in this dog.

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Resolution of anuric acute kidney injury in a dog with multiple organ dysfunction syndrome

Cited by 5 publications

References 42 publications

Clinical and microbiological characteristics of dogs in sepsis in an academic veterinary hospital in the north of Paraná

Clinical and microbiological characteristics of dogs in sepsis in an academic veterinary hospital in the north of Paraná

Bacterial urocystitis in dogs and cats (classification, pathogenesis, causative agents, treatment, and prevention)

Global brain ischemia in a dog with concurrent multiorgan dysfunction syndrome after bite wound trauma

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