Objectives: Feline infectious peritonitis (FIP) is a serious disease that arises due to feline coronavirus infection. The nucleoside analogues remdesivir and GS-441524 can be effective in its treatment, but most studies have used unregulated products of unknown composition. The aim of the present study was to describe the treatment of FIP using legally sourced veterinary-prescribed regulated veterinary compounded products containing known amounts of remdesivir (injectable) or GS-441524 (oral tablets). Methods: Cats were recruited via email advice services, product sales contacts and study publicity. Cats were excluded if they were deemed unlikely to have FIP, were not treated exclusively with the veterinary compounded products, or if there was a lack of cat and/or treatment (including response) data. Extensive cat and treatment data were collected. Results: Among the 307 cats recruited, the predominant type of FIP was most commonly abdominal effusive (49.5%) and then neurological (14.3%). Three treatment protocols were used; remdesivir alone (33.9%), remdesivir followed by GS-441524 (55.7%) and GS-441524 alone (10.4%). The median (range) initial treatment period duration and longest follow-up time point after starting treatment were 84 (1–330) days and 248 (1–814) days, respectively. The most common side effect was injection pain (in 47.8% of those given subcutaneous remdesivir). Of the 307 cats, 33 (10.8%) relapsed, 15 (45.5%) during and 18 (54.5%) after the initial treatment period. At the longest follow-up time point after completion of the initial treatment period, 84.4% of cats were alive. The cats achieving a complete response within 30 days of starting treatment were significantly more likely to be alive at the end of the initial treatment period than those cats that did not. Conclusions and relevance: Legally sourced remdesivir and GS-441524 products, either alone or used sequentially, were very effective in the treatment of FIP in this group of cats. Variable protocols precluded statistical comparison of treatment regimens.
Antimicrobial stewardship guidelines (ASGs) represent an important tool to help veterinarians optimize their antimicrobial use with the objective of decreasing antimicrobial resistance. The aim of this study was to map and qualitatively assess the ASGs for antimicrobial use in cats and dogs in Europe. Country representatives of the European Network for Optimization of Veterinary Antimicrobial Treatment (ENOVAT) were asked to identify ASGs published in their countries. All collated ASGs updated since January 2010 containing recommendations on antimicrobial therapy for at least three conditions affecting different organ systems in cats and dogs underwent detailed review including AGREE II analysis. Out of forty countries investigated, fifteen ASGs from eleven countries met the inclusion criteria. Several critical principles of antimicrobial use were identified, providing a framework that should assist development of stewardship guidance. The AGREE II analysis highlighted several methodological limitations of the currently available ASGs. This study sheds light on the lack of national ASGs for dogs and cats in multiple European countries and should encourage national bodies to prioritize guideline development in small animals. A greater awareness of the need to use a structured approach to guideline development could improve the quality of ASGs in the future.
Objectives: To describe the diagnostic tests used and their comparative performance in dogs diagnosed with sinonasal aspergillosis in the United Kingdom. A secondary objective was to describe the signalment, clinical findings and common clinicopathologic abnormalities in sinonasal aspergillosis.Materials and Methods: A multi‐centre retrospective survey was performed involving 23 referral centres in the United Kingdom to identify dogs diagnosed with sinonasal aspergillosis from January 2011 to December 2021. Dogs were included if fungal plaques were seen during rhinoscopy or if ancillary testing (via histopathology, culture, cytology, serology or PCR) was positive and other differential diagnoses were excluded.Results: A total of 662 cases were entered into the database across the 23 referral centres. Four hundred and seventy‐five cases met the study inclusion criteria. Of these, 419 dogs had fungal plaques and compatible clinical signs. Fungal plaques were not seen in 56 dogs with turbinate destruction that had compatible clinical signs and a positive ancillary test result. Ancillary diagnostics were performed in 312 of 419 (74%) dogs with observed fungal plaques permitting calculation of sensitivity of cytology as 67%, fungal culture 59%, histopathology 47% and PCR 71%.Clinical Significance: The sensitivities of ancillary diagnostics in this study were lower than previously reported challenging the clinical utility of such tests in sinonasal aspergillosis. Treatment and management decisions should be based on a combination of diagnostics including imaging findings, visual inspection, and ancillary testing, rather than ancillary tests alone.
Objectives: To evaluate the clinical benefit of faecal microbiota transplantation administered via a single retention enema, as an adjunctive treatment in the management of dogs with chronic enteropathy. Materials and Methods: Blinded, randomised controlled trial. Dogs with chronic enteropathy (>3 weeks of small or mixed intestinal diarrhoea) were randomly allocated to either the faecal microbiota transplantation or standard treatment group (ratio 1:1) via blinded selection. Dogs in the standard treatment group had a diet change only, while dogs in the faecal microbiota transplantation group had a diet change and faecal microbiota transplantation. faecal microbiota transplantation was performed using fresh faecal material from donor dogs, screened for selected enteropathogens and administered via retention rectal enema. Outcomes measured included the Canine Inflammatory Bowel Disease Activity Index, faecal score and the owner's reported improvement. Group comparisons were made using Fisher's exact tests (owner‐reported outcomes) and Kruskal–Wallis tests adjusted for ties (Canine Inflammatory Bowel Disease Activity Index and faecal score). Results: Forty‐two dogs with chronic enteropathy (median Canine Inflammatory Bowel Disease Activity Index score 6 [range 4 to 11]) were included in the study. Twenty‐five dogs were randomly assigned to receive faecal microbiota transplantation, while 17 dogs were allocated to standard treatment. A progressive improvement in stool consistency (reduced faecal score) was recorded over time for most dogs in both groups. By Day 90, the rates of owner‐defined clinical improvement were 76% (CI 54% to 90%) in the faecal microbiota transplantation group and 73% (CI 40% to 92%) in the standard treatment group. No significant differences were evident between the two groups based on the proportion of owners that reported clinical improvement, Canine Inflammatory Bowel Disease Activity Index score or faecal score. Clinical Significance: This study did not demonstrate a clear clinical benefit for adjunctive faecal microbiota transplantation via single retention enema in dogs with chronic enteropathy compared to diet change alone, although the small sample size means that a type II error cannot be excluded. The similar outcome for both groups supports high rates of food responsiveness among this cohort of chronic enteropathy dogs.
13 January 2025 in Journal of Small Animal Practice