A retrospective study of 237 dogs hospitalized with suspected acute hemorrhagic diarrhea syndrome : Disease severity, treatment, and outcome
© 2021 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals LLC on behalf of American College of Veterinary Internal Medicine..
BACKGROUND: Few studies have investigated management and outcome in dogs with acute hemorrhagic diarrhea syndrome (AHDS), and there is a paucity of data on dogs with concurrent signs of sepsis.
OBJECTIVES: To report outcome in dogs with suspected AHDS according to disease severity and antimicrobial treatment, and to evaluate effect of fluid resuscitation on clinical criteria.
ANIMALS: Two hundred thirty-seven dogs hospitalized with suspected AHDS.
METHODS: Retrospective study based on medical records. Disease severity was evaluated using AHDS index, systemic inflammatory response syndrome (SIRS) criteria, and serum C-reactive protein (CRP) according to 3 treatment groups: No, 1, or 2 antimicrobials.
RESULTS: Sixty-two percent received no antimicrobials, 31% received 1 antimicrobial, predominantly aminopenicillins, and 7% received 2 antimicrobials. At admission, median AHDS index was 13 (interquartile range, 11-15), which decreased significantly after the first day's hospitalization (P < .001) for all groups. Compared with no antimicrobials (7%), more dogs had ≥2 SIRS criteria in the antimicrobial groups (15% and 36%, respectively). C-reactive protein (CRP) correlated positively with AHDS index at hospitalization (P < .001). Across treatment groups, rehydration markedly reduced number of clinical SIRS criteria. Survival to discharge was 96%, lower for dogs receiving 2 antimicrobials (77%, P < .05).
CONCLUSIONS AND CLINICAL IMPORTANCE: The majority of dogs hospitalized with suspected AHDS improve rapidly with symptomatic treatment only, despite signs of systemic disease on initial presentation. The often-used SIRS criteria might be a poor proxy for identifying dogs with AHDS in need of antimicrobial treatment, in particular when hypovolemic. The role of CRP in clinical decision-making or prognostication warrants further investigation.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:35 |
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| Enthalten in: |
Journal of veterinary internal medicine - 35(2021), 2 vom: 15. März, Seite 867-877 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Dupont, Nana [VerfasserIn] |
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| Links: |
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| Themen: |
AHDS |
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| Anmerkungen: |
Date Completed 25.06.2021 Date Revised 25.06.2021 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1111/jvim.16084 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM321964861 |
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| 100 | 1 | |a Dupont, Nana |e verfasserin |4 aut | |
| 245 | 1 | 2 | |a A retrospective study of 237 dogs hospitalized with suspected acute hemorrhagic diarrhea syndrome |b Disease severity, treatment, and outcome |
| 264 | 1 | |c 2021 | |
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| 500 | |a Date Completed 25.06.2021 | ||
| 500 | |a Date Revised 25.06.2021 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2021 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals LLC on behalf of American College of Veterinary Internal Medicine. | ||
| 520 | |a BACKGROUND: Few studies have investigated management and outcome in dogs with acute hemorrhagic diarrhea syndrome (AHDS), and there is a paucity of data on dogs with concurrent signs of sepsis | ||
| 520 | |a OBJECTIVES: To report outcome in dogs with suspected AHDS according to disease severity and antimicrobial treatment, and to evaluate effect of fluid resuscitation on clinical criteria | ||
| 520 | |a ANIMALS: Two hundred thirty-seven dogs hospitalized with suspected AHDS | ||
| 520 | |a METHODS: Retrospective study based on medical records. Disease severity was evaluated using AHDS index, systemic inflammatory response syndrome (SIRS) criteria, and serum C-reactive protein (CRP) according to 3 treatment groups: No, 1, or 2 antimicrobials | ||
| 520 | |a RESULTS: Sixty-two percent received no antimicrobials, 31% received 1 antimicrobial, predominantly aminopenicillins, and 7% received 2 antimicrobials. At admission, median AHDS index was 13 (interquartile range, 11-15), which decreased significantly after the first day's hospitalization (P < .001) for all groups. Compared with no antimicrobials (7%), more dogs had ≥2 SIRS criteria in the antimicrobial groups (15% and 36%, respectively). C-reactive protein (CRP) correlated positively with AHDS index at hospitalization (P < .001). Across treatment groups, rehydration markedly reduced number of clinical SIRS criteria. Survival to discharge was 96%, lower for dogs receiving 2 antimicrobials (77%, P < .05) | ||
| 520 | |a CONCLUSIONS AND CLINICAL IMPORTANCE: The majority of dogs hospitalized with suspected AHDS improve rapidly with symptomatic treatment only, despite signs of systemic disease on initial presentation. The often-used SIRS criteria might be a poor proxy for identifying dogs with AHDS in need of antimicrobial treatment, in particular when hypovolemic. The role of CRP in clinical decision-making or prognostication warrants further investigation | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a AHDS | |
| 650 | 4 | |a C-reactive protein | |
| 650 | 4 | |a antibiotics | |
| 650 | 4 | |a canine | |
| 650 | 4 | |a hemorrhagic gastroenteritis | |
| 700 | 1 | |a Jessen, Lisbeth Rem |e verfasserin |4 aut | |
| 700 | 1 | |a Moberg, Frida |e verfasserin |4 aut | |
| 700 | 1 | |a Zyskind, Nathali |e verfasserin |4 aut | |
| 700 | 1 | |a Lorentzen, Camilla |e verfasserin |4 aut | |
| 700 | 1 | |a Bjørnvad, Charlotte Reinhard |e verfasserin |4 aut | |
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