Severe soft tissue infections in dogs: 47 cases (1996–2006)

Abstract

Objective -To describe the patient population, microbiological findings, treatment and outcome in dogs with severe soft tissue infections (SSTIs) and to compare survivors to nonsurvivors. Design -Retrospective study. Animals -Forty-seven dogs with confirmed soft tissue infections originating from the SC tissues, muscle or fascia. Interventions -None.Measurements and Main Results -Physical and clinicopathologic data on presentation, microbiological and histopathological findings, antimicrobial treatment and outcome. Dogs with SSTIs were predominantly large breed dogs with a median body weight of 35.6 kg. Incidence of pre-existing conditions (immunomodulating diseases, blunt trauma, injections, clean surgical procedures) that could have contributed to development of SSTIs was 34%. Abnormal physical examination and diagnostic parameters on presentation included increased body temperature (median temperature 39.5 1C [103.1 1F]) and low arterial blood pressure (median systolic blood pressure 103.5 mm Hg). While Streptococcus species were the most commonly isolated bacteria, the incidence of polymicrobial infections differed between antemortem (38.7%) and postmortem (57.1%) cultures. The overall survival rate was 46.8%. Survivors had a higher body weight and higher respiratory rate on presentation than nonsurvivors. Nonsurvivors had a significantly lower WBC count and higher lactate, BUN, aspartate aminotransferase, and bilirubin concentrations. Histopathologic examination of tissue specimens showed that the degree of necrosis was higher in survivors compared with nonsurvivors. Conclusions -SSTIs in dogs are serious conditions associated with high mortality, significant inflammatory changes, and cardiovascular compromise. A number of conditions, including those that compromise skin integrity and immunomodulating diseases have been identified in our patient population and could have contributed to development of SSTIs. Polymicrobial infections occurred in many cases, necessitating broadspectrum antimicrobial coverage.

Clinical use of plasma lactate concentration. Part 2: Prognostic and diagnostic utility and the clinical management of hyperlactatemia

“…Presently, there are few highly powered, large‐scale studies in the veterinary literature on which to base recommendations for using [LAC] measurements in patient evaluation and management. In an effort to provide some general guidelines, a literature search of PubMed, Scopus, and CAB Abstracts performed for this review identified 35 clinical studies that investigated [LAC] as a prognostic indicator in dogs and cats . As in the human medical literature, there was marked heterogeneity in study sizes, study populations, mortality, and selected lactate cut‐off points making comparison across studies challenging.…”

“…Despite these limitations, the association between increased admission or initial [LAC] and mortality is well documented in dogs. From the available clinical studies that contained sufficient data for analysis, nonsurviving dogs had significantly higher [LAC] than survivors in 18 of 22 studies . Studies that found significantly higher [LAC] in nonsurvivors were in: dogs with blunt or penetrating trauma, sepsis or systemic inflammatory response syndrome (SIRS), spontaneous hemoabdomen, immune‐mediated hemolytic anemia, babesiosis, heartworm, general illness or injury, gastric dilatation and volvulus (GDV), and following cholecystectomy .…”

“…Studies that found significantly higher [LAC] in nonsurvivors were in: dogs with blunt or penetrating trauma, sepsis or systemic inflammatory response syndrome (SIRS), spontaneous hemoabdomen, immune‐mediated hemolytic anemia, babesiosis, heartworm, general illness or injury, gastric dilatation and volvulus (GDV), and following cholecystectomy . A significant difference in [LAC] between survivors and nonsurvivors was not found in 4 of 22 studies: dogs with GDV, blunt trauma, babesiosis, and soft tissue infections . Notably, [LAC] was a significant predictor of mortality in the acute patient physiologic and laboratory evaluation (APPLE) scoring system, which is a rigorous, veterinary, disease severity scoring system .…”

Severe acute cellulitis and sepsis caused by Aeromonas spp. in a dog on immunosuppressive therapy

“…are also shed in the feces of some dogs so it is also possible that the infection was endogenous. The dog's history of immunosuppressive therapy is consistent with cases of SSTIs in the veterinary literature but is an inconsistent historical finding amongst Aeromonas ‐associated SSTIs in people. Most dogs that develop bacterial SSTIs have an underlying disease that affects their immune function or skin integrity .…”

“…Here, we report a case of severe acute panniculitis and cellulitis in a 5‐year‐old female Border Collie caused by Aeromonas spp. Although the current recommended treatment for severe soft tissue infections in both dogs and people includes aggressive surgical debridement, the patient in this case survived with medical treatment alone.…”