Antimicrobial use Guidelines for Treatment of Respiratory Tract Disease in Dogs and Cats

Question 1

What are the most common pathogens associated with FURTD?

Answer 1

• feline herpesirus 1 (FHV-1)
• calicivirus (FCV)

Question 2

What is the difference between the terms ‘feline upper respiratory tract dz’ VS ‘upper resp infection’?

Answer 2

FURTD= syndrome consisting of clinical signs including serous to mucopurulent ocular and nasal discharge, epistaxis, sneezing and conjunctivitis.
URI= used for cats with signs of FURTD with identified pathogen (??)

Question 3

What bacteria are commonly cultured in pt that develop secondary bacterial infections?

Answer 3

Staphylococcus spp., Streptococcus spp.,
Pasteurella multocida, Escherichia coli, and anaerobes

Question 4

Can cats have URTD with no virus?

Answer 4

yes. Several bacterial soecies have been isolated/detected from cats with URTD without presence of pathogenic viruses.

Question 5

What are predisposing factors for development of URTD in cats?

Answer 5

• no vaccination
• exposure to other cats
• contact with shelter, kennel, vet hosp
• exposure to dogs that have been boarded/shelter
• recent stress (reactivates FHV-1)
• FeLV/FIV positive
• immunosuppression
• lymphoma

Question 6

T/F: it is not recommended to start abx therapy in cats with serous discharge withour a purulent component.

Answer 6

T. as most likely it is an uncomplicated viral infection.

Question 7

T/F: it is recommended to start abx therapy in cats with mucopurulent or purulent discharge

Answer 7

F: if no evidence of the cause of URTD, then period of observation is recommended (10 days) (unless cat is systemically unwell).

Question 8

If abx are indicated, what are the recommendations?

Answer 8

• Doxy 7-10 days
• Amoxicillin if mycoplasma and Chlamydia felis not highly susp

Question 9

what is the MOA of doxycycline?

Answer 9

Bind to 30S ribosomal unit and inhibit protein synthesis. Actively transported(concentrated) into bacterial cells.
Bacteriostatic.

Question 10

When is a full work-up recommended?

Answer 10

After 10days of duration of clinical signs if pt systemically well. Otherwise earlier.

Question 11

What wpuld be the purpose of the work up?

Answer 11

Evaluate for other causes including Cuterebra spp. and fungal diseases as well as noninfectious causes of URTD
including allergic diseases, neoplasia, foreign bodies,
nasopharyngeal stenosis, oronasal fistulas, nasopharyngeal
polyps, and trauma.8–11 Referral to a specialist is
recommended if advanced

Question 12

When is it recommended to perform C&S?

(unclear really)

Answer 12

in cats with chronic bacterial URI with severe clinical signs to identify the antimicrobial susceptibility of severe secondary bacterial infections that occur secondary
to an untreatable underlying cause (eg, idiopathic inflammatory rhinitis); to provide relief.

Question 13

Define ‘multidrug resistant’.

Answer 13

Lack of susceptibility to at least one agent in three or more chemical classes of antibiotic (e.g. a beta-lactam, an aminoglycoside, a macrolide).

Question 14

When dealing with severe multidrug resistant infections= ABC where C stays for consult with IM

Question 15

What is the MOA of pradofloxacin?

Answer 15

InhibitDNA gyrase (bacterial topoisomerase II)&topoisomerase IV.

Inhibition of DNA gyrase = target for fluoroquinolones in gram- bacteria

Inhibition of topoisomerase IV = target for fluoroquinolones in gram+ bacteria

Question 16

What is the MOA of pradofloxacin and when is it recommended for tx of feline URTI?

Answer 16

should be reserved for situations when chlamydiosis is not likely and when other antimicrobial agents (eg, doxycycline, amoxicillin) are not viable options

Question 17

What is it recommended to do if Pseudomonas aeruginosa is isolated?

Answer 17

flush flush flush nasal cavities, see susceptibility and consult IM ;P (monotherapy with fluoroquinolone accepted in humans)

Question 18

If started, how long would you continue antibiotics?

Answer 18

For at least 7 days and if positive effect than 1 week after symptoms resolution of nasal d/c or plateau in response to tx