1Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO.
2Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, WI.
J Am Vet Med Assoc. 2022 Sep 27;261(1):1-9. doi: 10.2460/javma.22.07.0320.
To describe the prevalence of postoperative bacteriuria, clinical course of subclinical bacteriuria in the absence of antimicrobial intervention, clinical signs of bacteriuria that trigger antimicrobial treatment, and outcomes for dogs with subclinical bacteriuria following surgical decompression of acute intervertebral disc herniation (IVDH) Hansen type I.
Twenty client-owned dogs undergoing hemilaminectomy for acute (≤ 6 days) IVDH Hansen type I affecting the thoracolumbar spinal cord segments between August 2018 and January 2019.
In this prospective study, dogs were serially evaluated at presentation, hospital discharge, 2 weeks postoperatively, and between 4 and 6 weeks postoperatively. Dogs were monitored for clinical signs of bacteriuria, underwent laboratory monitoring (CBC, biochemical analyses, urinalysis, urine bacterial culture), and were scored for neurologic and urinary status. In the absence of clinical signs, bacteriuria was not treated with antimicrobials.
Four of the 18 dogs developed bacteriuria without clinical signs 4 days to 4 to 6 weeks after surgery. In all 4 dogs, bacteriuria resulted in lower urinary tract signs 13 to 26 weeks postoperatively. No dogs had evidence of systemic illness despite delaying antimicrobial treatment until clinical signs developed. New-onset incontinence was the only clinical sign in 3 dogs. All bacterial isolates had wide antimicrobial susceptibility. Bacteriuria and clinical signs resolved with beta-lactam antimicrobial treatment.
Postoperative bacteriuria occurs in some dogs with IVDH Hansen type I and, when present, may lead to clinical signs over time. Clinical signs of bacteriuria may be limited to new-onset urinary incontinence, inappropriate urination, or both. Delaying antimicrobial treatment until clinical signs of bacteriuria developed did not result in adverse consequences or systemic illness.
描述术后菌尿症的流行情况，在没有抗菌干预的情况下亚临床菌尿的临床过程，触发抗菌治疗的菌尿临床体征，以及接受 Hansen Ⅰ型急性椎间盘突出症（IVDH）手术减压的犬亚临床菌尿的转归。
20 只接受半椎板切除术治疗 Hansen Ⅰ型急性（≤6 天）IVDH 影响胸腰椎脊髓段的患犬，于 2018 年 8 月至 2019 年 1 月间入组。
在这项前瞻性研究中，犬在就诊时、出院时、术后 2 周和术后 4 至 6 周进行连续评估。监测犬有无菌尿的临床体征，进行实验室监测（全血细胞计数、生化分析、尿液分析、尿液细菌培养），并对神经和泌尿道状况进行评分。在无临床体征的情况下，未使用抗菌药物治疗菌尿。
18 只犬中有 4 只在术后 4 天至 4 至 6 周出现无临床体征的菌尿。在所有 4 只犬中，菌尿导致了下尿路体征，在术后 13 至 26 周。尽管直到出现临床体征才开始抗菌治疗，但没有犬出现全身疾病的证据。3 只犬仅有新发失禁这一临床体征。所有细菌分离株均具有广泛的抗菌药物敏感性。β-内酰胺类抗菌药物治疗后，菌尿和临床体征得到了缓解。
Hansen Ⅰ型 IVDH 犬术后发生菌尿，当存在菌尿时，可能会随时间出现临床体征。菌尿的临床体征可能仅限于新发的尿失禁、不适当的排尿或两者兼有。直到出现菌尿的临床体征才开始抗菌治疗不会导致不良后果或全身疾病。
