title: Comparison of two strategies for diagnosis and treatment of infection in dogs (Canis familiaris) with long-term intravascular catheters.
abstract: Exteriorized chronic intravascular catheters (ECICs) are used frequently for repeated substance administration, sampling, and measuring of hemodynamic parameters in biomedical research protocols. ECICs can be a management challenge because they have been associated with catheter occlusion, thrombosis, sepsis, and serious clinical sequela. A monitoring regimen that identified infection early and a treatment protocol that eliminated infection would be of great benefit to animals and to research protocols using ECICs. Using clinical pathology and other parameters, this study compares 2 management strategies in their ability to maintain the physiologic condition of the animals with ECICs. We compared the clinical outcome of treatment initiated in light of an elevated white blood cell count without delay for development of left shift or clinical signs coupled with prolonged duration of treatment (28 d for the first treatment and 42 d for subsequent treatments) with conventional antibiotic treatment initiated after the advent of clinical signs. Significant findings of the study were that the use of fever as an indicator of infection unnecessarily delayed the initiation of treatment by an average of 12 d and that the use of a single clinical pathologic parameter (white blood cell count more than 18,000 cells/ml) as indication for treatment, with or without fever, in addition to prolonged antibiotic treatment (28 d for the first treatment and 42 d for subsequent treatment) initiated as soon as the white blood cell count exceeded 18,000 cells/ml and without delay for development of fever resulted in superior health of the animals with ECICs.
authors.affiliation: Columbia University Medical Center, New York, NY, USA. cr2100@columbia.edu
authors.forename: Christina L
authors.initials: CL
authors.lastname: Winnicker
authors.forename: Thomas E
authors.initials: TE
authors.lastname: Martin
authors.forename: Joanne
authors.initials: J
authors.lastname: Tetens-Woodring
mesh_terms: D000818:Animals; D001424:Bacterial Infections / Q000175:diagnosis / Q000188:drug therapy / Q000662:veterinary*; D001831:Body Temperature; D002408:Catheters, Indwelling; D004283:Dog Diseases / Q000175:diagnosis* / Q000188:drug therapy* / Q000382:microbiology; D004285:Dogs; D007958:Leukocyte Count; D011552:Pseudomonas Infections / Q000175:diagnosis / Q000188:drug therapy / Q000662:veterinary