Community-Acquired Infectious Pneumonia in Puppies: 65 Cases

SMALL ANIMALS

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- dacvim , values at values 2 co dacvecc dacvim , pneumonia were , mcse , have reported on clinical findings and dacvecc Bordetella was isolated from tracheal dvm , Study Retrospective Reports: Scientific 1 year old, with disease being < mvb 2,3,6,11,12 Clinical experience suggests that community-ac 1 year old with community-acquired infectious pneu infectious community-acquired with old year 1 1 year old. In community-acquired particular, infec 2007;230:1493–1497) Thus, findings for adult dogs with aspiration pneumo nia or pneumonia secondary to opportunistic infection may not be applicable to puppies. The purpose of the causative identify to was therefore, here, reported study dogs for prognosis and outcome, treatment, organisms, < we were monia. particularly interested In in this study, munity-acquired munity-acquired infectious pneumonia in dogs we believe that it can be not been developed. However, have char infection respiratory tract contagious a as defined history a with dog a in bronchopneumonia by acterized of being housed in the community. quired infectious pneumonia is more common in pup pies, whereas aspiration pneumonia common and more are infection opportunistic to secondary pneumonia in adult dogs with some underlying disease. Previous studies dogs in secretions airway of culture microbial of results of various ages, but to our knowledge, little has been published specifically on pneumonia in dogs are that < pup in documented well been not has pneumonia tious regarding information published little is there and pies, prognosis. or outcome, treatment, organisms, causative In adult dogs with pneumonia, treatment and progno sis depend to a large extent on the underlying cause. ------Results Results suggested that a type of community-ac  ; Lesley G. King, ; Kenneth J. Drobatz, ; Kenneth J. Drobatz, pneumonia than in dogs with pneumonia caused by Bordetella Bordetella bronchiseptica . Pneu To the To 2 days > 3-6 vmd 7-10 dacvim , J Am Vet Med Assoc Med Vet Am J Bordetella (

dvm Dogs were considered to community-acquired pneumonia have infectious if To identify causative To organisms, treatment, outcome, and prognosis for dogs  Bordetella bronchiseptica Bordetella 65 dogs. Most dogs were hypoxemic at the time of initial examination, with pulmonary  William T. N. Culp, T. William Retrospective case series. Retrospective    in puppies: 65 cases (1993–2002) cases 65 in puppies: 1 year old with community-acquired infectious pneumonia. infectious old with community-acquired 1 year function becoming worse during the fewfirst of days hospitalization before improving; 57 (88%) dogs survived to discharge. enteric gram-negative predominantly organisms, other and dogs, (49%) 32 from fluid wash bacteria, were isolated from the other 33 (51%). been have to Dogs likely more significantly were weeks), with 21 vs 14 (median, younger significantly obtained from a pet store vs (19/31 7/32), had been owned for a significantly shorter time Pv higher significantly had days), 90 vs 18 (median, illness of onset the to prior initial examination mm (median, Hg), 48.7 were vs significantly41.3 more likely to receive supplemental oxygen (25/32 vs 16/33), and had other organism. significantly any pneumonia caused by than did dogs with vs 4.9 days) longer hospitalization(mean, 7.2 times Conclusions and Clinical Relevance quired infectious pneumonia could be identified in dogs more severe in dogs with other bacterial organisms. Objective < Design Animals Procedures had they clinical signs of primary respiratory tract disease in conjunction with radiographic wash tracheal of culture bacterial following results positive and disease alveolar of evidence fluid. Results Anant Radhakrishnan, Anant Radhakrishnan, Common causes of bacterial pneumonia in Community-acquired infectious pneumonia pneumonia infectious Community-acquired 1,2 In human medicine, community-acquired infec n dogs, bacterial pneumonia is characterized by colo by characterized is pneumonia bacterial dogs, n nization of the airways or pulmonary parenchyma Care Symposium, Atlanta, September 2005. Care Veterinary Medicine, Veterinary University of Pennsylvania, Philadelphia, PA is address Bluegrass present Veterinary Radhakrishnan’s 19104. Dr. Specialists, 2568 Richmond Rd, Lexington, KY 40509. Presented Presented at the International Veterinary Emergency and Critical Radhakrishnan. to Dr. correspondence Address 2007 15, May 230, No. 10, Vol JAVMA, been treated in a health care environment for immediately preceding the day of diagnosis. authors’ knowledge, criteria for the diagnosis of com From the Department of Clinical Studies–Philadelphia, School of tunistic infection is typically caused by gram-negative enteric pathogens, whereas the most common cause of infectious pneumonia is tious pneumonia is defined as the development of new radiographic pulmonary infiltrates in conjunction with signs clinical minor 2 or major 1 least at of presence the suggestive of pneumonia in an individual who has not with bacteria, resulting in exudation and lung consoli dation. clude aspiration of gastrointestinal tract contents and infection with opportunistic pathogens secondary immunosuppression. to However, community-acquired infectious pneumonia has also been reported. monia that develops secondary to aspiration or oppor I SMALL ANIMALS included in 1 group and dogs with bacterial pneumo bacterial with dogs and group 1 in included cheal wash fluid, with dogs positive for transtra or endotracheal of culture bacterial of results of basis the groupson 2 into separated werethen Dogs alveolardisease. of pulmonary board-certifieda by the confirm to radiologist presence evaluated were radiographs All outcome. and course; clinical treatment; samples; fluid wash transtracheal or antimicrobialand endotracheal of testing susceptibility CBCs and blood gas analyses; results of bacterial culture of results including testing, laboratory routine of sults findings; re examination physical history; of consisted from the medical records for dogs included in the study Procedures medical record wasincomplete. the if or aspiration of result a obviously was or condition other some to secondary developed have cluded from the study if pneumonia was determined to or transtracheal wash fluid were positive. Dogs were ex endotracheal cultureof bacterial results of and disease, alveolar of evidence radiographic was there tolerance), respiratorydifficulty,coughing, (ie, ease exercise or dis in tract respiratory to related signs clinical be of examined cause been had they if study the in included were Dogs performed. been had procedure wash cheal transtra or endotracheal an and radiography thoracic both which in and 2002 and 1993 between examined dogs identify to searched was Pennsylvania of University the at Hospital erinary Criteria for Selection ofCases nia causedby pneumo infectious community-acquired with puppies 1494 intact sexually (38%) 25 males, intact sexually 30 (46%) were There weeks). 49 to 4 (range, weeks 15 was studythe included indogsstudy. 65 the of ageMedian fulfilled criteria inclusion 65whichthe the for ofin es, Results < mercialsoftware com Standard range. and median as summarized are SD; continuous data that were not normally distributed were that normally distributed are summarized data as mean and Continuous distributed. normally not were ney test was used to compare continuous variables that mally distributed between nor groups, and the Mann-Whit were that variables continuous compare to used Unpaired distributed. normally were data whether determine to used were test Shapiro-Wilk the and graphs of inspection For visual groups. variables, continuous between variables categoric compare to clinical progression, and outcome. The treatment, testing, laboratory of results signs, clinical history,to regard with compared were Groups group. nia caused by any other organism included in the other 0.05were considered significant.

Data analysis review record Medical VetRyan J. Matthew the of database patient The h sac o te eia rcrs ile 8 cas 87 yielded records medical the of search The Scientific Reports: Retrospective Study B bronchiseptica. a was used for all analyses. Valuesanalyses. of all for used was  Data for all dogs were summarized. < ya od ht a been had that old year 1  nomto obtained Information χ B bronchiseptica 2 test was used t tests were tests P ------

≤ Sp (ie, oximetry pulse of means by determined as saturation, oxygen oxygen, that dogs supplemental 41 received the of 40 In days). 11 to 1 (range, days 4.4 was administration oxygen supplemental of mental oxygen while hospitalized; mean ceptible tomostantimicrobials tested septica 9), = (n left shift. Mean platelet count was 307 a leukocytosisorevidenceof had dogs(57%) 52 of 30 (31 [48%]). [74%]), increased respiratory effort (47 [72%]), and[78%]),increased fever51 bronchovesicular sounds(48lung examination abnormalitiescal = included tachypnea (n ethoprim-sulfonamide (2). trim and (6), enrofloxacin (10), cephalexin (15), lin tal included amoxicillin-clavulanate (n = 18), amoxicil hospi teaching veterinary the at examination initial to prior administered Antimicrobials dyspnea. had also 4 cise intolerancewasreported inonly4dogs (6.2%), all exer Although [48%]). (31 dyspnea and [54%]), (35 anorexia [62%]), (40 lethargy [75%]), 49 = (n cough tion at the veterinary teaching hospital. 31days (range, 3 to 330 days; n = 57) prior to examina acquiredmediancurrentoftheirbeen hadownersbya and 7 (11%) had been obtained from other sources. Dogs from a breeder, 5 (8%) had been obtained from a shelter, obtainedbeenhad (40%) store,25 pet obtained afrom Weimaraners (4). Twenty-six (41%) of the dogs had mostcommon been purebred dogs were Bulldogs (n =4) and withthe remainder breeding,representing mixed of a variety wereof breeds. dogsThe the of Eight lb]). [15.8 kg 7.2 mean, lb; 147 to (1.8 kg 67 to 0.8 fromranged examination initial of time the at weight Body males. castrated(5%) 3 andfemales, spayed(11%) 7females, grouped with the 30 other dogs from which from dogs other 30 the with grouped septica was isolated organisms the of one 10, these of 2 in and isolated, wereorganisms 2 dogs, 10 In (3). (3), spp tococcus Enterobacter remaining 33 (51%) the dogs, including in isolated were organisms Other dogs. (49%) 65 wash fluid samples yielded (Table 1) during the early hospitalization period before improving pulmonarythatdeterioratefunctionandtion tendedto poxemichypercarbicand initialtimetheofat examina tate concentration suggested that dogs were typically hy analyses, pulse oximetry, and measurement of blood lac lets/ cells/ 0.8 was countneutrophil band mean and 10 X 22.9 10 2. niirbas diitrd uig hospital during administered Antimicrobials 92%. 3 cells/ µ ot-n o te 5 6% dg rcie supple received dogs (63%) 65 the of Forty-one n nta eaiain te ot omn physi common most the examination, initial On included complaints historical frequent most The atra clue f norcel r transtracheal or endotracheal of culture Bacterial Mean 3 µ ± cells/ L. Examination of the results of venous blood gasvenousbloodresults Examinationtheof L. of L (referenceL0.2 to range,0 11.6 was isolated. In both groups, isolates were sus were isolates groups, both In isolated. was . For purposes of data analysis, these 2 dogs were spp (4), Escherichia coli Escherichia Pasteurellamultocida µ . L (reference range, 3.1 to 14.4 ± µ SD WBC count on initialexaminationoncount WBC was SD spp (4), L). Mean neutrophil count was 16.9 X 10 3 Enterococcus faecalis cells/ Pseudomonas aeruginosa JAVMA, Vol 230,No.10, May 15, 2007 µ (7), L (reference19.8L to range,5.3 B bronchiseptica Klebsiella pneumoniae Klebsiella (2), and other organismsother and (2), X 10 Staphylococcus (3), ± (Table 2) 3 146 cells/ X ± 10 Acinetobacter SD duration in 32 of the ± X 3 1.8 (4), B bronchi B B bronchiB 10 µ cells/ L). OnlyL). . o ± 3 2 plate Strep 9.9 X ± ) was ) 10 µ spp 2.6 (4), L), X 3 ------

SMALL ANIMALS

------) P 2 1495 co B bron 2.4 days; 3.7 days; ± ± (n = 12/32 (ie, Pv 2 (32.6%; range, = 0.014) longer longer 0.014) = B bronchiseptica (7.2 P (n = 30/32 [94%]) [94%]) 30/32 = (n 92  33–43 7.35–7.47 B bronchiseptica = 0.014) lower in dogs with dogs in lower 0.014) = 1 year old with P < B bronchiseptica 2.7 days; range, 0 to 12 days). B B bronchiseptica ± B bronchiseptica B = 0.013) more likely to receive 1 year old. For purposes of the P = 0.018) higher proportion of dogs = 0.018) higher proportion < and dogs with pneumonia caused by caused pneumonia with dogs and P

2.7 days; range, 1 to 11 days) was not (48.7 mm Hg; range, 32.8 to 65.8 mm = 0.258) different between dogs with ± P Study Retrospective Reports: Scientific n = 43 n = 45 n = 36 2 (1–6) 2 (1–7) 2 (1–10) (4.8 Results of the present study suggest that a type Dogs with pneumonia caused by Mean duration of hospitalization for dogs with Comparison of historical findings and results of B bronchiseptica B Discussion of community-acquired infectious pneumonia can be identified in dogs present dogs study, were considered to have commu ination was significantly ( significantly was ination pneumonia caused by 17.8% to 45.2%; n = 31) than in dogs (37.8%; range, 23.6% nia to caused by other organisms with pneumo 56.6%; n = 29). were significantly ( dogs were than [78%]) 25/32 = (n oxygen supplemental with pneumonia caused by [48%]). other However, organisms mean (16/33 duration of mentation for oxygen dogs with pneumonia caused by supple chiseptica with dogs for duration mean from different significantly pneumonia caused by (3.9 other organisms range, 1 to 9 administered days). were Bronchodilators in a significantly ( with pneumonia caused by [38%]) than dogs with pneumonia caused by other or ganisms (4/33 [12%]). pneumonia caused by ( significantly was days) 14 to 2 range, by caused pneumonia with dogs for duration mean than other (4.9 organisms not were to discharge of survived that dogs Proportions significantly ( by caused pneumonia and dogs with pneumonia caused by other organisms [82%]). (27/33 quired quired from a breeder (n = 8/31) than were dogs with (17/32). by other organisms pneumonia caused caused pneumonia with dogs between testing laboratory by other organisms revealed only 2 significant differenc es. Median venous partial pressure of CO at the time of initial examination was significantly ( = 0.015) higher in dogs with B bronchiseptica pneumonia caused by Hg; n = 25) than in dogs with pneumonia (41.3 other mm organisms Hg; range, 24.7 caused to 70.2 mm by exam initial of time the at Hct median and 23), = n Hg;

- - - = < n = 43 n = 46 n = 36 1

< 87 (81–96) 57 (28–76) P P 7.31 (6.87–7.42) were B bron 21/27 13/27 19/27 19/27 17/27 11/27 15/27 14/27 92%. Fluid 92%. ≤ B bronchiseptica 2.1 days (range, was isolated were were isolated was Other ± n = 48 n = 48 n = 21 values 91 (82–96) 2 43.8 (25–72) Initial value value Worst to worst value (d) Time range Reference B bronchiseptica o 7.36 (7.24–7.46) Causative organism 9/31 25/25 23/24 31/32 31/32 26/27 23/23 21/22 (n = 32) bacteria (n = 33)

(6.9 kg [15.2 lb]; range, 0.8 or some other bacterial organism. or some other bacterial B bronchiseptica Results Results of pulse oximetry and venous blood gas analyses in 65 dogs B bronchiseptica B = 0.01) more likely to have been  (mm Hg) P 2 (%) Data are given as median (range), followed by the number of dogs for which information was available. 2 o co Pv Data represent values obtained at the time of initial and recording of the worst value. period, and the time between initial examination during the hospitalization examination, the worst value recorded for each dog Variable Sp

pH Venous

= 0.027) less likely to have been ac = 0.004) younger (median, 14 weeks; P P Table Table 1 pneumonia. infectious community-acquired B bronchiseptica had also been owned for a significantly ( Results of Results bacterial and culture susceptibility testing of  Data are given as No. of susceptible isolates/No. of isolates Dogs from which from Dogs Dogs with pneumonia caused by Bordetella bronchiseptica Bordetella Ticarcillin Amikacin Gentamicin Enrofloxacin Doxycycline Chloramphenicol Trimethoprim-sulfonamide Amoxicillin-clavulanate tested. Antimicrobial by by Table 2 Table endotracheal or transtracheal wash samples from 65 dogs year old with community-acquired pneumonia infectious caused JAVMA, Vol 230, No. 10, May 15, 2007 15, May 230, No. 10, Vol JAVMA, caused by other organisms (median, 21 weeks; range, 4 range, weeks; 21 (median, organisms other by caused to 49 weeks). Dogs with pneumonia caused by chiseptica therapy was administered IV in 49 (75%) dogs. Mean duration of hospitalization was 6.1 0 to 14 days), and 57 (88%) dogs survived discharged. and were significantly ( range, 7 to 35 weeks) than were dogs with pneumonia ization included ampicillin (n = 34), aminoglycosides (31), (12), ticarcillin-clavulanate enrofloxacin (7), and cefazolin (1). Nebulization and coupage were used in 49 of the 65 (75%) dogs. Bronchodilators in were 16 of used the 65 (25%) dogs, with 13 of the 16 that re Sp having bronchodilators ceived with pneumonia caused by other Dogs with pneumonia caused by organisms (7/32). significantly ( to 24.5 kg [1.8 to 53.9 lb]) was not significantly ( with dogs of weight body median from different 0.097) lb]; [26.4 kg (12 organisms other by caused pneumonia range, 0.8 to 67 kg). were significantly ( acquired from a pet store (n = 19/31) than were dogs 0.001) shorter time (median, 18 days; range, 3 to 120 by caused pneumonia with dogs had than 28) = n days; days; 330 to 2 range, days; 90 (median, organisms other n = 29). Median body weight of dogs with pneumonia caused by SMALL ANIMALS bacterialorganismsas such other cause, bacterial identified commonlymost the is tracheobronchitis, althoughinfectious documented. been has sult of impairment of respiratory tract immune function, chitis,progression bronchopneumonia,to likelyre aas organisms.Indogsenteric with infectious tracheobron were isolates the of many although determined, be not could dogs these from isolated bacteria the of source The dogs. remaining the in identified were species bial transtracheal wash fluid, whereas a variety of antimicro bronchiseptica B ing todischarge. surviv dogs (88%) 65 the of 57 with improved, tually even dogs However,most hospitalization. of days few first the during dogs most in worse becoming function emic at the time of initial examination, with pulmonary hypox were study present the in dogs Most tract. tory respira the to related complaint primary a and disease ing thoracic radiography in dogs with systemic signs of perform of importance the emphasize findings These bronchopneumonia.severe despite unremarkablewere results many,CBC for and neutrophilia, band and ia, neutrophil leukocytosis, by characterized leukogram inflammatory an had dogs (57%) 52 Surpris of 30 ingly, fluid. only wash transtracheal or endotracheal of culture bacterial following results positive and disease alveolar pulmonary of evidence radiographic with tion conjunc in disease tract respiratory primary of signs clinical nity-acquiredhad they if pneumonia infectious 1496 ings for dogs with pneumonia caused by other organ other by caused pneumonia with dogs for ings by caused pneumonia with tract anddevelopmentofpneumonia. respiratory lower the of invasion allow to sufficiently defenses host impair can tracheobronchitis, infectious chiseptica inoculation. after days 16 and 6 between wereeuthanized that dogs treated some and dogs untreated all in pneumonia of separate a study contrast, In involvement. alveolar limited with infected perimentally of WBCsbyotherexotoxins. functions phagocytic of immunity,inhibition ated and cell-medi and humoral of suppression tissues, to age tion. func ciliary of inhibition of result a as direct and death of cell result a as both disrupted are defenses host Thus, cells. epithelial respiratory on receptors specific strain. the of virulence the on depending ciliostasis, of grees de variable induce that exotoxins releasing tract, tory or purchase. adoption of time the at pneumonia or cheobronchitis tra infectious had dogs these of many that suspect we and infection, opportunistic of reflection a been have than other organisms of isolation role.alsoplaya coccus

In 32 of the 65 (49%) dogs in the present study,present the in dogs (49%) 65 the of 32 In In the present study, we compared findings for dogs A previous short-term (14 days) study Bordetella 22 23 spp, 21 Further complicating factors may include dam include may factors complicating Further of experimentally infected dogs found evidence Adhesins facilitate binding of the organism to organism the of binding facilitate Adhesins Scientific Reports: Retrospective Study i cnucin ih te cmoet of components other with conjunction in , Pasteurella 23 Thus, in susceptible individuals, susceptible in Thus, organisms attach to cilia in the respira the in cilia to attach organisms 4,18-20 a ioae fo edtaha or endotracheal from isolated was Thus, in some dogs in this study,this in dogs some in Thus, spp, 4,14 n studies In E coli B bronchisepticaB Streptococcus B bronchiseptica B 22

, and B bronchisepticaB 14-17 Klebsiella bronchisepticaB spp, f os with dogs of 5 found only found of dogs ex with find with Staphylo spp may B bronB may ------

dogs, and there were no significant differences between was most likely attributable to the younger age of these Hct in dogs with pneumonia caused by by caused pneumonia B had bronchiseptica dogs whether predict to sured duringhospitalizationinthesedogs. mea routinely not was perfusion, tissue assess to used be can which concentration, Un lactate fortunately,blood perfusion. tissue inadequate of evidence clinical any had dogs the of none that in function, respiratory compromised to attributable were dogs these in seen sue perfusion, we suspect that the high values that were though Pv Al organisms. other by caused pneumonia with dogs did than disease severe more had they that suggesting with treated times, hospitalization be longer had and bronchodilators, to likely more were oxygen, mental initial examination, were more likely to require supple bronchisepticaB by caused pneumonia with dogs or addition, In ganisms. other by caused pneumonia with dogs were than were more likely to have been acquired from a pet store and disease, tract respiratory of onset the to prior time chiseptica by caused pneumonia with severity.Dogs and signs disease in differences significant found and isms situations, high-density in housed dogs among common most is microbial administration. of these puppies were treated by means of parenteralAfter admissionanti tothe veterinary teaching hospital, most istrationcontributedhavealsomaytreatment to failure. variabilityin owner compliance in regard to drug admin orallyadministered drugs in sick puppies combined with airways. the in and,therefore, maynot reach therapeutic concentrations tively poor ability to penetrate the blood-bronchusetration barrierinto thepulmonary parenchyma, they have rela vitro.Althoughpenicillin derivatives penachieve good were found to be susceptible to amoxicillin-clavulanatecillin-clavulanate, in all 25 these 24 dogs had ofbeen treated 20 thoughwith bronchopneumonia. amoxicillin Even toprogressed or amoxi thesepital,ofdogs,alldiseaseinthe yet apparently had crobials PO prior to referral to the by veterinary teaching hos be ineffective. others and effective be to binations combinations, with some studies bronchiseptica B of susceptibility the regarding literature the in reports conflicting been have There methoprim-sulfonamide. 31 of 9 only that exception the with agents, antimicrobial of lates from these dogs were susceptible to a wide variety treatment.bial that found we general, In appropriateantimicroof selection the and pneumonia bacterial of diagnosis the in are useful fluid wash cheal groups inregard tosexorneuterstatus. B bronchisepticaB We did not identify any factors that could be used be could that factors any identify Wenot did n lncl rcie ifciu tracheobronchitis infectious practice, clinical In Twenty-fourdogswith32thepneumoniaof caused Cytologic examination and bacterial culture of tra B bronchiseptica B were younger, had been owned for a shorter a for owned been younger,had were co 14,16,19 2 is dependent, in part, on adequacy of tis 4,24-26 versus some other organism. The lower had higher Pv higher had slts o trimethoprim-sulfonamide to isolates n ms dg i wih infectious which in dogs most and had been treated with various antimi Variability absorption enteral of in JAVMA, Vol 230,No.10, May 15, 2007 isolates were susceptible to tri to susceptible were isolates Bordetella co isolates that were tested 20,23 2 values at the time of time the at values 3,12 finding these com finding them to them finding B bronchiseptica Bordetella B bron B iso ------

SMALL ANIMALS

------Am 1497 Infect Borde Vet Vet Rec 2003;25: . 2nd ed. Res Vet Sci Vet Res . . Prev Vet Med Vet Prev in infectious infectious in J Small Anim J J Am Med Vet . Philadelphia: Ann Intern Med Intern Ann Klebsiella pneu Intensive Care Med Care Intensive J Am Med Vet Assoc 2003;25:902–914. in kennel cough. 1981;17:793–797. 1998;212:200–207. -induced ciliostasis. 1978;102:298–301. . Philadelphia: WB Saunders Co, Bordetella bronchiseptica Bordetella Bordetella bronchiseptica Bordetella Vet Rec Vet Compend Contin Educ Pract Vet Pract Educ Contin Compend 2001;56(suppl 4):iv1–iv64. J Am Vet Med Assoc Med Vet Am J 1977;135:753–761. 1981;3:67–73. J Am Anim Hosp Assoc infections in dogs and cats: treatment and 1995;206:206–209. isolates from small isolates companion from animals with Bordetella bronchiseptica Bordetella infections in dogs and cats: pathogenesis, clini pathogenesis, cats: and dogs in infections Thorax Infectious diseases of the dog and cat 2002;162:1021–1027. Bordetella Bordetella bronchiseptica Compend Contin Educ Pract Vet Compend Contin Educ Pract Vet Study Retrospective Reports: Scientific J Infect Dis Bordetella Bordetella 1984;45:1862–1866. Bordetella infection: risk factor for mortality and the impact of cap of impact the and mortality for factor risk infection: 1985;50:35–42. Rev Infect Dis 1998;212:657). 1998;212:657). 1991;32:455–459. Textbook of respiratory disease in dogs and cats of respiratory Textbook tions. dogs with kennel cough. detellosis. in tracheobronchitis dogs (Erratum published in Assoc fluenza virus and Res J Vet Greene CE, ed. Philadelphia: WB Saunders Co, 1998;33–38. Edinboro CH, Ward MP, Glickman LT. A placebo-controlled trial of two intranasal vaccines shelter. humane a entering dogs in cough) to (kennel prevent tracheobronchitis 2004;62:89–99. investigation field A RH. Muirhead CGG, Aitken MV, Thrusfield of kennel cough: efficacy of different treatments. Pract minants on Immun diagnosis. and signs, cal 896–900. chemother bordetellosis: Canine H. Thompson IAP, McCandlish apy using a combination. sulphadiazine-trimethoprim 1979;104:51–54. Datz C. prevention. ed. WB Saunders Co, 2003;229–251. secre respiratory into antibiotics of Penetration JE. Pennington ratory disease in dogs due to to due dogs in disease ratory 1976;20:16–23. clinical of Comparison al. et MR, Lappin LA, King PH, Jameson signs, diagnostic findings, organisms isolated, and clinical out (1986–1991). cases 93 pneumonia: bacterial with dogs in come Med Assoc J Am Vet guidelines for the management of community acquired pneu monia in adults. accept the change to reason a adults: in infections bloodstream infections. community-acquired of definition ed 2002;137:791–797. O, Leroy C, Santre Beuscart C, et al. A five-year study of severe community-acquired pneumonia with emphasis on prognosis unit. care intensive an to admitted patients in 1995;21:24–31. Siu LK, et Fung RW, Tsay al. CP, Characteristics of bacteremia between community-acquired and nosocomial moniae sular serotypes as a herald for community-acquired infection. Med Intern Arch isolated from dogs with tracheobronchitis. 1973;162:47–50. Roudebush Fales P, WH. Antibacterial susceptibility of tella bronchiseptica disease. respiratory Current veterinary therapy VII 1980;235–243. Thompson H, Cornwell HJC, et al. A McCandlish study IAP, of Datz C. Datz Ford Ford RB, Vaden SL. Canine infectious tracheobronchitis. In: Bemis DA, Wilson SA. Influence of potential virulence deter Wilkins Wilkins RJ, Helland DR. Antibacterial sensitivities of bacteria British Thoracic Society Standards of Care Committee. BTS Keil DJ, Fenwick B. Role of of Role B. Fenwick DJ, Keil Friedman ND, Kaye KS, Stout JE, et al. Health care-associated Wagener JS, Sobonya R, Minnich L, et al. Role of canine parain canine of Role al. et L, Minnich R, Sobonya JS, Wagener Bemis DA, Greisen HA, Appel MJG. Pathogenesis of canine bor canine of Pathogenesis MJG. Appel HA, Greisen DA, Bemis LG, King In: system. respiratory the affecting Drugs DM. Boothe McKiernan BC. Canine and feline pneumonia. In: Kirk RW, ed. McKiernan BC. Canine and feline pneumonia. In: Kirk RW,

19. 20. 23. 24. 26. 6. 9. 10. 12. 14. 22. 18. 21. 11. 7. 16. 8. 17. 15. 25. 13.

------Bor Bor from from Kirk’s cur Kirk’s J Am Med Vet Assoc B bronchiseptica 1976;52:184–186. 1984;20:731–735. Bordetella bronchiseptica Bordetella Aust Vet J Vet Aust . Philadelphia: WB Saunders Co, However, numerous questions re numerous However, J Am Anim Hosp Assoc Hosp Anim Am J 2,4 1 year old. pneumonia. Thus, more studies are needed to bronchopneumonia; however, the small number small the however, bronchopneumonia; < tory tract disease: 264 cases (1989–1995). 1997;210:55–58. of isolation The AF. Smits RG, Batey pneumonia. canine of outbreak an Ford Ford RB. Bacterial pneumonia. In: Bonagura JD, ed. rent veterinary therapy dog: XIII the in 2000;812–815. bronchopneumonia Bacterial SK. Robinson GW, Thayer cases. 42 of review a tracheal aspirates from dogs with suspected lower respira Stata, version 8.0 for Windows, Stata Corp, College Station, Tex. Station, College Corp, Stata Windows, for 8.0 version Stata, A few other limitations of the present study should study present the of limitations other few A Angus JC, Jang SS, Hirsch DC. Microbiological study of trans Thompson H, McCandlish IAP, Wright NG. Experimental respi NG. Experimental Wright IAP, H, McCandlish Thompson

JAVMA, Vol 230, No. 10, May 15, 2007 15, May 230, No. 10, Vol JAVMA, 4. References 1. 2. study were lost to follow-up, we cannot form any con clusions regarding the long-term consequences of detella and long-term impact of characterize the short- further infectious pneumonia in puppies. a. also be considered. Importantly, the which frequency bronchopneumonia with develops in Furthermore, unknown. animals is tracheobronchitis infectious with the number of puppies in which bronchitis resolves uneventfully infectious is unknown, preclud tracheo ing any objective evaluation of the true this incidence disease. Because of a number of dogs in the present meaningful analysis. It would have been interesting to know how long puppies had been held in the pet store their as well as adoption, or purchase to prior shelter or vaccination and treatment histories, but this informa tion was unavailable owing to the retrospective nature of the study. changes in environment and diet; and young enough to have immature immune systems. In contrast, pup maintained been have may breeders from obtained pies in a single environment during the first few months of life. Puppies adopted from shelters tended to be older to susceptible less seemed and study present the in detella precluded shelters from acquired been had that dogs of acquired acquired from a breeder than were dogs with pneumo nia caused by other organisms. Puppies obtained from pet stores may be at greater risk for developing to infec progression subsequent with tracheobronchitis, tious bronchopneumonia, because they are in closer contact con of because stress greater under puppies; other with bacterial, current viral, or parasite infections or greater main about etiologic factors related to the development the to related factors etiologic about main of infectious tracheobronchitis in young dogs. One is sue relates to whether puppy origin is associated with the risk of infectious tracheobronchitis. In the present dogs with pneumonia caused by study, were significantly more been have likely to likely less significantly and store to havepet a from acquired been tracheobronchitis tracheobronchitis progresses to pneumonia are young, often 3. 5.