ABSTRACT
OBJECTIVE: To assess the prognostic utility of admission quick Sequential Organ Failure Assessment (qSOFA) scores for in-hospital mortality in a population of dogs with surgically treated sepsis. DESIGN: Retrospective cohort study of dogs from January 2011 to January 2018. SETTING: University teaching hospital. ANIMALS: One thousand three hundred nine cases were identified with a clinical diagnosis of sepsis requiring surgical source control. Two hundred and four dogs with surgically treated sepsis met inclusion criteria, defined as: meeting 2 or more systemic inflammatory response syndrome (SIRS) criteria with a documented source of infection. One hundred and forty-three cases of septic peritonitis, 26 cases of septic soft tissue infection, 20 cases of pyometra, and 15 cases of pyothorax were evaluated. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Overall in-hospital mortality was 63 of 204 (30.9%). Patients with a qSOFA ≥ 2 were more likely to die or be euthanized (odds ratio [OR] 7.1, 95% confidence interval [CI] 2.9-16.4; P < 0.0001). Survivor and nonsurvivor qSOFA scores were significantly different in all categories. Dogs with septic peritonitis and a qSOFA ≥ 2 had an increased risk of postoperative complications (OR 3.9; 95% CI 1.3-11.1; P = 0.02). qSOFA scores were correlated with length of hospitalization in survivors of all-cause surgical sepsis (r = 0.28, P = 0.0007), septic peritonitis (r = 0.33, P = 0.001), and septic soft tissue infection (r = 0.59, P = 0.004). CONCLUSIONS: This was the first study to retrospectively evaluate the prognostic utility of qSOFA scores in dogs surgically treated for sepsis. Dogs diagnosed with septic peritonitis and other causes of surgically treated sepsis with a qSOFA ≥ 2 may have a higher risk of in-hospital mortality, although future prospective studies are necessary.
Subject(s)
Dog Diseases , Sepsis , Animals , Dog Diseases/diagnosis , Dog Diseases/surgery , Dogs , Intensive Care Units , Organ Dysfunction Scores , Prognosis , Prospective Studies , ROC Curve , Retrospective Studies , Sepsis/diagnosis , Sepsis/veterinary , Systemic Inflammatory Response Syndrome/veterinaryABSTRACT
Meloxicam, a non-steroidal anti-inflammatory drug, is approved for use in horses in several countries, but an equine formulation is not available in North America. However, meloxicam is being used in an extra-label manner in horses in Canada. The purpose of this study, therefore, was to assess the bioequivalence of an approved oral meloxicam suspension (Metacam 15 mg/mL for horses; Boehringer Ingelheim Vetmedica GmBH, Ingelheim, Germany) from the European Union with human meloxicam tablets (Meloxicam 15 mg tablets; TEVA Canada, Toronto, Ontario) compounded with molasses to improve palatability and administration. The geometric mean ratios (GMR test/reference) and the 90% confidence intervals of the pivotal pharmacokinetic parameters (area under the curve and maximum concentration) were within the defined limits of 80% to 125% generally accepted for products to be considered bioequivalent. Therefore, use of human meloxicam tablets compounded with molasses would be expected to produce a similar clinical response in horses as the approved oral product from the European Union.
Pharmacocinétique et bioéquivalence de 2 formulations de posologie orale de méloxicam chez des chevaux adultes en santé. Le méloxicam, un médicament anti-inflammatoire non stéroïdien, est approuvé pour utilisation chez les chevaux dans plusieurs pays, mais une formulation équine n'est pas disponible en Amérique du Nord. Cependant, le méloxicam est utilisé en dérogation des directives de l'étiquette chez les chevaux du Canada. Par conséquent, le but de la présente étude était d'évaluer la bioéquivalence d'une suspension orale approuvée de méloxicam (Metacam 15 mg/ml pour les chevaux; Boehringer Ingelheim Vetmedica GmBH, Ingelheim, Allemagne) de l'Union européenne avec celle des comprimés de méloxicam pour les humains (comprimés de 15 mg de méloxicam; TEVA Canada, Toronto, Ontario) préparés avec de la mélasse pour améliorer la sapidité et l'administration. Les ratios géométriques moyens (test RGM/référence) et les intervalles de confiance de 90 % des paramètres phamacocinétiques clés (secteur sous la courbe et concentration maximale) se situaient dans les limites définies de 80 % à 125 % généralement attendues pour des produits considérés comme bioéquivalents. Par conséquent, l'utilisation des comprimés de méloxicam pour humains préparés avec de la mélasse devrait produire une réponse clinique semblable chez les chevaux à celle du produit oral approuvé provenant de l'Union européenne.(Traduit par Isabelle Vallières).
