UTI risk raised in dogs on long-term ciclosporin
MedWire News: Dogs receiving long-term treatment with ciclosporin should be regularly monitored for bacteriuria, US veterinarians believe.
They say that dogs taking ciclosporin, an immunomodulatory drug used to treat inflammatory skin disorders, are at increased risk for urinary tract infections (UTI) and should undergo routine cystocentesis.
The research is published in Veterinary Dermatology and was carried out by Sheila Torres (University of Minnesota, St Paul, Minneapolis) and co-workers, who investigated the frequency of UTI in dogs receiving ciclosporin.
Torres et al retrospectively identified 146 dogs with inflammatory skin disorders, including atopic dermatitis, allergic dermatitis, sterile nodular panniculitis, and discoid lupus erythematosus. In all, 87 dogs received ciclosporin, of which 16 received concomitant glucocorticoids.
All dogs were free of UTI at the start of treatment and free of underlying conditions known to predispose an animal to UTI.
The first urine culture tested positive for bacteriuria in 13 (15%) of the ciclosporin-treated dogs and in two (3%) of nonciclosporin-treated dogs, a statistically significant difference.
Interestingly, the frequency of bacteriuria was also significantly higher in ciclosporin-treated dogs that received concomitant glucocorticoid than in ciclosporin-treated dogs that did not (25 vs 13%).
A total of 253 urinalyses were performed on the ciclosporin-treated dogs during the study period. In all, 29 (11.5%) were positive for bacteriuria, of which 15 (6.7%) had positive cultures. None of the dogs that developed UTI had any clinical signs, however.
Torres et al then calculated the sensitivity and specificity of different urinalysis parameters to predict UTI. The values were 64.1% and 98.1%, respectively, for bacteriuria; 74.4% and 70.9% for white blood cell count; and 56.4% and 65.3% for specific gravity.
The greatest specificity (100.0%) was obtained by combining all three parameters, but at the cost of lower sensitivity (38.5%).
Summarizing their results, Torres et al say that one-third of dogs receiving ciclosporin for chronic inflammatory skin diseases developed a UTI at some point during treatment, although clinical symptoms were apparent in only a minority of dogs.
"These findings suggest that routine urine cultures and urinalysis for bacteriuria should be part of the monitoring for dogs on these medications," they conclude. "However, a prospective, controlled study is needed to better define the influence of long-term ciclosporin therapy in the development of UTI in dogs."
By Joanna Lyford