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AHS HEARTWORM HOTLINE
In short, clinicians should consider HPT—as well as
clinical staging with physical examination, complete
blood count, blood chemistry analysis, urinalysis,
and radiography—whenever there is a strong clinical
suspicion of heartworm disease in the presence of
negative screening test results. One report identified
heartworm antigen in 64.7% of "negative" samples
from patients for which the veterinarian's clinical
suspicion strongly supported heartworm infection.
The bottom line: There is no substitute for
the clinical acumen of a veterinarian.
SUMMARY
Immune complex interference is one factor clinicians
should consider when interpreting the results of
diagnostic tests that rely on antigen detection,
especially when screening test results do not match
clinical suspicions. Recent research has provided
some insight into factors that can affect screening test
results while identifying specific scenarios that may
justify the added step of HPT of serum samples. These
findings highlight the importance of adhering to the
American Heartworm Society's diagnostic testing
recommendations. Annual screening for both antigen
and microfilariae is the best way to identify heartworm
infection as early and as consistently as possible.
VET REPORT VITALS continued from page 22
Brian DiGangi
Brian DiGangi, DVM, MS, DABVP, is a senior
director of shelter medicine for the ASPCA.
He earned his DVM from the University of
Florida and is board certified in both canine
and feline practice and shelter medicine
practice. He is a member of the board of
directors of the Association of Shelter
Veterinarians and the American Heartworm
Society. Dr. DiGangi has published research
on feline adoption, canine heartworm
disease, and immunology. Prior to joining
the ASPCA, he served as a clinical associate
professor at the University of Florida.
To see the references for this article,
please visit tvpjournal.com.
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VET REPORT VITALS
provision of antimicrobial drugs when indicated, with
their responsibilities as public health guardians.
8
CLINICAL BOTTOM LINE
The implications of AMR for companion animal
veterinarians, their patients, and clients can be severe,
including increased morbidity and mortality, longer illnesses,
and increased costs.
1
For veterinarians, there is a threat of
restrictions and regulations around the types of antimicrobial
drugs available and/or the requirement for approval to use
certain drugs in our patients. For all involved, the growing
threat of zoonotic spread of AMR is real and must be
addressed proactively. Discussions of both the short-term
and long-term implications of antimicrobial resistance in
support of judicious use of antimicrobial drugs is a crucial
behavior change for companion animal veterinarians
to take to proactively address this growing issue.
References
1. World Health Organization. Global action plan on antimicrobial
resistance. 2015. www.wpro.who.int/entity/drug_resistance/resources/
global_action_plan_eng.pdf Accessed September 2016.
2. Weese JS. Investigation of antimicrobial use and the impact of
antimicrobial use guidelines in a small animal veterinary teaching
hospital: 1995–2004. JAVMA 2006;228(4):553-558.
3. Weese JS, Giguere S, Guardabassi L, et al. ACVIM consensus statement
on therapeutic antimicrobial use in animals and antimicrobial resistance.
J Vet Intern Med 2015;29(2):487-498.
4. Gartry L. New salmonella superbug 'significant threat to public
health'. ABC News. October 27, 2016. abc.net.au/news/2016-10-27/
new-salmonella-superbug-significant-threat-to-public-health/7968618.
Accessed November 2016.
5. World Health Organization. Antimicrobial resistance fact sheet.
September 2016. who.int/mediacentre/factsheets/fs194/en/. Accessed
November 2016.
6. Lozano C, Rezusta A, Ferrer I, et al. Staphylococcus pseudintermedius
human infection cases in Spain: dog-to-human transmission. Vector
Borne Zoonotic Dis 2017;17(4):268-270.
7. Damborg P, Broens EM, Chomel BB, et al. Bacterial zoonoses transmitted
by household pets: state-of-the-art and future perspectives for targeted
research and policy actions. J Comp Pathol 2016;155(1):S27-S40.
8. American Veterinary Medicine Association. Veterinarian's Oath. https://
www.avma.org/KB/Policies/Pages/veterinarians-oath.aspx Accessed
October 2016.