A retrospective multi‐center study of treatment,outcome, and prognostic factors in 34 dogs with disseminated aspergillosis in Australia |
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| Authors: | Yi Yu Lim Caroline Mansfield Mark Stevenson Mary Thompson David Davies Joanna Whitney Fleur James Anna Tebb Darren Fry Sibylle Buob Lydia Hambrook Gladys Boo Julien R S Dandrieux |
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| Abstract: | BackgroundDisseminated aspergillosis (DA) in dogs has a guarded prognosis and there is a lack of a gold standard treatment protocol.ObjectiveTo retrospectively assess survival times and factors influencing survival times.AnimalsDogs diagnosed with DA from January 2007 to June 2017.MethodsDisseminated aspergillosis case data were retrieved from 13 Australian veterinary referral centers, with a diagnosis confirmed with culture or PCR. Factors influencing survival time after diagnosis were quantified using a Cox proportional hazards regression model.ResultsThirty‐four dogs met the study inclusion criteria. Twenty‐two dogs were treated with antifungal treatment and 12 dogs received no antifungal treatment. Accounting for censoring of dogs that were either still alive on the date of data collection or were loss to follow‐up, dogs treated with itraconazole alone (n = 8) had a median survival time (MST) of 63 (95% CI: 20−272) days compared to 830 (95% CI: 267‐1259) days for the n = 14 dogs that received multimodal antifungal therapy ( test statistic 8.6; = 1; P < .01). The daily hazard of death (DHOD) for dogs with abnormally high serum creatinine concentration at the time of diagnosis was 7.4 (95% CI: 1.9‐29) times that of dogs with serum creatinine within the reference interval.Conclusion and Clinical ImportanceSerum creatinine concentration at the time of diagnosis is a useful prognostic indicator for survival after a diagnosis of DA. The MST for dogs treated with multimodal antifungal therapy is longer than itraconazole alone and warrant further investigation (P < .01). |
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| Keywords: | canine median survival time outcome prognosis |
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