Molecular surveillance of parvoviruses circulating in cats in the United Kingdom

This dissertation was developed under the Curricular Traineeship scope, which took place at the University of Nottingham, between July 2016 and April 2017. Feline panleukopenia virus (FPV) and canine parvovirus (CPV), two closely related viruses, are known to cause acute enteritis in companion animals. Cats may be infected by strains of both viruses. Population-based surveillance studies have been lacking. This study investigated the prevalence of parvoviruses in a cross-sectional survey of clinically-healthy cats housed within 13 shelters across the United Kingdom, comprising 818 faecal samples. FPV/CPV DNA was detected by PCR. Overall, the prevalence of parvovirus was 3.8%. Five FPV/CPV-2a like strains and one CPV-2b were identified by sequence analysis. These results showed that parvoviruses are circulating in the UK feline population, providing an insight about parvovirus occurrence in a non-clinical population, which reinforces the possibility that asymptomatic cats may be important reservoirs for infection maintenance in companion animals; Resumo: Vigilância molecular dos Parvovírus circulantes em gatos no Reino Unido Esta dissertação foi elaborada no âmbito do Estágio Curricular, realizado na Universidade de Nottingham, entre julho de 2016 e abril de 2017. O vírus da panleucopénia felina (FPV) e o parvovirus canino (CPV), dois vírus estreitamente relacionados, são conhecidos por causar enterite aguda em animais de companhia. Os gatos podem ser infetados por estirpes de ambos os vírus. Investigou-se a prevalência de parvovirus através de um estudo transversal em gatos clinicamente saudáveis acolhidos em 13 abrigos de distintas localizações no Reino Unido, somando 818 amostras fecais. O DNA do FPV/CPV foi detetado por PCR. Globalmente, a prevalência de infeção por parvovirus foi de 3,8%. Cinco estirpes virais compatíveis com FPV/CPV-2a e uma estirpe CPV-2b foram identificadas através de sequenciação. Os resultados comprovam que diferentes variantes de parvovirus circulam na população felina do país, reforçando a possibilidade de gatos assintomáticos constituírem reservatórios importantes para manutenção da infeção em animais de companhia

Emerging variants of canine enteric coronavirus associated with seasonal outbreaks of severe canine gastroenteric disease

Canine enteric coronavirus (CECoV) variants have an emerging role in severe outbreaks of canine gastroenteritis. Here we used syndromic health data from a sentinel network of UK veterinary practices to identify an outbreak of severe canine gastroenteritis. Affected dogs frequently presented with vomiting, diarrhoea and inappetence. Data from sentinel diagnostic laboratories showed similar seasonal increases in CECoV diagnosis. Membrane glycoprotein (M) gene sequence analysis implied wide geographical circulation of a new CECoV variant. Whole genome sequencing suggested the main circulating 2022 variant was most closely related to one previously identified in 2020 with additional spike gene recombination; all variants were unrelated to CECoV-like viruses recently associated with human respiratory disease. Identifying factors that drive population-level evolution, and its implications for host protection and virulence, will be important to understand the emerging role of CECoV variants in canine and human health, and may act as a model for coronavirus population adaptation more widely

Antimicrobial prescription in canine and feline gastrointestinal clinical presentations: a mixed-methods approach using Electronic Health Records

Canine and feline gastrointestinal (GI) presentations are one of the most common clinical presentations for which antimicrobials are systemically prescribed. The use of such products may hasten antimicrobial resistance (AMR), which is a major worldwide health concern. Thus, currently we face the need to preserve antimicrobial efficacy, which requires identification of opportunities to safely reduce antimicrobial prescriptions. Although practice-level prescription guidance is widely available, a greater understanding of antimicrobial prescription at a population level is needed for the veterinary profession, especially for antimicrobials considered Highest Priority Critically Important Antimicrobials (HPCIA). To address this, we used a mixed-methods approach, harnessing veterinary health informatics data, in order to focus on two main objectives: (i) Characterising canine and feline GI clinical presentations and reappraising the use of antimicrobials: using data from the Small Animal Veterinary Surveillance Network (SAVSNET), we collated 23,337 electronic health records (EHRs) from canine and feline GI consultations, from 225 volunteer veterinary practices between April 2014 and September 2018 in the UK. Most of the canine and feline GI presentations were reported as mild, with non-haemorrhagic diarrhoea and vomiting being the most frequent clinical signs. Systemic antimicrobial prescription occurred in 28.6% of canine GI consultations and 22.4% of GI feline presentations, with HPCIA prescription occurring more frequently in feline consultations. Bacteriological and/or parasitological diagnostic tests were uncommonly used. Results of multivariable modelling showed the presence of non- haemorrhagic diarrhoea (canine GI presentations OR 2.11, 95% CI 1.91-2.33, p<0.001; feline GI presentations OR 1.77, 95% CI 1.48-2.11, p<0.001) and haemorrhagic diarrhoea (canine GI presentations OR 4.22, 95% CI 3.80-4.68, p<0.001; feline GI presentations OR 3.05, 95% CI 2.44-3.82, p<0.001) were significantly associated with systemic antimicrobial prescription when compared with the absence of diarrhoea. In addition, moderate/severe GI presentations were also associated with significantly increased odds of receiving a systemic antimicrobial (canine GI presentations OR 1.85, 95% CI 1.65-2.07, p<0.001; feline GI presentations OR 2.03, 95% CI 1.68-2.46, p<0.001). Older dogs were more likely to receive an antimicrobial prescription. (ii) Exploring justification and reasoning around antimicrobial use, particularly associated with HPCIA prescription: in a subset of the data, we used a complementary qualitative approach to identify the extent of discussion recorded in EHRs around reasoning for antimicrobial prescription (n=200 EHRs), and to further identify drivers, reasoning and attitudes within the clinical narrative of canine and feline GI consultations around HPCIA prescription (n=516 EHRs). Thematic analysis of clinical narrative content allowed the identification of nine recorded extrinsic factors underpinning reasoning for HPCIA prescription, related with perceived compliance; owner’s behaviour; perceived risk of infection; clinical signs; recent clinical history; perceived (positive) previous response to antimicrobial therapy; geriatric patients and euthanasia; concomitant conditions; and diagnostic testing. Moreover, the perceived veterinarian-client relationship and a behavioural trend led by the veterinary professional in trialling antimicrobial therapy indirectly shaped the decision-making process around HPCIA prescription in GI cases. By taking a complementary mixed-methods approach to EHRs, these studies have identified novel and valuable insights into antimicrobial choices made by veterinary professionals in GI presentations. The results of this work can help inform targeted interventions aimed at helping to preserve the most critical antimicrobials, contributing towards effective antimicrobial stewardship. Intensifying interdisciplinary efforts is crucial to ensure clinical compliance with currently published prescription guidance