EN01 - Clinical Impact of Bacteriuria and Early Empirical Antibiotics on Dogs with Diabetic Ketoacidosis

Abstract:

Background: Bacteriuria is common in diabetic dogs, but it is often subclinical with unknown clinical relevance. The prevalence of bacteriuria in dogs with diabetic ketoacidosis (DKA) and its effect on survival remains to be established. Hypothesis/

Objectives: To determine if bacteriuria and early empirical antibiotics (EEA; antibiotic administration within 24 hours of hospitalization) in DKA dogs impacts survival. Animals: Client-owned DKA dogs with a urine culture obtained within 24 hours of hospitalization from 2015-2025 (n = 120).

Methods: Single-center retrospective observational study. DKA was defined as ketonemia or ketonuria with metabolic acidosis. A subset of DKA were hyperosmolar and hyperglycemic (HHDKA; serum osmolarity > 325mOsm/kg and glucose > 600mg/dl). Duration of hospitalization analysis only included dogs that were discharged (n = 98). Statistical analyses utilized Mann-Whitney U, Fisher’s exact, and Chi-square tests.

Results: Bacteriuria prevalence was 8.3%, which was similar in HHDKA dogs (p = 0.7). Lower urinary tract signs were documented in 1.6%. Bacteriuria did not impact survival (p = 1), but did predict hospitalization time (p = 0.01). EEA lowered survival in DKA dogs (p = 0.01), but had no effect in HHDKA cases (p = 1), which were more commonly administered EEA (p = 0.01). Hospitalization time was not affected by EEA (p = 0.06). Azotemia, an active urine sediment, or historical diabetes mellitus did not predict bacteriuria (p = 1). Conclusions and Clinical Importance: Antibiotic administration to dogs with DKA should be individually assessed. Further studies should evaluate whether treating subclinical bacteriuria in DKA dogs is warranted.