2018 ACVIM Forum Research Abstract Program: Seattle, Washington, June 14 - 15, 2018

Owners of cats prescribed amoxicillin-clavulanic acid at Colorado State University or The Ohio State University were sent a survey regarding the occurrence of side effects (yes / no), specific type of side effect (vomiting, diarrhea, decreased appetite, none) and whether treatment was altered as a result. Signalment and clinicopathologic data were obtained from the medical record for cats for which surveys were returned. Cats included in the azotemic CKD group had a creatinine > 2.0 mg/dL, USG < 1.035 and a clinical designation of CKD. Cats included in the without azotemic CKD group were those had a creatinine < 2.0 mg/dL. A cut off between groups of creatinine 2.0 mg/dL was chosen to define cohorts as impaired clearance of amoxicillin-clavulanic acid is more common in humans with a greater degree renal impairment. Chi square was utilized to assess distribution of presence of side effects (yes / no) between groups, prevalence of specific side effects and changes in therapy. 73 surveys were returned with 12 being excluded for incomplete data or no serum creatinine available. 11 cats were categorized as azotemic CKD and consisted of 4 males and 7 females, with a median age of 14 years (range 4-20 years) and a median creatinine of 2.4 (range 2.0-6.0 mg/dL). 50 cats were categorized as not having azotemic CKD and consisted of 17 males and 33 females, with a median age of 11 years (range 1-18 years) and a median creatinine of 1.4 (range 0.7-1.9 mg/dL). Owners reported 6 / 11 cats (55 %) with azotemic CKD had side effects. Specific side effects included diarrhea 5 / 11 cats (45 %), vomiting 2 / 11 cats (18 %), and decreased appetite 3 / 11 cats (27%), with 5 / 11 cats (45 %) having more than one side effect. Owners reported 20 / 50 cats (40 %) cats without azotemic CKD had side effects. Specific side effects for these cats included diarrhea 11 / 50 cats (22 %), vomiting 10 / 50 cats (20 %), and decrease appetite 7 / 50 cats (14 %), with 6 / 50 cats (12 %) having more than one side effect. The difference in distribution of side effects (yes / no) or distribution of specific type of side effects was not statistically significant, however significantly more azotemic CKD cats had more than one side effect (p = 0.009). Additionally, significantly more owners of azotemic CKD cats reported that an alteration in treatment plan was necessitated by side effects with 55 % indicating the antibiotic was stopped, changed or supportive care was added due to side effects, while only 14 % of owners of cats without azotemic CKD reported alteration in treatment plan (p = 0.003).