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You decide to perform a bacterial culture of both Tupper and Charlie's feces, understanding that the results can sometimes be difficult to interpret since animals may carry this organism asymptomatically. Additionally, treatment of asymptomatic carriers is not recommended. In this case, however, the clinical signs and the diet history warrant investigation for this pathogen, as treatment would definitely be indicated.
In the meantime, you hospitalize Charlie as well and start intravenous fluids and antibiotic therapy similar to Tupper. During their time in the hospital, both pets are housed in the isolation ward and infection control measures are instituted. Charlie and Tupper improve within about 12 hours of treatment and are no longer febrile.
Both culture results isolate Salmonella enterica that, fortunately, is sensitive to fluoroquinolones. The ampicillin is discontinued in both patients at this time. Ideally, you would like to perform a bacterial culture on the food as well to see if similar results are obtained, but the owners discarded the food when Charlie and Tupper were hospitalized.
Given the evidence, you diagnose salmonellosis in both pets and suspect that the raw diet was the likely source. Tupper's history of intermittent diarrhea and illness was likely a result of his periodic sampling of Charlie's food. His previous positive response to metronidazole may have been coincidental or associated with the immunomodulating effects of the medication.
What are your recommendations to the owners regarding the zoonotic risks?
a) Tupper and Charlie should be kept in the hospital, regardless of their clinical signs, until they have negative culture results.
b) The owners should see their physician immediately so they can start receiving prophylactic antibiotic therapy.
c) The owners should be careful to practice good hand hygiene and disinfect the bowls and feeding areas.
d) Tupper and Charlie should continue to receive low-dose antibiotic therapy long-term because they are Salmonella species carriers.
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