Sepsis in horses is a systemic inflammatory response to infection, characterized by the presence of pathogenic microorganisms or their toxins in the blood or tissues. It can result from various bacterial, viral, or fungal infections and may lead to severe complications if not managed promptly. Clinical signs of sepsis in horses can include fever, increased heart and respiratory rates, altered mucous membrane color, and signs of organ dysfunction. Diagnosis often involves identifying the underlying infection source, alongside laboratory tests to detect inflammatory markers and organ function indicators. This page compiles peer-reviewed research studies and scholarly articles that explore the pathophysiology, diagnosis, treatment, and prognosis of sepsis in equine patients.
Olds AM, Stewart AA, Freeman DE, Schaeffer DJ.To determine the rate of development of septic arthritis after elective arthroscopy and evaluate associations between various factors and development of this complication in horses. Methods: Retrospective case series. Methods: 682 horses that underwent arthroscopic procedures at the University of Illinois Veterinary Teaching Hospital from 1994 to 2003. Methods: Information pertaining to signalment, joints treated, whether antimicrobials were administered, and development of postoperative septic arthritis was collected from medical records. Horses with a primary problem of septic arthritis or w...
Lorenzo-Figueras M, Pusterla N, Byrne BA, Samitz EM.To evaluate the effectiveness of a commercial conventional blood culture system (BCS), a commercial resin-containing BCS, and a commercial lysis-centrifugation-based BCS for the recovery of Escherichia coli from equine blood samples inoculated with that organism. Methods: Samples of blood obtained from a clinically normal horse that were inoculated with E coli. Methods: Blood samples were aseptically collected and inoculated with an E coli specimen (50 CFUs/mL) that had been previously isolated from a foal with sepsis. Subsequently, samples were spiked with gentamicin at a concentration of 30 ...
Knox PM, Watkins JP.A method for proximal interphalangeal joint (PIP joint) arthrodesis that provides a stable fixation and minimal duration of cast support is evaluated retrospectively. Objective: Evaluate the clinical use of a combined plate-screw method for PIP joint arthrodesis in a large number of horses. Methods: The records of 53 horses undergoing PIP joint arthrodesis were reviewed. Arthrodesis was performed with a dorsally placed 3-, 4- or 5-hole narrow dynamic compression plate (DCP) with 2 transarticular cortex screws placed in lag fashion either side of the plate. Subject details, clinical presentatio...
Nagy AD, Simhofer H.To report use of mandibular condylectomy for treatment of advanced degenerative joint disease of the temporomandibular joint (TMJ) caused by sepsis. Methods: Clinical case report. Methods: Two-year-old Noriker filly. Methods: Computed tomography (CT) was used to confirm advanced degenerative joint disease of the left TMJ and for follow-up after mandibular condylectomy and removal of necrotic meniscus. Results: Painful swelling (3 weeks duration) with drainage located just caudal to the left lateral canthus of the eye was associated with atrophy of the left masseter muscle, masticatory problems...
Jesty SA, Reef VB.This article first reviews cardiovascular infections, including endocarditis, myocarditis, vasculitis, and pericarditis. It then addresses what is known at this stage about the effects of sepsis on the cardiovascular system. Some information is provided from current human literature to familiarize the reader with the diagnostics and therapeutics that may eventually be used in equine practice as well.
Smith LJ, Mellor DJ, Marr CM, Mair TS.Septic digital tenosynovitis is a serious problem in the horse, with a poor prognosis being reported for recovery. Objective: The occurrence of septic digital tenosynovitis would significantly reduce the likelihood of a horse returning to its previous level of athletic function. Methods: Medical records of 90 horses treated for septic digital tenosynovitis were reviewed. Data retrieved included age, sex, location of inciting cause of sepsis, time from onset of clinical signs to presentation for treatment, and whether the horse survived to be discharged. Long-term outcome was determined through...
Pusterla N, Magdesian KG, Mapes S, Leutenegger CM.To determine gene expression of selected molecular markers (tumor necrosis factor [TNF]-alpha, interleukin [IL]-1beta, IL-6, IL-8, IL-10, procalcitonin [PCT], and transforming growth factor [TGF]-beta) in the blood of healthy and sick foals. Methods: 28 sick foals without sepsis, 21 foals with sepsis, and 21 healthy foals. Methods: Total RNA was extracted from blood samples and converted into complementary DNA (cDNA). Gene expression was measured for the molecular markers by use of real-time PCR assay, and final quantitation was performed with the comparative threshold cycle method. Results: S...
Peek SF, Semrad S, McGuirk SM, Riseberg A, Slack JA, Marques F, Coombs D, Lien L, Keuler N, Darien BJ.This prospective study compared survival rates of critically ill and septic foals receiving 1 of 2 different types of commercial equine plasma and analyzed admission variables as possible predictors of survival. Standardized clinical, hematologic, biochemical, and hemostatic admission data were collected and foals received either conventional commercially available hyperimmune equine plasma or equine plasma specifically rich in antiendotoxin antibodies in a double-blinded, coded fashion. Sepsis was defined as true bacteremia or sepsis score >11. Overall survival rate to discharge was 72% (4...
Jesty SA, Palmer JE, Parente EJ, Schaer TP, Wilkins PA.Rupture of the gastrocnemius muscle and subsequent disruption of the reciprocal mechanism of the hind limb was diagnosed in 6 foals examined at 7 hours to 3 weeks of age. In 2 foals, the musculoskeletal injury was detected as an ancillary finding to clinical signs of neurologic dysfunction ascribed to hypoxic ischemic insult during delivery, whereas in the other 4 foals, musculoskeletal injury, manifested as inability to rise or stand unsupported, was the chief complaint at admission. Five foals had a history of dystocia and assisted delivery. Common clinical signs were inability to rise, disr...
Dunkel B, Palmer JE, Olson KN, Boston RC, Wilkins PA.Foals may present to a referral hospital with the primary diagnosis of uroperitoneum (UP), or they may develop UP while hospitalized for other reasons. Historical, physical, laboratory, and diagnostic variables of foals presenting with UP were compared to those developing UP while hospitalized. Emphasis was placed on the presence of electrolyte abnormalities, evidence of sepsis or infection, and development of anesthetic complications during surgical correction of the defect. Foals developing UP while in the hospital frequently had a history of dystocia and presented at a very young age (< ...
Black SJ, Lunn DP, Yin C, Hwang M, Lenz SD, Belknap JK.The mechanisms that initiate the pathophysiologic changes in the digital laminae in equine laminitis are poorly understood. Due to the fact that (1) the horse at risk of laminitis has many similarities clinically to the human sepsis patient and (2) our recent finding of marked laminar proinflammatory cytokine expression at the developmental time point of the black walnut extract (BWE) model of laminitis, we tested the possibility that, similar to organ damage in human sepsis, leukocyte emigration is an early event in laminitis. Using immunoperoxidase methods with an anti-equine CD13 monoclonal...
Devine DV, Moll HD, Bahr RJ.This case report describes chronic sepsis of the right temporomandibular joint in a juvenile horse. Diagnostic work-up included physical examination, radiography, and computed tomography. Humane euthanasia was indicated due to the chronicity of the condition, prognosis, and financial constraints.
McTaggart C, Penhale J, Raidala SL.To evaluate the effect of plasma transfusion on phagocytosis and oxidative burst activity of peripheral blood neutrophils from healthy and septic equine neonates with sub-optimal passive transfer of maternal immunity. Methods: Nine healthy and seven septic foals with suboptimal passive transfer of maternal immunity (serum IgG or = 8 g/L. Methods: Foals with serum IgG concentrations or = 11. All foals received between 1 and 3 L of plasma to boost circulating IgG concentrations to > or = 8 g/L. Serum IgG concentrations were determined before and following transfusion by glutaraldehyde coagu...
Slack JA, McGuirk SM, Erb HN, Lien L, Coombs D, Semrad SD, Riseberg A, Marques F, Darien B, Fallon L, Burns P, Murakami MA, Apple FS, Peek SF.The cardiac biomarkers cardiac troponin T (cTnT) and I (cTnI) and the cardiac isoenzyme of creatine kinase (CKMB) are used extensively in human medicine to diagnose and provide valuable prognostic information in patients with ischemic, traumatic, and septic myocardial injury. We designed a study to establish normal values for these markers in healthy, neonatal foals and to compare them with values obtained from septic neonates in a referral hospital population. The 25th, 50th, 75th, and 95th percentiles for cTnI and CKMB in the healthy-foal population were 0.08, 0.14, 0.25, 0.49 ng/mL and 1.4,...
Sanchez LC.Neonatal infection remains a leading cause of morbidity and mortality in the equine industry, despite advances in prevention and treatment. Many factors can influence a foal's risk for the development of sepsis in the peripartum period. This article discusses those factors, causative organisms, and therapeutic options. Factors that influence prognosis and potential preventative strategies also are addressed.
Norman TE, Chaffin MK, Johnson MC, Spangler EA, Weeks BR, Knight R.Five horses were evaluated because of severe cutaneous burn injuries following a barn fire. Gross hemolysis and morphologic changes in RBCs consistent with oxidative damage were detected in all of the horses. Of these horses, 4 became azotemic. The overall goals of treatment included wound care, correction of dehydration and provision of diuresis, control of inflammation, pain management, and prophylaxis against sepsis. After treatment, 2 horses survived and were discharged from the hospital. Red blood cell damage and hemolysis following cutaneous burn injury have been investigated in other sp...
Toribio RE, Kohn CW, Hardy J, Rosol TJ.Hypocalcemia and hypomagnesemia are common in horses with sepsis and endotoxemia. We hypothesize that endotoxemia triggers a systemic inflammatory response that results in hypocalcemia and hypomagnesemia. The goal of this study was to determine the effect of endotoxin (lipopolysaccharide [LPS]) administration to healthy horses on serum parathyroid hormone (PTH), ionized calcium (Ca2+) and total calcium (tCa), ionized magnesium (Mg2+) and total magnesium (tMg), phosphate (Pi), potassium (K+), sodium (Na+), chloride (Cl-), and insulin concentrations, and on the urinary excretion of these electro...
Welschen SE, de Bruijn CM, Sloet van Oldruitenborgh-Oosterbaan MM.The short- and long-term results of admission to the 'Neonatal Intensive Care Unit' (ICU) at the Department of Equine Sciences of the Utrecht University were evaluated. The patients were categorized, based on specific criteria, into different groups: 'Sepsis', 'Pneumonia', 'Enteritis', 'Asphyxia', 'Premature', 'Isoerythrolysis', and 'Equine herpes virus (EHV)'. The survival rate and mean duration of hospitalization were determined for each group. The venous blood variables at admission were compared for 'surviving' and 'non-surviving' foals within groups, between groups, and for the overall gr...
Carmalt JL, Wilson DG.To report arthroscopic debridement and lavage of a septic temporomandibular joint (TMJ) in a horse. Methods: Clinical case report. Methods: A 12-year-old Thoroughbred mare. Methods: Arthroscopic investigation of the dorsal joint pouch of the right TMJ was made through a stab incision into the dorsocaudal compartment. Mechanized resection of synovium and fibrinous debris combined with copious lavage, and intra-articular and systemic antibiotic administration was used to treat the septic TMJ. Results: Arthroscopic debridement and lavage of the TMJ, in combination with intra-articular and systemi...
Corley KT, Donaldson LL, Furr MO.Blood lactate concentration has been shown to be a useful clinical indicator in human patients, but has not been formally investigated in critically ill foals. Objective: To investigate the association of blood lactate with hospital survival, markers of cardiovascular status, metabolic acid base status, sepsis and systemic inflammatory response syndrome (SIRS). Methods: A database containing clinical, haematological, plasma biochemical and hospital outcome data on neonatal foals referred to an intensive care unit in 2000-2001 was analysed. Seventy-two foals for which arterial lactate was measu...
Archer DC, Clegg PD, Edwards GB.A 21-year-old Arab gelding with clinical signs of acute peritonitis had a perforating ulcer on the mesenteric border of the jejunum which resulted in localised contamination of the abdomen with ingesta. The affected segment of jejunum was resected and the abdomen was lavaged extensively. Postoperatively, the gelding was treated with broad-spectrum antibiotics, non-steroidal anti-inflammatory drugs and intravenous fluids, but after four days it became acutely non-weight bearing on its right hindlimb, and a tendonitis of the lateral digital flexor tendon within the tarsal sheath was identified u...
Bucki EP, Giguère S, Macpherson M, Davis R.The objectives of this study were to investigate the pharmacokinetics of once-daily amikacin in healthy neonates, to determine amikacin concentrations in hospitalized foals, and to determine the minimum inhibitory concentrations (MICs) of amikacin against gram-negative isolates from blood cultures in septic foals. Median half-life, clearance, and volume of distribution of amikacin in healthy 2- to 3-day-old foals after administration of an intravenous bolus of amikacin (25 mg/kg) were 5.07 hours (4.86-5.45 hours), 1.82 mL/min/kg (1.35-1.97 mL/min/kg), and 0.785 L/kg (0.638-0.862 L/kg), respect...
McCann JL, Dixon PM, Mayhew IG.Disorders of the equine sphenopalatine sinus, including empyema and neoplasia, have been reported to cause damage to cranial nerves II and V. However, the clinical anatomy of these sinuses is not well described in horses. Objective: To examine the anatomy of the sphenopalatine sinuses in a range of equidae and, in particular, to examine the relationship of these sinuses to adjacent major nerves and vessels. Methods: The anatomy of the sphenoidal and palatine paranasal sinuses was examined in 16 equidae, primarily using transverse skull sections. Relevant structures were documented and photogra...
Fraser BS, Bladon BM.Lacerations to the digital flexor tendon sheath (DFTS) are a common injury in the horse, but little information is available in the literature regarding prognostic indicators. Objective: To ascertain whether laceration of the DFTS carried a better prognosis if treated by tenoscopic lavage, debridement and repair within 36 h of the original injury. Methods: A retrospective analysis of 39 horses treated surgically for lacerations to the DFTS was performed over a 3 year period. The injury-to-surgery interval was recorded as <36 or >36 h. The structures damaged by the injury were also recorded, as...
Kidd JA, Voute LC, Hewetson M.A 12-year-old hunter gelding became severely lame as a result of a laceration to the sheath of the digital flexor tendons of its left hindlimb, but there was no apparent damage to the tendons. The injury became chronically infected with Pseudomonas and Streptococcus species and Escherichia coli which did not respond to antibiotic treatment, and the horse remained lame. A postmortem examination revealed that the tendons had ruptured.
Smith LJ, Marr CM, Payne RJ, Stoneham SJ, Reid SW.Septic arthritis is a serious problem in the neonate, with a poor prognosis being reported for recovery. The impact of neonatal septic arthritis on the likelihood that Thoroughbred (TB) foals will start on a racecourse is not known. Objective: The development of septic arthritis in a TB foal significantly reduces the likelihood that it will race when compared to foals from the same dam. Methods: Medical records of 69 foals treated for septic arthritis were reviewed. The dam's foaling records were reviewed and lifetime racing records were then retrieved for both the affected foals and at least ...
Lescun TB, Morisset SM, Fugaro MN, Blevins WE.A 3-month-old Quarter Horse colt sustained a penetrating injury over the coronary band on the right forelimb resulting in an articular bone sequestrum and septic arthritis of the distal interphalangeal joint. Despite aggressive treatment for septic arthritis, severe osteoarthritis and ongoing sepsis resulted in persistent lameness. Facilitated ankylosis of the distal interphalangeal joint was performed using a combination of open surgical debridement, placement of an autogenous cancellous bone graft and stabilisation within a transfixation cast. Bony ankylosis of the joint was observed radiogr...
Grosenbaugh DA, Morgan SJ, Hood DM.This review indicates that the patient-to-patient uniqueness commonly seen in chronic laminitis represents the variable presence of the digital pathologies. Although some degree of mechanical failure is always present, the secondary metabolic and growth dysplasias, vascular pathologies, and sepsis may or may not be evident. The presence and severity of these pathologies appear to have a more significant impact on the prognosis of individual cases than does the displacement of the distal phalanx. It should be reiterated that it is often the combined presence of these individual pathologies that...
Groom LJ, Gaughan EM, Lillich JD, Valentino LW.Arthrodesis was performed to treat septic arthritis of the proximal interphalangeal joint of 8 horses. Records of the horses were reviewed to determine outcome and possible factors that influenced success or failure. All horses were female. Seven horses had 1 joint treated and 1 horse was treated for bilateral pelvic limb involvement. The duration of sepsis before surgery ranged from 1 to 66 days. Bone lysis and production was radiographically apparent in 7 horses before surgery. Six horses had multiple bacterial organisms cultured from bone or synovial tissues; 2 horses had single isolates id...
McNeal CD, Ryan CA, Berghaus LJ, Credille BC, Lo CP, Fajt VR.Cephalosporin antimicrobials can be utilized for the treatment of sepsis in neonatal foals, particularly when an aminoglycoside is contraindicated. Some cephalosporins, however, are not utilized because of cost, sporadic availability, or uncertainty about efficacy. The plasma disposition of ceftazidime, a third-generation cephalosporin with a broad spectrum of activity against a wide variety of gram-negative bacteria and minimal renal side effects has not been reported in neonatal foals. In this study, the plasma disposition of single intravenous (IV) and intramuscular (IM) doses of ceftazidim...
Lapointe JM, Céleste C, Villeneuve A.An adult quarter horse mare was presented with acute colic and fever. Physical examination and abdominocentesis showed septic peritonitis, and the mare was euthanatized. Necropsy and histopathologic examination revealed a focal partial perforation of the right ventral colon, which contained a single bot fly larva, identified as a third-instar larva of Gasterophilus intestinalis. This larva was embedded deep within the muscularis and the submucosa. Although bot fly larvae are known to attach to aberrant sites within the digestive tract, this is the first known report of deep penetration of the ...
Allen DA, Schertel ER.Shock has been described and defined by the inciting cause. This method of categorization does little to clarify common pathophysiologic changes known to occur regardless of the etiology. Each type of shock involves different stages that are determined by the inciting cause, its duration, severity of the initial result, susceptibility of the patient, and adequacy of treatment.
Sanmartí J, Armengou L, Viu J, Alguacil E, Civit S, Ríos J, Jose-Cunilleras E.Sparse information regarding plasma iron concentration in neonatal foals and its utility as an inflammatory marker in this population has been published. Objective: To determine the physiologic plasma iron concentration in neonatal foals. To assess its utility as an inflammatory marker to predict systemic inflammatory response syndrome (SIRS) and as a prognostic marker. Methods: Forty-seven ill neonatal foals admitted to a referral equine hospital were divided in 2 groups based on the SIRS criteria (24 SIRS and 23 non-SIRS). Two control groups of 43 hospital and 135 stud farm healthy neonatal ...
Gareis M, Seidel KE, Diehl T.268 diagnostic samples from dogs, cats, horses and cattle were examined in a commercially available blood culture system. Samples of blood, liquor, ascites, thorax punctate, synovia and urine were examined with a blood culture system (Oxoid) over a period of two years in cooperation with the veterinary clinical institutes of internal medicine and surgery, Ludwig-Maximilians-University, Munich and different veterinarians. It was shown that this blood culture system, which has been initially developed for the requirements of human bacteriology, can be used for isolation of clinical important mic...
Mercer MA, Davis JL, McKenzie HC, Messenger KM, Schaefer E, Council-Troche RM, Werre SR.Acetaminophen has been evaluated in horses for treatment of musculoskeletal pain but not as an antipyretic. Objective: To determine the pharmacokinetics and efficacy of acetaminophen compared to placebo and flunixin meglumine in adult horses with experimentally induced endotoxemia. Methods: Eight university owned research horses with experimentally induced endotoxemia. Methods: Randomized placebo controlled crossover study. Horses were treated with acetaminophen (30 mg/kg PO; APAP), flunixin meglumine (1.1 mg/kg, PO; FLU), and placebo (PO; PLAC) 2 hours after administration of LPS. Plasma ...
Schiavo S, Cillán-García E, Elce Y, Liuti T, Taylor SE.Solar foot penetration is one of the causes of deep digital flexor tendon injuries in horses, however, limited information is available on the prognosis for return to soundness in the absence of synovial sepsis. Objectives of this retrospective observational study were to describe low-field magnetic resonance imaging (MRI) findings and long-term outcome for a group of horses with this combination of clinical problems. Horses were included if low-field standing MRI of the foot was performed following puncture wounds, injury of the deep digital flexor tendon was diagnosed, and sepsis was confirm...
de la Calle J, Burba DJ, Ramaswamy CM, Hosgood G, Williams J, LeBlanc C, Moore RM.To compare plasma and synovial fluid endothelin-1 (ET-1) and nitric oxide (NO) concentrations in clinically normal horses and horses with joint disease. Methods: 36 horses with joint disease, and 15 horses without joint disease. Methods: Horses with joint disease were assigned to 1 of the 3 groups (ie, synovitis, degenerative joint disease [DJD], or joint sepsis groups) on the basis of findings on clinical and radiographic examination and synovial fluid analysis. Endothelin-1 and NO concentrations were measured in plasma from blood samples, collected from the jugular vein and ipsilateral cepha...
Strootmann T, Spitzbarth I, Della Tommasa S, Brehm W, Köller G, Troillet A.Research and provision of data on macrophages by cytological synovial fluid analysis and light microscopy in horses with septic arthritis MATERIAL AND METHODS: Records of 167 synovial fluid samples were evaluated and subdivided into different groups: (1) non-septic, (2) haematogenous septic arthritis in foals and (3) traumatic/iatrogenic septic arthritis. The effect of joint lavage on synovial fluid cytology and on the occurrence of macrophage phenotypes was investigated. Results: Regardless of aetiology and age of the horse, macrophage concentrations in synovial sepsis are decreased to a medi...
Brianceau P, Divers TJ.A hypercoagulable condition and poor perfusion to distal extremities might occur during equine endotoxaemic or septic shock, which could cause thrombosis of limb arteries. In our review, thrombosis occurred in neonatal foals in association with gram-negative bacteraemia. In 3 older foals and adults, thrombosis was associated with inflammatory bowel disease, diarrhoea and toxaemia. All patients had been treated with broad-spectrum antibiotics, nonsteroidal antiinflammatory drugs and i.v. crystalloid solutions. Two horses received i.v. hyperimmune plasma. A generalised coagulopathy was not suspe...
Bentley AP, Barton MH, Lee MD, Norton NA, Moore JN.To determine which antimicrobials that are used to treat neonatal foals with septicemia attributable to Escherichia coli will minimize endotoxin release from bacteria and subsequent activity of inflammatory mediators while maintaining bactericidal efficacy. Methods: Blood samples from 10 healthy foals. Methods: Escherichia coli isolates A and B were isolated from 2 septicemic foals, and minimal inhibitory concentrations (MIC) were determined for 9 antimicrobials. Five of these antimicrobials were tested in vitro at 2 and 20 times their respective MIC. Whole blood or mononuclear cells grown in ...
Welschen SE, de Bruijn CM, Sloet van Oldruitenborgh-Oosterbaan MM.The short- and long-term results of admission to the 'Neonatal Intensive Care Unit' (ICU) at the Department of Equine Sciences of the Utrecht University were evaluated. The patients were categorized, based on specific criteria, into different groups: 'Sepsis', 'Pneumonia', 'Enteritis', 'Asphyxia', 'Premature', 'Isoerythrolysis', and 'Equine herpes virus (EHV)'. The survival rate and mean duration of hospitalization were determined for each group. The venous blood variables at admission were compared for 'surviving' and 'non-surviving' foals within groups, between groups, and for the overall gr...
Mc Nally TP, Slone DE, Hughes FE, Lynch TM.To describe a tenosynoviotomy technique for treatment of sepsis of the digital flexor tendon sheath (DFTS) in horses and report long-term outcome. Methods: Case series. Methods: Horses (n = 9). Methods: Horses were positioned in lateral recumbency with the affected limb uppermost. A linear incision was made just lateral to the mesotenon beginning 5 cm proximal to the apices of the proximal sesamoid bones, extending 2 cm distal to the bifurcation of the superficial digital flexor tendon (SDFT). The incision was continued through the skin, subcutaneous tissue, palmar/plantar annular ligament, an...
Goehring LS, Sloet van Oldruitenborgh-Oosterbaan MM.A 2 day old foal was presented with central nervous depression (coma) after moxidectin overdose. Moxidectin belongs to the milbemycin anthelmintics which elicit their working mechanism through a GABA (gamma-aminobutyric acid)-stimulatory mode of action. The foal developed profound hypothermia, bradycardia and hypoventilation. Absence of urine voiding and mild abdominal distension suggested a ruptured bladder, which was confirmed by transabdominal ultrasound and clinical-pathologic parameters. Repeat auscultation of the ventral lung parts and the occurrence of gastric reflux were suggestive of ...
Sumano López H, Hoyas Sepúlveda ML, Brumbaugh GW.This article deals with treatment of the chronically foundered horse. The first section of this article is focused on aspects of the traditional pharmacologic approaches to management of digital pain and sepsis, dietary management, and thyroid supplementation. A second section introduces the concepts, principles, and agents that are used in homeopathic treatments for laminitis. Lastly, a third section of this article reviews the use of acupuncture and traditional Chinese medicine approaches to treatment of chronic laminitis.
Terschuur JA, Coomer RPC, McKane SA.The objective of this study was to investigate the postoperative use of intrasynovial honey as an antimicrobial after treatment for synovial sepsis in horses. One colt and 2 mares were presented with acute lameness, with or without an associated wound. All 3 cases were initially managed with surgical endoscopic or tenoscopic debridement and lavage for treatment of different synovial structures. Collection of synovial fluid was consistent with synovial sepsis and this was diagnosed in each case. All horses subsequently underwent arthroscopic lavage under general anesthetic and intraarticular or...
Archer DC, Clegg PD, Edwards GB.A 21-year-old Arab gelding with clinical signs of acute peritonitis had a perforating ulcer on the mesenteric border of the jejunum which resulted in localised contamination of the abdomen with ingesta. The affected segment of jejunum was resected and the abdomen was lavaged extensively. Postoperatively, the gelding was treated with broad-spectrum antibiotics, non-steroidal anti-inflammatory drugs and intravenous fluids, but after four days it became acutely non-weight bearing on its right hindlimb, and a tendonitis of the lateral digital flexor tendon within the tarsal sheath was identified u...
Borchers A, Magdesian KG, Schenck PA, Kass PH.Vasopressin dysregulation occurs in critically ill human patients and in neonatal foals. Limited data about serial plasma vasopressin dynamics exist in sick neonatal foals. Objective: To evaluate serial plasma arginine vasopressin (AVP) concentrations in sick neonatal foals. Methods: Prospective, longitudinal clinical study. Methods: Plasma samples were collected from 7 healthy and 26 sick foals before and after initial fluid resuscitation and 12, 24, 36, 48 and 96 h after presentation. Foals with a modified sepsis score ≥ 11 were considered septic. Results: Admission AVP was increased in se...
Hay AN, Potter A, Kasmark L, Zhu J, Leeth CM.Varying susceptibility exists among mammalian species to the development of potentially fatal endotoxemia due to gram-negative bacteria molecular component, lipopolysaccharide (LPS). Toll-like receptor 4 (TLR4) is responsible for LPS-associated immune response and is expressed on numerous immune cells including B lymphocytes. TLR4 is expressed in a functional form on mouse B lymphocytes, a species much less susceptible to endotoxemia compared with humans who are highly sensitive to endotoxin. Humans possess B lymphocytes that are not responsive to LPS. Likewise, horses are highly susceptible t...
Lavoie JP, Madigan JE, Cullor JS, Powell WE.The purpose of this study was to evaluate the effects of experimentally induced sublethal endotoxaemia in equine neonates. Four foals, between two and five days of age, were infused intravenously with 0.5 microgram/kg bodyweight of Salmonella typhimurium endotoxin (LPS) over a 5 h period. A four-day-old and a five-day-old foal, similarly infused with sterile isotonic saline, served as controls. Clinical signs were monitored, blood samples obtained for evaluation of selected haematological and biochemical parameters; and haemodynamic parameters were recorded hourly during the infusion, as well ...
Hirsh DC, Kirkham C, Wilson WD.Fifteen isolates of Escherichia coli obtained from the blood and tissues of septic foals had plasmid DNA of size ranging from 2.5 to 93 megadaltons. These isolates grew in normal equine serum (serum resistant), a trait previously documented to be expressed by isolates obtained from blood and tissues of septic foals, but not by isolates obtained from the feces of clinically normal horses. Of these isolates, 3 contained conjugal plasmids that encoded resistance to multiple antimicrobial agents linked to serum resistance and, in 1 isolate, to production of aerobactin as well. Serum resistance and...
Benbarek H, Deby-Dupont G, Deby C, Serteyn D.The capacity of the two cytokines TNF-alpha and IL-1beta to directly stimulate the oxidative activity of polymorphonuclear neutrophils remains debated. The purpose of this study was to verify if a direct stimulation of equine neutrophils by TNF-alpha and IL-1beta was possible. Equine neutrophils were isolated from blood by discontinuous density gradient centrifugation. The cell viability after isolation was >98%. The neutrophils were used at 1.25 x 10(6) cells by assay, immediately after isolation. The oxidative activity of neutrophils was measured by luminol- or lucigenin-enhanced chemilumine...
Honnas CM, Schumacher J, Cohen ND, Watkins JP, Taylor TS.The medical records of 25 horses with septic tenosynovitis treated over 7 years (1983 to 1989) were reviewed to determine clinical features of the disease and response to treatment. The median age of horses with septic tenosynovitis was 5 years (range, 1 month to 21 years). Fourteen fore limbs and 11 hind limbs were affected. Sepsis was located in the sheath of the digital flexor tendons of 22 horses. Sepsis was located in the sheath of the extensor carpi radialis tendon (1 horse), sheath of the long digital extensor tendon (1 horse), or sheath of the common digital extensor tendon (1 horse) i...
Armengou L, Monreal L, Delgado MÁ, Ríos J, Cesarini C, Jose-Cunilleras E.Heparin is used in humans as prophylaxis of hypercoagulable states and disseminated intravascular coagulation (DIC). However, babies need a higher heparin dose than do adults. Septic neonate foals are at high risk of hypercoagulable state and DIC, and there is limited objective information about heparin dose for equine neonates. Objective: To assess whether neonate foals require higher dosages of low-molecular-weight heparin (LMWH) than adults. Methods: Eighteen healthy and 11 septic neonate foals. Methods: Experimental and clinical studies. Firstly, healthy foals were randomly distributed in ...
Barton MH, Hurley D, Norton N, Heusner G, Costa L, Jones S, Byars D, Watanabe K.Lactoferrin is a colostral glycoprotein with antimicrobial properties. Objective: (1) Serum lactoferrin and immunoglobulin G (IgG) concentrations are correlated and increase in healthy foals after ingestion of colostrum; (2) compared to healthy foals, ill foals will have lower lactoferrin concentrations that correlate with their IgG concentration, neutrophil count, the diagnosis of sepsis, and survival; and (3) plasma concentrations of lactoferrin will be less than serum concentrations. Methods: Healthy foals (n = 16), mature horses (n = 10), and ill foals 1-4 days old (n = 111) that were exam...
Troy JR, Holcombe SJ, Fogle CA, Epstein KL, Woodie JB.To determine the influence of hyaluronate-carboxymethylcellulose (HA-CMC) membranes applied to intestinal anastomoses or enterotomies on postoperative complications after emergency exploratory celiotomy. Methods: Multicenter retrospective case-controlled series. Methods: Adult horses (59 in the HA-CMC group and 91 controls). Methods: Medical records from 4 referral hospitals were searched for horses ≥1 year of age, treated between 2008 and 2014 with emergency exploratory celiotomy, and surviving at least 24 hours postoperatively. Horses receiving repeat celiotomy during the same hospitalizat...
Wong DM, Young L, Dembek KA.Sepsis is common in foals and several treatments are used to facilitate recovery. Evidence in people suggests an association between low blood concentrations of thiamine, ascorbic acid, and cortisol and sepsis, with further evidence suggesting that administration of hydrocortisone, thiamine, and ascorbic acid may improve outcome. No information is available with regard to these treatments in foals. Objective: To compare blood concentrations of thiamine, ascorbic acid, and cortisol in healthy and ill foals. Methods: Fifteen healthy and 27 ill (septic and sick-nonseptic [SNS]) foals were evaluat...
Rings LM, Kamr AM, Kinsella HM, Hostnik LD, Swink JM, Burns TA, Christie K, David JB, Toribio RE.The enteroinsular axis (EIA) is an energy regulatory system that modulates insulin secretion through the release of enteroendocrine factors (incretins). Despite the importance of energy homeostasis in the equine neonate, information on the EIA in hospitalized foals is lacking. The goals of this study were to measure serum insulin and plasma incretin (glucose-dependent insulinotropic polypeptide [GIP], glucagon-like peptide-1 [GLP-1] and glucagon-like peptide-2 [GLP-2]) concentrations, to determine the insulin and incretin association, as well as their link to disease severity and outcome in ho...
