Topic:Sepsis
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.
Coagulopathy in the equine critical care patient. Disseminated intravascular coagulation (DIC) is a clinicopathologic syndrome resulting from a multitude of underlying causes that manifests itself clinically as hemostatic/fibrinolytic failure. There is much debate on the definition, diagnosis, and treatment of DIC, a situation that is most likely the result of the multifaceted clinical presentation of the syndrome and the fact that patient outcome is often influenced by the underlying disease process. The fact that DIC increases morbidity and mortality in critical care patients is well established, but the exact mechanism of what specifically...
Sepsis in adults and foals. Sepsis develops in horses when the host response to the invading pathogens is not properly balanced according to the severity of the insult. Several clinical conditions frequently encountered in equine practice may be associated with the development of sepsis and have the potential to progress to more severe forms, such as severe sepsis, MODS, and septic shock. Consequently, it is important for equine practitioners to be aware of the manifestations,pathophysiology, and treatment of sepsis. Although enormous progress has been made in recent years in our understanding of the pathophysiology of s...
Parathyroid hormone (PTH) secretion, PTH mRNA and calcium-sensing receptor mRNA expression in equine parathyroid cells, and effects of interleukin (IL)-1, IL-6, and tumor necrosis factor-alpha on equine parathyroid cell function. Parathyroid hormone (PTH) is secreted by the chief cells of the parathyroid gland in response to changes in ionized calcium (Ca(2+)) concentrations. In this study, we measured PTH secretion, and PTH mRNA and calcium-sensing receptor (CaR) mRNA expression by equine parathyroid chief cells in vitro. We also evaluated the effects of interleukin (IL)-1beta, IL-6, and tumor necrosis factor (TNF)-alpha on PTH secretion, and PTH and CaR mRNA expression. The relationship between PTH and Ca(2+) was inversely related. PTH secretion decreased from 100% (day 0) to 13% (day 30). PTH mRNA expression decline...
Septic peritonitis due to colonic perforation associated with aberrant migration of a Gasterophilus intestinalis larva in a horse. 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 ...
Lipopolysaccharide from Rhodobacter sphaeroides is an agonist in equine cells. Endotoxemia is associated with the principal causes of death in adult horses and equine neonates and, therefore, veterinary researchers are expending efforts to identify new therapeutic interventions that might be beneficial in these animals. Endotoxin antagonists inhibit interaction of endotoxin with cellular receptors and may be beneficial in the treatment of endotoxemia and sepsis. Diphosphoryl lipid A from Rhodobacter sphaeroides (RsDPLA) is a potent antagonist of enteric LPS in human cells, but is an agonist in hamster cells. In this study, the effect of lipopolysaccharide from R. sphaero...
Plasma and synovial fluid endothelin-1 and nitric oxide concentrations in horses with and without joint disease. 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...
High volume continuous venovenous haemofiltration (HV-CVVH) in an equine endotoxaemic shock model. Equine acute abdominal disease is often associated with shock. Important aspects in the onset of this complication include hypovolaemia, the translocation of endotoxins from the gut and the subsequent activation of the cytokine network. The clinical efficacy of high volume continuous venovenous haemofiltration (HV-CVVH) and the clearance of cytokines were therefore investigated in an equine endotoxaemic model. Ten male Shetland ponies received a slow infusion of LPS (2 microg/kg bwt) under general anaesthesia. The treatment group (n = 5) received HV-CVVH (2 ml/kg bwt/min) using a 75 kD polymet...
[Glanders–a potential disease for biological warfare in humans and animals]. Infection with Burkholderia mallei (formerly Pseudomonas mallei) can cause a subcutaneous infection known as "farcy" or can disseminate to condition known as Glanders. It is primarily a disease affecting horses, donkeys and mules. In humans, Glanders can produce four types of disease: localized form, pulmonary form, septicemia, and chronic form. Necrosis of the tracheobronchial tree and pustular skin lesions characterize acute infection with B. mallei. Other symptoms include febrile pneumonia, if the organism was inhaled, or signs of sepsis and multiple abscesses, if the skin was the port of e...
Actinobacillus sp. bacteremia in foals: clinical signs and prognosis. Medical records of 101 blood culture-confirmed bacteremic foals were reviewed to determine whether foals with Actinobacillus sp. bacteremia are affected at an earlier age, have more severe signs of disease, and have a worse prognosis than do foals with bacteremia of other causes. Thirty percent (30/101) of bacteremic foals had Actinobacillus sp. cultured, and these were 2 times more likely to die (crude odds ratio [OR(CR)] 0.8, 4; P = .14), with a survival rate of 43% (13/30) compared to the overall survival rate of 55% (56/101). When compared to other bacteremic foals, foals with actinobacill...
[Hematogenous (suspected-)septic inflammation of the synovial fossa in the adult horse: rare but deceptive (3 case reports)]. Septic inflammation of the synovial fossa in the horse is a severe disorder that can lead to permanent invalidity. The synovitis can occur as a result of a perforating trauma, or via the blood (haematogenous). The latter route is rare in the adult horse. Three cases of suspected haematogenous septic synovitis are described in adult horses (older than 1 year). In two horses, timely and adequate treatment resulted in recovery, but this was followed by fatal recurrence. In one of these horses a persistent primary infection was found as cause; the other horse was not available for autopsy. The thi...
Evaluation of lipopolysaccharide-induced activation of equine neutrophils. To evaluate lipopolysaccharide (LPS)-induced activation of equine neutrophils in blood. Methods: Blood samples from 5 healthy adult Thoroughbreds. Methods: Neutrophil integrin (CD11/CD18) expression, size variation, degranulation, and deformability were measured with and without incubation with LPS. Time and concentration studies were done. The mechanism of endotoxin-induced neutrophil activation was investigated by inactivating complement or preincubating neutrophils with inhibitors of tumor necrosis factor-alpha (TNF-alpha) synthesis, prostaglandin-leukotriene synthesis, or platelet-activati...
Antimicrobial-induced endotoxin and cytokine activity in an in vitro model of septicemia in foals. 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 ...
Opsonic capacity of foal serum for the two neonatal pathogens Escherichia coli and Actinobacillus equuli. Two of the most commonly isolated foal pathogens are Escherichia coli and Actinobacillus equuli. The hypothesis tested in this study was that young foals carry a lower opsonic capacity for these bacteria compared to adult horses. A flow-cytometric method for the phagocytosis of these by equine neutrophils was established. The opsonic capacity of serum from healthy foals from birth to age 6 weeks was evaluated and related to the concentrations of IgGa and IgGb. Phagocytosis of yeast was used as a control. Serum was required for phagocytosis, with higher concentrations for E. coli than for A. eq...
A comparison of foal and adult horse neutrophil function using flow cytometric techniques. Flow cytometric assays were used to compare phagocytic and oxidative burst activity of neutrophils from healthy foals less than 7 days of age with the activity of cells from healthy adult horses. The phagocytosis of Staphylococcus aureus by foal neutrophils was less than that observed for adult neutrophils when autologous serum was used as the source of opsonins in the assay. The use of adult serum did not significantly improve the ability of foal neutrophils to attach bacteria. The oxidative burst activity of foal neutrophils was equivalent to that of adult cells. However, when serum or plasm...
Listeria monocytogenes septicaemia in foals. Listeria monocytogenes rarely causes disease in horses
(Emerson and Jarvis 1968; McCain and Robinson 1976; Clark et
al. 1978; Welsh 1983; Wallace and Hathcock 1995; Larochelle et
al. 1999; Wilkins et al. 2000). It is described as a cause of
abortion, septicaemia in equine neonates, mature horses and
ponies and neurological disease in a foal (Emerson and Jarvis
1968; McCain and Robinson 1976; Clark et al. 1978; Welsh
1983; Wallace and Hathcock 1995; Larochelle et al. 1999;
Wilkins et al. 2000). Most cases of listeriosis in other species
arise from the ingestion of contaminated food and...
Characterization of equine E-selectin. Expression of E-selectin on activated endothelium is a critical initial step that leads to extravasation of leucocytes during inflammation, yet E-selectin is largely uncharacterized in several animal species including the horse. We have sequenced and compared E-selectin genes derived from activated cultures of purified equine (horse), cervid (black-tailed deer) and ovine (sheep) pulmonary artery endothelial cells (ECs). Phylogenetic and amino acid sequence comparisons indicate that bovine, cervid and ovine E-selectin are similar, whereas human and equine E-selectin are more closely related to ...
Osteitis of the axial border of the proximal sesamoid bones in horses: eight cases (1993-1999). To determine clinical, radiographic, and scintigraphic abnormalities in and outcome of horses with septic or nonseptic osteitis of the axial border of the proximal sesamoid bones. Methods: Retrospective study. Methods: 8 horses. Methods: Data collected from medical records included signalment; history; horse use; severity and duration of lameness; results of perineural anesthesia, radiography, ultrasonography, and scintigraphy; and outcome following surgery. Results: Five horses did not have any evidence of sepsis; the other 3 had sepsis of the metacarpophalangeal or metatarsophalangeal joint ...
Bacterial isolates from blood and their susceptibility patterns in critically ill foals: 543 cases (1991-1998). To assess microorganisms isolated from blood specimens obtained from critically ill neonatal foals and to evaluate their antimicrobial susceptibility patterns. Methods: Retrospective study. Methods: 543 neonatal foals. Methods: Medical records of foals that were < 1 month old and were admitted to a referral neonatal intensive care unit were reviewed for results of bacteriologic culture of blood and antimicrobial susceptibility patterns. Results: At least 1 microorganism was isolated from 155 of 543 (28.5%) foals. Escherichia coli was the most commonly isolated bacterium. A single gram-posit...
Treatment of sepsis in the small tarsal joints of 11 horses with gentamicin-impregnated polymethylmethacrylate beads. Gentamicin-impregnated polymethylmethacrylate beads were used to treat infective arthritis in the small tarsal joints of 11 severely lame horses. Under general anaesthesia, between five and 10 beads were placed into a 7 to 8 mm tract drilled across the affected joint and, in all except one horse, they were left in place for 14 days. Two of the horses were euthanased for reasons other than persistent tarsal joint sepsis, but the other nine survived and seven of them returned to their previous level of athletic performance.
Intragastric pH in critically ill neonatal foals and the effect of ranitidine. To characterize intragastric pH profiles in critically ill foals and determine whether administration of ranitidine altered pH profiles. Methods: Prospective observational study. Methods: 23 hospitalized neonatal foals < or = 4 days of age. Methods: Intragastric pH was measured continuously for up to 24 hours by use of an indwelling electrode and continuous data recording system. In 21 foals, ranitidine was administered IV. Results: 10 foals had predominantly or exclusively alkaline profiles, 10 had profiles typical of those reported for healthy foals, with periods of acidity (hourly mean p...
Acute thrombosis of limb arteries in horses with sepsis: five cases (1988-1998). 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...
The medical management of eight horses with grade 3 rectal tears. Eight horses with Grade 3b rectal tears of the peritoneal part of the rectum or small colon were treated by a combination of medical therapy and dietary manipulation. All of the horses developed septic peritonitis during the course of treatment. Medical therapy consisted of a combination of penicillin, gentamicin and flunixin meglumine administered parenterally, metronidazole administered orally and liquid paraffin administered by nasogastric tube. Some horses also received fluid and electrolyte therapy i.v., plasma and heparin i.v. All horses were maintained on a laxative diet. Six of the 8 h...
Uroperitoneum in the hospitalised equine neonate: retrospective study of 31 cases, 1988-1997. Historical, physical and diagnostic data were reviewed retrospectively in 31 equine neonates with uroperitoneum. Gender predilection was not observed, and classic electrolyte abnormalities were seen in less than 50% of the cases. Aetiologies for uroperitoneum have been well described, but this review found that septicaemia/severe illness played a crucial role the outcome of uroperitoneum. Approximately half the individuals with uroperitoneum had positive sepsis scores. Foals receiving fluid therapy were more likely to be septic and to have normal electrolyte concentrations. Ultrasonographic fi...
Treatment of traumatically induced synovial sepsis in horses with gentamicin-impregnated collagen sponges. Eight horses with synovial sepsis induced by trauma were treated by arthroscopic/tenoscopic debridement and lavage followed by the implantation of a gentamicin-impregnated collagen sponge. Seven of them responded favourably and were sound six months after treatment. The other underwent a further surgical procedure and recovered. Gentamicin-impregnated collagen sponges appear to be a safe and useful adjunct in the treatment of septic joints and tendon sheaths, and have the advantage of being bioabsorbable.
Arthrodesis of the proximal interphalangeal joint affected with septic arthritis in 8 horses. 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...
Pharmacologic considerations in the treatment of neonatal septicemia and its complications. This article focuses on the pharmacologic properties of drugs commonly used in the treatment of neonatal septicemia and its complications. Rational therapy demands an awareness of not only the pharmacology of individual drugs but also the interactions and anticipated fate of such drugs in the rapidly changing physiologic environment of the neonate. Further research in the area of equine neonatal pharmacology should greatly assist our understanding of the impact of the disease state on the unique physiology of the newborn and should allow us to better predict the ultimate fate of drugs commonly...
Factors associated with prognosis for survival and athletic use in foals with septic arthritis: 93 cases (1987-1994). To identify factors affecting the prognosis for survival and athletic use in foals with septic arthritis. Methods: Retrospective study. Methods: 93 foals with septic arthritis. Methods: Medical records were reviewed to obtain clinical findings, laboratory test results, radiographic findings, treatment method, and outcome. Race records for Thoroughbreds and Standardbreds were evaluated to determine whether foals subsequently raced and whether they raced successfully. Results: 43 foals had 1 affected joint, 44 foals had multiple affected joints, and number of affected joints was not recorded for...
The digital pathologies of chronic laminitis. 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...