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.
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...
Pharmacologic and alternative therapies for the horse with chronic laminitis. 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.
[Moxidectin poisoning in a foal?]. 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 ...
Endotoxin induction of nitric oxide synthase and cyclooxygenase-2 in equine alveolar macrophages. To determine the amount of cyclooxygenase-2 (COX-2) and inducible nitric oxide synthase (iNOS) enzymes induced in vitro in equine alveolar macrophages in response to lipopolysaccharide (LPS). Sample Population-Alveolar macrophages obtained from 12 horses. Methods: Alveolar macrophages were collected by bronchoalveolar lavage from 12 horses and incubated for 6 hours with LPS (0.001 to 10 microg/ml) or vehicle. Total RNA was extracted and purified. After first-strand cDNA synthesis, mRNA induction was measured, using a polymerase chain reaction (PCR) technique for COX-2, iNOS, and glyceraldehyde...
Evaluation of peritoneal fluid pH, glucose concentration, and lactate dehydrogenase activity for detection of septic peritonitis in horses. To determine whether peritoneal fluid pH, glucose concentration, and lactate dehydrogenase activity can be used to differentiate horses with septic peritonitis from those with nonseptic peritonitis. Methods: Prospective study. Methods: 46 horses, including 10 healthy horses, 15 horses with septic peritonitis, and 21 horses with nonseptic peritonitis. Methods: Peritoneal fluid and blood samples were analyzed for pH, glucose concentration, and lactate dehydrogenase activity. Complete blood cell counts were performed, and peritoneal fluid samples were submitted for bacterial culture. Results: Hor...
Endoscopy of the navicular bursa: a new technique for the treatment of contaminated and septic bursae. A technique for evaluation of the navicular bursa using a 4 mm 25 degrees inclined view arthroscope is described. This allows examination of the palmar/plantar surface of the navicular bone, the insertions of the navicular suspensory, T and impar ligaments, the bursal synovium and the dorsal surface of the deep digital flexor tendon. The technique was used in 16 horses with punctures of the navicular bursa. Procedures facilitated by the technique were bursal lavage, removal of pannus, synovial resection and debridement of lesions on the palmar/plantar surface of the bone and in the deep digita...
Equine neutrophil myeloperoxidase in plasma: design of a radio-immunoassay and first results in septic pathologies. The strangulated intestinal pathologies of horses are accompanied by a local activation of the neutrophils, that can be revealed by measuring the tissular enzymatic activity of the granulocytic enzyme myeloperoxidase (MPO). To estimate the possible spreading of this neutrophil activation to the systemic circulation, we designed a radioimmunoassay (RIA) for equine neutrophil myeloperoxidase (MPO) (EC 1.11.1.7) using a specific rabbit antiserum. MPO was labeled with 1 mCi 125I by a technique of self-labeling in the presence of 10(-4) M hydrogen peroxide. The RIA was performed by incubation of 10...
Septic osteitis of the distal phalanx: findings and surgical treatment in 18 cases. Eighteen cases of septic osteitis of the distal phalanx were diagnosed clinically and confirmed at surgery over a 6 year period (1990-1996). Focal bone lysis was the most common radiographic finding. Sequestra were identified in 4 horses, one of which was associated with a fractured plantar process. All the horses were treated surgically with open debridement. The septic process recurred in 4 horses: one was subjected to euthanasia due to navicular bursa infection, secondary to a pathological fracture, the other 3 horses responded to further debridement. A pathological fracture occurred in ano...
Enterocolitis associated with Clostridium perfringens infection in neonatal foals: 54 cases (1988-1997). To identify clinical signs, physical examination findings, results of diagnostic tests, treatments administered, and clinical outcome of neonatal foals with enterocolitis associated with Clostridium perfringens infection. Methods: Retrospective study. Methods: 54 neonatal foals. Results: Most foals had acute onset of obtunded mentation, colic, or diarrhea and developed leukopenia, neutropenia, an abnormally high number of band neutrophils, toxic WBC, and hypoproteinemia within 24 hours after admission, despite high serum IgG concentrations (> 800 mg/dl). Abdominocentesis and abdominal radiogra...
Electrolyte disturbances in foals with severe rhabdomyolysis. Marked electrolyte abnormalities characterized by profound hyperkalemia, hyponatremia, hypocalcemia, and hyperphosphatemia were noted in 4 neonatal foals with acute rhabdomyolysis and pigmenturia. In 2 foals, rhabdomyolysis developed 4-6 days after admission for dysmaturity, and in 2 foals, rhabdomyolysis was evident on presentation. Rhabdomyolysis was a consequence of selenium deficiency with or without vitamin E deficiency, possibly combined with increased oxidant stress due to sepsis or hypoxia and reperfusion injury after parturition. Foals gained from 7 to 15% of their initial body weight...
Role of prokinetic drugs for treatment of postoperative ileus in the horse. All horses undergoing coeliotomy for an acute abdominal crisis are at risk of developing ileus and should receive therapy aimed at promoting gastrointestinal function by restoring fluid and electrolyte balance. Adequate analgesia and prevention against peritonitis, bacteraemia and endotoxaemia should be provided. Horses that at the time of surgery have a strangulating or non-strangulating small intestinal obstruction should be considered to be at greater risk of developing a persistent ileus that is refractory to treatment than those horses with lesions involving the large intestine. In horses...
Hemostatic and fibrinolytic indices in neonatal foals with presumed septicemia. Thirteen coagulation tests evaluating hemostatic and fibrinolytic indices and serum cytokine and plasma endotoxin concentrations were obtained in 34 foals with a positive sepsis score (septic group) and 46 age-matched healthy foals. Compared to healthy foals, the prothrombin, activated partial thromboplastin, and whole blood recalcification times were significantly longer in septic foals. The fibrinogen and fibrin degradation products concentrations, percent plasminogen, alpha-2 antiplasmin, and plasminogen activator inhibitor activities, and tumor necrosis factor and interleukin-6 activities ...
Laparoscopic adhesiolysis in a horse. The purpose of this report was to describe the use of laparoscopy as a method of treatment for abdominal adhesions in the horse. Methods: Unilateral ovariectomy for removal of a granulosa cell tumor was performed through a diagonal paramedian approach in a 14-year-old Arabian mare. Progressive incisional swelling and hemorrhage culminated in acute incisional dehiscence with herniation of ileum on the sixth postoperative day. Septic peritonitis that responded to parenteral antibiotic therapy was identified 7 days after hernia repair. Seven days later, the mare had signs of abdominal pain, and a...
Septic tenosynovitis and focal osteomyelitis of the lateral proximal sesamoid bone in a thoroughbred gelding. Chronic septic tenosynovitis with concurrent, associated focal osteomyelitis of the lateral proximal sesamoid bone was diagnosed in a seven-year-old thoroughbred gelding. Surgical management of this case consisted of open annular ligament desmotomy and curettage of the affected sesamoid. Following lavage of the digital sheath the incisional wound was closed but a 2 cm gap was left distally to allow for postoperative open drainage. The distal limb was bandaged and the horse treated with antibiotics and non-steroidal anti-inflammatories. Sepsis resolved and the horse made a gradual return to ful...
Sepsis of the common digital extensor tendon sheath secondary to hemicircumferential periosteal transection in a foal. A 4-month-old Quarter Horse was admitted for evaluation of infection that developed following bilateral hemicircumferential periosteal transection and elevation. Sepsis of the common digital extensor tendon sheath was diagnosed. Treatment included lavage of the tendon sheath, placement of an indwelling drain for lavage after surgery, establishment of drainage, and administration of antimicrobial and anti-inflammatory drugs. Three months after treatment, the foal was clinically normal.
Survey of diplomates of the American College of Veterinary Internal Medicine and the American College of Veterinary Surgeons regarding clinical aspects and treatment of endotoxemia in horses. A questionnaire designed to elicit information concerning prevalence, underlying causes, diagnosis, prevention, treatment, and complications of endotoxemia in horses was mailed to diplomates of the American College of Veterinary Internal Medicine and the American College of Veterinary Surgeons who identified themselves as equine practitioners. Gastrointestinal tract compromise, conditions associated with foaling, and grain overload were reported to be the most common clinical conditions that led to endotoxemia. Most of the respondents diagnosed endotoxemia on the basis of the following clinica...
[Experience with the use of a blood culture system for demonstration of clinically relevant bacteria in veterinary medicine diagnosis]. 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...