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.
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...
Equine neonatal septicaemia: 24 cases. Equine neonatal septicaemia was confirmed in 24 foals hospitalised at the Rural Veterinary Centre between 1989 and 1992 with suspected septicaemia. Septicaemia was confirmed by culture of bacteria from blood of live foals and tissues obtained at necropsy of foals that died or were euthanased. Pathogenic bacteria isolated were predominantly Enterobacteriaceae (including Escherichia coli and Salmonella serovars) and Actinobacillus equuli. Clinical manifestations of septicaemia included signs of depression, dehydration, abnormalities in body temperature and manifestations of localised infection i...
Anti-inflammatory and immune support in endotoxemia and septicemia. Endotoxemia and septicemia are encountered frequently in equine veterinary practice. The deleterious effects of endotoxin are related to the severity of the response of the host's inflammatory system. Consequently, it is imperative that appropriate steps be taken to identify animals at risk of developing endotoxemia or septicemia, and to initiate treatments that will reduce the inflammatory response. This article discusses the anti-inflammatory and immune support of horses and foals with endotoxemia and septicemia.
Pathogenic aspects of circulatory shock. 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.
Pentoxifylline inhibits mediator synthesis in an equine in vitro whole blood model of endotoxemia. Whole blood from 10 healthy horses was aseptically collected into heparin or citrate anticoagulant and incubated in vitro for 6 hr in the absence (saline control) or presence of 1 ng endotoxin/ml blood. Pentoxifylline (0.1, 1, 10, or 100 micrograms/ml blood) was added 1 hr before, at the same time, or 1 hr after endotoxin. As compared to saline controls, pentoxifylline alone had no effect on mediator production, with the exception of significantly increasing 6-ketoprostaglandin F1 alpha concentration. Pentoxifylline inhibited endotoxin-induced increases in tumor necrosis factor (TNF) and inter...
Systemic candidiasis in four foals. Four foals were admitted to the neonatal intensive care unit in the first 2 days of life with problems related to birth hypoxia (neonatal maladjustment syndrome, renal failure, necrotizing enterocolitis) and sepsis. Foals were hospitalized for an extended period (35 to 70 days) and received treatment with several broad spectrum antimicrobial agents. Invasive monitoring and treatment procedures included intravenous catheterization, urinary catheterization, and parenteral nutritional and ventilatory support. In each foal, infections of undetermined cause developed, and systemic candidiasis was d...
Laboratory and clinical evaluation of a chromogenic endotoxin assay for horses with acute intestinal disorders. In this study the laboratory and clinical performance of a chromogenic endotoxin assay for equine plasma was evaluated. The assay was sensitive (detection limit 3 ng LPS/L plasma), reproducible (within and between-assay CV at 50 ng LPS/L E. coli O111:B4 LPS standard addition was 5% and 7.5%, respectively), and not substantially affected by enhancement or inhibition phenomena (recovery of an in vitro spike was 75-125% in 80% of the samples). LPS added to whole blood was rapidly inactivated upon incubation at 37 degrees C but not at 0 degrees C. A recently developed blood collection tube for LPS...
Update on neonatal septicemia. Septicemia is the second most commonly diagnosed problem in the equine neonate, superseded only by the problem of inadequate transfer of maternal antibodies. This article reviews the factors that may put a foal at high risk for developing sepsis, the diagnostic tools used to identify these animals, some of the sequelae of sepsis, and the therapeutic modalities available to the clinician.
Musculoskeletal disorders of the neonate. Musculoskeletal disorders in newborn foals are complex, multifactorial, and associated with prematurity, dysmaturity, and twinning. They include incomplete ossification of cuboidal bones, tendon laxity, congenital angular limb deformities, septic arthritis, osteomyelitis, and septicemia. Other deformities associated with nutrition, large size, and rapid growth include osteochondrosis, physitis, ruptured tendons, acquired flexural deformities, and postnatal angular limb deformities. Optimal management of the complexly interrelated musculoskeletal disorders of the neonate also is discussed.
Ventilatory support of the neonatal foal. Many sick neonatal foals have respiratory failure secondary to perinatal hypoxia, sepsis, or pneumonia. These foals require ventilatory support to prevent respiratory embarrassment and other complications associated with chronic hypoxia and hypercapnia. This article discusses practical aspects of ventilatory therapy, such as choosing a candidate for mechanical ventilation, choosing the proper ventilatory mode, placing a foal on a ventilator, maintaining a foal on mechanical ventilation, and weaning from mechanical ventilation. This article details some of the techniques that have been develope...
Plasma endotoxin concentrations in clinically normal and potentially septic equine neonates. Plasma endotoxin concentrations were measured at 1 to 2 and 5 to 6 days of age in clinically normal foals and in potentially septic neonatal foals admitted to North Carolina State University's Veterinary Teaching Hospital for a variety of conditions. In 1 to 2 and 5 to 6 day old normal foals, median plasma endotoxin concentrations were 2.17 (range, 1.61-2.54; n = 6) and 2.89 (range, 2.61-3.50; n = 7) endotoxin units/mL (EU/mL), respectively. Median plasma endotoxin concentration in potentially septic foals with negative blood cultures or gram positive isolates (n = 8) was 2.73 (range, 0.59-4.0...