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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.
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...
Retrospective analysis of the results of 151 exploratory laparotomies in horses with gastrointestinal disease. Of 149 horses that underwent 151 exploratory laparotomies for gastrointestinal disorders from September 1987 to May 1991, 107 (72%) were discharged from the hospital: 100 (66%) survived for > 7 months, 94 of which returned to their intended use. Survival rate (64/80) for horses with caecum/large colon obstruction was significantly (P = 0.003) higher than for horses with small intestinal obstruction (33/64). Prolonged surgery was associated with significantly (P < 0.001) lower survival rates than short surgical time. In the large intestine, survival rate (15/29) for strangulated obstructi...
Peritonitis in horses: 67 cases (1985-1990). Peritonitis was diagnosed in 67 horses between 1985 and 1990: 14 horses developed septic peritonitis after intestinal rupture, 25 horses developed peritonitis after abdominal surgery, and 28 horses had peritonitis not associated with intestinal rupture or abdominal surgery. Forty of 67 horses (59.7%) did not survive. Nonsurvivors had higher heart rates (P = 0.01), RBC count (P = 0.039), serum creatinine concentration (P = 0.036), PCV (P = 0.007), and anion gap (P = 0.005); lower venous blood pH (P = 0.002); and a greater number of bacterial species cultured from peritoneal fluid samples (P = 0...
Linkage of serum resistance, aerobactin production, and resistance to antimicrobial agents on conjugal plasmids in some strains of Escherichia coli isolated from septic foals. 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...
A prospective study of septicaemia in colostrum-deprived foals. Fourteen mares and their foals were attended at parturition. After mare-foal bonding, 8 colostrum-deprived (CD) foals were removed from their dams, deprived of colostrum, and provided with an alternative milk source for the first 24 h of life. The mares were milked out every 2-4 h during this period to remove colostrum, after which the CD foals were returned to their mares and allowed to nurse. Six colostrum-fed (CF) foals were allowed to suck colostrum in the normal manner. Foal serum IgG concentration was determined by single radial immunodiffusion (means, CD = 0 mg/dl; CF = 1,508 mg/dl). Ac...
Pharmacokinetics of cefotaxime in neonatal pony foals. Serum concentrations of cefotaxime and desacetylcefotaxime were measured in 1-week-old pony foals after IV administration of a single dose of cefotaxime. The cefotaxime disposition data conformed to a two-compartment model with elimination half-life of 0.60 hour. The combined cefotaxime and desacetylcefotaxime data was best described by a four-compartment model. The apparent half-life describing the disappearance of desacetylcefotaxime was 1.69 hours. Dosage of 40 mg/kg of body weight given IV every 4 to 6 hours for neonatal foals with gram-negative septicemia and every 2 hours for foals with ...
Intermittent antimicrobial infusion for management of a septic distal interphalangeal joint in a horse. A 13-month-old Quarter Horse colt sustained a puncture wound to the frog region of the foot, which penetrated the navicular bursa and distal interphalangeal joint, 7 days prior to examination. A street-nail procedure was performed to debride the tract and provide drainage of the navicular bursa and distal interphalangeal joint. An indwelling lavage system was placed through the dorsal aspect of the joint and antimicrobials were infused intermittently to supply a high local concentration of drug and to frequently lavage the distal interphalangeal joint and navicular bursa.
Regional limb perfusion for antibiotic treatment of experimentally induced septic arthritis. Septic arthritis was induced in one antebrachiocarpal joint of seven horses by the intra-articular injection of 1 mL Staphylococcus aureus suspension containing a mean of 10(5) colony-forming units. Twenty-four hours after inoculation, four horses were treated by regional perfusion with 1 g of gentamicin sulfate, and three horses received 2.2 mg/kg gentamicin sulfate intravenously (IV) every 6 hours. Synovial fluid was collected for culture and cytology at regular intervals, and the synovial membranes were collected for culture and histologic examination at euthanasia 24 hours after the first ...
Septic peritonitis associated with caudal myotomy in a Tennessee walking horse. A 2-year-old Tennessee Walking Horse colt was admitted for evaluation of signs of abdominal pain, inappetence, and constipation of 5 days' duration. Two days prior to the onset of signs, the owner had cut the sacrococcygeal muscles as part of a tail-setting procedure. On examination, the horse was febrile and lethargic, and intestinal sounds were not heard on auscultation. Results of peritoneal fluid analysis were indicative of peritonitis. The horse continued to deteriorate and died despite treatment with antimicrobials, flunixin meglumine, and balanced electrolyte solution. At necropsy, the ...
Septic metritis secondary to torsion of a pedunculated uterine fibroleiomyoma in a filly. A 2-year-old Arabian filly was referred for evaluation of a serosanguineous vaginal discharge. Palpation per rectum revealed a large, fluid-filled uterus and a uterine mass. The filly developed septic metritis and secondary laminitis as a result of torsion and necrosis of a pedunculated uterine mass. Ovariohysterectomy was performed. The entire cervix was removed with the uterus. Gross examination of the excised uterus revealed 3 intraluminal masses. Histologic evaluation identified the tumors as fibroleiomyoma. The filly recovered completely, and there was no recurrence of the tumor.
Septic cholangitis and peritonitis in a gelding. An 8-year-old Arabian gelding with septic cholangitis and peritonitis was successfully treated with trimethoprim/sulfadiazine. The gelding was referred for evaluation of signs of abdominal pain, icterus, fever, and weight loss. Peritoneal fluid analysis revealed septic and suppurative peritonitis. Culture of the peritoneal fluid yielded Escherichia coli and Klebsiella pneumoniae, which were sensitive to trimethoprim/sulfadiazine. On the basis of results of hepatic ultrasonography, a diagnosis of septic cholangitis also was made. The horse was treated with 30 mg of trimethoprim/sulfadiazine/kg,...
Relation between pharmacokinetics of amikacin sulfate and sepsis score in clinically normal and hospitalized neonatal foals. Pharmacokinetic values after IV administration of amikacin sulfate were determined for clinically normal and hospitalized foals during the first week of life. The relations between drug disposition and sepsis score and serum creatinine concentration also were studied. In clinically normal foals, differences in sepsis score, serum creatinine concentration, and pharmacokinetic variables of amikacin were not found between foals 1 to 3 and 4 to 7 days old. In hospitalized foals, sepsis score, serum creatinine concentration, area under the curve, area under the moment curve, and mean residence time...
Association between serum cytotoxicity and selected clinical variables in 240 horses admitted to a veterinary hospital. A total of 378 serum samples from 240 hospitalized horses and 47 sera from healthy control horses were assayed for growth effects on actinomycin D-treated L929 cells. On average, patient and control sera stimulated cell growth; however, mean percentage of the relative growth index (RGI) of sera from clinical cases was significantly (P less than 0.001) lower than that of control sera. Approximately 35% of patient sera and 6% of control sera had tumor necrosis factor-like cytotoxic activity for L929 cells (ie, RGI less than 100%). Sera from horses with either peritoneal leakage of gastrointestin...
