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.
Thomson M.Three thoroughbred foals were treated with anti-endotoxin hyperimmune serum. The serum was injected into the affected joint spaces. Two of the foals made a complete recovery.
Morris DD, Beech J.Disseminated intravascular coagulation (DIC) was diagnosed as a secondary disease in 6 horses. Four horses had localized and/or systemic sepsis, one horse had disseminated neoplasia, and one had idiopathic ulcerative enteropathy. The diagnosis of DIC was based on the finding of at least 3 of 4 abnormalities: thrombocytopenia, prolonged prothrombin time, prolonged activated partial thromboplastin time, and a high concentration of fibrinolytic degradation products. The most common clinical signs other than those attributable to the primary disease process were abnormal hemorrhage (4 hours) and v...
Fessler JF, Bottoms GD, Roesel OF, Moore AB, Frauenfelder HC, Boon GD.A study was made of flunixin meglumine (FM), an analgesic agent with antiprostaglandin activity, in the management of endotoxin-induced changes in ponies. Three groups of 5 ponies each were used: A--controls, B--nontreated ponies with endotoxin-induced shock, and C--ponies with endotoxin-induced shock treated with FM. Shock was induced in anesthetized ponies with IV injections of Escherichia coli endotoxin. Disruption of glucose homeostasis, insulin levels, hemograms, aerobic metabolism, and cell damage as indicated by plasma enzymes were observed. Treatment with FM (5 minutes) after shock was...
Smith BP.The practical implications of equine salmonellosis in the light of present knowledge are reviewed. Emphasis is placed on the various clinical forms which the disease may take. These include asymptomatic infections, signs of fever, anorexia and depression, severe acute diarrhoea and the septicaemic form. Diagnosis depends on recovery of the organism from the blood or faeces or, at necropsy, from tissues. In asymptomatic infections, it may be necessary to make serial faecal cultures over several days before a negative diagnosis may be made with any degree of certainty. Isolation of salmonellae i...
Sembrat RF, Di Stazio J, Stremple JF.This study was conducted to determine the feasibility of using alert, conscious ponies as a model for septic shock in man. Ten ponies were given 0.7-5 X 10(9) organisms/kg of body weight of live E coli intravenously over one hour. All ponies died and exhibited signs of low cardiac output septic shock. significant decreases were found in cardiac index to 3.15 +/- 0.1 liters/min/m2 (P less than 0.05), white blood cell count to 1,930 +/- 100 cells/m3 (P less than 0.05), preterminal blood glucose to 75 +/- 5 mg/dl (P less than 0.05), PaO2 to 75.7 +/- 5.7 mm Hg (P less than 0.05), and pH to 7.15 +/...
Rumbaugh GE.Physical, neurologic, and clinicopathologic findings in a 3-year-old female Morgan horse with anorexia and nasal discharge suggested suppurative meningitis. Necropsy findings substantiated the tentative diagnosis. Actinomyces sp was cultured from a meningeal abscess surrounding the pituitary gland and from resolving lung abscesses.
There is a paucity of information regarding the association between common disorders and outcome over time in a large population of ill equine neonates. Objective: To describe the relative frequency of neonatal disorders in a large population of foals admitted to a neonatal intensive care unit, to determine the disorders and factors associated with nonsurvival and determine if the outcome of ill neonatal foals has improved over time. Methods: Retrospective study. Methods: Cases were selected from equine neonatal (≤14 days of age) admissions between 1982 and 2008. Multivariable logistic regre...
Divers TJ.Regulation of renal blood flow is by both extrinsic and intrinsic systems. Intrinsic regulation occurs via the afferent and efferent arterioles and tubuloglomerular feedback mechanisms with activation of the juxtaglomerular apparatus. Mechanisms of acute kidney injury are frequently associated with changes in renal blood flow. Acute tubular necrosis and apoptosis are common in horses following ischemic or toxic insults and in sepsis-associated acute kidney injury. Sepsis-associated renal injury often has a complex mechanism of disease involving both functional and obstructive changes in intrar...
Neil KM, Axon JE, Begg AP, Todhunter PG, Adams PL, Fine AE, Caron JP, Adkins AR.To determine the clinical characteristics, short-term outcome and future athletic performance of foals with septic osteomyelitis. Methods: Retrospective clinical study of 108 Thoroughbred foals with radiographic evidence of bone infection that were presented at the Scone Veterinary Hospital between August 1995 and December 2001. Medical records were reviewed and information concerning signalment, the clinical, laboratory and radiographic findings, treatment and outcome was obtained. Racing records were obtained and evaluated for surviving foals that had reached racing age. Results: Mean age of...
Mair TS.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...
Clabough DL, Duckett W.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,...
McClure SR, Hooper RN, Watkins JP.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.
Palmer JE.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...
Scilimati N, Pepe M, Pressanto MC, Angeli G, Beccati F.A 4-month-old Thoroughbred filly was referred for evaluation of severe left forelimb lameness of 24 hours duration. Radiographic projections of the shoulder revealed mild irregularity and sclerosis of the proximal humeral apophysis. Ultrasonographic examination showed a moderate increase in the amount of anechogenic synovial fluid within the intertubercular bursa and scapulohumeral joint, and irregularity of the ossifying bone surface of the intermediate tubercle of the humerus. Computed tomographic (CT) examination revealed a circular hypoattenuating area at the level of the proximal apophysi...
Pearson GB, Ysebaert MP, Papa B, Reesink HL.This article, as part of the Currents in One Health series, reviews the current state of diagnostics for synovial sepsis. Synovial sepsis is a condition that affects veterinary and human medicine and requires coordinated efforts from both parties, as well as environmental considerations to accurately diagnose and preserve effective treatments. The article discusses best practices to identify the causative agent in septic synovitis, trends in bacterial identification and antimicrobial resistance patterns across common bacterial species, and a one-health perspective to optimize diagnostics acros...
van den Boom R, Rijkenhuizen AB.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...
Spurlock GH.The prognosis for returning horses with open joint injuries to athletic function is most closely related to the duration of the injury prior to treatment. Prompt diagnosis and appropriate therapy should yield a favorable result. Delayed diagnosis or inappropriate therapy that allow the wound to progress to an infected state makes the likelihood of return to athletic function poor. Refractory joint infection can occur despite early diagnosis and prompt appropriate therapy. The development of these infections is undoubtedly increased by tissue loss and gross contamination. Appropriate antibiotic...
Hough VA, Wycislo KL, Hofmeister EH, Piech TL, Maki LC, Shaver SL.Veterinary students' accuracy, confidence, and time required to diagnose bacterial sepsis in fluid cytology samples was evaluated using two different slide preparation methods: direct smears and cytocentrifuged concentrated preparations. We hypothesized veterinary students would diagnose fluids as septic on concentrated preparations more accurately and quickly than on direct smears. Thirty third- and fourth-year students who had previously participated in a clinical pathology course completed a survey regarding general cytology experience and reviewed 40 randomized Romanowsky-stained slides vi...
Lacerenza MD, Arantes JA, Reginato GM, Passarelli D, Balieiro JCC, Amaral AR, Vendramini THA, Brunetto MA, Dória RGS.β-glucan is part of the cell wall of fungi and yeasts and has been known for decades to have immunomodulating effects on boosting immunity against various infections as a pathogen-associated molecular pattern that is able to modify biological responses. β-glucan has been used in rat models and in vitro studies involving sepsis and SIRS with good results, but this supplement has not been evaluated in the treatment of endotoxemia in horses. This study aims to evaluate the effects of preventive supplementation with β-glucan in horses submitted to endotoxemia by means of inflammatory response m...
Lanci A, Ellero N, Castagnetti C, Perina F, Dondi F, Mariella J.Alpha-fetoprotein (AFP) concentrations have been reported in healthy foals and proposed as a biomarker of sepsis in foals born from mares with experimentally induced placentitis. This study aimed to describe the diagnostic and prognostic value of plasma AFP in foals spontaneously affected by different diseases. The study included all foals less than 72 h old that were diagnosed with either: (1) prematurity (PRE), when born prior to 320 days of gestation with immature physical characteristics; (2) sepsis (SEP), in the presence of both positive blood culture and SIRS or (3) neonatal encephalopat...
Debes L, Venner M, Koether K, Vervuert I, Blanco M, Sieme H, Sielhorst J.Little is known about the health status of foals born alive from mares treated for placental disease. The aims of the present study were (1) to compare the neonatal health status and health development during the rearing period of foals born from mares treated for ultrasonographically assessed placental abnormalities (UPA) to age-matched healthy foals from the same warmblood stud and (2) analyze the influence of mare's placental health on colostrum quality. Foals (n = 127) born from mares with UPA (UPA group; P) in 2017-2019 were compared to 127 foals born from healthy mares (control group; ...
Drahonovska A, O'Neill HD. The objectives of this study were (1) to evaluate the need for flexed radiographs of the proximal medial trochlear ridge (PMTR) after trauma involving medial tarsus; (2) to evaluate outcome following arthroscopic removal of traumatic osteochondral fragments (TOCF) resulting from direct injury to PMTR. Methods: Records of patients with wounds to the medial tarsus were searched and those with TOCF of the PMTR included. Patient history, fracture etiology, preoperative diagnostics, and intraoperative findings were documented. Postoperative performance data were collected using Thoroughbred R...
Kamr AM, Bartish C, Summers J, Horton J, Hostnik LD, Orr K, Browne N, Dembek KA, Saliba C, Gomez DE, Toribio RE.Information about the association of antimicrobial peptides with hypovitaminosis D in hospitalized foals is lacking. Objective: We aimed to longitudinally determine the association of serum concentrations of vitamin D metabolites, vitamin D binding protein (DBP), and parathyroid hormone (PTH) with antimicrobial peptides (β-defensin-1 and cathelicidin-1) and the mRNA expression of the vitamin D receptor (VDR), 1α-hydroxylase (CYP27B1), 24-hydroxylase (CYP24A1), toll-like receptor-4 (TLR-4), tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), disease severity, and mortality in hospita...
Loppnow Z, Kersh K, Wang C, Spaethe S, Troy J.The clinical outcomes in horses diagnosed with established synovial sepsis (SS) or minimally contaminated synovial wounds (SW)/non-established sepsis, following intravenous regional limb perfusion (IVRLP) treatment, have not been reported since 2010. Additionally, previous reports on this subject were confined to just two clinical retrospective reports. This study aimed to provide an update on the short-term (hospital discharge) and long-term (≥1 year) survival rates in adult horses diagnosed with SS or SW treated with IVRLP at a single institution in the USA from 2010-2020. The study also...
Gao T, Liu X, Qiu D, Li Y, Qiu Z, Qi J, Li S, Guo X, Zhang Y, Wang Z, Gao X, Ma Y, Ma T.Cefquinome is used to treat septicemia caused by () and respiratory infections caused by subsp. in foals. However, studies reporting the use of cefquinome to target as pathogens of sepsis are lacking. Therefore, this study aimed to determine the optimal dosage regimen for cefquinome against using a PK/PD model. After the administration of 1 mg/kg cefquinome (intramuscularly or intravenously), blood samples were collected at different time points to determine the serum concentration of cefquinome via HPLC. The pharmacokinetic parameters were evaluated via NCA (WinNonlin 5.2.1 software). Th...
Neudeck S, Sauter PK, Kutter APN, Steblaj B, Söbbeler FJ, Reiners J, Freise F, Gutiérrez Bautitsta AJ, Kästner SBR.Endotoxaemia is a significant cause of morbidity and mortality in equids due to perfusion impairment and possible destruction of the glycocalyx. To evaluate our hypothesis that endotoxaemia induces changes in global cardiovascular and haematologic parameters and compromises glycocalyx integrity, evidenced by an early rise in plasma shedding products. In vivo experiments METHODS: In a prospective, randomised, controlled experimental trial, endotoxaemia was induced with E. coli B55:O5 LPS 30 ng kg over 30 min IV in six healthy adult horses ventilated with oxygen supplemented with isoflurane. St...
Rivera Maza S, Bishop RC, Austin SM, Foreman JH, Wilkins PA.Meconium impaction/retention is a significant cause of colic in foals. Historically, limitations of both medical and surgical treatment are noted. Outcomes of meconium impaction/retention have not recently been reported. Unassigned: To describe case characteristics and outcomes in foals with meconium impaction/retention. Unassigned: Retrospective, single referral hospital. Unassigned: Medical records from 2006 to 2024 were searched for foals ≤3 days old with a history of straining to defecate, abdominal distention, colic, weakness and/or tail flagging. Signalment, presenting complaint, treat...
Gomez DE, Kamr A, Gilsenan WF, Burns TA, Mudge MC, Hostnik LD, Toribio RE.Endothelial glycocalyx (EG) degradation occurs in septic humans and EG products can be used as biomarkers of endothelial injury. Information about EG biomarkers and their association with disease severity is lacking in hospitalized foals. Objective: Measure serum syndecan-1 (SDC-1), heparan sulfate (HS), angiopoietin-2 (ANG-2), aldosterone (ALD), and plasma atrial natriuretic peptide (ANP) concentrations and to determine their association with disease severity and death in hospitalized foals. Methods: Ninety foals ≤3 days old. Methods: Prospective, multicenter, longitudinal study. Foals we...
Hobbs KJ, Ueda Y, Le Sueur ANV, Cooper BL, Burke MJ, Sheats MK.To determine the effect of hemoperfusion with a polymer-based column on systemic cytokine concentrations and neutrophil dysfunction in lipopolysaccharide-treated horses in vivo. Unassigned: 6 university-owned horses received 60 ng/kg lipopolysaccharide, IV, as a bolus and then 60 ng/kg, IV, as a constant rate infusion over 1 hour. Endotoxemia was confirmed by clinical signs and neutropenia. In a crossover model that was completed from January 2024 through July 2024, hemoperfusion was performed for 4 hours with either a sham or polymer column. Blood was collected at 5 time points over a 72-hour...
Hisaeda K, LE NAT, Kadekaru S, Ono T, Hiasa Y, Ohzawa E, Hata A, Kutara K, Sugimoto K, Une Y, Iwata E, Kunieda T, Zhang C, Kitagawa H.We evaluated metabolic abnormalities in six neonatal Noma foals (Nos. 54-57, 62, and 66) that died shortly after birth, using laboratory tests, pathological examinations, serum amino acid (AA) analyses, gas chromatography/mass spectrometry (GC/MS), and genetic analyses. Nonspecific clinical symptoms, such as poor suckling and weakness, were commonly observed at birth. Sepsis caused by various bacterial infections was detected in foal Nos. 54, 62, and 66, while a heart malformation was identified in foal No. 57. Laboratory tests showed high aspartate transaminase, lactate dehydrogenase, and cre...
Samuels AN, Collins NM, Hanlon K, Bartish C, Kelly P, Kamr AM, Toribio RE.Early and accurate identification of septicemia in neonatal foals improves survival. In human medicine, the neutrophil-to-lymphocyte ratio (NLR), neutrophil-to-monocyte ratio (NMR), monocyte-to-lymphocyte ratio (MLR), and plasma cell-free DNA (cfDNA) aid in early bacteremia detection. This study evaluated the diagnostic utility of these markers in conjunction with other clinical and hematological parameters in hospitalized foals < 5 days old to predict positive blood culture at admission and to distinguish between Gram-positive, Gram-negative, or polymicrobial bacteremia. A total of 391 foal...
Wallace PD, Schoonover MJ, Williams MR, Maxwell LK, Taylor JD.To evaluate plasma and synovial fluid amikacin concentrations following cephalic or saphenous IV regional limb perfusion (IVRLP) with a dosing protocol of 25 mg of amikacin/kg, divided into 16.7 mg/kg systemically and 8.3 mg/kg regionally. We hypothesized that plasma amikacin concentrations observed at 30 minutes after systemic administration would exceed a therapeutic target of 53 μg/mL and that synovial fluid concentrations would exceed a therapeutic target of 80 μg/mL. Unassigned: Over a 5-month period (spring/summer of 2023), 8 healthy neonatal foals were administered each protocol at le...
Birckhead EM, Raidal SL, Das S, Raidal SR.Sepsis is a main cause of death in neonatal foals. While the syndrome is not completely understood, sepsis is a dysregulated inflammatory response of the host to infection. It can be difficult to diagnose because of varying and non-specific clinical signs and imperfect diagnostic tests. Increased circulating nucleosome levels have been detected in humans and animals with sepsis, but this has not been documented in foals. Nucleosomes are released extracellularly during neutrophil extracellular trap formation, as well as from damaged and dead cells. We analysed plasma samples from clinically hea...
