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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.
Factors associated with the risk of positive blood culture in neonatal foals presented to a referral center (2000-2014).
Journal of veterinary internal medicine    October 12, 2020   Volume 34, Issue 6 2738-2750 doi: 10.1111/jvim.15923
Furr M, McKenzie H.Bloodstream infections (BSI) are common in sick foals and increase foal morbidity and mortality when they occur. Recognition of risk factors for BSI could be an important means to limit their occurrence, but studies on this topic are limited. Objective: Historical as well as maternal and foal physical examination findings will predict risk of BSI in neonatal foals. Methods: Foals <14 days of age admitted to a referral equine hospital for care. Methods: Retrospective case-control study with univariate and multivariable logistic regression analysis. Results: Four hundred twenty-nine (143 cases...
Effects of administration of ascorbic acid and low-dose hydrocortisone after infusion of sublethal doses of lipopolysaccharide to horses.
Journal of veterinary internal medicine    October 7, 2020   Volume 34, Issue 6 2710-2718 doi: 10.1111/jvim.15896
Anderson MJ, Ibrahim AS, Cooper BR, Woolcock AD, Moore GE, Taylor SD.Sepsis is associated with ascorbic acid (AA) depletion and critical illness-related corticosteroid insufficiency (CIRCI) in humans. Objective: Intravenous infusion of lipopolysaccharide (LPS) would (a) decrease endogneous AA concentrations, (b) induce CIRCI and (c) administration of a combination of AA and hydrocortisone (HC) would have decreased indices of inflammation compared to either drug alone. Methods: Thirty-two healthy horses. Methods: Randomized placebo-controlled experimental trial. Horses were assigned to 1 of 4 groups (saline, AA and HC, AA only, or HC only). Treatments were admin...
Epidural administration of opioid analgesics improves quality of recovery in horses anaesthetised for treatment of hindlimb synovial sepsis.
Equine veterinary journal    September 23, 2020   Volume 53, Issue 4 682-689 doi: 10.1111/evj.13338
Louro LF, Milner PI, Bardell D.Opioid epidural analgesia has been shown to provide effective analgesia in horses. There is a lack of evidence regarding the effect of opioid epidural analgesia on quality of recovery in horses. Objective: Identify whether opioid epidural analgesia influences quality of recovery in horses undergoing general anaesthesia required for management of hindlimb synovial sepsis. Methods: Single-centre retrospective cross-sectional study. Methods: Data were obtained from the clinical records of horses which had undergone arthroscopic or tenoscopic surgery for management of hindlimb synovial sepsis over...
Procalcitonin Detection in Veterinary Species: Investigation of Commercial ELISA Kits.
Animals : an open access journal from MDPI    August 26, 2020   Volume 10, Issue 9 1511 doi: 10.3390/ani10091511
Battaglia F, Meucci V, Tognetti R, Bonelli F, Sgorbini M, Lubas G, Pretti C, Intorre L.In human medicine, procalcitonin (PCT), the precursor of calcitonin, is used for the rapid identification of the origin and severity of sepsis. In veterinary medicine, PCT has been studied in horses, cattle, and dogs, but the use of PCT in diagnostic and/or prognostic settings is not possible because of the lack of validated assays to obtain reference ranges. The aim of the present study was the investigation of commercially available ELISA kits for the detection of canine and equine PCT in plasma samples. Validation of the ELISA kits was performed by using species-specific recombinant protein...
Standing Arthroscopic Treatment of Temporomandibular Joint Sepsis in a Horse.
Journal of veterinary dentistry    August 20, 2020   Volume 37, Issue 2 94-99 doi: 10.1177/0898756420948269
Elzer EJ, Wulster KB, Richardson DW, Ortved KF.A 15-year-old Thoroughbred gelding was presented for investigation of fever, right temporomandibular region swelling, and progressive pain when opening the mouth. Right temporomandibular joint (TMJ) sepsis was diagnosed based on synovial fluid analysis, sonographic imaging, and standing robotic cone-beam computed tomography. Concurrent otitis media and temporohyoid osteoarthropathy (THO) were also noted. The horse was treated with arthroscopic debridement and lavage during standing sedation followed by local and systemic antimicrobial therapy. There were no complications associated with the su...
Accuracy of differences in blood and peritoneal glucose to differentiate between septic and non-septic peritonitis in horses.
Research in veterinary science    June 20, 2020   Volume 132 237-242 doi: 10.1016/j.rvsc.2020.06.017
Alonso JM, Esper CS, Pantoja JCF, Rosa GDS, Giampietro RR, Dos Santos B, Guerra ST, Ribeiro MG, Takahira RK, Watanabe MJ, Alves ALG, Rodrigues CA....Difference in blood and peritoneal glucose (DBPG) is used in clinical practice to support a diagnosis of septic peritonitis in horses. It is inexpensive, easy and rapid to perform. The aim of this study was to evaluate the accuracy of the DBPG to differentiate between septic and non-septic peritonitis in horses. Blood and peritoneal fluids were harvested from suspected animals. Plasma and peritoneal glucose levels, total nucleated cell count, direct microscopic and microbiological examinations of the peritoneal fluid were evaluated. Using DBPG levels, the animals were classified into two group...
Meloxicam ameliorates the systemic inflammatory response syndrome associated with experimentally induced endotoxemia in adult donkeys.
Journal of veterinary internal medicine    May 28, 2020   Volume 34, Issue 4 1631-1641 doi: 10.1111/jvim.15783
Mendoza Garcia FJ, Gonzalez-De Cara C, Aguilera-Aguilera R, Buzon-Cuevas A, Perez-Ecija A.Little information is available about endotoxemia in donkeys. Characterizing the systemic inflammatory response (SIRS) to lipopolysaccharide (LPS) in donkeys would provide valuable clinical and therapeutic information. The effects of meloxicam on endotoxemia have not been studied in this species. Objective: To study the pathophysiology and gene expression associated with experimentally induced endotoxemia, and evaluate the effects of meloxicam on experimentally induced endotoxemia in donkeys and in equine monocyte cultures. Methods: Six healthy adult female donkeys. Methods: Endotoxemia was in...
Clinical and laboratorial description of the differential diagnoses of hemostatic disorders in the horse.
Iranian journal of veterinary research    May 6, 2020   Volume 21, Issue 1 1-8 
Satué K, Gardon JC, Muñoz A.The process of fibrin clot formation is a series of complex and well-regulated reactions involving blood vessels, platelets, procoagulant plasma proteins, natural inhibitors, and fibrinolytic enzymes. Vasculitis can be caused by a variety of different agents as bacteria, viruses, protozoal, rickettsial organisms, toxic, drugs, medications, and neoplasms. The most common cause of vasculitis is the purpura hemorrhagica, which is associated with exposure to Streptococcus equi ssp. equi or less commonly, equine influenza. Deficiencies or defects of the hemostatic components may result in bleeding ...
Plasma iron concentrations and systemic inflammatory response syndrome in neonatal foals.
Journal of veterinary internal medicine    April 16, 2020   Volume 34, Issue 3 1325-1331 doi: 10.1111/jvim.15770
Sanmartí J, Armengou L, Viu J, Alguacil E, Civit S, Ríos J, Jose-Cunilleras E.Sparse information regarding plasma iron concentration in neonatal foals and its utility as an inflammatory marker in this population has been published. Objective: To determine the physiologic plasma iron concentration in neonatal foals. To assess its utility as an inflammatory marker to predict systemic inflammatory response syndrome (SIRS) and as a prognostic marker. Methods: Forty-seven ill neonatal foals admitted to a referral equine hospital were divided in 2 groups based on the SIRS criteria (24 SIRS and 23 non-SIRS). Two control groups of 43 hospital and 135 stud farm healthy neonatal ...
Adjuvant intraperitoneal ceftriaxone in the treatment of septic peritonitis in horses.
The Veterinary record    March 31, 2020   Volume 187, Issue 4 e29 doi: 10.1136/vr.105570
Alonso JM, Rosa GDS, Santos B, Guerra S, Ribeiro M, Watanabe MJ, Alves A, Rodrigues C, Takahira RK, Hussni CA.Intraperitoneal administration of ceftriaxone maintains therapeutic abdominal concentrations for 24 hours in healthy horses. Therefore, it is a possible treatment for septic peritonitis. The aim of this study was to evaluate the efficacy of ceftriaxone as an adjuvant treatment in horses with septic peritonitis. Methods: Twenty-six horses with clinical signs, sonography and/or laboratory findings of septic peritonitis were included. Peritoneal fluid was collected for microbiological culture and in vitro microbial sensitivity profile assessment. Daily intraperitoneal administration of ceftriax...
A retrospective histologic study of 140 cases of clinically significant equine ocular disorders. Flores MM, Del Piero F, Habecker PL, Langohr IM.Ocular diseases are an important category in equine medicine; however, most articles regarding histologic ocular lesions in horses are exclusive to a specific condition and do not provide a complete review of clinically significant ocular disease frequency in a diagnostic laboratory. We reviewed sections of equine eyes from 140 cases (98 enucleations [biopsies] and 42 autopsies) with clinically relevant ocular alterations at 2 diagnostic centers in the United States. The most common primary conditions were non-traumatic keratitis (36), equine recurrent uveitis (ERU; 31), traumatic injuries (22...
Can blood serum amyloid A concentrations in horses differentiate synovial sepsis from extrasynovial inflammation and determine response to treatment?
The Veterinary record    February 25, 2020   Volume 187, Issue 6 235 doi: 10.1136/vr.105153
Sinovich M, Villarino NF, Singer E, Robinson CS, Rubio-Martínez LM.Serum amyloid A (SAA) concentrations in blood and synovial fluid of horses with synovial sepsis have diagnostic value. Studies suggest serial blood SAA measurements could act as a prognostic indicator. This study evaluated the use of serial blood SAA concentrations for monitoring of horses with synovial sepsis. A prospective clinical trial was performed of horses referred to a single hospital with synovial sepsis that survived (n=17), synovial sepsis that were euthanised (n=5), non-septic intrasynovial pathologies (n=14) or extensive extrasynovial lacerations (n=5). SAA concentrations were det...
Differences in isolation rate and antimicrobial susceptibility of bacteria isolated from foals with sepsis at admission and after ≥48 hours of hospitalization.
Journal of veterinary internal medicine    February 5, 2020   Volume 34, Issue 2 955-963 doi: 10.1111/jvim.15692
Theelen MJP, Wilson WD, Byrne BA, Edman JM, Kass PH, Mughini-Gras L, Magdesian KG.Antimicrobial treatment protocols for foals with sepsis that do not improve clinically often are adjusted based on bacteriological and antimicrobial susceptibility testing results from samples collected at hospital admission. Objective: To evaluate whether hospitalization for ≥48 hours affects bacteriological and antimicrobial susceptibility testing results. Methods: Two-hundred sixty-seven foals <30 days of age admitted to a neonatal intensive care unit and diagnosed with sepsis. Methods: Medical records were reviewed retrospectively to identify foals with sepsis and positive bacteri...
Rhodococcus equi Joint Sepsis and Osteomyelitis Is Associated With a Grave Prognosis in Foals.
Frontiers in veterinary science    January 14, 2020   Volume 6 503 doi: 10.3389/fvets.2019.00503
Ruocco NA, Luedke LK, Fortier LA, Ducharme NG, Reesink HL.The most common pathologic manifestation of , a gram-positive, facultative intracellular bacterium, is pyogranulomatous pneumonia in foals and weanlings. Hematogenous spread of bacteria may subsequently occur, resulting in joint sepsis, osteomyelitis, or subcutaneous abscessation. Medical records from horses presenting to the Cornell University Equine Hospital from 1998 to 2018 were reviewed for cases diagnosed with joint and/or bone infection, and information about case progression and outcome were analyzed. We hypothesized that, despite advances in diagnostic imaging, antimicrobials and ant...
Correlation Between Peritonitis and Incisional Infections in Horses.
Journal of equine veterinary science    January 9, 2020   Volume 87 102903 doi: 10.1016/j.jevs.2019.102903
Dória RGS, Freitas SH, Laskoski LM, Arruda LP, Shimano AC.Surgical site infection of abdominal incisions is an important complication after laparotomy with increased risk of incisional hernia formation in horses. This study aims to evaluate the healing process of abdominal incisions and correlate peritonitis with the occurrence of surgical site infection and incisional hernias. Nine horses underwent standardized laparotomy, intestinal exploration, and induced septic peritonitis. Standardized relaparotomy was performed two (n = 3), four (n = 3), and six (n = 3) months later to evaluate the abdominal cavity for adhesions and to collect the sutured v...
CTX-M-15 Producing Escherichia coli Sequence Type 361 and Sequence Type 38 Causing Bacteremia and Umbilical Infection in a Neonate Foal.
Journal of equine veterinary science    December 14, 2019   Volume 85 102881 doi: 10.1016/j.jevs.2019.102881
Shnaiderman-Torban A, Navon-Venezia S, Dahan R, Dor Z, Taulescu M, Paitan Y, Edery N, Steinman A.An eighteen-hour-old Tennessee walking horse foal was referred due to weakness and abdominal pain. Physical examination revealed dehydration, distended abdomen, and uveitis. Blood analysis revealed leukopenia, neutrophils' toxicity and left shift. The foal developed bloody diarrhea, gastric reflux, and was diagnosed with sepsis and enterocolitis. The foal was treated with intravenous fluids, plasma, antibiotics (ceftriaxone and metronidazole), partial parenteral nutrition (dextrose and amino acids), flunixin meglumine, and ophthalmic drops. Umbilical ultrasound revealed a fluid pocket adjacent...
Endotoxin-induced changes in expression of cyclooxygenase isoforms in the lamellar tissue of extracorporeally haemoperfused equine limbs.
Anatomia, histologia, embryologia    November 27, 2019   Volume 49, Issue 5 597-605 doi: 10.1111/ahe.12520
Patan-Zugaj B, Egerbacher M, Licka TF.Angiogenesis and sepsis-related equine laminitis have several features in common. Both events can be induced by endotoxin (lipopolysaccharide- LPS) and both are associated with increased expression of the enzyme cyclooxygenase (COX), of which two isoforms (COX-1 and COX-2) exist. To examine the causal relationship between LPS exposure and COX expression and to investigate the tissue distribution of COX in the LPS-exposed tissue, the technique of extracorporeal haemoperfusion of isolated equine forelimbs was utilized. Perfusion was performed for 10 hr under physiological conditions (control-pe...
Influence of digital hypothermia on lamellar events related to IL-6/gp130 signalling in equine sepsis-related laminitis.
Equine veterinary journal    October 24, 2019   Volume 52, Issue 3 441-448 doi: 10.1111/evj.13184
Dern K, Burns TA, Watts MR, van Eps AW, Belknap JK.Interleukin-6 (IL-6) is consistently increased in the digital lamellae in different studies of sepsis-related laminitis (SRL). IL-6 signalling through the gp130 receptor activates similar signalling (i.e. mTORC1-related signalling) previously reported to be activated in models of endocrinopathic laminitis. Objective: To assess the activation state of signalling proteins downstream of IL-6/gp130 receptor complex activation in an experimental model of SRL. Methods: Randomised experimental study. Methods: Lamellar phospho-(P) protein concentrations downstream of the IL-6/gp130 receptors were asse...
A multi-centre cohort study investigating the outcome of synovial contamination or sepsis of the calcaneal bursae in horses treated by endoscopic lavage and debridement.
Equine veterinary journal    October 16, 2019   Volume 52, Issue 3 404-410 doi: 10.1111/evj.13180
Isgren CM, Salem SE, Singer ER, Wylie CE, Lipreri G, Graham RJTY, Bladon B, Boswell JC, Fiske-Jackson AR, Mair TS, Rubio-Martínez LM.Previous studies investigating factors associated with survival following endoscopic treatment of contamination/sepsis of the calcaneal bursa are limited. Objective: To investigate the factors associated with survival in horses with contamination/sepsis of the calcaneal bursae treated endoscopically and to describe the bacterial isolates involved in the synovial infections. Methods: Retrospective analysis of clinical records. Methods: Medical records from 128 horses with contamination/sepsis of the calcaneal bursae treated by endoscopic lavage at seven equine hospitals were reviewed. A follow-...
Comparison of Serum Amyloid A Measurements in Equine Synovial Fluid With Routine Diagnostic Methods to Detect Synovial Infection in a Clinical Environment.
Frontiers in veterinary science    October 1, 2019   Volume 6 325 doi: 10.3389/fvets.2019.00325
Stack JD, Cousty M, Steele E, Handel I, Lechartier A, Vinardell T, David F.Synovial fluid analysis is utilized to diagnose septic synovitis. However, not all cases are clearly and rapidly discernible with the diagnostic tools available in the laboratory. Serum amyloid A (SAA), an acute phase protein, has been shown to be elevated in synovial fluid from inflamed synovial structures. The goal of this study is to describe the correlation between two diagnostic tests measuring equine SAA levels in septic and non-septic synovial structures and to understand the correlation between an elevated SAA result and synovial sepsis. Prospective estimation of sensitivity (Se) and s...
Plasma concentrations of steroid precursors, steroids, neuroactive steroids, and neurosteroids in healthy neonatal foals from birth to 7 days of age.
Journal of veterinary internal medicine    September 5, 2019   Volume 33, Issue 5 2286-2293 doi: 10.1111/jvim.15618
Aleman M, McCue PM, Chigerwe M, Madigan JE.Transient hypothalamic-pituitary-adrenal axis dysfunction occurs in critically ill foals with sepsis and neonatal maladjustment syndrome (NMS). Cortisol is the most commonly measured steroid. However, a complex interaction of various steroid compounds might play a role in pathophysiology of this disorder. Objective: To identify steroid compounds present at high concentrations at birth that rapidly and steadily decrease within the first 7 days of life in healthy foals and that might be supportive diagnosis of NMS and other neonatal disorders. Methods: Ten healthy neonatal Quarter Horse foals ...
Hydroxyethyl starches in equine medicine.
Journal of veterinary emergency and critical care (San Antonio, Tex. : 2001)    June 22, 2019   Volume 29, Issue 4 349-359 doi: 10.1111/vec.12854
van Galen G, Hallowell G.To review and discuss the use of hydroxyethyl starches (HES) in equine veterinary medicine, and to provide recommendations for its use. Methods: Veterinary and human peer-reviewed medical literature including scientific reviews, meta-analyses, and original research articles. Results: Increasing evidences on adverse effects after HES use and decreasing support for beneficial effects with regards to volume expansion and colloid osmotic pressure (COP) support in critically ill subjects have led to a recent guideline to limit the use of HES in critically ill people. Unassigned: The rationale for H...
Synovial sepsis of unknown origin in the adult Thoroughbred racehorse.
Equine veterinary journal    May 20, 2019   Volume 52, Issue 1 91-97 doi: 10.1111/evj.13127
Byrne CA, Lumsden JM, Lang HM, O'Sullivan CB.Synovial sepsis of unknown origin is a rare cause of lameness in the adult horse, and a haematogenous pathogenesis has been proposed in previous cases. Objective: To describe the features and outcome of synovial sepsis of unknown origin in adult Thoroughbred racehorses. Methods: Retrospective case series. Methods: Hospital records for admissions between 2005 and 2015 were reviewed to identify adult horses diagnosed with synovial sepsis of unknown origin. Presentation, clinicopathological, microbiological and diagnostic imaging findings were recorded. Treatment methods, surgical findings, compl...
Multiple adrenocortical steroid response to administration of exogenous adrenocorticotropic hormone to hospitalized foals.
Journal of veterinary internal medicine    May 20, 2019   Volume 33, Issue 4 1766-1774 doi: 10.1111/jvim.15527
Dembek KA, Johnson LM, Timko KJ, Minuto JS, Hart KA, Barr BS, Toribio RE.The hypothalamic-pituitary-adrenal axis regulates the response to sepsis-associated stress. Relative adrenal insufficiency or adrenocorticotropic hormone (ACTH):cortisol imbalance, defined as a poor cortisol response to administration of ACTH, is common and associated with death in hospitalized foals. However, information on other adrenal steroid response to ACTH stimulation in sick foals is minimal. Objective: To investigate the response of multiple adrenocortical steroids to administration of ACTH in foals. Methods: Hospitalized (n = 34) and healthy (n = 13) foals. Methods: In this prospecti...
The synovial fluid proteome differentiates between septic and nonseptic articular pathologies.
Journal of proteomics    April 25, 2019   Volume 202 103370 doi: 10.1016/j.jprot.2019.04.020
Anderson JR, Smagul A, Simpson D, Clegg PD, Rubio-Martinez LM, Peffers MJ.Articular conditions are common in horses and can result in loss of function, chronic pain and/or inability to work. Common conditions include osteoarthritis, osteochondrosis and synovial sepsis, which can be life-threatening, but despite the high clinical prevalence of these conditions, rapid and specific diagnosis, monitoring and prognostication remains a challenge for practicing veterinarians. Synovial fluid from a range of arthropathies was enriched for low abundance proteins using combinatorial peptide ligand ProteoMiner™ beads and analysed via liquid chromatography-tandem mass spectrom...
Enterococcus infections in foals.
Veterinary journal (London, England : 1997)    April 6, 2019   Volume 248 42-47 doi: 10.1016/j.tvjl.2019.04.005
Willis AT, Magdesian KG, Byrne BA, Edman JM.Enterococci have been increasing in prevalence in foal sepsis over the past three decades. There are no published studies in the peer-reviewed literature documenting common sites of infection, antimicrobial susceptibility, or outcome specifically associated with enterococcal infections in foals. Our objectives were to evaluate the sites of origin, antimicrobial susceptibility, and survival outcome to discharge in foals with enterococcal infections compared with foals with sepsis of another bacterial etiology. Seventy-five foals 0-30 days of age with cultures positive for Enterococcus and 170 c...
RAPID COMMUNICATION: TLR4 expressed but with reduced functionality on equine B lymphocytes.
Journal of animal science    March 23, 2019   Volume 97, Issue 5 2175-2180 doi: 10.1093/jas/skz074
Hay AN, Potter A, Kasmark L, Zhu J, Leeth CM.Varying susceptibility exists among mammalian species to the development of potentially fatal endotoxemia due to gram-negative bacteria molecular component, lipopolysaccharide (LPS). Toll-like receptor 4 (TLR4) is responsible for LPS-associated immune response and is expressed on numerous immune cells including B lymphocytes. TLR4 is expressed in a functional form on mouse B lymphocytes, a species much less susceptible to endotoxemia compared with humans who are highly sensitive to endotoxin. Humans possess B lymphocytes that are not responsive to LPS. Likewise, horses are highly susceptible t...
A Comparative Review of Equine SIRS, Sepsis, and Neutrophils.
Frontiers in veterinary science    March 12, 2019   Volume 6 69 doi: 10.3389/fvets.2019.00069
Sheats MK.The most recent definition of sepsis in human medicine can be summarized as organ dysfunction caused by a dysregulated host response to infection. In equine medicine, although no consensus definition is available, sepsis is commonly described as a dysregulated host systemic inflammatory response to infection. Defense against host infection is the primary role of innate immune cells known as neutrophils. Neutrophils also contribute to host injury during sepsis, making them important potential targets for sepsis prevention, diagnosis, and treatment. This review will present both historical and u...
A minimally invasive partial condylectomy and temporal bone resection for the treatment of a suspected chronic synovial sepsis of the temporomandibular joint in a 3.5-year-old paint horse gelding.
The veterinary quarterly    February 19, 2019   Volume 38, Issue 1 118-124 doi: 10.1080/01652176.2018.1535216
Frietman SK, van Proosdij ER, Veraa S, de Heer N, Ter Braake F.No abstract available
Synovial sepsis is rare following intrasynovial medication in equine ambulatory practice.
Equine veterinary journal    January 18, 2019   Volume 51, Issue 5 595-599 doi: 10.1111/evj.13063
Smith LCR, Wylie CE, Palmer L, Ramzan PHL.There are few observational studies regarding the potentially serious complication of synovial sepsis following intrasynovial medication in general equine practice. Quantification of risk is fundamental to fully inform decision-making and owner consent prior to undertaking procedures. Objective: To describe the occurrence of synovial sepsis following intrasynovial injections in a large ambulatory equine practice between 2006-2011. Methods: Retrospective cohort study. Methods: Medication records were cross-referenced against synovial cytology submissions and hospital admissions for synovial sep...