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.
Iacono E, Merlo B, Pirrone A, Antonelli C, Brunori L, Romagnoli N, Castagnetti C.This paper documents the treatment of severe decubitus ulcers with amniotic fluid mesenchymal stem cells and platelets rich plasma (PRP) gel in a septic neonatal foal. The colt needed 25 days of hospitalization: during this period ulcers were treated for 15 days with mesenchymal stem cells (MSCs) plus PRP, PRP gel alone, or aloe gel. Healing was faster using MSCs+PRP, and at 7 months an ulcer treated with aloe gel was still not completely healed.
Hennessy SE, Cudmore L, Jackson LP, Vasey JR, Russell T.To (1) develop an arthroscopic approach to the subextensorius recess of the lateral femorotibial (LFT) joint in foals and (2) report its use in foals with LFT joint sepsis. Methods: (1) Anatomic study and (2) retrospective case series. Methods: (1) Cadaveric hind limbs (n = 32 foals) to delineate the anatomy of the subextensorius recess; 13 foal limbs for cadaver surgery to assess the approach to the subextensorius recess; and (2) foals (n = 8) with LFT joint sepsis. Methods: (1) The LFT joint was distended and examined ultrasonographically. Dissection was used to document periarticular landma...
Warner SL, Boggs J, Lee JK, Reddy S, Banes M, Cooley J.Listeria monocytogenes was isolated from the blood, lungs, and liver of a 5-week-old American Quarter Horse filly that presented with a 2-day history of fever, lethargy, ataxia, and seizure activity. The foal was born on a well-managed breeding facility to a multiparous mare with no periparturient complications. At 8 hr of age, the foal had an adequate passive transfer of immunity (immunoglobulin G > 2,000 mg/dl). Since the time of birth, the foal reportedly had mild, intermittent diarrhea that responded to gastrointestinal protectants and probiotics. Despite prompt and aggressive treatment af...
Herdan CL, Acke E, Dicken M, Archer RM, Forsyth SF, Gee EK, Pauwels FE.Three Thoroughbred horses, a 6-week-old filly (Case 1), a 15-year-old broodmare (Case 2) and a yearling filly (Case 3), sustained synovial sepsis secondary to trauma. Results: Case 1 presented with a heel bulb laceration communicating with the distal interphalangeal joint. Arthroscopic lavage was performed and treatment commenced using systemic and local broad spectrum antimicrobial drugs. A pure growth of multi-drug-resistant (MDR) Enterococcus gallinarum was cultured from samples of synovium and joint fluid. Antimicrobial treatment was changed according to the susceptibility results. Respons...
Hewson J, Johnson R, Arroyo LG, Diaz-Mendez A, Ruiz-López JA, Gu Y, del Castillo JR.Healthy neonatal foals were treated with cefotaxime by bolus (40 mg/kg i.v. q6h for 12 doses; n=10) or by infusion (loading dose of 40 mg/kg i.v. followed by continuous infusion of a total daily dose of 160 mg/kg per 24 h for 3 days; n=5). Population pharmacokinetics was determined, and concentrations in cavity fluids were measured at steady state (72 h). Highest measured serum drug concentration in the bolus group was 88.09 μg/mL and minimum drug concentration (C(min)) was 0.78 μg/mL at 6-h postadministration (immediately before each next dose), whereas infusion resulted in a steady-state c...
Gold JR, Cohen ND, Welsh TH.The hypothalamic-pituitary-adrenal (HPA) is influenced by the proinflammatory cytokines IL-6, IL-1β, and TNF-α in critically ill humans. Information about the association of cytokines with the HPA axis in neonatal foals is lacking. Objective: The objectives were to describe for hospitalized septic and nonseptic foals (1) temporal changes in blood concentrations of ACTH, and cortisol, and leukocyte cytokine gene expression, and (2) coassociation of these HPA axis hormones with blood leukocyte cytokine gene expression. Methods: Hospitalized septic foals (N = 15) and hospitalized nonseptic foal...
Tennent-Brown BS.In hospitalized horses, hypovolemia and the resulting decrease in tissue perfusion is the most common cause of hyperlactatemia. Therefore, measurement of blood lactate concentration can be a useful tool for guiding fluid therapy. Similarly, measuring blood lactate concentration can be used to assess the need for and adequacy of transfusions in horses receiving whole blood. Inflammatory leukocytes within closed body cavities consume glucose and produce lactate. Simultaneous measurement of blood lactate concentration and lactate concentration of peritoneal, pleural, or synovial fluid has been us...
Cesarini C, Macieira S, Girard C, Drolet R, d'Anjou MA, Jean D.The costochondral junction constitutes a potential site of infection in septic foals and it could be favored by thoracic trauma. Standard radiographs and ultrasonography are useful tools for diagnosis of this condition and ultrasound-guided needle aspiration could permit the definitive confirmation of infection. La jonction costochondrale constitue un site potentiel d’infection chez le poulain septicémique et le développement de l’infection pourrait être favorisée par un traumatisme costal. Les radiographies standards et l’échographie sont des aides diagnostiques et l’aspiration ...
Tennent-Brown BS.Blood lactate concentration can be easily measured by practitioners using inexpensive point-of-care meters. Anaerobic tissue metabolism resulting from inadequate oxygen delivery (DO2) is the most important cause of an increase in blood lactate concentration in equine patients. However,hyperlactatemia also occurs under conditions of apparently adequate DO2, usually in association with sepsis and an intense inflammatory reaction. Numerous mechanisms have been proposed for aerobic hyperlactatemia, including increased Na+/K+-ATPase activity in response to inflammatory mediators; inhibition of pyru...
Mendez-Angulo JL, Mudge M, Zaldivar-Lopez S, Vilar-Saavedra P, Couto G.To evaluate citrated recalcified thromboelastography (TEG) in healthy newborn foals, and to determine intra-assay, inter-individual and intra-individual (at 12 h, 24 h and 7 days after birth) variations. Additionally, to compare TEG variables, haematological values and conventional coagulation profiles from healthy, sick non-septic, and septic foals. Methods: Prospective study. Methods: The study group comprised 18 healthy, 15 sick non-septic and 17 septic foals. Two citrated (3.2%; 1 : 9 anticoagulant : blood ratio) blood samples were submitted for haemostatic evaluation using a TEG analyser ...
Tennent-Brown B.Although a range of plasma-based products (e.g., cryoprecipitate, albumin, platelet-rich plasma, individual coagulation factors) are available to human physicians, equine veterinarians are largely restricted to using whole blood, frozen plasma, and fresh frozen plasma for transfusions. The indications for frozen or fresh frozen plasma in human medicine are relatively limited, and there is little evidence supporting the efficacy of these products in many cases. Furthermore, many human physicians have concerns regarding disease transmission and anaphylactic reactions after administration of any ...
Graubner C, Gerber V, Imhasly A, Gorgas D, Koch C.Three horses (age 17 - 23 years) were referred to the equine clinic of the University of Berne due to colic, fever, tachycardia and tachypnea. All horses showed pleural effusion. Clinical findings in 2 of the horses were highly suggestive of an intra-thoracic esophageal perforation. Severe septic pleuropneumonia without suspicion of an esophageal lesion was diagnosed in the 3rd horse. In addition, an 11 year old stallion was referred to the equine clinic for treatment of a presumptive large colon impaction. The horse was given laxatives after nasogastric intubation. Subsequent dramatic clinica...
Haggett EF, Magdesian KG, Kass PH.To determine whether high liver enzyme activities were negatively associated with outcome in sick neonatal foals as compared with foals that did not have high liver enzyme activities. Methods: Retrospective case-control study. Methods: 147 foals < 30 days old with high γ-glutamyltransferase activity, high sorbitol dehydrogenase activity, or both (case foals) and 263 foals < 30 days old with γ-glutamyltransferase and sorbitol dehydrogenase activities within reference limits (control foals). Methods: Medical records were reviewed for information on signalment, physical examination findin...
Labelle AL, Hamor RE, Townsend WM, Mitchell MA, Zarfoss MK, Breaux CB, Thomasy SM, Hall T.To determine types and frequency of ophthalmic lesions detected in neonatal foals evaluated for nonophthalmic disease at 3 veterinary referral hospitals and to investigate associations between systemic and ophthalmic diseases in these foals. Methods: Prospective cross-sectional study. Methods: 70 foals < 30 days old. Methods: Complete ophthalmic examinations were performed. Signalment, clinical signs, mentation during ophthalmic examination, results of clinicopathologic tests, and diagnosis of systemic disease were recorded. Descriptive data analysis including a χ(2) test for associations was...
Piviani M, Segura D, Monreal L, Bach-Raich E, Mesalles M, Pastor J.Two neutrophilic indices reported by the ADVIA 120 Hematology Analyzer, neutrophilic myeloperoxidase index (MPXI), and mean light absorbance (neutrophil X mean [NXM]) have been proposed as indicators of systemic inflammatory disease in horses and of neutrophil activation in coronary ischemic syndromes in people. Objective: The aim of this study was to evaluate NXM and MPXI in healthy, sick nonseptic, and sick septic foals to determine whether conditions likely associated with neutrophil activation result in decreases in these variables. Methods: In this retrospective study, CBC data from 61 ne...
Ribera T, Monreal L, Armengou L, Ríos J, Prades M.Increased synovial fibrinolytic activity (detected by increases in synovial D-Dimer concentrations) has been observed in different joint diseases in humans and adult horses, presumably in order to minimize fibrin deposition within the joint and thus avoid its detrimental effects. Objective: To investigate fibrinolytic pathway activation in joint sepsis in foals by measuring synovial D-Dimer concentrations. Methods: Eighteen septic foals with septic joints, 9 septic foals without septic joints, 9 systemically healthy foals with septic joint, and 3 controls are included. Methods: Prospective obs...
Dechant JE, Symm WA, Nieto JE.To compare agreement between a portable clinical analyzer and laboratory-based bench-top analyzer for analysis of pH, lactate, and glucose concentrations in synovial fluid. Methods: Prospective experimental study. Methods: Clinically normal horses (n=8); 6 horses euthanatized for reasons unrelated to the study; 11 horses that had synoviocentesis for reasons other than sepsis; 7 horses that had synoviocentesis for evaluation of sepsis; and 2 horses without recorded clinical data. Median age of horses was 8 years (range, 1 day to 24 years). Methods: Supernatant from each synovial fluid sample wa...
Staempfli SA, Saied A, Wakamatsu N, Serra V, Eades SC.A 5-day-old Thoroughbred colt was presented with profuse watery diarrhea, hypovolemic shock, and a patent urachus. Despite intensive medical therapy, the colt was euthanized 15 d later due to poor clinical response. Necropsy revealed a small intestinal structural abnormality that formed a closed jejunal ring. Although rare, intestinal malformations should be considered in neonatal foals with clinical signs resembling enteritis. Entérite septique résistante au traitement causée par une malformation jéjunale chez un poulain Thoroughbred âgé de 5 jours. Un poulain Thoroughbred âgé de 5 jo...
Löhr CV, Polster U, Kuhnert P, Karger A, Rurangirwa FR, Teifke JP.Actinobacillus suis-like organisms (ASLOs) have been isolated from the genital, respiratory, and digestive tracts of healthy adult horses, horses with respiratory disease, and septic foals. Two foals with congenital hypothyroidism-dysmaturity syndrome from separate farms developed ASLO infection. At necropsy, both had contracted carpal flexor tendons, thyroid hyperplasia, and thrombotic and necrotizing mesenteric lymphangitis and lymphadenitis; one foal also had mandibular prognathism. Numerous ASLOs were isolated from tissues from both foals, including intestine. Biochemical testing and mass ...
Burns TA, Westerman T, Nuovo GJ, Watts MR, Pettigrew A, Yin C, Belknap JK.Oxidative stress reportedly plays a role in sepsis-induced organ dysfunction and failure in many species. In septic horses, laminae are targeted; evidence of laminar oxidative stress has been reported experimentally in the black walnut extract (BWE) model. Carbohydrate (CHO)-induced laminitis may be more similar to clinical sepsis-related laminitis than the BWE model in that animals with CHO-induced disease commonly develop laminar failure. The role of oxidative stress in the CHO model remains unknown. Objective: Markers of oxidative stress will be increased in laminae from horses with BWE- an...
Yamamoto H, Yamamoto F, Tanaka F, Nishikawa Y.We describe the influence of methicillin-resistant Staphylococcus aureus (MRSA) bacteremia on histopathological alteration of a glutaraldehyde-fixed equine pericardial roll (EPR) graft in a 77-year-old male who underwent in-situ EPR replacement of a ruptured infected abdominal aorta with concomitant repair of the perforated duodenum. The patient died of circulatory failure after septic shock due to MRSA infection and gastrointestinal bleeding on postoperative day (POD) 23. The autopsy revealed no perforation of the EPR graft or anastomotic disruption between the native abdominal aorta and EPR ...
Hart KA, Barton MH, Ferguson DC, Berghaus R, Slovis NM, Heusner GL, Hurley DJ.Relative cortisol insufficiency occurs in septic foals and impacts survival. Serum free (biologically available) cortisol concentration might be a better indicator of physiologic cortisol status than serum total cortisol concentration in foals. Objective: In septic foals, (1) low free cortisol concentration correlates with disease severity and survival and (2) predicts disease severity and outcome better than total cortisol concentration. Methods: Fifty-one septic foals; 11 healthy foals; 6 healthy horses. Methods: In this prospective clinical study, foals meeting criteria for sepsis at admiss...
Schwarz BC, van den Hoven R, Schwendenwein I.The myeloperoxidase index (MPXI) was investigated as a diagnostic indicator of systemic inflammation in a retrospective study using data from 859 hospitalised horses. A reference interval of 8.5-10.4 for the MPXI was established. In horses with systemic inflammatory response syndrome (SIRS), the MPXI was significantly lower than in healthy horses, those with localised inflammation and those with sepsis. The MPXI in horses with sepsis was also significantly lower than in healthy animals and those with localised inflammation. Horses in the SIRS group with leucopenia, white blood cell (WBC) count...
Schroeder EL, Holcombe SJ, Cook VL, James MD, Gandy JC, Hauptman JG, Sordillo LM.Endotoxaemia causes substantial morbidity and mortality in horses with colic and sepsis. Ethyl pyruvate is a novel anti-inflammatory medication that improved survival in preclinical models of severe sepsis endotoxaemia and intestinal ischaemia and reperfusion in rodents, swine, sheep and dogs and may be a useful medication in horses. Objective: Ethyl pyruvate has no adverse effects in normal horses and is biologically active based on suppression of proinflammatory gene expression in endotoxin stimulated whole blood, in vitro. Methods: Physical and neurological examinations, behaviour scores, e...
Barsnick RJ, Hurcombe SD, Smith PA, Slovis NM, Sprayberry KA, Saville WJ, Toribio RE.Endocrine dysregulation of hormones of energy metabolism is well documented in critically ill humans, but limited information exists in septic foals. The purpose of this study was to provide information on the hormonal response to energy metabolism in critically ill foals, focusing on insulin, glucagon, and leptin. Objective: Concentrations of insulin, glucagon, leptin, and triglycerides will be higher, whereas glucose concentration will be lower in septic foals than in healthy and sick nonseptic foals. The magnitude of these differences will be associated with severity of disease and nonsurvi...
Dumoulin M, Pille F, van den Abeele AM, Boyen F, Boussauw B, Oosterlinck M, Pasmans F, Gasthuys F, Martens A.Standard methods for culturing equine synovial fluid (SF) are often unrewarding. Evidence-based information on the relative efficiency of different systems used for optimisation of isolation of microorganisms from equine SF is lacking. Objective: To compare the results of different culture systems performed in parallel on SF samples from horses clinically diagnosed with synovial sepsis. Methods: Synovial fluid specimens were collected between February 2007 and October 2008 from all horses admitted to a referral hospital that were clinically diagnosed with synovial sepsis and from control horse...
Morrison S.Maggot debridement therapy is a nontraumatic, minimally invasive method to treat infections in a foot compromised by chronic laminitis. A mechanical strategy must first be in place to address the instability of the distal phalanx and hoof capsule. Adverse reactions to maggot debridement therapy are uncommon and the only side effect observed has been irritation or hypersensitivity at the site. Chronic laminitic cases of sepsis/necrosis within the hoof benefit from this procedure due to the noninvasive, continuous debridement and healing properties provided by the larvae.
Armengou L, Monreal L, Delgado MÁ, Ríos J, Cesarini C, Jose-Cunilleras E.Heparin is used in humans as prophylaxis of hypercoagulable states and disseminated intravascular coagulation (DIC). However, babies need a higher heparin dose than do adults. Septic neonate foals are at high risk of hypercoagulable state and DIC, and there is limited objective information about heparin dose for equine neonates. Objective: To assess whether neonate foals require higher dosages of low-molecular-weight heparin (LMWH) than adults. Methods: Eighteen healthy and 11 septic neonate foals. Methods: Experimental and clinical studies. Firstly, healthy foals were randomly distributed in ...
Peiró JR, Barnabé PA, Cadioli FA, Cunha FQ, Lima VM, Mendonça VH, Santana AE, Malheiros EB, Perri SH, Valadão CA.The clinical efficacy of IV infusion of lidocaine for treatment of equine endotoxemia has not been studied. Objective: Lidocaine infusion after exposure to lipopolysaccharide (LPS) will inhibit the inflammatory response and have inhibitory effects on the hemodynamic and cytokine responses to endotoxemia. Methods: Twelve horses. Methods: Two equal groups (n=6): saline (GI) and lidocaine (GII). In all animals, endotoxin (500 ng/kg body weight [BW]) was injected intraperitoneally over 5 minutes. Twenty minutes later, animals received a bolus of GI or GII (1.3 mg/kg BW) over 5 minutes, followed by...
Jose-Cunilleras E, Viu J, Corradini I, Armengou L, Cesarini C, Monreal L.Nutritional support in critically ill neonatal foals is of great importance given their high metabolic rate and minimal stores of energy and protein. Nutrient requirements of healthy growing foals have been estimated based on daily milk intake; however, little is known about the resting energy expenditure (REE) of sick foals. Objective: To determine REE in critically ill neonatal foals (sepsis and/or hypoxic-ischaemic encephalopathy [HIE] and compare this with REE in control foals. Methods: Critically ill newborn foals admitted to the Fundació Hospital Clinic Veterinari, Universitat Autònoma...
Wilkins PA.Equine neonatal intensive care units have expanded knowledge and understanding of the normal and abnormal physiology of the equine neonate, resulting in successful treatment of critically ill equine neonates. The overall survival rate has increased tremendously since the early 1980s, from a little more than 50% to 80% or more for most facilities. The severely septic foal and the very premature foal still remain large treatment challenges, but less severely septic foals and foals challenged by adverse peripartum events such as dystocia and placentitis are surviving to hospital discharge and per...
Dallap BL.Disseminated intravascular coagulation (DIC) is a clinicopathologic syndrome resulting from a multitude of underlying causes that manifests itself clinically as hemostatic/fibrinolytic failure. There is much debate on the definition, diagnosis, and treatment of DIC, a situation that is most likely the result of the multifaceted clinical presentation of the syndrome and the fact that patient outcome is often influenced by the underlying disease process. The fact that DIC increases morbidity and mortality in critical care patients is well established, but the exact mechanism of what specifically...
Taylor SD, Serpa PBS, Santos AP, Hart KA, Vaughn SA, Moore GE, Mukhopadhyay A, Page AE.A systemic and dysregulated immune response to infection contributes to morbidity and mortality associated with sepsis. Peripheral blood-derived mesenchymal stromal cells (PB-MSC) mitigate inflammation in animal models of sepsis. Allogeneic PB-MSC administered IV to horses is well-tolerated but therapeutic benefits are unknown. Objective: After IV lipopolysaccharide (LPS) infusion, horses treated with PB-MSC would have less severe clinical signs, clinicopathological abnormalities, inflammatory cytokine gene expression, and oxidative stress compared to controls administered a placebo. Methods: ...
Gardner RB, Nydam DV, Luna JA, Bicalho ML, Matychak MB, Flaminio MJ.Phagocytic activity of neonatal foals has been reported to be similar to that of adult horses, but serum opsonization capacity develops with age and may be further altered when opsonins are consumed during infection. Objective: Phagocytosis, oxidative burst activity, and serum opsonization capacity in neonatal foals admitted to an intensive care unit are reduced in comparison with control foals. Methods: Blood samples were collected from hospitalized neonatal foals and from control foals. Hospitalized foals were characterized as sick or septic on the basis of a sepsis score and received intrav...
Dabareiner RM, Watkins JP, Carter GK, Honnas CM, Eastman T.To determine clinical, radiographic, and scintigraphic abnormalities in and outcome of horses with septic or nonseptic osteitis of the axial border of the proximal sesamoid bones. Methods: Retrospective study. Methods: 8 horses. Methods: Data collected from medical records included signalment; history; horse use; severity and duration of lameness; results of perineural anesthesia, radiography, ultrasonography, and scintigraphy; and outcome following surgery. Results: Five horses did not have any evidence of sepsis; the other 3 had sepsis of the metacarpophalangeal or metatarsophalangeal joint ...
Wright IM, Phillips TJ, Walmsley JP.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...
Martin LM, Johnson PJ, Amorim JR, Honaker AR, Donaldson RS, DeClue AE.Horses affected with gastrointestinal conditions such as colic or colitis are at substantial risk for translocation of bacterial components such as lipopolysaccharide (LPS, endotoxin) from the gastrointestinal tract into circulation resulting in systemic inflammation and subsequent morbidity and mortality. Therefore, there is a need for effective preventive and treatment strategies aimed at minimizing the host's inflammatory reaction to these pathogen-associated molecular patterns (PAMPs) from gastrointestinal disease. Resveratrol (RES, trans-3,5,4'-trihydroxystilbene) is a phytoalexin commonl...
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...
Piviani M, Segura D, Monreal L, Bach-Raich E, Mesalles M, Pastor J.Two neutrophilic indices reported by the ADVIA 120 Hematology Analyzer, neutrophilic myeloperoxidase index (MPXI), and mean light absorbance (neutrophil X mean [NXM]) have been proposed as indicators of systemic inflammatory disease in horses and of neutrophil activation in coronary ischemic syndromes in people. Objective: The aim of this study was to evaluate NXM and MPXI in healthy, sick nonseptic, and sick septic foals to determine whether conditions likely associated with neutrophil activation result in decreases in these variables. Methods: In this retrospective study, CBC data from 61 ne...
Jesty SA, Palmer JE, Parente EJ, Schaer TP, Wilkins PA.Rupture of the gastrocnemius muscle and subsequent disruption of the reciprocal mechanism of the hind limb was diagnosed in 6 foals examined at 7 hours to 3 weeks of age. In 2 foals, the musculoskeletal injury was detected as an ancillary finding to clinical signs of neurologic dysfunction ascribed to hypoxic ischemic insult during delivery, whereas in the other 4 foals, musculoskeletal injury, manifested as inability to rise or stand unsupported, was the chief complaint at admission. Five foals had a history of dystocia and assisted delivery. Common clinical signs were inability to rise, disr...
Burke MJ, Tomlinson JE, Blikslager AT, Johnson AL, Dallap-Schaer BL.Continuous digital cryotherapy experimentally prevents development and reduces severity of sepsis-associated laminitis. A sleeve style ice boot where ice is in direct contact with the skin, and water drains from the boot is being used clinically for distal limb cryotherapy. The degree of cooling achieved by this boot is unknown. Objective: Evaluate skin and lamellar cooling after application of the ice sleeve in healthy horses, and the same horses during an endotoxaemia model. Methods: Prospective study, crossover design. Methods: In eight healthy horses thermocouples were inserted into dorsal...
Zicker SC, Spensley MS, Rogers QR, Willits NH.Concentrations of amino acids in the plasma of 13 neonatal foals with septicemia were compared with the concentrations of amino acids in the plasma of 13 age-matched neonatal foals without septicemia. Analysis of the results revealed significantly lower concentrations of arginine, citrulline, isoleucine, proline, threonine, and valine in the plasma of foals with septicemia. The ratio of the plasma concentrations of the branched chain amino acids (isoleucine, leucine, and valine) to the aromatic amino acids (phenylalanine and tyrosine), was also significantly lower in the foals with septicemia....
Barton AK, Richter IG, Ahrens T, Merle R, Alalwani A, Lilge S, Purschke K, Barnewitz D, Gehlen H.The purpose of the study was to compare the results of sepsis scoring (clinical examination and clinical pathology) to the concentrations of matrix-metalloproteinases (MMPs) -2, -8, and -9; tissue-inhibitor of metalloproteinases (TIMPs) -1 and -2; and inflammatory chemokines interleukin (IL) 1β and tumor-necrosis-factor-alpha (TNF-α) in plasma and peritoneal fluid of equine colic patients. A modified sepsis scoring including general condition, heart and respiratory rate, rectal temperature, mucous membranes, white blood cell count (WBC), and ionized calcium was applied in 47 horses presented...
Alonso JM, Martins ES, Peccinini RG, Rosa GS, Guerra ST, Ribeiro MG, Santos B, García HDM, Watanabe MJ, Takahira RK, Rodrigues CA, Alves ALG....Intraperitoneal ceftriaxone administration in healthy horses results in high and prolonged peritoneal concentrations. Recent findings suggest that intraperitoneal ceftriaxone might increase survival rates in horses affected by peritonitis. The present study aimed to evaluate plasma and peritoneal concentrations of ceftriaxone after intraperitoneal administration in horses with septic peritonitis. Twenty-six horses presenting clinical, laboratorial, and sonographic findings compatible with the disease were included. All horses received daily intraperitoneal ceftriaxone (25 mg/kg bwt) in additi...
Yamamoto H, Yamamoto F, Tanaka F, Nishikawa Y.We describe the influence of methicillin-resistant Staphylococcus aureus (MRSA) bacteremia on histopathological alteration of a glutaraldehyde-fixed equine pericardial roll (EPR) graft in a 77-year-old male who underwent in-situ EPR replacement of a ruptured infected abdominal aorta with concomitant repair of the perforated duodenum. The patient died of circulatory failure after septic shock due to MRSA infection and gastrointestinal bleeding on postoperative day (POD) 23. The autopsy revealed no perforation of the EPR graft or anastomotic disruption between the native abdominal aorta and EPR ...
Theuerkauf K, Obach-Schröck C, Staszyk C, Moritz A, Roscher KA.In humans, activated platelets contribute to sepsis complications and to multiple organ failure. In our prospective analytical study of cases of the equine systemic inflammatory response syndrome (SIRS), we adapted a standard human protocol for the measurement of activated platelets and platelet-leukocyte aggregates (PLAs) in equine platelet-leukocyte-rich plasma (PLRP) by flow cytometry, and we investigated the hypothesis that activated platelets and PLAs are increased in clinical cases of SIRS. We included 17 adult horses and ponies fulfilling at least 2 SIRS criteria, and 10 healthy equids ...
Lu KG, Sprayberry KA.Selected conditions affecting broodmares are discussed, including arterial rupture, dystocia, foal support with ex utero intrapartum treatment, uterine prolapse, postpartum colic, the metritis/sepsis/systemic inflammatory response syndrome complex, and retained fetal membranes. Postpartum colic beyond third-stage labor contractions should prompt comprehensive evaluation for direct injuries to the reproductive tract or indirect injury of the intestinal tract. Mares with perforation or rupture of the uterus are typically recognized 1 to 3 days after foaling, with depression, fever, and leukopen...
Barton MH, Moore JN.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...
Laurberg M, Saegerman C, Jacobsen S, Berg LC, Laursen SH, Hoeberg E, Sånge EA, van Galen G.Equine neonatal sepsis can be challenging to diagnose and prognosticate. Neutrophil gelatinase-associated lipocalin (NGAL), a new marker of renal damage and inflammation, can potentially be helpful. To evaluate NGAL in neonatal foals with sepsis, and assess its relation to outcome. Foals ≤ 14 days, with admission blood analysis and stored serum. NGAL was measured on stored serum from 91 foals. Foals were scored for sepsis and survival and categorized according to sepsis status (septic, sick non-septic, healthy, and uncertain sepsis status) and outcome groups (survivors and non-survivors). Th...
Toth B, Slovis NM, Constable PD, Taylor SD.Bacterial sepsis remains a leading cause of morbidity and mortality in neonatal foals, but accurate diagnostic and prognostic markers are lacking. Adrenomedullin (AM) is a polypeptide with diverse biologic effects on the cardiovascular system that increases in septic humans and laboratory animals. Objective: Plasma AM concentration (p[AM]) is increased in septic neonatal foals compared to sick nonseptic and healthy control foals, and p[AM] is predictive of survival in septic neonatal foals. Methods: Ninety critically ill (42 septic, 48 sick nonseptic) and 61 healthy foals <1 week of age. Metho...
Jacobsen S, Mortensen CD, Høj EA, Vinther AM, Berg LC, Adler DMT, Verwilghen D, van Galen G.Neutrophil gelatinase-associated lipocalin (NGAL) has been suggested to be a highly sensitive and specific marker of joint infection in humans. The aim of the study was to investigate NGAL concentrations in synovial fluid (SF) from horses with septic synovitis, horses without septic synovitis, and horses with uncertain status. NGAL was measured in 177 admission samples obtained from 152 horses. From a subset of horses ( = 35), additional samples obtained sequentially over the course of treatment were available. Concentrations of NGAL were significantly higher in septic synovitis ( = 47 samples...
Ehrmann C, Engel J, Moritz A, Roscher K.In addition to maintaining hemostasis, platelets have an important role in modulating innate and adaptive immune responses. A low platelet count has been found to be a negative prognostic factor for survival in humans and horses with critical illnesses, such as sepsis or systemic inflammatory response syndrome (SIRS). Decreased platelet aggregation, caused by in vivo activation, has been found in human patients with severe sepsis. In our prospective controlled study, we assessed platelet biology in blood samples from 20 equine SIRS cases and 120 healthy control horses. Platelet variables such ...
Scavone D, Sgorbini M, Borges AS, Oliveira-Filho JP, Vitale V, Paltrinieri S.Paraoxonase-1 (PON-1) is an antioxidant enzyme, whose activity decreases during the acute phase response in many species. Little is known about PON-1 and its role as a negative acute phase protein during septic inflammation in horses, but promising findings about its utility in diagnosing SIRS and predicting the outcome in diseased horses, were recently highlighted. The objective of the study was to investigate the behaviour of PON-1 in horses after experimentally induced endotoxemia. To this aim, PON-1 activity was measured on 66 plasma samples collected from six clinically healthy mares, pre...
Mendez-Angulo JL, Mudge M, Zaldivar-Lopez S, Vilar-Saavedra P, Couto G.To evaluate citrated recalcified thromboelastography (TEG) in healthy newborn foals, and to determine intra-assay, inter-individual and intra-individual (at 12 h, 24 h and 7 days after birth) variations. Additionally, to compare TEG variables, haematological values and conventional coagulation profiles from healthy, sick non-septic, and septic foals. Methods: Prospective study. Methods: The study group comprised 18 healthy, 15 sick non-septic and 17 septic foals. Two citrated (3.2%; 1 : 9 anticoagulant : blood ratio) blood samples were submitted for haemostatic evaluation using a TEG analyser ...
Rohdich N, Zschiesche E, Heckeroth A, Wilhelm C, Leendertse I, Thomas E.A multicentre field study was conducted in accordance with VICH Guideline on Good Clinical Practice (VICH 2000) to confirm the efficacy and safety of a new formulation of cefquinome for the treatment of naturally occurring severe bacterial infections and septicaemia in foals. Thirty-nine foals suffering from severe bacterial infections (such as pneumonia, gastro-enteritis, arthritis, omphalitis, or wound infections) or acute septicaemia were treated twice daily with the test product (1 mg cefquinome/kg body weight) intravenously for three days and then intramuscularly for three to 11 days. Inv...
Haerdi-Landerer MC, Habermacher J, Wenger B, Suter MM, Steiner A.The search for an effective treatment for septic arthritis is ongoing. Current therapies are expensive since they require repeated joint lavage and long term antibiotic treatment. Local application of antimicrobial drugs is advantageous because high concentrations can be attained at the infection site, although repeated injections increase the risk of superinfection of the joint. Thus, slow release formulations, which have the advantage of local treatment yet single application of the drug, are appealing. Antibiotics used in slow release formulations are selected for tissue compatibility, an a...
Sweeney RW, Divers TJ, Rossier Y.Plasma concentration of gentamicin was measured 1, 4, and 6 hours after IV administration in 35 hospitalized adult horses on days 1, 3, 5, and 10 of treatment. The mean apparent elimination rate constant beta was 0.53 +/- 0.10 h-1 on day 1 for horses with normal plasma creatinine concentration and 0.41 +/- 0.13 h-1 for horses with abnormally high plasma creatinine concentration. There was no significant difference between beta of the hospitalized horses and of 6 healthy horses treated with gentamicin, but total clearance for the hospitalized horses with normal plasma creatinine concentration w...
In this study, a new sandwich-type immunoenzymatic assay, based on a molecularly imprinted polymer (MIP) as an artificial antibody (pseudo-ELISA), was developed for the determination of procalcitonin (PCT) in veterinary species. The quantification of PCT in human medicine represents the state of the art for the diagnosis of sepsis; instead the clinical studies on the relevance of PCT as a sepsis predictor in veterinary patients are few, likely due to the total absence of validated assays. MIPs have been widely used as antibody mimics for important applications, and MIP-based sandwich assays ha...
Naseri A, Akyuz E, Turgut K, Guzelbektes H, Sen I.The term "sepsis-induced cardiomyopathy" (SIC) is used to describe transient cardiac dysfunction in septic patients. However, there is no universally accepted definition of SIC; a reduction in left ventricular ejection fraction (LVEF) is often used. In addition to systolic dysfunction, diastolic dysfunction is now recognized as an essential component of SIC. It can be emphasized that previous animal experiments played an essential role in revealing SIC and hemodynamic instability in sepsis and septic shock. The diagnostic and prognostic capabilities of echocardiography for the assessment of SI...
