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.
Thromboelastography in healthy, sick non-septic and septic neonatal foals. 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 ...
Plasma therapy in foals and adult horses. 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 ...
[Intrathoracic esophageal perforation of unknown cause in four horses]. 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...
Clinical implications of high liver enzyme activities in hospitalized neonatal foals. 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...
Ophthalmic lesions in neonatal foals evaluated for nonophthalmic disease at referral hospitals. 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...
Neutrophilic myeloperoxidase index and mean light absorbance in neonatal septic and nonseptic foals. 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...
Synovial fluid D-dimer concentration in foals with septic joint disease. 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...
Comparison of pH, lactate, and glucose analysis of equine synovial fluid using a portable clinical analyzer with a bench-top blood gas analyzer. 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...
Therapy resistant septic enteritis due to a jejunal malformation in a 5-day-old Thoroughbred colt. 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...
Mesenteric lymphangitis and sepsis due to RTX toxin-producing Actinobacillus spp in 2 foals with hypothyroidism-dysmaturity syndrome. 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 ...
Role of oxidative tissue injury in the pathophysiology of experimentally induced equine laminitis: a comparison of 2 models. 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...
Vulnerability of an equine pericardial roll graft to Gram-positive cocci after graft replacement for a ruptured infected abdominal aorta. 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 ...
Serum free cortisol fraction in healthy and septic neonatal foals. 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...
Diagnostic value of the neutrophil myeloperoxidase index in horses with systemic inflammation. 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...
Preliminary safety and biological efficacy studies of ethyl pyruvate in normal mature horses. 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...
Insulin, glucagon, and leptin in critically ill foals. 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...
Use of blood culture medium enrichment for synovial fluid culture in horses: a comparison of different culture methods. 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...
Maggot debridement therapy for laminitis. 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.
Low-molecular-weight heparin dosage in newborn foals. 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 ...
Effects of lidocaine infusion during experimental endotoxemia in horses. 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...
Proinflammatory cytokine responses of cultured equine keratinocytes to bacterial pathogen-associated molecular pattern motifs. Further knowledge of equine keratinocyte physiology and keratinocyte response to various stimuli is important in developing a better understanding of disease states involving the epidermis. Objective: To assess the inflammatory cytokine response of cultured equine keratinocytes to various pathogen-associated molecular pattern molecules (PAMPs) from both Gram-negative and positive bacteria likely to be present in equine sepsis. Methods: Keratinocytes were isolated from skin of 2 horses and primary cultures performed. Keratinocytes were harvested for RNA extraction after exposure to lipopolysacc...
Effect of intravenous lidocaine administration on laminar inflammation in the black walnut extract model of laminitis. Laminitis is a serious complication of horses suffering from sepsis/endotoxaemia-related events. Laminitis in horses and organ injury in human sepsis are both reported to involve inflammatory injury to the laminae/organs including early activation of endothelium and leucocytes leading to emigration of neutrophils into the tissue interstitium. In the black walnut extract (BWE) model, systemic inflammatory events coincide with marked increase in laminar mRNA concentrations of inflammatory genes including proinflammatory cytokines (i.e. IL-1beta, IL-6), COX-2, chemokines (i.e. IL-8) and endotheli...
Bacterial culture of septic synovial structures of horses: does a positive bacterial culture influence prognosis? The influence of synovial fluid culture on short- and long-term prognosis of cases with septic synovitis requires study. Objective: Horses with a positive bacterial culture from septic synovial fluid are less likely to survive or return to successful athletic function than those with a negative bacterial culture from septic synovial fluid. Methods: Records of mature horses presented to 2 equine referral hospitals for investigation of suspected septic synovitis were examined. Horses (n=206) were included in the study if synovial fluid was submitted for full laboratory examination, including bac...
Surgical treatment of septic jugular thrombophlebitis in nine horses. To report a technique for surgical treatment of septic jugular thrombophlebitis unresponsive to medical treatment. Methods: Case series. Methods: Horses (n=9) with septic jugular thrombophlebitis unresponsive to medical treatment. Methods: Jugular vein thrombectomy was performed under standing sedation and local anesthesia. The contents of the affected portion of vein were removed by multiple incisions in the vein, with the incisions left open to drain and heal by second intention. Results: The technique was curative in all instances, although 2 horses required a 2nd procedure. One horse requi...
Osteomyelitis and osteonecrosis after intraosseous perfusion with gentamicin. To describe and discuss previously unreported complications associated with intraosseous perfusion with gentamicin in horses. Methods: Case report. Methods: Ten-year-old Warmblood gelding. Methods: Intraosseous perfusion with gentamicin into the proximal phalanx (P1) was used as part of the treatment regimen for distal interphalangeal joint and navicular bursa synovial sepsis. Although the sepsis responded favorably complications developed at the perfusion site, including persistent osteomyelitis, progressive osteonecrosis, and ultimately pathologic fracture of P1. Results: The progression of ...
Antimicrobial delivery by intrasynovial catheterisation with systemic administration for equine synovial trauma and sepsis. To present the technique for intra-articular catheter placement and report the clinical outcomes of 38 cases of equine synovial trauma and/or infection treated with broad-spectrum antimicrobials administered via an intrasynovial catheter (ISC). Methods: Retrospective study. Methods: Medical records of 38 horses treated for synovial trauma and sepsis with frequent antimicrobial administration through an ISC from 1995 to 2008 were reviewed. Follow-up information was obtained via clinical re-evaluation or telephone contact with the owners. Results: The majority of horses (84%) received amikacin a...
Chronic laminitis: strategic hoof wall resection. In the chronic-laminitic foot, severe soft-tissue compression and compromised circulation can result in osteitis and sepsis at the margin of the distal phalanx. Resultant inflammation and sepsis may cause the coronary corium to swell, drain, or separate from the hoof capsule, usually within 8 weeks of laminitis onset. Slow-onset cases of soft-tissue impingement can develop secondary to distal phalanx displacement due to lack of wall attachment. With either presentation, partial upper wall resection is required to reverse compression and vascular impingement by the hoof capsule. If the patholog...
Retrospective study of 108 foals with septic osteomyelitis. 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...
Uveal inflammation in septic newborn foals. Septicemia in humans is described as a leading cause of uveitis, which eventually can induce blindness. Objective: Uveal inflammatory findings could be related to sepsis severity in newborn foals and might be used as an indirect indicator for survival. Methods: Seventy-four septic foals, 54 nonseptic foals, and 42 healthy foals. Methods: Prospective observational clinical study. A detailed blinded, ophthalmic examination was performed by boarded ophthalmologists on all admitted newborn foals. Foals were grouped as septic (when blood culture resulted positive or the sepsis score was > or =14...