Septicemia in horses is a systemic condition characterized by the presence of pathogenic microorganisms or their toxins in the bloodstream, leading to widespread inflammation and potential organ dysfunction. It is often a result of bacterial infections and can occur in foals and adult horses, with foals being particularly susceptible due to their immature immune systems. The condition can manifest through various clinical signs such as fever, lethargy, and changes in behavior or appetite, and may progress to shock or organ failure if not addressed promptly. This page compiles peer-reviewed research studies and scholarly articles that explore the pathophysiology, diagnosis, treatment, and management of septicemia in equine patients.
Ricard RM, St-Jean G, Atwal HK, Wobeser BK.This study aims to identify the most common causes of equine perinatal loss up to 7 d of age in Canada. Equine. Necropsy reports from 360 equine perinatal loss cases were acquired from provincial veterinary diagnostic labs across Canada. Each case was classified into a basic cause (noninfectious, infectious, or unidentified) of perinatal loss, then further classified into primary and secondary categories for analysis. Of the basic causes of perinatal loss, noninfectious causes were the most common. Bacterial causes, such as septicemia, were the most common primary diagnosis overall. was the m...
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...
Spiesshofer P, Kilcoyne I, Spriet M, Katzman SA, Affolter VK, Vaughan B.To describe the etiologies, clinicopathologic findings, diagnostic modalities employed, treatments, and outcome associated with cases of septic bicipital bursitis. 9 horses. Medical records of horses diagnosed with septic bicipital bursitis between 2000 and 2021 were reviewed. Horses were included if synoviocentesis of the bicipital bursa revealed a total nucleated cell count of ≥ 20,000 cells/µL with a neutrophil proportion of ≥ 80%, a total protein concentration of ≥ 4.0 g/dL, and/or the presence of bacteria on cytology, or positive culture of the synovial fluid. Information retrieved...
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...
Kamali M, Carossino M, Del Piero F, Peak L, Mitchell MS, Willette J, Baker R, Li F, Kenéz Á, Balasuriya UBR, Go YY. subsp. is the etiological agent of sleepy foal disease, an acute form of fatal septicemia in newborn foals. is commonly found in the mucous membranes of healthy horses' respiratory and alimentary tracts and rarely causes disease in adult horses. In this study, we report a case of a 22-year-old American Paint gelding presenting clinical signs associated with an atypical pattern of pleuropneumonia subjected to necropsy. The gross and histopathological examinations revealed a unilateral fibrinosuppurative and hemorrhagic pleuropneumonia with an infrequent parenchymal distribution and heavy iso...
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...
Whisenant KD, Ruggles AJ, Stefanovski D, Woodie JB, Hopper SA, Embertson RM.Haematogenous septic arthritis is a major cause of morbidity and mortality in foals. Previous research has demonstrated a variable prognosis for athletic performance in foals diagnosed with septic arthritis. Objective: To determine the racing prognosis for Thoroughbred foals, 6 months of age or less with single septic joint of presumed haematogenous origin without recognised systemic sepsis or other serious comorbidity compared with a group of maternal sibling controls. Methods: Retrospective cohort study. Methods: Data were collected from Rood and Riddle Equine Hospital in-patient records fro...
Hoeberg E, Sånge A, Saegerman C, Bohlin A, Nostell K, Durie I, Husted L, Öhman A, Jacobsen S, Berg L, Laursen SH, van Galen G.Serum amyloid A (SAA) has been reported to hold promise as diagnostic and prognostic marker in foals. This has not been investigated thoroughly. Objective: Evaluate admission SAA concentrations as predictor of sepsis and outcome. Methods: Five hundred and ninety hospitalized foals <14 days old. Methods: Retrospective multicenter study. Foals were scored with sepsis and survival scores, grouped according to health category (septic, sick but nonseptic, uncertain sepsis status) and outcome; septic foals were further categorized according to severity (normal sepsis, severe sepsis, and septic sho...
Boger BL, Manfredi JM, Yob C, Weber PSD, Jacobs CC.Diagnosis of equine septic arthritis is not straightforward, and increasing time between onset, diagnosis, and treatment can have serious consequences for quality of life. Defensins are used in diagnosis of human joint infection. The presence of beta defensins (BDs) in equine synovial fluid and their utility as a biomarker of sepsis has not been investigated; therefore, our objectives were to (1) compare in vitro gene expression of lipopolysaccharide (LPS)-stimulated equine neutrophils to unstimulated neutrophils and (2) compare BD protein expression from normal, aseptically inflamed, and sept...
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...
Zakia L, Shaw S, Bonomelli N, O'Sullivan S, Zur Linden A, Dubois M, Baird J, Guest B.A 3-month-old foal with a history of acute hematuria was evaluated. Hydronephrosis and hydroureter were visualized upon renal ultrasonography of the left kidney. Cystoscopy identified a blood clot occluding the left ureter. Computed tomography (CT) revealed a large retroperitoneal abscess at the level of the aortic bifurcation and a left internal iliac aneurysm. Due to the severity of the lesions and the poor prognosis, the filly was euthanized and the clinical findings were confirmed by post-mortem examination. This report emphasizes the value of obtaining a precise diagnosis CT in order to ...
O'Brien TJ, Rosanowski SM, Mitchell KD, Carrick JB, Butt TD, Adkins AR.There is little consensus on factors associated with survival in foals with septic arthritis and limited data on long-term racing performance of Thoroughbred foals treated for septic arthritis. A more thorough understanding of short- and long-term outcome is necessary to help inform owners, and subsequently guide treatment. Objective: To investigate factors associated with survival, and to analyse racing performance of foals with septic arthritis compared with their maternal siblings. Methods: Retrospective cohort and a case-control study. Methods: Veterinary clinical records of Thoroughbred f...
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...
Chapuis RJJ, Ragno VM, Ariza CA, Movasseghi AR, Sayi S, Uehlinger FD, Montgomery JB.In the summer of 2017, 4 horses were diagnosed with septic fibrinous pericarditis at the Western College of Veterinary Medicine, Saskatoon. This case series occurred after a significant outbreak of forest tent caterpillars in the province during that spring. Three horses were immediately euthanized, and treatment was attempted in 1 mare. This is the first case series of pericarditis possibly associated with the ingestion of forest tent caterpillars to be reported in western Canada. Although cause-effect is not proven, it is prudent to prevent the ingestion of caterpillars by horses. Key clini...
Torpiano P, Nestorova N, Vella C.Streptococcus equi subsp. equi is a group C β-hemolytic streptococcus, and is an invasive pathogen with a very restricted host, causing the equine infection known as 'strangles'. It is a poor colonizer in horses, preferentially causing invasion and infection, compared with its ancestor Streptococcus equi subsp. zooepidemicus, which is considered an opportunistic commensal of the equine upper respiratory tract. In humans, S. equi subsp. equi causes invasive infections in immunocompromised hosts, often following close contact with horses. Such infections are associated with a high mortality, as...
Pecoraro HL, Felippe MJB, Miller AD, Divers TJ, Simpson KW, Guyer KM, Duhamel GE.Common variable immunodeficiency (CVID) is a rare condition in adult horses characterized by hypogammaglobulinemia and increased susceptibility to parasitic and bacterial infections, including recurrent respiratory diseases, septicemia, and meningitis. Lyme disease is often included as a differential diagnosis in CVID horses with signs of meningitis; however, the Borrelia burgdorferi organism has not been demonstrated previously within central nervous system tissues of CVID horses with neurologic disease, to our knowledge. We report herein a case of neuroborreliosis in a CVID horse, confirmed ...
Gilbertie JM, Schnabel LV, Stefanovski D, Kelly DJ, Jacob ME, Schaer TP.Bacterial colonization of synovial structures can cause infections that are difficult to treat. Systemic and local antimicrobials and repeated joint lavages are the mainstays of therapy. However, despite aggressive treatments, infection may persist, leading to significant tissue damage or death of the patient. In order to investigate the impact of bacterial culture and antimicrobial resistance on survival to discharge, we reviewed medical records of horses admitted to the University of Pennsylvania's large animal teaching hospital from 2010-2015. Two-hundred and six cases with a definitive dia...
Wormstrand B, Østevik L, Ekman S, Olstad K.Failure of the cartilage canal blood supply leads to ischemic chondronecrosis which causes osteochondrosis, and osteochondral lesions. Osteochondrosis is a disease with a heritable component and usually occurs under aseptic conditions. Because bacteria can bind to growth cartilage and disrupt the blood supply in pigs and chickens, we considered whether this might play a role in development of equine osteochondrosis. The aim of this study was to examine whether bacteria are present in canals in the growth cartilage of foals with septic arthritis/osteomyelitis, and whether this is associated wit...
Wong DM, Ruby RE, Dembek KA, Barr BS, Reuss SM, Magdesian KG, Olsen E, Burns T, Slovis NM, Wilkins PA.The original equine sepsis score provided a method of identifying foals with sepsis. New variables associated with sepsis have been evaluated, but the sepsis score has not been updated. Objective: To evaluate the sensitivity and specificity of 2 updated sepsis scores and the systemic inflammatory response syndrome (SIRS) criteria in regard to detecting sepsis in foals. Methods: Two-hundred and seventy-three ill foals and 25 healthy control foals. Methods: Historical, physical examination, and clinicopathologic findings were used to calculate the original sepsis score and 2 updated sepsis score...
Hammerschmitt ME, Rolim VM, Snel GGM, Siqueira FM, Driemeier D, Pavarini SP.Chromobacterium violaceum is an opportunistic pathogen of mammals that produces characteristic violet pigment in bacterial culture. We report pneumonia and septicaemia caused by C. violaceum in a horse. Necropsy examination was performed on a 3-year-old Quarter Horse stallion with a history of recurrent episodes of pneumonia, fever, dyspnoea and sanguineous nasal discharge. The lungs were not collapsed, but they contained dark red foci mixed with white areas, and multiple nodules of firm consistency. Within the liver and kidney there were randomly distributed, multifocal, white pinpoint lesion...
Arroyo MG, Slovis NM, Moore GE, Taylor SD.Septic pleuropneumonia is a common cause of morbidity and mortality in horses, but there is limited data available regarding factors associated with survival. Objective: To identify factors predictive of survival in horses with septic pleuropneumonia. Methods: A total of 97 horses with septic pleuropneumonia at 2 referral institutions. Methods: A retrospective study was performed. A diagnosis of septic pleuropneumonia was based on the presence of sepsis, pleural effusion, and positive bacterial culture from tracheal aspiration (TA) or pleural fluid (PF). Results: Thirty-one percent of horses h...
Gillespie CC, Adams SB, Moore GE.To determine common methods for intra-articular injections and variables associated with the risk of septic arthritis following intra-articular injection in the horse. Methods: Cross-sectional survey. Methods: Equine veterinarians. Methods: A link to an online survey was distributed to equine practitioners in 2014. Responses for descriptive data were tabulated. Data on infection rates obtained from medical records were analyzed. Variables associated with the risk of septic arthritis were determined using χ or Fisher's exact tests and logistic regression. Results: Common current methods for in...
Werners AH.Endotoxins, constituents of the cell wall of gram-positive and gram-negative bacteria, regularly result in severe illness and death in horses. In endotoxaemia, these constituents are present in the systemic circulation; in septicaemia, whole microbes invade normally sterile parts of the body. Interaction of these endotoxins with pathogen recognition receptors leads to an inflammatory response that cannot always be sufficiently contained and hence needs direct treatment. Over the last decennia, our understanding of the pathophysiology of endotoxaemia and septicaemia has significantly increased....
Pusterla N, Hall TL, Wetzlich SE, Monmaney G, Collier JR, Hill JA, Tell LA.The objective of this study was to determine the pharmacokinetics of single- and multi-dose ceftiofur crystalline-free acid (CCFA) administered subcutaneously at a dose of 13.2 mg/kg to 12 neonatal foals 1-3 days of age. Six foals received a single subcutaneous dose, while 6 additional foals received 4 doses of CCFA at 48-h intervals. Blood samples were collected at pre-determined times following drug administration, and plasma concentrations of ceftiofur free acid equivalents (CFAE) were measured using high-performance liquid chromatography. Following single-dose administration of CCFA, the...
Murakami M, Shimonishi Y, Hobo S, Niwa H, Ito H.We describe here the first isolation of Actinobacillus genomospecies 2 in Japan. The isolate was found in a septicemic foal and characterized by phenotypic and genetic analyses, with the latter consisting of 16S rDNA nucleotide sequence analysis plus multilocus sequence analysis using three housekeeping genes, recN, rpoA and thdF, that have been proposed for use as a genomic tool in place of DNA-DNA hybridization.
Fielding CL, Magdesian KG.Sepsis and septic shock represent a major cause of morbidity and mortality in equine neonates and in all species. Early recognition of the condition is important, but definitive examination and laboratory variables to predict equine neonatal sepsis are lacking. Early and aggressive treatment should include broad-spectrum antimicrobial coverage, source control, and hemodynamic support. Field practitioners and intensive care clinicians work together in the management of this condition because the recognition and initial treatment should begin as early as possible.
Hytychová T, Bezděková B.To identify the specific pathogens causing sepsis in hospitalized foals in the Czech Republic and identify important factors associated with their survival. Methods: A retrospective study from 2011 to 2013. Methods: University veterinary teaching hospital. Methods: Fifty compromised foals. Methods: None. Results: Blood was aseptically collected for bacterial culture from compromised foals. The foals were classified as septic according to a positive blood culture result or sepsis score ≥11. Blood cultures were positive in 44% of the foals. In these positive cultures, 27.3% had only Gram-posit...
Giordano A, Castagnetti C, Panzani S, Paltrinieri S, Freccero F, Veronesi MC.In newborn babies, endothelin 1 (ET-1), a potent vasoconstrictor, increases during septicemia and severe respiratory syndromes. Because equine neonatal sepsis (ENS) and perinatal asphyxia syndrome (PAS) are major causes of morbidity and mortality in newborn foals and because no information on the concentration of ET-1 in healthy and sick foals has been reported yet, the aims of this study were (1) to define the serum concentration of Big ET-1 in healthy neonatal foals during the first week of age; (2) to preliminarily explore the diagnostic and prognostic role of Big ET-1 during ENS and PAS. S...
Hepworth-Warren KL, Wong DM, Fulkerson CV, Wang C, Sun Y.To determine clinical characteristics, clinicopathologic data, and bacterial culture and antimicrobial susceptibility results associated with septic arthritis in foals ≤ 180 days old. Methods: Retrospective case series. Methods: 83 foals with septic arthritis. Methods: Medical records at 2 teaching hospitals between 1998 and 2013 were searched to identify those for foals ≤ 180 days old with confirmed infection of ≥ 1 synovial structure. Data extracted from the records included signalment, clinicopathologic information, bacteriologic culture and antimicrobial susceptibility results, and o...
Cohen ND.A prospective study was conducted to describe the causes of and farm management factors associated with disease and death in a population of foals in Texas. Data from 2,468 foals at 167 farms were provided by veterinarians for all 12 months during 1991. Among 2,468 foals, 116 deaths were reported (4.7%). Pneumonia was the most commonly reported cause of death, followed by septicemia. When considered as a group, musculoskeletal disorders (traumatic, infectious, or deforming problems) represented the most common cause of all reported deaths. Daily risk of death was greatest during the first 7 da...
Wong DM, Ruby RE, Dembek KA, Barr BS, Reuss SM, Magdesian KG, Olsen E, Burns T, Slovis NM, Wilkins PA.The original equine sepsis score provided a method of identifying foals with sepsis. New variables associated with sepsis have been evaluated, but the sepsis score has not been updated. Objective: To evaluate the sensitivity and specificity of 2 updated sepsis scores and the systemic inflammatory response syndrome (SIRS) criteria in regard to detecting sepsis in foals. Methods: Two-hundred and seventy-three ill foals and 25 healthy control foals. Methods: Historical, physical examination, and clinicopathologic findings were used to calculate the original sepsis score and 2 updated sepsis score...
Morris DD.Endotoxemia remains the leading cause of death in horses, being intimately involved in the pathogenesis of gastrointestinal disorders that cause colic and neonatal foal septicemia. Endotoxins, normally present within the bowel, gain access to the blood across damaged intestinal mucosa, or endotoxemia occurs when gram negative organisms proliferate in tissues. Endotoxins are removed from the circulation by the mononuclear phagocyte system, and the response of mononuclear phagocytes to these lipopolysaccharides (LPS) play an important role in determining the severity of clinical disease. Macroph...
Hurcombe SD, Toribio RE, Slovis N, Kohn CW, Refsal K, Saville W, Mudge MC.Sepsis is an important cause for neonatal foal mortality. The hypothalamic-pituitary-adrenal axis (HPAA) responses to sepsis are well documented in critically ill humans, but limited data exist in foals. The purpose of this study was to evaluate the HPAA response to sepsis in foals, and to associate these endocrine changes with survival. Objective: Blood concentrations of arginine vasopressin (AVP), adrenocorticotropin hormone (ACTH), and cortisol will be higher in septic foals as compared with sick nonseptic and healthy foals. The magnitude of increase in hormone concentration will be negativ...
Gayle JM, Cohen ND, Chaffin MK.In order to identify variables obtained at admission that could be used to predict survival in septicemic foals, medical records of 65 foals diagnosed with septicemia were reviewed. Initially, variables were analyzed independently (univariate analysis) for association with survival. Of the physical examination and historical data examined using univariate analysis, the ability to stand at admission, respiratory rate > or = 60 breaths per minute (bpm), and normal-appearing mucous membranes were significantly associated with survival. Foals with history of induced parturition were significant...
Arroyo MG, Slovis NM, Moore GE, Taylor SD.Septic pleuropneumonia is a common cause of morbidity and mortality in horses, but there is limited data available regarding factors associated with survival. Objective: To identify factors predictive of survival in horses with septic pleuropneumonia. Methods: A total of 97 horses with septic pleuropneumonia at 2 referral institutions. Methods: A retrospective study was performed. A diagnosis of septic pleuropneumonia was based on the presence of sepsis, pleural effusion, and positive bacterial culture from tracheal aspiration (TA) or pleural fluid (PF). Results: Thirty-one percent of horses h...
Gold JR, Divers TJ, Barton MH, Lamb SV, Place NJ, Mohammed HO, Bain FT.Little information exists on the hypothalamic-pituitary-adrenal axis in septic foals. Objective: The plasma concentrations of adrenocorticotropin (ACTH) and cortisol are expected to be higher in septic foals as compared to normal foals. The concentrations of hormones in septic foals also are expected to differ further depending upon survival. Methods: Twenty-eight control foals and 46 septic foals 11 or a positive blood culture. The control foals were age matched to the septic foals in the study. ACTH and cortisol concentrations were measured by a chemiluminescent immunoassay system. Results: ...
Koterba AM, Brewer BD, Tarplee FA.In an effort to identify improved methods for diagnosis of infection in the neonatal foal, clinical records from 38 septicaemic foals of less than one week of age were examined for trends in history, physical examination and clinicopathological findings. The survival rate of septicaemic foals, 26 per cent, was markedly less than the rate for all other foal admissions. Blood cultures were valuable in diagnosis and treatment of septicaemia and identified a preponderance of Gram-negative infection. Zinc sulphate turbidity test results were abnormally low in all septicaemic foals tested. The clini...
Wilson WD, Madigan JE.Diagnosis of bacterial septicemia was confirmed by results of bacteriologic culture of antemortem blood samples and/or necropsy specimens obtained from 47 foals up to 8 days old. Gram-negative bacteria were isolated from all 47 foals, and mixed infections with more than one organism were involved in 26 (55%). Escherichia coli, Actinobacillus spp, and Klebsiella pneumoniae were the most frequent isolates, infecting 55, 34, and 23% of foals, respectively. Gram-positive bacteria and anaerobic bacteria were isolated only from foals with mixed infections with gram-negative organisms. Clostridium pe...
Russell CM, Axon JE, Blishen A, Begg AP.To assist correct decision-making about antimicrobial treatment of equine neonates with septicaemia. Methods: Retrospective study of microbial blood culture results obtained from foals less than 7 days of age. Methods: Microbial blood culture results from foals less than 7 days of age admitted to an intensive care unit between July 1999 and December 2004 were reviewed. Antimicrobial sensitivity was assessed by the Kirby Bauer disc diffusion method. Antimicrobials were defined as an effective first-line choice antimicrobial if greater than 70% of isolates were susceptible. Multiple drug resista...
Burton AB, Wagner B, Erb HN, Ainsworth DM.Previously it was reported that compared to surviving septic foals, non-surviving foals had a 35-fold increase in interleukin-10 (IL-10) and 15-fold increase in IL-6 gene expression in their peripheral blood mononuclear cells (PBMC). As gene expression profiles can be time-consuming, we sought to determine if serum IL-6 and IL-10 in foals would aid in the diagnosis and prognosis of septicemia. A prospective study of septic neonatal foals admitted to the Cornell University Equine Hospital during 2007 and 2008 was performed. Septicemia was confirmed in 15 foals using blood culture results and se...
Peek SF, Semrad S, McGuirk SM, Riseberg A, Slack JA, Marques F, Coombs D, Lien L, Keuler N, Darien BJ.This prospective study compared survival rates of critically ill and septic foals receiving 1 of 2 different types of commercial equine plasma and analyzed admission variables as possible predictors of survival. Standardized clinical, hematologic, biochemical, and hemostatic admission data were collected and foals received either conventional commercially available hyperimmune equine plasma or equine plasma specifically rich in antiendotoxin antibodies in a double-blinded, coded fashion. Sepsis was defined as true bacteremia or sepsis score >11. Overall survival rate to discharge was 72% (4...
Sanchez LC.Neonatal infection remains a leading cause of morbidity and mortality in the equine industry, despite advances in prevention and treatment. Many factors can influence a foal's risk for the development of sepsis in the peripartum period. This article discusses those factors, causative organisms, and therapeutic options. Factors that influence prognosis and potential preventative strategies also are addressed.
Mapes S, Rhodes DM, Wilson WD, Leutenegger CM, Pusterla N.Fifty-five isolates of Escherichia coli from septicaemic neonatal foals were used to validate five real-time pcr assays targeting different known virulence factor genes: curli fibre (csgD), ferric hydroxamate uptake (fhuA), type 1A pilin (fimA), aerobactin (lutA) and yersiniabactin (fyuA). A pcr assay targeting a universal sequence of the bacterial 16S rrna gene served as quality control. The pcr assays showed good analytical specificity and sensitivity on the basis of sequencing the pcr products, their lack of cross-reactivity with non-E coli organisms, high amplification efficiency and a lim...
Weber EJ, Sanchez LC, Giguère S.The modified sepsis scoring system provides a method to identify sepsis in foals early in the disease process, but inconsistent results have been obtained from its clinical application in previous studies. Objective: To evaluate the sensitivity and specificity of the modified sepsis score in a larger population of foals. A secondary objective was to identify factors associated with sepsis. Methods: Retrospective cohort study. Methods: Records were retrospectively analysed for neonatal admissions to the University of Florida Large Animal Hospital from 1982 to 2008. Backwards stepwise multivaria...
Kablack KA, Embertson RM, Bernard WV, Bramlage LR, Hance S, Reimer JM, Barton MH.Historical, physical and diagnostic data were reviewed retrospectively in 31 equine neonates with uroperitoneum. Gender predilection was not observed, and classic electrolyte abnormalities were seen in less than 50% of the cases. Aetiologies for uroperitoneum have been well described, but this review found that septicaemia/severe illness played a crucial role the outcome of uroperitoneum. Approximately half the individuals with uroperitoneum had positive sepsis scores. Foals receiving fluid therapy were more likely to be septic and to have normal electrolyte concentrations. Ultrasonographic fi...
Dembek KA, Onasch K, Hurcombe SD, MacGillivray KC, Slovis NM, Barr BS, Reed SM, Toribio RE.The renin-angiotensin-aldosterone system (RAAS) and hypothalamic-pituitary-adrenal axis (HPAA) and their interactions during illness and hypoperfusion are important to maintain organ function. HPAA dysfunction and relative adrenal insufficiency (RAI) are common in septic foals. Information is lacking on the RAAS and mineralocorticoid response in the context of RAI in newborn sick foals. Objective: To investigate the RAAS, as well as HPAA factors that interact with the RAAS, in hospitalized foals, and to determine their association with clinical findings. We hypothesized that critical illness i...
Gilbertie JM, Schnabel LV, Stefanovski D, Kelly DJ, Jacob ME, Schaer TP.Bacterial colonization of synovial structures can cause infections that are difficult to treat. Systemic and local antimicrobials and repeated joint lavages are the mainstays of therapy. However, despite aggressive treatments, infection may persist, leading to significant tissue damage or death of the patient. In order to investigate the impact of bacterial culture and antimicrobial resistance on survival to discharge, we reviewed medical records of horses admitted to the University of Pennsylvania's large animal teaching hospital from 2010-2015. Two-hundred and six cases with a definitive dia...
Hytychová T, Bezděková B.To identify the specific pathogens causing sepsis in hospitalized foals in the Czech Republic and identify important factors associated with their survival. Methods: A retrospective study from 2011 to 2013. Methods: University veterinary teaching hospital. Methods: Fifty compromised foals. Methods: None. Results: Blood was aseptically collected for bacterial culture from compromised foals. The foals were classified as septic according to a positive blood culture result or sepsis score ≥11. Blood cultures were positive in 44% of the foals. In these positive cultures, 27.3% had only Gram-posit...
Torpiano P, Nestorova N, Vella C.Streptococcus equi subsp. equi is a group C β-hemolytic streptococcus, and is an invasive pathogen with a very restricted host, causing the equine infection known as 'strangles'. It is a poor colonizer in horses, preferentially causing invasion and infection, compared with its ancestor Streptococcus equi subsp. zooepidemicus, which is considered an opportunistic commensal of the equine upper respiratory tract. In humans, S. equi subsp. equi causes invasive infections in immunocompromised hosts, often following close contact with horses. Such infections are associated with a high mortality, as...
Fessler JF, Bottoms GD, Coppoc GL, Gimarc S, Latshaw HS, Noble JK.Endotoxin (LPS) was quantitated in experimental subjects and in horses with naturally occurring gastrointestinal strangulation obstruction and/or septicaemic diseases to establish the fate of LPS and the clinical usefulness of the Limulus amoebocyte lysate (LAL) assay. The assay was validated for sensitivity (10 pg/ml), recovery (90 to 106 per cent), intra-assay precision (CV = 5.5 per cent) inter-assay precision (CV = 11 per cent), and stability of diluted, heat treated, frozen samples (at least 90 days). Plasma concentrations of LPS after sublethal (3 micrograms/kg) jugular or portal vein bo...
Layman QD, Rezabek GB, Ramachandran A, Love BC, Confer AW.Several Actinobacillus spp. are common commensal bacteria of the oral cavity, gastrointestinal tract, and reproductive tract of horses and can cause disease in both foals and adults. The current retrospective study was designed to review Actinobacillus spp. isolated from clinical samples or necropsies of 99 horses during 1999-2011. The cases consisted of 43 foals (2 years of age), 2 aborted fetuses, and 11 with unspecified ages. Clinical history, signs, bacterial species isolated, and associated lesions were documented. Actinobacillus spp. were isolated 111 times. The most common isolates were...
Moore BR, Hinchcliff KW.Heparin is used clinically in horses to treat hemostatic abnormalities associated with severe gastrointestinal disease, septicemia, and endotoxemia. The primary anticoagulant effect of heparin is through the suppression of thrombin-dependent amplification of the coagulation cascade, and inhibition of thrombin-mediated conversion of fibrinogen to fibrin. Heparin may be of benefit in preventing the complications associated with hypercoagulable states such as jugular vein thrombosis, laminitis, and organ failure. Heparin may also be beneficial in the prevention of intraabdominal adhesions after g...
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...
Hurcombe SD, Toribio RE, Slovis NM, Saville WJ, Mudge MC, Macgillivray K, Frazer ML.Disorders of calcium regulation are frequently found in humans with critical illness, yet limited information exists in foals with similar conditions including septicemia. The purpose of this study was to determine whether disorders of calcium exist in septic foals, and to determine any association with survival. Objective: Blood concentrations of ionized calcium (Ca(2+)) and magnesium (Mg(2+)) will be lower in septic foals with concomitant increases in parathyroid hormone (PTH), calcitonin (CT), and parathyroid-related peptide (PTHrP) compared with healthy foals. The magnitude of these differ...
Hawkins JF, Bowman KF, Roberts MC, Cowen P.Peritonitis was diagnosed in 67 horses between 1985 and 1990: 14 horses developed septic peritonitis after intestinal rupture, 25 horses developed peritonitis after abdominal surgery, and 28 horses had peritonitis not associated with intestinal rupture or abdominal surgery. Forty of 67 horses (59.7%) did not survive. Nonsurvivors had higher heart rates (P = 0.01), RBC count (P = 0.039), serum creatinine concentration (P = 0.036), PCV (P = 0.007), and anion gap (P = 0.005); lower venous blood pH (P = 0.002); and a greater number of bacterial species cultured from peritoneal fluid samples (P = 0...
Barton MH, Morris DD, Norton N, Prasse KW.Thirteen coagulation tests evaluating hemostatic and fibrinolytic indices and serum cytokine and plasma endotoxin concentrations were obtained in 34 foals with a positive sepsis score (septic group) and 46 age-matched healthy foals. Compared to healthy foals, the prothrombin, activated partial thromboplastin, and whole blood recalcification times were significantly longer in septic foals. The fibrinogen and fibrin degradation products concentrations, percent plasminogen, alpha-2 antiplasmin, and plasminogen activator inhibitor activities, and tumor necrosis factor and interleukin-6 activities ...
Haas SD, Bristol F, Card CE.The purpose of this study was to determine the incidence of neonatal mortality in a large, extensively managed mare herd and what risk factors were involved in foal mortality. For a 6 wk period between April 18, 1994, and May 31, 1994, 334 foals were born, of which 74 died before reaching 10 d of age, giving an overall mortality of 22% for this period. Seventy four percent of the foal deaths occurred within 48 h of parturition. The major causes of foal mortality included starvation/exposure 27%, septicemia 26%, and dystocia 20%. Weekly incidences varied significantly, ranging from 67% for week...
Wagner B, Ainsworth DM, Freer H.Soluble CD14 (sCD14) binds bacterial lipopolysaccharide (LPS) and acts as an anti-inflammatory LPS-inhibitor in vivo. In humans, sCD14 is one of the soluble biomarkers used for various inflammatory diseases and conditions, however, sCD14 assays have not yet been evaluated in horses. Here, we developed and optimized a bead-based assay for the quantification of sCD14 in horses. The assay was then used to determine native sCD14 concentrations in serum from healthy and septic foals, in the colostrum of healthy mares and in plasma from adult horses with recurrent airway obstruction (RAO) and contro...
Cotovio M, Monreal L, Armengou L, Prada J, Almeida JM, Segura D.Septicemia in human neonates frequently is complicated by activation of the coagulation system, disseminated intravascular coagulation (DIC) and multiple organ failure syndrome, which may contribute to high mortality. In adult horses with DIC, the lung has been the organ most frequently affected by fibrin deposits. In addition, in vivo studies suggest that hemostatic mechanisms may be immature in foals < 1-day old. Objective: Newborn foals with severe septicemia have fibrin deposits in their tissues independently of their age, and these fibrin deposits are associated with organ failure. Met...
