Topic:Septicemia
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.
Septic tenosynovitis in horses: 25 cases (1983-1989). The medical records of 25 horses with septic tenosynovitis treated over 7 years (1983 to 1989) were reviewed to determine clinical features of the disease and response to treatment. The median age of horses with septic tenosynovitis was 5 years (range, 1 month to 21 years). Fourteen fore limbs and 11 hind limbs were affected. Sepsis was located in the sheath of the digital flexor tendons of 22 horses. Sepsis was located in the sheath of the extensor carpi radialis tendon (1 horse), sheath of the long digital extensor tendon (1 horse), or sheath of the common digital extensor tendon (1 horse) i...
Concentrations of amino acids in the plasma of neonatal foals with septicemia. 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....
An outbreak of equine neonatal salmonellosis. An outbreak of salmonellosis in foals occurred on a large Thoroughbred farm in California. Only foals less than 8 days of age exhibited clinical signs, which included depression, anorexia, and diarrhea. Three foals died from septicemia. The agent responsible was Salmonella ohio, which is rarely involved in salmonellosis in horses. During the course of the outbreak, S. ohio was isolated from 27 of 97 mares (27.8%) and 34 of 97 foals (35.1%). Mares were the presumed source of infection for foals. The absence of clinical signs in mares allowed for increased exposure of foals through environmental...
Endotoxemia in horses. A review of cellular and humoral mediators involved in its pathogenesis. 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...
Elective cesarean section in mares: eight cases (1980-1989). From 1980 to 1989, 8 cesarean sections were performed on an elective basis in 5 mares. Four mares had partially obstructed pelvic canals; 2 of these mares had previously lost foals because of dystocia. Cervical adhesions that might obstruct passage of the fetus through the pelvic canal was suspected in the fifth mare. Cesarean section was performed prior to mares entering the first stage of labor. Readiness for birth was estimated by development of the mare's mammary gland and the presence of colostrum in the udder. A ventral midline celiotomy provided excellent exposure and healed without com...
Septicemia, atrial fibrillation, cardiomegaly, left atrial mass, and Rhodococcus equi septic osteoarthritis in a foal. A foal with vegetative bacterial endocarditis affecting the wall of the left atrium was treated successfully with cefotaxime, erythromycin, and rifampin. Bacterial isolates included Escherichia coli from blood and Rhodococcus equi from a P-type osteomyelitic lesion of the left third metatarsal bone and from synovial fluid from the left metatarsophalangeal joint. Cardiac complications included cardiomegaly and atrial fibrillation, which responded to treatment with digoxin and quinidine sulfate. Cardiac function was considered normal 18 months after treatment. Bacteriologic cure of osteoarthriti...
Synovial fluid pH, cytologic characteristics, and gentamicin concentration after intra-articular administration of the drug in an experimental model of infectious arthritis in horses. Chemical and cytologic effects and bactericidal activity of gentamicin in septic synovial fluid were evaluated in an experimental model of infectious arthritis in horses. Septic arthritis was induced by inoculation of approximately 7.5 X 10(6) colony-forming units of Escherichia coli into 1 antebrachiocarpal joint in each of 16 clinically normal adult horses. Clinical signs of septic arthritis were evident 24 hours after inoculation. Horses were allotted to 3 groups: group-1 horses (n = 5) each were given 150 mg of gentamicin (50 mg/ml; 3 ml) intra-articularly (IA); group-2 horses (n = 5) each...
Anaerobic bacterial pneumonia with septicemia in two racehorses. Anaerobic bacterial pneumonia with septicemia was diagnosed in 2 Thoroughbred racehorses referred with respiratory tract disease that had failed to respond to initial treatment with various antibiotics including penicillin and trimethoprim-sulfamethoxazole. Multiple anaerobic organisms, including Bacteroides spp and Fusobacterium spp, were isolated from blood and transtracheal aspirates obtained from both horses and from aspirates of cutaneous nodules obtained from 1 horse. The latter horse responded to metronidazole treatment followed by procaine penicillin G administration and regained its h...
Pericarditis in horses: six cases (1982-1986). Records of 6 horses with pericarditis were reviewed. Septic pericarditis was suspected in all horses, based on historic and clinical findings. In horses 1, 2, and 4, cytologic examination of the pericardial effusion revealed acute inflammation with severe neutrophil degeneration. In horses 3 and 5, cytologic examination of pericardial fluid revealed subacute inflammation with degenerated neutrophils, and in horse 6, chronic active inflammation, with well preserved neutrophils. In horses 1 and 3, bacteria were identified on cytologic examination of pericardial fluid. Results of microbiologic cu...
Debridement of septic physeal lesions in 3 foals. Radiographically, osteolysis of the physis consistent with a septic physitis was observed in 3 foals. The foals were treated with surgical debridement and antimicrobials. Two of the horses were sound for use as adults; the third was euthanatized due to concurrent infectious arthritis and septicemia.
Pharmacokinetics of amikacin in critically ill neonatal foals treated for presumed or confirmed sepsis. Fourteen foals less than four days of age were treated with the aminoglycoside, amikacin sulphate, and either penicillin or ampicillin for septicaemia, pneumonia, and/or failure of passive immunoglobulin transfer. Serum amikacin concentrations were determined at three times during an 8 or 12 h dosing interval. A 7.0 mg/kg bodyweight dose of amikacin every 8 h was appropriate. Prematurity did not influence mortality. All seven premature foals survived, whereas four of the seven full term foals died. Uraemia in three foals was caused by urinary bladder rupture; amikacin-induced nephrotoxicity wa...
Comparison of bacteriologic culture of blood and necropsy specimens for determining the cause of foal septicemia: 47 cases (1978-1987). 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...
Surgical treatment of septic pedal osteitis in horses: nine cases (1980-1987). Over an 8-year period, 9 horses with septic pedal osteitis were admitted to the New York State College of Veterinary Medicine. Septic pedal osteitis was defined by the presence of purulent exudate combined with radiographic evidence of lysis of the distal phalanx. The condition described involved only the distal phalanx, the laminae and hoofwall, and the soft tissues of the sole. Treatment included curettage and removal of the affected portion of the distal phalanx through a ventral approach to the foot, combined with systemic administration of antibodies. Of the 9 horses, 7 returned to soundn...
Serratia marcescens septicemia associated with infusion of an amino acid solution in two horses. Clinical septicemia developed in 2 clinically normal horses after both were administered a portion of an amino acid solution IV. Serratia marcescens was subsequently isolated from blood of both horses. The isolates were shown to be identical on the basis of antibiograms and plasmid biochemistry, incriminating the infusate as the source of bacterial infection. The horses recovered after supportive and antimicrobial treatment.
Clinical, ultrasonographic, and surgical findings in foals with umbilical remnant infections. Infection of umbilical arteries, umbilical vein, and/or urachus was diagnosed ultrasonographically in 33 foals 1 to 90 days old (mean, 17.7 +/- 17.3 days). In these foals, the most common initial problems were umbilical abnormalities, septic arthritis, and/or neonatal septicemia. In 16 foals, abnormalities of the external umbilical stalk were noticed on admission. Abnormalities of the internal umbilical structures were identified when enlargement and echogenic material (fluid and/or gas) were imaged ultrasonographically within these structures. Multiple structures were affected in 23 foals, wi...
Plasma endotoxin concentrations in experimental and clinical equine subjects. 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...
Open joint injuries in horses: 58 cases (1980-1986). A retrospective study was made of 58 horses with open joint injuries admitted to the veterinary teaching hospital. Twenty-five (43%) were admitted within 24 hours of injury, 15 (26%) were examined 2 to 7 days after injury, and 18 (31%) were evaluated a week or more after the initial injury. The joints of the lower portions of the limbs most commonly were affected, with injuries that varied from puncture wounds to severe lacerations with soft tissue deficits. Diagnosis was made on the basis of clinical signs and results of synovial fluid analysis and radiography. Radiography was found to be an ...
Omphalophlebitis and osteomyelitis associated with Klebsiella septicemia in a premature foal. Gram-negative neonatal septicemia was diagnosed in a premature Standardbred colt. Clinical signs included lethargy, weakness, loss of suckle reflex, tachypnea, and injected mucous membranes. Sequelae included pneumonia, omphalophlebitis, septic arthritis, and osteomyelitis. Prepartum maternal uterine infection, premature delivery, abnormal parturition with premature fetal membrane separation, and failure of passive transfer of colostral immunoglobulins increased the foal's risk for developing sepsis. Treatment included administration of moxalactam disodium and cefadroxil. The clinical efficacy...
Septicemic salmonellosis and suspected phenylbutazone toxicosis in an aged pony. A 16-year-old pony with signs of intermittent abdominal pain was treated with phenylbutazone in excess of the recommended dosage. Endoscopy revealed ulceration of the esophagus, stomach, and proximal portion of small intestine. The pony developed diarrhea. Salmonella typhimurium was isolated from the blood and feces. Treatment included fluids, trimethoprim-sulfadiazine, sucralfate, and ranitidine hydrochloride. The diarrhea resolved, as did the gastrointestinal ulceration. This case was unusual because septicemia with salmonellosis is an uncommon finding in adult equids. Also, complications co...
Septic periorchitis in a horse. A 2-month-old Standard-bred colt with signs of abdominal pain and large scrotum was found to have septic periorchitis involving the right testis. Surgical exploration of the abdomen and scrotum was performed; the colt was then castrated. Actinobacillus equuli was isolated from specimens obtained at surgery. The colt was treated with broad-spectrum antibiotics and flunixin meglumine after surgery, and fully recovered. The clinical signs of periorchitis in the colt were similar to an inguinal/scrotal hernia.
Therapy of suspected septicemia in neonatal foals using plasma-containing antibodies to core lipopolysaccharide (LPS). Equine antiserum to core lipopolysaccharide (LPS) was evaluated in a double-blind prospective study for therapeutic benefit in suspected septicemia in neonatal foals. Forty foals younger than 7 days of age were included in the study by satisfaction of clinical and laboratory criteria, suggestive of gram-negative septicemia. Twenty-two foals were treated with core LPS antiserum (plasma produced from horses which were hyperimmunized with rough gram-negative mutant bacterin) and 18 foals received "nonimmune" plasma (from horses prior to immunization against core LPS). All foals received antimicro...
Emergence of antibiotic-resistant Salmonella agona in horses in Kentucky. Eighty-seven of 283 isolates of salmonellae recovered from horses in Kentucky by the Livestock Disease Diagnostic Center from July 1, 1980 through June 30, 1984 were Salmonella agona. No isolations of S agona were made from Jan 1, 1972 through June 30, 1980. Salmonella agona was isolated from horses on 56 farms and most of the isolations were made in the spring. All age classes of horses were involved. Clinical forms of salmonellosis observed were diarrhea, septicemia, infertility, and abortion. Antibiotic susceptibilities were determined for 83 of the 87 isolates, and 79 were resistant to mul...
Immunodeficiency manifested by oral candidiasis and bacterial septicemia in foals. Oral candidiasis and bacterial septicemia were diagnosed in 8 foals that had laboratory and/or pathologic evidence of immunodeficiency. Two foals suffered solely from complete failure of passive transfer of colostal immunoglobulins. Six foals had evidence of immune defects but did not meet the criteria for diagnosis of any of the currently recognized primary equine immunodeficiency syndromes. All six of these foals died or were euthanatized due to bacterial infections. One foal with failure of passive transfer recovered and the other died of a mesenteric torsion before the effect of treatment ...
Cardiovascular disease in the equine neonate. Cardiac disease in the equine neonate occurs infrequently. Murmurs are often heard in foals and are not considered significant unless they persist beyond 4 days of age. Congenital cardiac defects are the most common form of primary cardiac disease in the foal, with ventricular septal defects occurring most frequently. Other neonatal foal diseases such as ruptured bladders, white muscle disease, neonatal respiratory distress syndrome, and septicemia have secondary cardiac involvement.
Prevention and control of infection. Foal septicemia is a major cause of neonatal morbidity and mortality. In order to improve success rates, earlier diagnosis and treatment are essential. This article stresses methods to prevent and treat infections in the compromised equine neonate.
Musculoskeletal disorders in neonatal foals. Angular limb deformities are not uncommon in foals. Mild angular deviation due to laxity of supporting soft tissues often resolves spontaneously. However, external splinting or casting may be needed in severe cases or in those that do not resolve. When incomplete ossification of carpal or tarsal bones is the cause of the limb deformity, external support is mandatory to prevent further deformation and abnormal development of the bones. When epiphyseal and metaphyseal abnormalities cause axial deviation, surgical intervention is usually necessary. Circumferential periosteal transection and/or tr...