FREE SHIPPING over $40
OVER 10000 FIVE-STAR REVIEWS
5% OFF ALL SUBSCRIPTIONS
100% HAPPINESS GUARANTEE
Analyze Diet
0
Equine veterinary journal2022; 55(4); 584-592; doi: 10.1111/evj.13891

Equine blood cultures: Can we do better?

Abstract: Blood culture is considered the gold standard test for documenting bacteraemia in patients with suspected bacterial sepsis in veterinary and human medicine. However, blood culture often fails to yield bacterial growth even though the clinical picture is strongly suggestive of bacterial sepsis, or contaminating organisms can overgrow the true pathogen, making accurate diagnosis and appropriate management of this life-threatening condition very challenging. Methodology for collecting blood cultures in equine medicine, and even in human hospitals, is not standardised, and many variables can affect the yield and type of microorganisms cultured. Microbiological culture techniques used in the laboratory and specific sample collection techniques, including volume of blood collected, aseptic technique utilised, and the site, timing and frequency of sample collection, all have substantial impact on the accuracy of blood culture results. In addition, patient-specific factors such as husbandry factors, the anatomical site of the primary infection, and changing microflora in different geographic locations, also can impact blood cultures. Thus, blood cultures obtained in practice may not always accurately define the presence or absence of, or specific organisms causing, bacteraemia in horses and foals with suspected sepsis. Erroneous blood culture results can lead to inappropriate antimicrobial use, which can result in poor outcomes for individual patients and contribute to the development of antimicrobial resistance in the patient's microflora and the environmental microcosm. This review summarises current indications and methodology, and specific factors that may be optimised, for equine blood culture, with particular focus on available literature from neonatal foals with suspected bacterial sepsis. To standardise and optimise blood culture techniques in horses and foals, future research in this area should be aimed at determining the optimal volume of blood that should be collected for culture, and the ideal site, timing, and frequency of sample collection.
© 2022 The Authors. Equine Veterinary Journal published by John Wiley & Sons Ltd on behalf of EVJ Ltd.
Get Full Text
Publication Date: 2022-10-18 PubMed ID: 36210694DOI: 10.1111/evj.13891Google Scholar: Lookup
The Equine Research Bank provides access to a large database of publicly available scientific literature. Inclusion in the Research Bank does not imply endorsement of study methods or findings by Mad Barn.
LinkedInCopy
  • Journal Article
  • Review

Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

This research article discusses the shortcomings and inconsistencies in the methodology of blood culture testing in horses, particularly in relation to bacterial sepsis. The article also offers arguments for standardised and optimised techniques in this field, with a focus on neonatal foals with suspected sepsis.

Methodology of Blood Culture Collection

  • The researchers emphasize the lack of standardization in the methodology of collecting blood cultures in both human and equine medicine. This includes variables like techniques used for microbiological culture in the laboratory, and methods of sample collection such as the volume of blood collected, aseptic technique used, and the site, timing, and frequency of sample collection.
  • All these variables have a significant impact on the accuracy of the blood culture results.

    • Factors Affecting Blood Cultures

    • The article also highlights the influence of certain patient-specific factors on the results of blood cultures. These include husbandry factors, the anatomical site of the primary infection, and changing microflora in different geographic locations.
    • These unpredictable variables mean that blood cultures obtained in practice may not accurately define the presence or absence of bacteria causing sepsis, or specifically identify the bacteria involved.
    • Inaccurate results can lead to inappropriate use of antimicrobials, giving rise to poor patient outcomes and contributing to the development of antimicrobial resistance.

    Proposed Standardized Techniques

    • The research article proposes that there’s a pressing need for standardization and optimization in how blood culture samples are taken in equine medicine, particularly in neonatal foals with suspected sepsis.
    • The researchers call for future research to determine the optimal volume of blood to be collected, and the most appropriate site, timing, and frequency of sample collection.

Cite This Article

APA
Giancola S, Hart KA. (2022). Equine blood cultures: Can we do better? Equine Vet J, 55(4), 584-592. https://doi.org/10.1111/evj.13891

Publication

Equine veterinary journal
ISSN: 2042-3306
NlmUniqueID: 0173320
Country: United States
Language: English
Volume: 55
Issue: 4
Pages: 584-592

Researcher Affiliations

Giancola, Shyla
  • Department of Large Animal Medicine, University of Georgia College of Veterinary Medicine, Athens, Georgia, USA.
Hart, Kelsey A
  • Department of Large Animal Medicine, University of Georgia College of Veterinary Medicine, Athens, Georgia, USA.

MeSH Terms

  • Animals
  • Humans
  • Horses
  • Animals, Newborn
  • Blood Culture / veterinary
  • Horse Diseases / microbiology
  • Bacteremia / diagnosis
  • Bacteremia / veterinary
  • Bacteremia / microbiology
  • Sepsis / diagnosis
  • Sepsis / veterinary
  • Anti-Infective Agents

References

This article includes 83 references
  1. Singer M, Deutschman CS, Seymour CW, Shankar-Hari M, Annane D, Bauer M. The third international consensus definitions for sepsis and septic shock (Sepsis-3).. JAMA 2016;315:801-10.
  2. Hackett ES, Lunn DP, Ferris RA, Horohov DW, Lappin MR, McCue PM. Detection of bacteraemia and host response in healthy neonatal foals.. Equine Vet J 2015;47:405-9.
  3. Marsh P, Palmer J. Bacterial isolates from blood and their suspectibility patterns in critically ill foals: 543 cases (1991-1998).. J Am Vet Med Assoc 2001;218:1608-10.
  4. Nobre Pacifico Pereira KH, Fuchs KDM, Hibaru VY, Dos Santos C, Correia LE, Ferreira JCP. Neonatal sepsis in dogs: incidence, clinical aspects and mortality.. Theriogenology 2022;177:103-15.
  5. Otto C. Clinical trials in spontaneous disease in dogs: a new paradigm for investigations of sepsis.. J Vet Emerg Crit Care 2007;17:359-67.
  6. Otto C. Sepsis in veterinary patients: what do we know and where can we go?. J Vet Emerg Crit Care 2007;17:329-32.
  7. Rudd KE, Johnson SC, Agesa KM, Shackelford KA, Tsoi D, Kievlan DR. Global, regional, and national sepsis incidence and mortality, 1990-2017: analysis for the global burden of disease study.. Lancet 2020;395:200-11.
  8. Wong DM, Ruby RE, Dembek KA, Barr BS, Reuss SM, Magdesian KG. Evaluation of updated sepsis scoring systems and systemic inflammatory response syndrome criteria and their association with sepsis in equine neonates.. J Vet Intern Med 2018;32:1185-93.
  9. Wong DM, Wilkins PA. Defining the systemic inflammatory response syndrome in equine neonates.. Vet Clin North Am Equine Pract 2015;31:463-81.
  10. Weinstein MP, Murphy JR, Reller LB, Lichtenstein KA. The clinical significance of positive blood cultures: a comprehensive analysis of 500 episodes of bacteremia and fungemia in adults. II. Clinical observations, with special reference to factors influencing prognosis.. Rev Infect Dis 1983;5:54-70.
  11. Furr M, McKenzie H 3rd. Factors associated with the risk of positive blood culture in neonatal foals presented to a referral center (2000-2014).. J Vet Intern Med 2020;34:2738-50.
  12. Lee A, Mirrett S, Reller LB, Weinstein MP. Detection of bloodstream infections in adults: how many blood cultures are needed?. J Clin Microbiol 2007;45:3546-8.
  13. Theelen MJ, Wilson WD, Edman JM, Magdesian KG, Kass PH. Temporal trends in prevalence of bacteria isolated from foals with sepsis: 1979-2010.. Equine Vet J 2014;46:169-73.
  14. Woodford EC, Dhudasia MB, Puopolo KM, Skerritt LA, Bhavsar M, DeLuca J. Neonatal blood culture inoculant volume: feasibility and challenges.. Pediatr Res 2021;90:1086-92.
  15. Greiner M, Wolf G, Hartmann K. A retrospective study of the clinical presentation of 140 dogs and 39 cats with bacteraemia.. J Small Anim Pract 2008;49:378-83.
  16. Lamy B, Dargère S, Arendrup MC, Parienti JJ, Tattevin P. How to optimize the use of blood cultures for the diagnosis of bloodstream infections? A State-of-the Art. Front Microbiol 2016;7:697.
  17. Li J, Plorde JJ, Carlson LG. Effects of volume and periodicity on blood cultures.. J Clin Microbiol 1994;32:2829-31.
  18. Schelonka RL, Chai MK, Yoder BA, Hensley D, Brockett RM, Ascher DP. Volume of blood required to detect common neonatal pathogens.. J Pediatr 1996;129:275-8.
  19. Young A. Blood culture: indications and technique.. Equine Vet Educ 1990;2(1):38-40.
  20. Brewer B, Koterba A. Development of a scoring system for the early diagnosis of equine neonatal sepsis.. Equine Vet J 1988;20:18-22.
  21. Corley KT, Pearce G, Magdesian KG, Wilson WD. Bacteraemia in neonatal foals: clinicopathological differences between gram-positive and gram-negative infections, and single organism and mixed infections.. Equine Vet J 2007;39:84-9.
  22. Hollis AR, Wilkins PA, Palmer JE, Boston RC. Bacteremia in equine neonatal diarrhea: a retrospective study (1990-2007).. J Vet Intern Med 2008;22:1203-9.
  23. Fouché N, Gerber V, Thomann A, Perreten V. Antimicrobial susceptibility patterns of blood culture isolates from foals in Switzerland.. Schweiz Arch Tierheilkd 2018;160:665-71.
  24. Hytychová T, Bezděková B. Retrospective evaluation of blood culture isolates and sepsis survival rate in foals in The Czech Republic: 50 cases (2011-2013).. J Vet Emerg Crit Care 2015;25:660-6.
  25. Koterba AM, Brewer BD, Tarplee FA. Clinical and clinicopathological characteristics of the septicaemic neonatal foal: review of 38 cases.. Equine Vet J 1984;16:376-82.
  26. Russell CM, Axon JE, Blishen A, Begg AP. Blood culture isolates and antimicrobial sensitivities from 427 critically ill neonatal foals.. Aust Vet J 2008;86:266-71.
  27. Wilson W, Madigan J. Comparison of bacteriologic culture of blood and necropsy specimens for determining the cause of foal septicemia: 47 cases (1978-1987).. J Am Vet Med Assoc 1989;195:1759-63.
  28. Henderson B, Diaz M, Martins C, Kenney D, Baird JD, Arroyo LG. Valvular endocarditis in the horse: 20 cases (1993-2020).. Can Vet J 2020;61:1290-4.
  29. Johns I, Tennent-Brown B, Schaer BD, Southwood L, Boston R, Wilkins P. Blood culture status in mature horses with diarrhoea: a possible association with survival.. Equine Vet J 2009;41:160-4.
  30. Hann M, Timofte D, Isgren CM, Archer DC. Bacterial translocation in horses with colic and the potential association with surgical site infection: a pilot study.. Vet Rec 2020;187:68.
  31. Kern I, Bartmann CP, Verspohl J, Rohde J, Bienert-Zeit A. Bacteraemia before, during and after tooth extraction in horses in the absence of antimicrobial administration.. Equine Vet J 2017;49:178-82.
  32. Marr CM. Equine acquired Valvular disease.. Vet Clin North Am Equine Pract 2019;35:119-37.
  33. Hirsh DC, Jang SS, Biberstein EL. Blood culture of the canine patient.. J Am Vet Med Assoc 1984;184:175-8.
  34. Heilmann RM, Xenoulis PG, Barr JW, Dowd SE, Lawhon SD, Suchodolski JS. Comparison of PCR and conventional blood culture to analyze blood from dogs with suspected sepsis.. Vet J 2013;198:714-6.
  35. O'Reilly KL, Bauer RW, Freeland RL, Foil LD, Hughes KJ, Rohde KR. Acute clinical disease in cats following infection with a pathogenic strain of Bartonella henselae (LSU16).. Infect Immun 1999;67:3066-72.
  36. Aldridge BM, Garry FB, Adams R. Neonatal septicemia in calves: 25 cases (1985-1990).. J Am Vet Med Assoc 1993;203:1324-9.
  37. Biolatti C, Bellino C, Borrelli A, Capucchio M, Gianella P, Maurella C. Sepsis and bacterial suppurative meningitis-meningoencephalitis in critically ill neonatal Piedmontese calves: clinical approach and laboratory findings.. Schweiz Arch Tierheilkd 2012;154:239-46.
  38. Credille BC, Woolums AR, Giguère S, Robertson T, Overton MW, Hurley DJ. Prevalence of bacteremia in dairy cattle with acute puerperal metritis.. J Vet Intern Med 2014;28:1606-12.
  39. Houe H, Eriksen L, Jungersen G, Pedersen D, Krogh HV. Sensitivity, specificity and predictive value of blood cultures from cattle clinically suspected of bacterial endocarditis.. Vet Rec 1993;133:263-6.
  40. Wenz JR, Barrington GM, Garry FB, McSweeney KD, Dinsmore RP, Goodell G. Bacteremia associated with naturally occuring acute coliform mastitis in dairy cows.. J Am Vet Med Assoc 2001;219:976-81.
  41. Alonso-Menchén D, Muñoz P, Sánchez-Carrillo C, Pérez-Latorre L, Bouza E. Unresolved issues in the epidemiology and diagnosis of bacteremia: an opinion paper.. Rev Esp Quimioter 2022.
    doi: 10.37201/req/066.2022google scholar: lookup
  42. Coburn B, Morris AM, Tomlinson G, Detsky AS. Does this adult patient with suspected bacteremia require blood cultures?. JAMA 2012;308:502-11.
  43. Fabre V, Carroll KC, Cosgrove SE. Blood culture utilization in the hospital setting: a call for diagnostic stewardship.. J Clin Microbiol 2022;60:e0100521.
  44. Fabre V, Sharara SL, Salinas AB, Carroll KC, Desai S, Cosgrove SE. Does this patient need blood cultures? A scoping review of indications for blood cultures in adult nonneutropenic inpatients.. Clin Infect Dis 2020;71:1339-47.
  45. Long B, Koyfman A. Best clinical practice: blood culture utility in the emergency department.. J Emerg Med 2016;51:529-39.
  46. Ombelet S, Kpossou G, Kotchare C, Agbobli E, Sogbo F, Massou F. Blood culture surveillance in a secondary care hospital in Benin: epidemiology of bloodstream infection pathogens and antimicrobial resistance.. BMC Infect Dis 2022;22:119.
  47. Woods-Hill CZ, Koontz DW, King AF, Voskertchian A, Colantuoni EA, Miller MR. Practices, perceptions, and attitudes in the evaluation of critically ill children for bacteremia: a National Survey.. Pediatr Crit Care Med 2020;21:e23-9.
  48. Cockerill FR 3rd, Wilson JW, Vetter EA, Goodman KM, Torgerson CA, Harmsen WS. Optimal testing parameters for blood cultures.. Clin Infect Dis 2004;38:1724-30.
  49. Riedel S, Bourbeau P, Swartz B, Brecher S, Carroll KC, Stamper PD. Timing of specimen collection for blood cultures from febrile patients with bacteremia.. J Clin Microbiol 2008;46:1381-5.
  50. Giguère S, Weber EJ, Sanchez LC. Factors associated with outcome and gradual improvement over time in 1065 equine neonates admitted to an intensive care unit.. Equine Vet J 2017;49:45-50.
  51. Washington JA 2nd. Blood cultures: principles and techniques.. Mayo Clin Proc 1975;50:91-8.
  52. Ekwall-Larson A, Yu D, Dinnétz P, Nordqvist H, Özenci V. Single-site sampling versus multisite sampling for blood cultures: a retrospective clinical study.. J Clin Microbiol 2022;60:e0193521.
  53. Rand KH, Beal SG, Rivera K, Allen B, Payton T, Lipori GP. Hourly effect of pretreatment with IV antibiotics on blood culture positivity rate in emergency department patients.. Open Forum Infect Dis 2019;6:ofz179.
  54. Maeda N, Mori N, Shinjoh M, Komiyama O, Takahashi T. Comparison of 0.5% chlorhexidine gluconate alcohol with 10% povidone-iodine for skin disinfection in children to prevent blood culture contamination.. J Infect Chemother 2021;27:1027-32.
  55. Ota K, Oba K, Fukui K, Ito Y, Hamada E, Mori N. Sites of blood collection and topical antiseptics associated with contaminated cultures: prospective observational study.. Sci Rep 2021;11:6211.
  56. Sanders AM, Agger WA, Gray AM, Fischer CM, Kamprud EA. Use of hair nets and face masks to decrease blood culture contamination rates.. Diagn Microbiol Infect Dis 2019;95:15-9.
  57. Washer LL, Chenoweth C, Kim HW, Rogers MA, Malani AN, Riddell J 4th. Blood culture contamination: a randomized trial evaluating the comparative effectiveness of 3 skin antiseptic interventions.. Infect Control Hosp Epidemiol 2013;34:15-21.
  58. Ling CL, Roberts T, Soeng S, Cusack TP, Dance DAB, Lee SJ. Impact of delays to incubation and storage temperature on blood culture results: a multi-Centre study.. BMC Infect Dis 2021;21:173.
  59. Higgins R, Goyette G, Sauvageau R, Lemaire T. Septicemia due to listeria monocytogenes in a newborn foal.. Can Vet J 1987;28:63.
  60. Jose-Cunilleras E, Hinchcliff KW. Listeria monocytogenes septicemia in foals.. Equine Vet J 2001;33:519-22.
  61. Lawhon SD, Lopez FR, Joswig A, Black HC, Watts AE, Norman TE. Weissella confusa septicemia in a foal.. J Vet Diagn Invest 2014;26:150-3.
  62. Wallace SS, Hathcock TL. Listeria monocytogenes septicemia in a foal.. J Am Vet Med Assoc 1995;207:1325-6.
  63. Wilkins PA, Marsh PS, Acland H, Del Piero F. Listeria monocytogenes septicemia in a thoroughbred foal.. J Vet Diagn Invest 2000;12:173-6.
  64. Willis AT, Magdesian KG, Byrne BA, Edman JM. Enterococcus infections in foals.. Vet J 2019;248:42-7.
  65. Kempker JA, Martin GS. The changing epidemiology and definitions of sepsis.. Clin Chest Med 2016;37:165-79.
  66. Martin GS, Mannino DM, Eaton S, Moss M. The epidemiology of sepsis in the United States from 1979 through 2000.. N Engl J Med 2003;348:1546-54.
  67. Ryan C, Giguère S, Hagen J, Hartnett C, Kalyuzhny A. Effect of age and mitogen on the frequency of interleukin-4 and interferon gamma secreting cells in foals and adult horses as assessed by an equine-specific ELISPOT assay.. Vet Immunol Immunopathol 2010;133:66-71.
  68. Theelen MJP, Wilson WD, Byrne BA, Edman JM, Kass PH, Mughini-Gras L. Differences in isolation rate and antimicrobial susceptibility of bacteria isolated from foals with sepsis at admission and after ≥48 hours of hospitalization.. J Vet Intern Med 2020;34:955-63.
  69. Dharmapalan D, Shet A, Yewale V, Sharland M. High reported rates of antimicrobial resistance in Indian neonatal and pediatric blood stream infections.. J Pediatric Infect Dis Soc 2017;6:e62-8.
  70. Wang J, Zhang H, Yan J, Zhang T. Literature review on the distribution characteristics and antimicrobial resistance of bacterial pathogens in neonatal sepsis.. J Matern Fetal Neonatal Med 2022;35:861-70.
  71. Underwood JC, Harvey RW, Metge DW, Repert DA, Baumgartner LK, Smith RL. Effects of the antimicrobial sulfamethoxazole on groundwater bacterial enrichment.. Environ Sci Technol 2011;45:3096-101.
  72. Platt H. Septicemia in the foal: a review of 61 cases.. Br Vet J 1973;129:221-9.
  73. Whitwell KE. Investigations into fetal and neonatal losses in the horse.. Vet Clin North Am Large Anim Pract 1980;2:313-31.
  74. Love BC, Rostagno MH. Comparison of five culture methods for salmonella isolation from swine fecal samples of known infection status.. J Vet Diagn Invest 2008;20:620-4.
  75. Myles IA, Reckhow JD, Williams KW, Sastalla I, Frank KM, Datta SK. A method for culturing gram-negative skin microbiota.. BMC Microbiol 2016;16:60.
  76. Doern GV, Carroll KC, Diekema DJ, Garey KW, Rupp ME, Weinstein MP. Practical guidance for clinical microbiology laboratories: a comprehensive update on the problem of blood culture contamination and a discussion of methods for addressing the problem.. Clin Microbiol Rev 2019;33(1):e00009-19.
  77. Smith DA, Nehring SM. Bacteremia.. StatPearls, StatPearls Publishing 2022.
  78. Book M, Lehmann LE, Zhang X, Stüber F. Monitoring infection: from blood culture to polymerase chain reaction (PCR).. Best Pract Res Clin Anaesthesiol 2013;27:279-88.
  79. Luethy PM, Johnson JK. The use of matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) for the identification of pathogens causing sepsis.. J Appl Lab Med 2019;3:675-85.
  80. Pusterla N, Mapes S, Byrne BA, Magdesian KG. Detection of bloodstream infection in neonatal foals with suspected sepsis using real-time PCR.. Vet Rec 2009;165:114-7.
  81. Uchida-Fujii E, Niwa H, Kinoshita Y, Nukada T. Matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) for identification of bacterial isolates from horses.. J Equine Vet Sci 2020;95:103276.
  82. Brewer B, Koterba A, Rowe E. Comparison of empirically developed sepsis score with a computer generated and weighted scoring system for the identification of sepsis in the equine neonate.. Equine Vet J 1988;20:23-4.
  83. Sparks R, Harada A, Chavada R, Trethewy C. Comparison of different sepsis scoring systems and pathways: qSOFA, SIRS, Shapiro criteria and CEC SEPSIS KILLS pathway in bacteraemic and non-bacteraemic patients presenting to the emergency department.. BMC Infect Dis 2022;22:76.

Citations

This article has been cited 6 times.
  1. Chen LT, Wesdorp E, Jager M, Siegers EW, Theelen MJP, Besselink N, Vermeulen C, Zomer AL, Broens EM, Wagenaar JA, de Ridder J. Bacterial cell-free DNA profiling reveals the co-elevation of multiple bacteria in newborn foals with suspected sepsis. iScience 2025 Dec 19;28(12):114005.
    doi: 10.1016/j.isci.2025.114005pubmed: 41476946google scholar: lookup
  2. Graham AE, Colgate VA, Floyd EF. Antibiograms of Bacterial Cultures From Equine Neonates at a United Kingdom Hospital: 381 Samples (2018-2023). J Vet Intern Med 2025 Sep-Oct;39(5):e70198.
    doi: 10.1111/jvim.70198pubmed: 40802493google scholar: lookup
  3. Rachidi F, Elhadi A, Bittner-Schwerda L, Schären-Bannert M, Köller G, Schinköthe J, Majcher A, Diehl B, Hansmann F, Kühn T, Starke A. Case Report: Clinical, laboratory, and pathological findings in cows with osteomyelitis of the ribs and sternum and endocarditis valvularis thromboticans. Front Vet Sci 2025;12:1589472.
    doi: 10.3389/fvets.2025.1589472pubmed: 40717917google scholar: lookup
  4. Borriello G, Valentini F, Ferrini S, Di Muro G, Cagnotti G, Grego E, Catania AM, Stella MC, Ala U, Nebbia P, D'Angelo A, Bellino C. Characterization of blood microbial population in beef calves with clinical signs of sepsis using 16S rRNA gene sequencing. PLoS One 2025;20(5):e0324469.
    doi: 10.1371/journal.pone.0324469pubmed: 40408396google scholar: lookup
  5. Wilkins PA, Wong D, Slovis NM, Collins N, Barr BS, MacKenzie C, De Solis CN, Castagnetti C, Mariella J, Burns T, Perkins G, Delvescovo B, Sanchez LC, Kemper AM, Magdesian KG, Bedenice D, Taylor SD, Gold J, Dunkel B, Pranzo G, Constable PD. The Systemic Inflammatory Response Syndrome and Predictors of Infection and Mortality in 1068 Critically Ill Newborn Foals. J Vet Intern Med 2025 Mar-Apr;39(2):e70004.
    doi: 10.1111/jvim.70004pubmed: 40091577google scholar: lookup
  6. Pas ML, Boyen F, Castelain D, Chantillon L, Paepe D, Pille F, Pardon B, Bokma J. Bayesian evaluation of sensitivity and specificity of blood culture media and hypoglycemia in sepsis-suspected calves. J Vet Intern Med 2024 May-Jun;38(3):1906-1916.
    doi: 10.1111/jvim.17040pubmed: 38526076google scholar: lookup
Subscribe to our newsletter
Join 99,850 horse owners like you who receive our email updates on horse health and nutrition.