Pleural Empyema in Six Horses: A Retrospective Case Series.
Abstract: The clinical findings of pleural empyema in six horses were retrospectively studied using epidemiological, clinical pathology, microbiological, ultrasound, and post-mortem data. The clinical findings included tachycardia (n = 3/6), tachypnea (n = 6/6), cyanotic mucosa (n = 2/6), hyperthermia (n = 4/6), inspiratory or mixed dyspnea (n = 6/6), presence of fluid and/or pleural rubbing (n = 2/6) and coarse crackling on auscultation (n = 4/6). Horses demonstrated leukocytosis (16.22 × 103/µL) with neutrophilia (12.32 × 103/µL) and hyperfibrinogenemia (633.33 mg/dL) and an increase in urea (69.80 mg/kg) and globulins (5.22 g/dL). The pleural fluid exhibited exudate (n = 5/6). The pathogens isolated from transtracheal wash (TTW) and/or pleural effusion included Aspergillus fumigatus, Enterobacter cloacae, alpha and beta hemolytic Streptococcus, Pseudomonas aeruginosa, Salmonella sp., Streptococcus equi subsp. zooepidemicus, and beta hemolytic Staphylococcus. The in vitro tests of microbial sensitivity of the isolates revealed that ceftiofur (5/6) and penicillin (3/6) were the most effective drugs. The fatality rate was 83% (5/6). The main post-mortem finding was the presence of fibrin in the pleural cavity with adhesion between the parietal and visceral pleura. These results show that pleural empyema is a complex disease pathophysiology that is refractory to conventional treatment.
Copyright © 2023. Published by Elsevier Inc.
Publication Date: 2023-08-27 PubMed ID: 37643695DOI: 10.1016/j.jevs.2023.104912Google Scholar: Lookup
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Summary
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The research article presents a retrospective case study of pleural empyema in six horses. The study investigates the clinical, epidemiological, microbiological, and other key aspects of the condition and its treatment.
Clinical Findings
The research starts by summarizing the clinical symptoms observed in the six horses with pleural empyema. These symptoms were:
- Tachycardia was observed in 3 out of 6 horses.
- All six showed signs of tachypnea, a condition marked by an accelerated breathing rate.
- Cyanotic mucosa, a sign of insufficient oxygenation, was noticed in 2 out of 6 horses.
- Four horses displayed hyperthermia, or high body temperature.
- All six horses manifested either inspiratory or mixed dyspnea, indicating difficulties in breathing.
- Presence of fluid and/or pleural rubbing was detected in 2 horses.
- On auscultation, coarse crackling sounds were heard in 4 horses. This is generally a sign of fluid accumulation in the lungs.
Pathological and Microbiological Findings
Further insights were generated from the clinical pathology and microbiological data of the horses. These findings included:
- Elevated levels of leukocytes (white blood cells) indicated an ongoing immune response in the horses.
- The horses also showed signs of neutrophilia, which implies an increase in a specific type of white blood cell called neutrophils.
- The horses exhibited elevated levels of fibrinogen, another sign of inflammation and infection.
- An increase in urea and globulins was also noted, suggesting possible kidney dysfunction and an ongoing immune response, respectively.
- Pleural fluid exudate was found in 5 out of 6 horses, further evidence of pleural empyema.
- Pathogens found in the fluid samples taken from the horses included Aspergillus fumigatus, Enterobacter cloacae, several types of Streptococcus, Pseudomonas aeruginosa, Salmonella sp., and Staphylococcus.
Medicinal Findings and Mortality Rate
Further findings of the research were in terms of medicinal sensitivity and the mortality rate of the horses.
- According to in vitro sensitivity tests, ceftiofur and penicillin proved to be the most effective drugs against the isolated pathogens in 5 and 3 horses respectively.
- The fatality rate among the subjects was found to be quite high, with 5 of the 6 horses not surviving the disease.
Post Mortem Findings and Conclusion
Post mortem examinations also revealed important findings related to pleural empyema.
- The main finding was the detection of fibrin in the pleural cavity, with adherence noted between the parietal and visceral pleura.
The study concludes by emphasizing that pleural empyema is a complex disease with a pathophysiology that can be resistant to conventional treatment.
Cite This Article
APA
Battistin L, Cerri FM, Watanabe MJ, Takahira RK, Ribeiro MG, Rocha NS, de Oliveira-Filho JP, Borges AS, Amorim RM.
(2023).
Pleural Empyema in Six Horses: A Retrospective Case Series.
J Equine Vet Sci, 130, 104912.
https://doi.org/10.1016/j.jevs.2023.104912 Publication
Researcher Affiliations
- Veterinary Clinic Department, Botucatu, Sao Paulo, Brazil.
- Veterinary Clinic Department, Botucatu, Sao Paulo, Brazil.
- Veterinary Surgery and Animal Reproduction Department, Botucatu, Sao Paulo, Brazil.
- Veterinary Clinic Department, Botucatu, Sao Paulo, Brazil.
- Preventive Veterinary Medicine and Animal Production, Botucatu, Sao Paulo, Brazil.
- Veterinary Clinic Department, Botucatu, Sao Paulo, Brazil.
- Veterinary Clinic Department, Botucatu, Sao Paulo, Brazil.
- Veterinary Clinic Department, Botucatu, Sao Paulo, Brazil.
- Veterinary Clinic Department, Botucatu, Sao Paulo, Brazil. Electronic address: rogerio.amorim@unesp.br.
Conflict of Interest Statement
Declaration of Competing Interest There was no conflict of interest.
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