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Perina F, Mariella J, Ellero N, Freccero F, Castagnetti C, Lanci A. Retrospective analysis of factors associated with umbilical diseases in foals. J Equine Vet Sci 2024; 135:105045. [PMID: 38471637 DOI: 10.1016/j.jevs.2024.105045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 02/20/2024] [Accepted: 03/09/2024] [Indexed: 03/14/2024]
Abstract
In neonatal foals, umbilical remnants can be affected by infectious and non-infectious diseases. This study aimed to retrospectively evaluate historical, management and clinical factors that may be related to the occurrence of umbilical remnant diseases. Clinical reports of foals born or hospitalized within 24 h of life during the 2017-2021 foaling seasons were reviewed. Forty/183 foals (21.9 %) developed umbilical remnant diseases (URD group), while 143/183 foals (78.1 %) had normal umbilical remnants (NUR group). In the URD group, 24/40 (60 %) had a patent urachus, 16/40 (40 %) omphalo-arteritis, 4/40 (10 %) omphalo-phlebitis, 10/40 (25 %) urachitis, 9/40 (22.5 %) abscess, 3/40 (7.5 %) periumbilical hematoma and 12/40 (30 %) more than one condition. URD frequency was higher in foals hospitalized after birth than in those born at the hospital (17/46 vs 23/137; P = 0.0068), lower in those that had access to the paddock before three days of life (p = 0.0426) and higher in recumbent foals (P = 0.0001). URD occurred more frequently after dystocia (P = 0.0068), prolonged stage II parturition (19±20.51 min vs 13±6.41 in NUR group; P = 0.0279), traction at parturition (P = 0.0005), and in foals with lower APGAR scores (8±1.72 vs 9±0.86 in NUR; P = 0.0063). Sepsis (P = 0.0245), neonatal encephalopathy (P = 0.0014), meconium retention (P = 0.0241) and congenital flexural limb deformities (P = 0.0049) were the most common associated diseases. Umbilical cord (UC) coiling, abnormal UC rupture, umbilical hemorrhage and increased umbilical stump volume occurred more frequently in URD than in NUR group (P = 0.0329, P = 0.0191, P = 0.0007 and P < 0.00001, respectively). Recognition of the identified predisposing historical, management and clinical factors should prompt careful umbilical remnant monitoring in neonatal foals.
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Affiliation(s)
- F Perina
- Department of Veterinary Medical Sciences, Bologna Università, Via Tolara di Sopra 50, Ozzano dell'Emilia 40064, Italy.
| | - J Mariella
- Department of Veterinary Medical Sciences, Bologna Università, Via Tolara di Sopra 50, Ozzano dell'Emilia 40064, Italy
| | - N Ellero
- Department of Veterinary Medical Sciences, Bologna Università, Via Tolara di Sopra 50, Ozzano dell'Emilia 40064, Italy
| | - F Freccero
- Department of Veterinary Medical Sciences, Bologna Università, Via Tolara di Sopra 50, Ozzano dell'Emilia 40064, Italy
| | - C Castagnetti
- Department of Veterinary Medical Sciences, Bologna Università, Via Tolara di Sopra 50, Ozzano dell'Emilia 40064, Italy; Health Sciences and Technologies Interdepartmental Center for Industrial Research (CIRI-SDV), Bologna University, 40100, Italy
| | - A Lanci
- Department of Veterinary Medical Sciences, Bologna Università, Via Tolara di Sopra 50, Ozzano dell'Emilia 40064, Italy
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Samuels AN, Kamr AM, Reed SM, Slovis NM, Hostnik LD, Burns TA, Toribio RE. Association of the neutrophil-lymphocyte ratio with outcome in sick hospitalized neonatal foals. J Vet Intern Med 2024; 38:1196-1206. [PMID: 38284437 PMCID: PMC10937482 DOI: 10.1111/jvim.16995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 01/12/2024] [Indexed: 01/30/2024] Open
Abstract
BACKGROUND The neutrophil-lymphocyte ratio (NLR) in human medicine is an objective biomarker that reflects prognosis. The NLR as an independent biomarker to help predict nonsurvival in hospitalized neonatal foals has not been thoroughly interrogated. OBJECTIVES/HYPOTHESIS Retrospectively evaluate if the NLR at admission is associated with nonsurvival in sick hospitalized foals <4 days old. We hypothesized that a lower NLR will be associated with nonsurvival. ANIMALS One thousand one hundred ninety-six client-owned foals <4 days old of any breed and sex: 993 hospitalized foals and 203 healthy foals. METHODS Retrospective multicenter study. Medical records of foals presenting to 3 equine referral hospitals were reviewed. Foals were included if they had complete CBCs, sepsis scores, and outcome data. The NLR was calculated by dividing the absolute neutrophil count by the absolute lymphocyte count. Data were analyzed by nonparametric methods and univariate analysis. RESULTS Of the 993 sick hospitalized foals, 686 were sick nonseptic and 307 were septic. The median NLR was lower in sick hospitalized foals (median [95% confidence interval], 3.55 [0.5-13.9]) compared with healthy foals (6.61 [3.06-18.1]). Septic foals had the lowest NLR (2.00 [0.20-9.71]). The NLR was lower in nonsurviving (1.97 [1.67-2.45]) compared with surviving foals (4.10 [3.76-4.33]). Nonsurviving septic foals had the lowest NLR (1.47 [1.70-3.01]). Foals with a NLR of <3.06 or <1.6 at admission had odds ratio of 3.21 (2.24-4.29) and 4.03 (2.86-5.67) for nonsurvival, respectively. CONCLUSIONS AND CLINICAL IMPORTANCE A NLR < 3.06 at admission in sick hospitalized foals is readily available and clinically useful variable to provide prognostic information.
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Affiliation(s)
- Amanda N. Samuels
- Department of Veterinary Clinical Sciences, College of Veterinary MedicineThe Ohio State UniversityColumbusOhioUSA
| | - Ahmed M. Kamr
- Department of Veterinary Clinical Sciences, College of Veterinary MedicineThe Ohio State UniversityColumbusOhioUSA
| | | | | | - Laura D. Hostnik
- Department of Veterinary Clinical Sciences, College of Veterinary MedicineThe Ohio State UniversityColumbusOhioUSA
| | - Teresa A. Burns
- Department of Veterinary Clinical Sciences, College of Veterinary MedicineThe Ohio State UniversityColumbusOhioUSA
| | - Ramiro E. Toribio
- Department of Veterinary Clinical Sciences, College of Veterinary MedicineThe Ohio State UniversityColumbusOhioUSA
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Elder E, Wong D, Johnson K, Robertson H, Marner M, Dembek K. Assessment of the hypothalamic-pituitary-adrenocortical axis function using a vasopressin stimulation test in neonatal foals. J Vet Intern Med 2023; 37:1881-1888. [PMID: 37432047 PMCID: PMC10473012 DOI: 10.1111/jvim.16808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 06/27/2023] [Indexed: 07/12/2023] Open
Abstract
BACKGROUND Bacterial sepsis is the leading cause of death in foals and is associated with hypothalamic-pituitary-adrenocortical axis (HPAA) dysfunction. HPAA function can be evaluated by an arginine-vasopressin (AVP) stimulation test. HYPOTHESES/OBJECTIVES Administration of AVP will stimulate a dose-dependent rise in systemic adrenocorticotropin-releasing hormone (ACTH) and cortisol in neonatal foals. There will be no response seen in corticotropin-releasing hormone (CRH) and baseline AVP will be within reference interval. ANIMALS Twelve neonatal foals, <72 hours old. METHODS HPAA function was assessed in foals utilizing 3 doses of AVP (2.5, 5, and 7.5 IU), administered between 24 and 48 hours of age in this randomized cross-over study. Cortisol, ACTH, CRH and AVP were measured at 0 (baseline), 15, 30, 60 and 90 minutes after AVP administration with immunoassays. The fold increase in cortisol and ACTH was calculated at 15 and 30 minutes compared to baseline. RESULTS All doses of AVP resulted in a significant increase in cortisol concentration over time, and a dose-dependent increase in ACTH concentration over time. ACTH and cortisol were significantly increased at 15 and 30 minutes, respectively after all 3 doses of AVP compared to baseline (P < .01). There was no change in endogenous CRH after stimulation with AVP. CONCLUSION AND CLINICAL IMPORTANCE Administration of AVP is safe and results in a significant rise in ACTH and cortisol in neonatal foals. A stimulation test with AVP (5 IU) can be considered for HPAA assessment in septic foals.
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Affiliation(s)
- Erin Elder
- Department of Clinical Sciences, College of Veterinary MedicineNorth Carolina State UniversityRaleighNorth CarolinaUSA
| | - David Wong
- Department of Clinical Sciences, College of Veterinary MedicineIowa State UniversityAmesIowaUSA
| | - Katheryn Johnson
- Department of Clinical Sciences, College of Veterinary MedicineIowa State UniversityAmesIowaUSA
| | - Hannah Robertson
- Department of Clinical Sciences, College of Veterinary MedicineNorth Carolina State UniversityRaleighNorth CarolinaUSA
| | | | - Katarzyna Dembek
- Department of Clinical Sciences, College of Veterinary MedicineNorth Carolina State UniversityRaleighNorth CarolinaUSA
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Morales-Vázquez MM, Meza-Serrano E, Lara-Pereyra I, Acuña-González RJ, Alonso-Morales R, Hayen-Valles S, Boeta AM, Zarco L, Lozano-Cuenca J, López-Canales JS, Flores-Herrera H. Equine Placentitis in Mares Induces the Secretion of Pro-Inflammatory Cytokine eIL-1β and the Active Extracellular Matrix Metalloproteinase (MMP)-9. Vet Sci 2023; 10:532. [PMID: 37756054 PMCID: PMC10536981 DOI: 10.3390/vetsci10090532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 08/05/2023] [Accepted: 08/09/2023] [Indexed: 09/28/2023] Open
Abstract
Equine placentitis is characterized by infection and inflammation of the placenta. Different biomarkers associated with this inflammatory response have been evaluated in experimentally induced equine placentitis, but not in pregnant mares with spontaneous placentitis. The aim of the current study was to determine the concentration of eIL-1β and the activity of proMMP-2 and proMMP-9 in the serum of healthy mares and mares with placentitis on days 240 and 320 of gestation to explore whether these biomarkers are associated with equine maternal placentitis and/or with the birth of an infected or inviable foals. Serum samples were collected from sixteen pregnant English Thoroughbred mares, retrospectively classified as follows: (1) healthy mares with full-term gestation; and (2) mares with ultrasonographic signs of placentitis. The health of each foal was examined at birth, and it was decided to classify the cases into four groups: (1) healthy mares delivering a healthy foals (HM-HF, n = 6); (2) mares with USP delivering a healthy foal (USP-HF, n = 3); (3) mares with USP delivering a live septic foal (USP-LSeF, n = 4); and (4) mares with USP delivering a dead foal (USP-DF, n = 3). eIL-1β was quantified by ELISA, and proMMP-2 and proMMP-9 activity by gelatin zymography electrophoresis. In healthy mares, the serum concentrations of eIL-1β underwent a significant 16.5-fold increase from day 240 to day 320 of gestation. Although similar results were found in the mares with ultrasonographic signs of placentitis that delivered a healthy foal, those delivering a live septic or nonviable foal exhibited much higher concentrations of eIL-1β. proMMP-2 and proMMP-9 activity was not associated with maternal placentitis, foal infection, or death. Hence, the presence of placentitis severe enough to affect the health of the foal can be confirmed or discarded by determining the eIL-1β concentration in mares that have shown ultrasonographic signs of placentitis.
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Affiliation(s)
- María Margarita Morales-Vázquez
- Departamento de Immunobioquímica, Instituto Nacional de Perinatología “Isidro Espinosa de los Reyes” INPerIER, Ciudad de México 11000, CP, Mexico; (M.M.M.-V.); (R.J.A.-G.)
- Departamento de Reproducción, Facultad de Medicina Veterinaria y Zootecnia, Universidad Nacional Autónoma de México, Ciudad Universitaria, Ciudad de México 04510, CP, Mexico; (E.M.-S.); (S.H.-V.); (A.M.B.)
| | - Europa Meza-Serrano
- Departamento de Reproducción, Facultad de Medicina Veterinaria y Zootecnia, Universidad Nacional Autónoma de México, Ciudad Universitaria, Ciudad de México 04510, CP, Mexico; (E.M.-S.); (S.H.-V.); (A.M.B.)
| | - Irlando Lara-Pereyra
- Departamento de Ginecología, Hospital General de Zona 252, Instituto Mexicano del Seguro Social, Atlacomulco 28984, Mexico
| | - Ricardo Josué Acuña-González
- Departamento de Immunobioquímica, Instituto Nacional de Perinatología “Isidro Espinosa de los Reyes” INPerIER, Ciudad de México 11000, CP, Mexico; (M.M.M.-V.); (R.J.A.-G.)
| | - Rogelio Alonso-Morales
- Genética, Laboratorio de Biotecnologías, Facultad de Medicina Veterinaria y Zootecnia, Universidad Nacional Autónoma de México, Ciudad Universitaria, Ciudad de México 04510, CP, Mexico;
| | - Sergio Hayen-Valles
- Departamento de Reproducción, Facultad de Medicina Veterinaria y Zootecnia, Universidad Nacional Autónoma de México, Ciudad Universitaria, Ciudad de México 04510, CP, Mexico; (E.M.-S.); (S.H.-V.); (A.M.B.)
| | - Ana Myriam Boeta
- Departamento de Reproducción, Facultad de Medicina Veterinaria y Zootecnia, Universidad Nacional Autónoma de México, Ciudad Universitaria, Ciudad de México 04510, CP, Mexico; (E.M.-S.); (S.H.-V.); (A.M.B.)
| | - Luis Zarco
- Centro de Enseñanza, Investigación y Extensión en Producción Ovina, Facultad de Medicina Veterinaria y Zootecnia, Universidad Nacional Autónoma de México, Tres Marías, Ciudad de México 62515, Mexico;
| | - Jair Lozano-Cuenca
- Departamento de Fisiología y Desarrollo Celular, Instituto Nacional de Perinatología “Isidro Espinosa de los Reyes” INPerIER, Ciudad de México 11000, Mexico; (J.L.-C.); (J.S.L.-C.)
| | - Jorge Skiold López-Canales
- Departamento de Fisiología y Desarrollo Celular, Instituto Nacional de Perinatología “Isidro Espinosa de los Reyes” INPerIER, Ciudad de México 11000, Mexico; (J.L.-C.); (J.S.L.-C.)
- Sección de Estudios de Posgrado e Investigación, Escuela Superior de Medicina del Instituto Politécnico Nacional, Ciudad de México 11340, Mexico
| | - Héctor Flores-Herrera
- Departamento de Immunobioquímica, Instituto Nacional de Perinatología “Isidro Espinosa de los Reyes” INPerIER, Ciudad de México 11000, CP, Mexico; (M.M.M.-V.); (R.J.A.-G.)
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Scalco R, de Oliveira GN, da Rosa Curcio B, Wooten M, Magdesian KG, Hidai ST, Pandit P, Aleman M. Red blood cell distribution width to platelet ratio in neonatal foals with sepsis. J Vet Intern Med 2023; 37:1552-1560. [PMID: 37306395 PMCID: PMC10365058 DOI: 10.1111/jvim.16793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 05/26/2023] [Indexed: 06/13/2023] Open
Abstract
BACKGROUND Rapid and accurate markers to aid diagnosis of sepsis are needed in neonatal foals. The CBC variable red blood cell distribution width (RDW) to platelet ratio (RPR) is associated with inflammatory response and linked to poor outcomes of sepsis in human patients. HYPOTHESIS Explore the correlation of RPR with sepsis in neonatal foals and evaluate RPR predictive and prognostic value. ANIMALS Three hundred seventeen hospitalized neonatal foals ≤7 days of age that had a CBC and physical exam performed at admission between 2012 and 2021. METHODS Retrospective case-control study. Clinical records were used to calculate sepsis scores and define groups. Red blood cell distribution width to platelet ratio was calculated and compared between groups (septic vs nonseptic) based on Kruskal-Wallis and Wilcoxon signed-rank tests. A multivariate logistic regression model to predict sepsis was created. The cutoff for RPR was obtained based on the maximal Youden Index. The Kaplan-Meier method and the log-rank test were used to estimate survival curves and compare survival rates based on RPR. RESULTS Red blood cell distribution width to platelet ratio was significantly higher in septic foals (Median = 0.099, confidence interval [CI] [0.093; 0.108]) than in sick nonseptic (0.085, CI [0.083; 0.089]) and healthy foals (0.081, CI [0.077; 0.086]; P < .0001). Red blood cell distribution width to platelet ratio was able to predict sepsis with high accuracy (AUC = 82.1%). The optimal RPR cutoff for sepsis was 0.09. CONCLUSIONS AND CLINICAL IMPORTANCE Red blood cell distribution width to platelet ratio calculation is practical, inexpensive, and based on CBC-derived data. Calculation of RPR along with CBC can aid in the diagnosis of sepsis and estimation of outcome.
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Affiliation(s)
- Rebeca Scalco
- Department of Medicine and Epidemiology, School of Veterinary MedicineUniversity of CaliforniaDavisCaliforniaUSA
- Present address:
Department of Pathology & Laboratory MedicineSchool of Medicine, University of CaliforniaSacramentoCaliforniaUSA
| | - Gabriela Novo de Oliveira
- Department of Medicine and Epidemiology, School of Veterinary MedicineUniversity of CaliforniaDavisCaliforniaUSA
| | - Bruna da Rosa Curcio
- Department of Veterinary Clinics, School of Veterinary MedicineUniversidade Federal de Pelotas‐RSPelotasBrazil
| | - McCaide Wooten
- Department of Medicine and Epidemiology, School of Veterinary MedicineUniversity of CaliforniaDavisCaliforniaUSA
- Present address:
Faculty of Veterinary MedicineUniversity of CalgaryCalgaryAlbertaCanada
| | - K. Gary Magdesian
- Department of Medicine and Epidemiology, School of Veterinary MedicineUniversity of CaliforniaDavisCaliforniaUSA
| | - Stephanie Takako Hidai
- Department of Medicine and Epidemiology, School of Veterinary MedicineUniversity of CaliforniaDavisCaliforniaUSA
| | - Pranav Pandit
- EpiCenter for Disease Dynamics, One Health Institute, School of Veterinary MedicineUniversity of CaliforniaDavisCaliforniaUSA
| | - Monica Aleman
- Department of Medicine and Epidemiology, School of Veterinary MedicineUniversity of CaliforniaDavisCaliforniaUSA
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Eaton S. Neonatal sepsis – Pathology and clinical signs. EQUINE VET EDUC 2023. [DOI: 10.1111/eve.13796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/30/2023]
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Scalco R, Aleman M, Nogueira CEW, Freitas NB, Curcio BR. Red cell distribution width values and red cell distribution width-to-platelet ratio in Thoroughbred foals in the first 24 hours of life. J Vet Emerg Crit Care (San Antonio) 2023; 33:217-222. [PMID: 36537889 DOI: 10.1111/vec.13274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Revised: 02/19/2022] [Accepted: 02/24/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVES To report red cell distribution width (RDW) values, to calculate RDW-to-platelet ratio (RPR), and to investigate a possible correlation of RDW and RPR index values in neonatal foals classified as healthy or at risk based on clinical information from a population of foals up to 24 hours of life. DESIGN Retrospective study conducted from records and CBCs of foals born between June and November from 2018 to 2020 foaling seasons. SETTING Breeding farm. ANIMALS Three hundred and nine neonatal full-term Thoroughbred foals. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS Foals were evaluated by a veterinarian within 15 minutes after birth, and a blood sample was collected within 24 hours of life. Based on clinical information, 88 of 309 foals (28.4%) were considered at risk of perinatal disease, and 201 were healthy. Mean gestational age for the foals was 346.3 ± 9.7 days. RDW values did not differ between groups. Gestational length demonstrated to have a negative correlation with RDW (r = -0.156, P = 0.005) and mean corpuscular volume (r = -0.135, P = 0.01), indicating a link of these variables to foal maturity. RPR index was higher for at-risk (0.073 ± 0.018) than for healthy foals (0.068 ± 0.014, P = 0.01). CONCLUSION RPR might be a promising early indicator of disease for the field triage of neonatal foals.
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Affiliation(s)
- Rebeca Scalco
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, Davis, California, USA
- Departamento de Clínicas Veterinária, Faculdade de Medicina Veterinária, Universidade Federal de Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | - Monica Aleman
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, Davis, California, USA
| | - Carlos E W Nogueira
- Departamento de Clínicas Veterinária, Faculdade de Medicina Veterinária, Universidade Federal de Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | - Natalia B Freitas
- Departamento de Clínicas Veterinária, Faculdade de Medicina Veterinária, Universidade Federal de Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | - Bruna R Curcio
- Departamento de Clínicas Veterinária, Faculdade de Medicina Veterinária, Universidade Federal de Pelotas, Pelotas, Rio Grande do Sul, Brazil
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Laurberg M, Saegerman C, Jacobsen S, Berg LC, Laursen SH, Hoeberg E, Sånge EA, van Galen G. Use of admission serum neutrophil gelatinase-associated lipocalin (NGAL) concentrations as a marker of sepsis and outcome in neonatal foals. PLoS One 2023; 18:e0285819. [PMID: 37200285 DOI: 10.1371/journal.pone.0285819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Accepted: 05/02/2023] [Indexed: 05/20/2023] Open
Abstract
BACKGROUND 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. OBJECTIVES To evaluate NGAL in neonatal foals with sepsis, and assess its relation to outcome. ANIMALS Foals ≤ 14 days, with admission blood analysis and stored serum. METHODS 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). The septic foals were further sub-categorized according to severity (normal sepsis, severe sepsis and septic shock). A Kruskal-Wallis test was used to compare serum NGAL concentrations in survivors and non-survivors, in the sepsis status groups, and in the sepsis severity groups. Optimal cut-off values for serum NGAL concentrations to diagnose sepsis and outcome were determined with receiver operating characteristic (ROC) curves. NGAL was compared to creatinine and SAA. RESULTS Median serum NGAL concentrations were significantly higher in septic than non-septic foals. However, serum NGAL concentrations did not differ between sepsis severity subgroups. Serum NGAL concentrations were significantly lower in survivors than in non-survivors. Optimal cut-off values of serum NGAL concentrations were 455 μg/L (sensitivity 71.4%, specificity 100%) and 1104 μg/L (sensitivity 39.3%, specificity 95.2%) for predicting sepsis and non-survival, respectively. NGAL correlated to SAA, but not to creatinine. NGAL performed similarly to SAA to diagnose sepsis. CONCLUSION Serum NGAL concentrations may be useful for diagnosing sepsis and predicting outcome.
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Affiliation(s)
- Malene Laurberg
- Sydney School of Veterinary Science, University of Sydney, Camden, NSW, Australia
| | - Claude Saegerman
- Medicine and Surgery, Department of Veterinary Clinical Sciences, University of Copenhagen, Taastrup, Denmark
| | - Stine Jacobsen
- Faculty of Veterinary Medicine, Research Unit in Epidemiology and Risk Analysis Applied to Veterinary Sciences (UREAR-ULiège), Fundamental and Applied Research for Animal and Health (FARAH) Center, University of Liege, Liege, Belgium
| | - Lise C Berg
- Faculty of Veterinary Medicine, Research Unit in Epidemiology and Risk Analysis Applied to Veterinary Sciences (UREAR-ULiège), Fundamental and Applied Research for Animal and Health (FARAH) Center, University of Liege, Liege, Belgium
| | - Sigrid Hyldahl Laursen
- Faculty of Veterinary Medicine, Research Unit in Epidemiology and Risk Analysis Applied to Veterinary Sciences (UREAR-ULiège), Fundamental and Applied Research for Animal and Health (FARAH) Center, University of Liege, Liege, Belgium
| | - Emma Hoeberg
- Faculty of Veterinary Medicine, Research Unit in Epidemiology and Risk Analysis Applied to Veterinary Sciences (UREAR-ULiège), Fundamental and Applied Research for Animal and Health (FARAH) Center, University of Liege, Liege, Belgium
| | - Elaine Alexandra Sånge
- Faculty of Veterinary Medicine, Research Unit in Epidemiology and Risk Analysis Applied to Veterinary Sciences (UREAR-ULiège), Fundamental and Applied Research for Animal and Health (FARAH) Center, University of Liege, Liege, Belgium
| | - Gaby van Galen
- Sydney School of Veterinary Science, University of Sydney, Camden, NSW, Australia
- Faculty of Veterinary Medicine, Research Unit in Epidemiology and Risk Analysis Applied to Veterinary Sciences (UREAR-ULiège), Fundamental and Applied Research for Animal and Health (FARAH) Center, University of Liege, Liege, Belgium
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Dembek K, Timko K, Moore C, Johnson L, Frazer M, Barr B, Toribio R. Longitudinal assessment of adrenocortical steroid and steroid precursor response to illness in hospitalized foals. Domest Anim Endocrinol 2023; 82:106764. [PMID: 36162341 DOI: 10.1016/j.domaniend.2022.106764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 08/24/2022] [Accepted: 08/25/2022] [Indexed: 10/14/2022]
Abstract
Sepsis is a major cause of morbidity and mortality in neonatal foals. Relative adrenal insufficiency (RAI), defined as an inadequate cortisol response to stress, has been associated with sepsis, prematurity, and poor outcome in newborn foals. In addition to cortisol, the adrenal gland synthesizes several biologically important steroids and steroid precursors, including aldosterone, androgens, and progestogens. However, concentration of these hormones during hospitalization and their association with the severity of disease and mortality in critically ill foals have not been completely evaluated. We hypothesized, that in addition to cortisol and aldosterone, concentration of steroid precursors (progestogens and androgens) will be altered in critically ill foals. We also proposed that septic foals will have higher concentrations of steroid precursors than healthy foals, and steroid concentrations will be persistently increased during hospitalization in non-surviving septic and premature foals. Foals <4 days of age were categorized as healthy, septic, sick non-septic, and premature based on physical exam, medical history, and laboratory data. Blood samples were collected on admission (0 h), 24 h, and 72 h after admission. Concentrations of steroids and ACTH were measured by immunoassays. The area under the curve over 72 h (AUC0-72h) of hospitalization was calculated for each hormone. Serum cortisol, aldosterone, progesterone, pregnenolone, dehydroepiandrosterone sulfate (DHEAS), and 17 α-hydroxyprogesterone concentrations were higher in septic and premature foals compared to healthy foals at 0 h and throughout 72 h of hospitalization (P < 0.05). Plasma ACTH concentrations were higher in septic and premature foals on admission compared to healthy controls (P < 0.05). The progesterone (AUC0-72h) cut-off value above which non-survival could be reliably predicted in hospitalized foals was 1,085 ng/mL/h, with 82% sensitivity and 77% specificity. Critically ill neonatal foals had an appropriate response to stress characterized by increased concentrations of cortisol and steroid precursors on admission. A rapid decline in steroid concentration was observed in healthy foals. However, persistently elevated progestogen and androgen concentrations were associated with a lack of improvement in the course of disease and poor outcome.
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Affiliation(s)
- K Dembek
- College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA.
| | - K Timko
- College of Veterinary Medicine, The Ohio State University, Columbus, OH, USA
| | - C Moore
- Jacksonville Equine Associates, Jacksonville, FL, USA
| | - L Johnson
- Fairfield Equine Associates, Newtown, CT, USA
| | - M Frazer
- Hagyard Equine Medical Institute, Lexington, KY, USA
| | - B Barr
- Rood and Riddle Equine Hospital, Lexington, KY, USA
| | - R Toribio
- College of Veterinary Medicine, The Ohio State University, Columbus, OH, USA
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10
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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 as a marker to detect sepsis and predict outcome in hospitalized neonatal foals. Vet Med (Auckl) 2022; 36:2245-2253. [PMID: 36239317 DOI: 10.1111/jvim.16550] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 09/15/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Serum amyloid A (SAA) has been reported to hold promise as diagnostic and prognostic marker in foals. This has not been investigated thoroughly. OBJECTIVES Evaluate admission SAA concentrations as predictor of sepsis and outcome. ANIMALS 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 shock). SAA was compared between groups using Mann-Whitney test and Kruskal-Wallis test. Receiver operating characteristic curves identified optimal SAA cut off values for detecting sepsis and predicting outcome. RESULTS Admission SAA concentrations differed significantly between sick nonseptic foals (312.1 ± 685.4 mg/L) and septic foals (1079.7 ± 1254.5 mg/L) and increased with increasing sepsis score. SAA did not differ between sepsis severity groups. The optimal cut off for sepsis detection was 1050 mg/L (sensitivity 30.2%, specificity 90.7%). Admission SAA concentrations were lower in surviving (435.0 ± 723.6 mg/L) compared to nonsurviving foals (1062.7 ± 1440.1 mg/L) and decreased with increasing survival score. The optimal cut off for nonsurvival prediction was 1250 mg/L (sensitivity 22.1%, specificity 90.8%). CONCLUSIONS AND CLINICAL IMPORTANCE SAA concentration was higher in septic foals and nonsurviving foals. Even though optimal cut offs for SAA to detect sepsis and predict outcome had low sensitivity, they had good specificity. SAA can therefore be used as a marker to rule out sepsis and nonsurvival.
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Affiliation(s)
- Emma Hoeberg
- Medicine and Surgery, Department of Veterinary Clinical Sciences, University of Copenhagen, Taastrup, Denmark.,Faculty of Veterinary Medicine, Norwegian University of Life Sciences, Ås, Norway
| | - Alexandra Sånge
- Medicine and Surgery, Department of Veterinary Clinical Sciences, University of Copenhagen, Taastrup, Denmark.,Evidensia Equine Specialist Hospital Helsingborg, Helsingborg, Sweden
| | - Claude Saegerman
- Research Unit in Epidemiology and Risk Analysis Applied to Veterinary Sciences (UREAR-ULiege), Fundamental and Applied Research for Animal Health (FARAH) Center, Faculty of Veterinary Medicine, University of Liege, Liège, Belgium
| | - Anna Bohlin
- Evidensia Equine Specialist Hospital Helsingborg, Helsingborg, Sweden
| | | | - Inge Durie
- Evidensia Equine Specialist Hospital Stromsholm, Stromsholm, Sweden
| | | | - Anna Öhman
- Evidensia Equine Specialist Hospital Helsingborg, Helsingborg, Sweden
| | - Stine Jacobsen
- Medicine and Surgery, Department of Veterinary Clinical Sciences, University of Copenhagen, Taastrup, Denmark
| | - Lise Berg
- Medicine and Surgery, Department of Veterinary Clinical Sciences, University of Copenhagen, Taastrup, Denmark
| | - Sigrid Hyldahl Laursen
- Medicine and Surgery, Department of Veterinary Clinical Sciences, University of Copenhagen, Taastrup, Denmark.,Equine Medical Consult, Hornbaek, Denmark
| | - Gaby van Galen
- Medicine and Surgery, Department of Veterinary Clinical Sciences, University of Copenhagen, Taastrup, Denmark.,Sydney School of Veterinary Science, Faculty of Science, The University of Sydney, Sydney, Australia
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11
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Giancola S, Hart KA. Equine blood cultures: Can we do better? Equine Vet J 2022. [PMID: 36210694 DOI: 10.1111/evj.13891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 10/02/2022] [Indexed: 11/30/2022]
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.
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Affiliation(s)
- Shyla Giancola
- Department of Large Animal Medicine, University of Georgia College of Veterinary Medicine, Athens, Georgia, USA
| | - Kelsey A Hart
- Department of Large Animal Medicine, University of Georgia College of Veterinary Medicine, Athens, Georgia, USA
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12
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Kirtland A, Pusterla N, Bozorgmanesh R. Successful management of an outbreak of Tyzzer's disease on a Thoroughbred breeding farm in central Kentucky; use of sorbitol dehydrogenase to identify sub‐clinical cases. EQUINE VET EDUC 2022. [DOI: 10.1111/eve.13699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Abbe Kirtland
- McGee Medicine Center Hagyard Equine Medical Institute Lexington Kentucky USA
| | - Nicola Pusterla
- Department of Medicine and Epidemiology, School of Veterinary Medicine University of California Davis California USA
| | - Rana Bozorgmanesh
- McGee Medicine Center Hagyard Equine Medical Institute Lexington Kentucky USA
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13
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Allen BA, Evans SJM. Diagnostic accuracy of cytology for the detection of bacterial infection in fluid samples from veterinary patients. Vet Clin Pathol 2022; 51:252-257. [DOI: 10.1111/vcp.13092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 11/03/2021] [Accepted: 11/06/2021] [Indexed: 11/26/2022]
Affiliation(s)
- Brittany A. Allen
- Department of Veterinary Biosciences Ohio State University College of Veterinary Medicine Columbus OH USA
| | - Samantha J. M. Evans
- Department of Veterinary Biosciences Ohio State University College of Veterinary Medicine Columbus OH USA
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14
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Peng Y, Wang X, Yin S, Wang M. A new indicator: The diagnostic value of CD8+T/B lymphocyte ratio in sepsis progression. Int J Immunopathol Pharmacol 2022; 36:3946320221123164. [PMID: 36036157 PMCID: PMC9421217 DOI: 10.1177/03946320221123164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objective To reveal the value of single lymphocyte subpopulation and their ratios in
the progression of sepsis. Methods From January 2019 to March 2021, 39 sepsis patients, 16 septic shock
patients, and 50 healthy volunteers were recruited in the Second Xiangya
Hospital for this cross-sectional study. The absolute quantitation of CD4+T,
CD8+T, B lymphocytes, and NK cells in peripheral blood were determined by
flow cytometry. SPSS Software was used to analyze the results. Results On the whole, the numbers of lymphocytes in the sepsis group and in the
septic shock group were lower than that in the healthy control group.
Surprisingly, the percentage of CD8+T lymphocytes in the septic shock group
was slightly higher than that in the sepsis group. The percentage of B
lymphocytes in the sepsis group was higher than that in the healthy control
group. The AUC of CD8+T/B was 0.724, with the sensitivity and specificity
being 75.00% and 71.79%, respectively. Conclusion The immune expression pattern of patients with sepsis was not a simple
decrease in the number of lymphocytes. The change in the ratios of
lymphocyte subpopulation might be more meaningful along the development and
progression of sepsis. The ratio of CD8+T/B could be used to diagnose the
progression of sepsis and reduce the misdiagnosis rate to a certain
extent.
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Affiliation(s)
- Yizhi Peng
- Department of Laboratory Medicine, 70566The Second Xiangya Hospitalof Central South University, Changsha, Hunan, China
| | - Xiaofan Wang
- Department of Laboratory Medicine, 70566The Second Xiangya Hospitalof Central South University, Changsha, Hunan, China
| | - Sheng Yin
- Department of Laboratory Medicine, 70566The Second Xiangya Hospitalof Central South University, Changsha, Hunan, China
| | - Min Wang
- Department of Laboratory Medicine, 70566The Second Xiangya Hospitalof Central South University, Changsha, Hunan, China
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15
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Hess EK, Reinhart JM, Anderson MJ, Jannasch AS, Taylor SD. Pharmacokinetics of thiamine (vitamin B1) in adult horses after administration of three single intravenous doses. J Vet Pharmacol Ther 2021; 44:937-944. [PMID: 34407222 DOI: 10.1111/jvp.13007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Revised: 07/08/2021] [Accepted: 08/06/2021] [Indexed: 11/30/2022]
Abstract
Thiamine is a vital co-factor for several anti-inflammatory and antioxidant processes that are critical for mitigation of sepsis-associated inflammation, but pharmacokinetic (PK) analysis has not been reported in horses. We hypothesized that IV thiamine hydrochloride (TH) at increasing dosages would result in corresponding increases in plasma thiamine concentrations without causing adverse effects. A randomized cross-over study was performed in 9 healthy horses that each received TH at 5, 10, and 20 mg/kg IV. Blood was collected immediately prior to drug administration and at several time points thereafter. High-performance liquid chromatography with mass spectrometry was used to quantify thiamine concentrations at each time point. Non-compartmental PK methods showed that IV TH resulted in supraphysiologic plasma concentrations with a short half-life (0.77-1.12 h) and no adverse clinical signs were observed. The terminal rate constant decreased as the dosage increased (p < .0001) and clearance significantly decreased at the 20 mg/kg dosage (p = .0011). The area under the curve (AUC) increased in a non-linear fashion. These findings suggest that thiamine follows non-linear elimination kinetics in horses, which is likely due to saturation of renal elimination. Future studies are needed to identify therapeutic plasma concentrations and develop thiamine dosing recommendations for horses.
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Affiliation(s)
- Emily K Hess
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Purdue University, West Lafayette, IN, USA
| | - Jennifer M Reinhart
- Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois, Urbana, IL, USA
| | - Melinda J Anderson
- Department of Basic Medical Sciences, College of Veterinary Medicine, Purdue University, West Lafayette, IN, USA
| | - Amber S Jannasch
- Bindley Bioscience Center, Purdue University, West Lafayette, IN, USA
| | - Sandra D Taylor
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Purdue University, West Lafayette, IN, USA
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16
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Colmer SF, Luethy D, Abraham M, Stefanovski D, Hurcombe SD. Utility of cell-free DNA concentrations and illness severity scores to predict survival in critically ill neonatal foals. PLoS One 2021; 16:e0242635. [PMID: 33901192 PMCID: PMC8075268 DOI: 10.1371/journal.pone.0242635] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 04/13/2021] [Indexed: 11/18/2022] Open
Abstract
Plasma cell-free DNA (cfDNA) levels have been associated with disease and survival status in septic humans and dogs. To date, studies investigating cfDNA levels in association with critical illness in foals are lacking. We hypothesized that cfDNA would be detectable in the plasma of foals, that septic and sick-nonseptic foals would have significantly higher cfDNA levels compared to healthy foals, and that increased cfDNA levels would be associated with non-survival. Animals used include 80 foals of 10 days of age or less admitted to a tertiary referral center between January and July, 2020 were stratified into three categories: healthy (n = 34), sick non-septic (n = 11) and septic (n = 35) based on specific criteria. This was a prospective clinical study. Blood was collected from critically ill foals at admission or born in hospital for cfDNA quantification and blood culture. Previously published sepsis score (SS) and neonatal SIRS score (NSIRS) were also calculated. SS, NSIRS, blood culture status and cfDNA concentrations were evaluated to predict survival. Continuous variables between groups were compared using Kruskal-Wallis ANOVA with Dunn’s post hoc test. Comparisons between two groups were assessed using the Mann-Whitney U-test or Spearman rank for correlations. The performance of cfDNA, sepsis score and NSIRS score to predict survival was assessed by receiver operator characteristic (ROC) curve analysis including area under the curve, sensitivity and specificity using cutoffs. Plasma cfDNA was detectable in all foals. No significant differences in cfDNA concentration were detected between healthy foals and septic foals (P = 0.65) or healthy foals and sick non-septic foals (P = 0.88). There was no significant association between cfDNA and culture status, SS, NSIRS or foal survival. SS (AUC 0.85) and NSIRS (AUC 0.83) were superior to cfDNA (AUC 0.64) in predicting survival. Although cfDNA was detectable in foal plasma, it offers negligible utility to diagnose sepsis or predict survival in critical illness in neonates.
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Affiliation(s)
- Sarah Florence Colmer
- Department of Clinical Sciences, The University of Pennsylvania School of Veterinary Medicine, New Bolton Center, Philadelphia, Pennsylvania, United States of America
| | - Daniela Luethy
- Department of Clinical Sciences, The University of Pennsylvania School of Veterinary Medicine, New Bolton Center, Philadelphia, Pennsylvania, United States of America
| | - Michelle Abraham
- Department of Clinical Sciences, The University of Pennsylvania School of Veterinary Medicine, New Bolton Center, Philadelphia, Pennsylvania, United States of America
| | - Darko Stefanovski
- Department of Clinical Sciences, The University of Pennsylvania School of Veterinary Medicine, New Bolton Center, Philadelphia, Pennsylvania, United States of America
| | - Samuel David Hurcombe
- Department of Clinical Sciences, The University of Pennsylvania School of Veterinary Medicine, New Bolton Center, Philadelphia, Pennsylvania, United States of America
- * E-mail:
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17
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Borba LDA, Nogueira CEW, Bruhn FRP, da Silva GC, Feijó LS, Canisso IF, Curcio BDR. Peripheral blood markers of sepsis in foals born from mares with experimentally induced ascending placentitis. Vet Rec 2021; 187:29. [PMID: 33638540 DOI: 10.1136/vr.104710] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Revised: 12/18/2019] [Accepted: 02/22/2020] [Indexed: 11/03/2022]
Abstract
BACKGROUND Neonatal sepsis is a leading cause of neonatal death during the first-week postfoaling. Despite recent advancements in the diagnosis and treatment of sepsis in the newborn foal, the non-specific clinical signs and subtle nature of this disease may result in delayed diagnosis until severe progression of the disease; thus, early detection of sepsis remains critical for a favourable outcome. This study aimed to identify early blood markers as predictive of sepsis on foals. METHODS Thirty-five foals were allocated into three groups: healthy control foals (n=7) and foals born from mares with placentitis: septic foals (n=9) and non-septic foals (n=19). Blood samples were obtained immediately after foaling and at 12, 24 and 48 hours. All samples were assessed for glucose, lactate, triglycerides, total cholesterol, urea, creatinine, total solids, fibrinogen, gamma-glutamyl transferase (GGT), serum amyloid A (SAA) and alpha-fetoprotein (AFP) concentrations. RESULTS At foaling, glucose and GGT concentrations were lower in septic foals (P<0.001). Of interest, SAA, AFP, creatinine and total cholesterol were higher in septic foals at parturition (P<0.05). At 12 hours, lactate, triglycerides and total cholesterol concentrations were higher in septic foals. When evaluated at 24 and 48 hours, higher concentrations of SAA and AFP were found in placentitis foals than in the control group. CONCLUSIONS Total cholesterol and lactate appear to be suitable markers for sepsis during the first 24 hours postpartum. Septic foals displayed altered energy metabolisms as determined by increased triglycerides and cholesterol concentrations, hypoglycaemia at birth and reduced activity of the GGT and increased lactate and urea concentrations. Sepsis was associated with high concentrations of SAA and AFP.
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Affiliation(s)
- Luciana de Araujo Borba
- Departamento de Clínicas Veterinária, Faculdade de Veterinária, Universidade Federal de Pelotas, Pelotas, Brazil
| | | | - Fábio Raphael Pascoti Bruhn
- Departamento de Medicina Veterinária Preventiva, Faculdade de Veterinária, Universidade Federal de Pelotas, Pelotas, Brazil
| | - Gabriela Castro da Silva
- Departamento de Clínicas Veterinária, Faculdade de Veterinária, Universidade Federal de Pelotas, Pelotas, Brazil
| | - Lorena Soares Feijó
- Departamento de Clínicas Veterinária, Faculdade de Veterinária, Universidade Federal de Pelotas, Pelotas, Brazil
| | - Igor F Canisso
- Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois Urbana-Champaign, Urbana, IL, USA
| | - Bruna da Rosa Curcio
- Departamento de Clínicas Veterinária, Faculdade de Veterinária, Universidade Federal de Pelotas, Pelotas, Brazil
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18
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Davis C, Faruki A, Breyer D, Cumbler E, Fisher B, Hassell A, Hess S, Pierce R, Wiler J, Zane R. The Case for Virtual Sepsis Surveillance and Intervention. Telemed J E Health 2021; 28:102-106. [PMID: 33826409 DOI: 10.1089/tmj.2020.0513] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Study Objective: To determine whether deployment of an integrated virtual sepsis surveillance program could improve time to antibiotics and mortality in a longitudinal cohort of non-present on admission (NPOA) sepsis cases. Methods: We used an uncontrolled pre- and poststudy design to compare time to antibiotics and mortality between a time-based cohort of NPOA sepsis cases separated by the deployment of a virtual sepsis surveillance program. Results: A total of 566 NPOA sepsis cases were included in this study. Three hundred and thirty-five cases compromised the preintervention arm, whereas the postintervention cohort included 231 cases. After deployment of the virtual sepsis surveillance program, median time to antibiotics improved from 92 to 59 min (p < 0.001). Mortality was reduced from 30% to 21% (p = 0.015). Conclusion: Deployment of a virtual sepsis surveillance program resulted in a decreased time to antibiotics and an overall reduction in NPOA sepsis mortality.
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Affiliation(s)
- Christopher Davis
- Department of Emergency Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Adeel Faruki
- Department of Anesthesia, UCHealth, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Diana Breyer
- Department of Anesthesia, UCHealth, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Ethan Cumbler
- Departments of Medicine and Surgery, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Brett Fisher
- Department of Anesthesia, UCHealth, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Amy Hassell
- Department of Anesthesia, UCHealth, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Steve Hess
- Department of Anesthesia, UCHealth, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Read Pierce
- Division of Hospital Medicine, Department of Internal Medicine, Dell Medical School, University of Texas at Austin, Austin, Texas, USA
| | - Jennifer Wiler
- Department of Emergency Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Richard Zane
- Department of Emergency Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
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19
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Valverde A. Fluid Resuscitation for Refractory Hypotension. Front Vet Sci 2021; 8:621696. [PMID: 33778035 PMCID: PMC7987676 DOI: 10.3389/fvets.2021.621696] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 02/01/2021] [Indexed: 12/22/2022] Open
Abstract
Hypotension is a common occurrence, especially in anesthetized patients and in critical patients suffering from hypovolemia due to shock and sepsis. Hypotension can also occur in normovolemic animals, anesthetized or conscious, under conditions of vasodilation or decreased cardiac function. The main consequence of hypotension is decreased organ perfusion and tissue injury/dysfunction. In the human literature there is no consensus on what is the threshold value for hypotension, and ranges from < 80 to < 100 mmHg for systolic blood pressure and from < 50 to < 70 mmHg for mean arterial blood pressure have been referenced for intraoperative hypotension. In veterinary medicine, similar values are referenced, despite marked differences in normal arterial blood pressure between species and with respect to humans. Therapeutic intervention involves fluid therapy to normalize volemia and use of sympathomimetics to enhance cardiac function and regulate peripheral vascular resistance. Despite these therapeutic measures, there is a subset of patients that are seemingly refractory and exhibit persistent hypotension. This review covers the physiological aspects that govern arterial blood pressure control and blood flow to tissues/organs, the pathophysiological mechanisms involved in hypotension and refractory hypotension, and therapeutic considerations and expectations that include proper interpretation of cardiovascular parameters, fluid recommendations and therapy rates, use of sympathomimetics and vasopressors, and newer approaches derived from the human literature.
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Affiliation(s)
- Alexander Valverde
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
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20
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de Barros ADMC, Silva AFR, Zibordi M, Spagnolo JD, Corrêa RR, Belli CB, de Camargo MM. Equine simplified acute physiology score: Personalised medicine for the equine emergency patient. Vet Rec 2021; 189:e136. [PMID: 33729604 DOI: 10.1002/vetr.136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 12/11/2020] [Accepted: 01/26/2021] [Indexed: 11/12/2022]
Abstract
BACKGROUND Scoring models are useful tools that guide the attending clinician in gauging the severity of disease evolution and in evaluating the efficacy of treatment. There are few tools available with this purpose for the non-human patient, including horses. We aimed (i) to adapt the simplified acute physiology score 3 (SAPS-3) model for the equine species, reaching a margin of accuracy greater than 75% in the calculation of the probability of survival/death and (ii) to build a decision tree that helps the attending veterinarian in assessment of the clinical evolution of the equine patient. METHODS From an initial pool of 5568 medical records from University-based Veterinary Hospitals, a final cohort of 1000 was further mined manually for data extraction. A set of 19 variables were evaluated and tested by five machine learning data mining algorithms. RESULTS The final scoring model, named EqSAPS for equine simplified acute physiology score, reached 91.83% of correct estimates (post hoc) for probability of death within 24 hours upon hospitalization. The area under receiver operating characteristic curve for outcome 'death' was 0.742, while for 'survival' was 0.652. The final decision tree was able to refine prognosis of patients whose EqSAPS score suggested 'death'. CONCLUSION EqSAPS is a useful tool to gauge the severity of the clinical presentation of the equine patient.
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Affiliation(s)
| | - Ana Flávia Rocha Silva
- School of Zootechnics and Food Engineering, University of São Paulo, Pirassununga, Brazil
| | - Miriam Zibordi
- School of Veterinary Medicine, University of São Paulo, São Paulo, Brazil
| | - Julio David Spagnolo
- Veterinary Hospital, Large Animals Surgery Section, School of Veterinary Medicine, University of São Paulo, São Paulo, Brazil
| | - Rodrigo Romero Corrêa
- Department of Surgery, School of Veterinary Medicine, University of São Paulo, São Paulo, Brazil
| | - Carla B Belli
- Department of Clinics, School of Veterinary Medicine, University of São Paulo, São Paulo, Brazil
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21
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Vitale V, Conte G, Baragli P, Jose-Cunilleras E, Sgorbini M. Heart rate variability in newborn foals and its association with illness: a pilot study. ITALIAN JOURNAL OF ANIMAL SCIENCE 2021. [DOI: 10.1080/1828051x.2021.1957724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Valentina Vitale
- Dipartimento Scienze Veterinarie, University of Pisa, Pisa, Italy
- Ospedale Didattico Veterinario “Mario Modenato”, University of Pisa, Pisa, Italy
| | - Giuseppe Conte
- Dipartimento di Scienze Agrarie, Alimentali e Agro-Alimentari, University of Pisa, Pisa, Italy
| | - Paolo Baragli
- Dipartimento Scienze Veterinarie, University of Pisa, Pisa, Italy
| | - Eduard Jose-Cunilleras
- Departament de Medicina i Cirurgia Animals, Autonomous University of Barcelona, Barcelona, Spain
| | - Micaela Sgorbini
- Dipartimento Scienze Veterinarie, University of Pisa, Pisa, Italy
- Ospedale Didattico Veterinario “Mario Modenato”, University of Pisa, Pisa, Italy
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22
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Dor Z, Shnaiderman-Torban A, Kondratyeva K, Davidovich-Cohen M, Rokney A, Steinman A, Navon-Venezia S. Emergence and Spread of Different ESBL-Producing Salmonella enterica Serovars in Hospitalized Horses Sharing a Highly Transferable IncM2 CTX-M-3-Encoding Plasmid. Front Microbiol 2020; 11:616032. [PMID: 33391248 PMCID: PMC7773750 DOI: 10.3389/fmicb.2020.616032] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Accepted: 11/27/2020] [Indexed: 11/13/2022] Open
Abstract
Salmonella enterica is a major causative pathogen of human and animal gastroenteritis. Antibiotic resistant strains have emerged due to the production of extended-spectrum β-lactamases (ESBLs) posing a major health concern. With the increasing reports on ESBL-producing Enterobacterales that colonize companion animals, we aimed to investigate ESBL dissemination among ESBL-producing Salmonella enterica (ESBL-S) in hospitalized horses. We prospectively collected ESBL-S isolates from hospitalized horses in a Veterinary-Teaching Hospital during Dec 2015–Dec 2017. Selection criteria for ESBL-S were white colonies on CHROMagarESBL plates and an ESBL phenotypic confirmation. Salmonella enterica serovars were determined using the Kaufmann-White-Le-Minor serological scheme. ESBL-encoding plasmids were purified, transformed and compared using restriction fragment length polymorphism (RFLP). Whole genome sequencing (Illumina and MinION platforms) were performed for detailed phylogenetic and plasmid analyses. Twelve ESBL-S were included in this study. Molecular investigation and Sequence Read Archive (SRA) meta-analysis revealed the presence of three unique Salmonella enterica serovars, Cerro, Havana and Liverpool, all reported for the first time in horses. PFGE revealed the clonal spread of S. Cerro between seven horses. All twelve isolates carried blaCTX–M–3 and showed an identical multidrug resistance profile with co-resistance to trimethoprim/sulfamethoxazole and to aminoglycosides. Plasmid RFLP proved the inter-serovar horizontal spread of a single blaCTX–M–3-encoding plasmid. Complete sequence of a representative plasmid (S. Havana strain 373.3.1), designated pSEIL-3 was a -86.4 Kb IncM2 plasmid, that encoded nine antibiotic resistance genes. pSEIL-3 was virtually identical to pCTX-M3 from Citrobacter freundii, and showed high identity (>95%) to six other blaCTX–M–3 or blaNDM–1 IncM2 broad host range plasmids from various Enterobacterales of human origin. Using a specific six gene-based multiplex PCR, we detected pSEIL-3 in various Enterobacterales species that co-colonized the horses’ gut. Together, our findings show the alarming emergence of ESBL-S in hospitalized horses associated with gut shedding and foal morbidity and mortality. We demonstrated the dissemination of CTX-M-3 ESBL among different Salmonella enterica serovars due to transmission of a broad host range plasmid. This report highlights horses as a zoonotic reservoir for ESBL-S, including highly transmissible plasmids that may represent a ‘One-Health’ hazard. This risk calls for the implementation of infection control measures to monitor and control the spread of ESBL-S in hospitalized horses.
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Affiliation(s)
- Ziv Dor
- Department of Molecular Biology, Ariel University, Ariel, Israel
| | - Anat Shnaiderman-Torban
- Koret School of Veterinary Medicine, The Robert H. Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Kira Kondratyeva
- Department of Molecular Biology, Ariel University, Ariel, Israel
| | | | - Assaf Rokney
- Government Central Laboratories, Ministry of Health, Jerusalem, Israel
| | - Amir Steinman
- Koret School of Veterinary Medicine, The Robert H. Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Shiri Navon-Venezia
- Department of Molecular Biology, Ariel University, Ariel, Israel.,The Dr. Miriam and Sheldon G. Adelson School of Medicine, Ariel University, Ariel, Israel
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Swink JM, Rings LM, Snyder HA, McAuley RC, Burns TA, Dembek KA, Gilsenan WF, Browne N, Toribio RE. Dynamics of androgens in healthy and hospitalized newborn foals. J Vet Intern Med 2020; 35:538-549. [PMID: 33277956 PMCID: PMC7848305 DOI: 10.1111/jvim.15974] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 11/11/2020] [Accepted: 11/12/2020] [Indexed: 01/25/2023] Open
Abstract
Background Information on steroids derived from the adrenal glands, gonads, or fetoplacental unit is minimal in newborn foals. Objective To measure androgen concentrations in serum and determine their association with disease severity and outcome in hospitalized foals. Animals Hospitalized (n = 145) and healthy (n = 80) foals. Methods Prospective, multicenter, cross‐sectional study. Foals of ≤3 days of age from 3 hospitals and horse farms were classified as healthy and hospitalized (septic, sick nonseptic, neonatal maladjustment syndrome [NMS]) based on physical exam, medical history, and laboratory findings. Serum androgen and plasma ACTH concentrations were measured with immunoassays. Data were analyzed by nonparametric methods and univariate analysis. Results Serum dehydroepiandrosterone (DHEA), androstenedione, testosterone, and dihydrotestosterone (DHT) concentrations were higher upon admission in hospitalized foals (P < .05), were associated with nonsurvival, decreased to 4.9‐10.8%, 5.7‐31%, and 30.8‐62.8% admission values in healthy, SNS, and septic foals, respectively (P < .05), but remained unchanged or increased in nonsurviving foals. ACTH:androgen ratios were higher in septic and NMS foals (P < .05). Foals with decreased androgen clearance were more likely to die (odds ratio > 3; P < .05). Conclusions and Clinical Importance Similar to glucocorticoids, mineralocorticoids, and progestagens, increased serum concentrations of androgens are associated with disease severity and adverse outcome in hospitalized newborn foals. In healthy foals, androgens decrease over time, however, remain elevated longer in septic and nonsurviving foals. Androgens could play a role in or reflect a response to disorders such as sepsis or NMS in newborn foals.
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Affiliation(s)
- Jacob M Swink
- College of Veterinary Medicine, The Ohio State University, Columbus, Ohio, USA
| | - Lindsey M Rings
- College of Veterinary Medicine, The Ohio State University, Columbus, Ohio, USA.,Rood and Riddle Equine Hospital, Lexington, Kentucky, USA
| | - Hailey A Snyder
- College of Veterinary Medicine, The Ohio State University, Columbus, Ohio, USA
| | - Rachel C McAuley
- College of Veterinary Medicine, The Ohio State University, Columbus, Ohio, USA
| | - Teresa A Burns
- College of Veterinary Medicine, The Ohio State University, Columbus, Ohio, USA
| | - Katarzyna A Dembek
- College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, USA
| | | | - Nimet Browne
- Hagyard Equine Medical Institute, Lexington, Kentucky, USA
| | - Ramiro E Toribio
- College of Veterinary Medicine, The Ohio State University, Columbus, Ohio, USA
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24
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Jafari-Khataylou Y, Emami SJ, Mirzakhani N. Troxerutin attenuates inflammatory response in lipopolysaccharide-induced sepsis in mice. Res Vet Sci 2020; 135:469-478. [PMID: 33261826 DOI: 10.1016/j.rvsc.2020.11.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 11/17/2020] [Accepted: 11/22/2020] [Indexed: 12/16/2022]
Abstract
Troxerutin (Tx), known as vitamin P4 is a derivative of natural bioflavonoid rutin. Tx possesses different biological activities such as antioxidant, anticancer, and anti-inflammatory. The current study was conducted to determine potential therapeutic effect of Tx in lipopolysaccharides (LPS)-induced sepsis in mice. In LPS-induced sepsis, the mice were treated intraperitoneally (ip) with Tx twice daily. Therapeutic effect was assessed by measuring serum level of cytokines, alanine aminotransferase (ALT) and lactate dehydrogenase (LDH). Level of nitric oxide (NO), superoxide dismutase (SOD), catalase (CAT), Myeloperoxidase (MPO) and Malondialdehyde (MDA) was measured. Expression of CD40 receptor on leucocytes was measured using flowcytometry. Splenocyte proliferation was evaluated using MTT assay. The effect of Tx on survival rate during administration of lethal dose of LPS was investigated. The results showed that Tx inhibited LPS induced NO production. Inflammatory pathways were suppressed by reduction of inflammatory cytokines production. Further, elevated CD40 expression of leucocytes and proliferation of splenocytes markedly reduced in Tx treated group. Antioxidant defense system was enhanced by increased activity of SOD and CAT and decreased level of MDA. MPO, ALT and LDH activity. Additionally, treatment with Tx significantly increased the mean survival time of mice compared with the LPS treated group. Histologically, Tx treatment decreased inflammatory cells infiltration and histopathologicl changes in the liver. Our findings showed that reduced inflammatory parameters, improved antioxidant activity, reduced histological lesions and increased survival rate. These findings suggest that Tx is an effective anti-inflammatory agent for the treatment of LPS-induced sepsis.
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Affiliation(s)
- Yaser Jafari-Khataylou
- Assistant Professor of Immunology, Department of Pathobiology, Faculty of Veterinary Medicine, University of Tabriz, Tabriz, Iran.
| | - Seyyed Jamal Emami
- Department of Food Hygiene and Quality Control, Faculty of Veterinary Medicine, University of Tehran, Tehran, Iran
| | - Navideh Mirzakhani
- Assistant Professor of Pathology, Department of Pathobiology, Faculty of Veterinary Medicine, Amol University of Special Modern Technologies, Amol, Iran
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25
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Furr M, McKenzie H. Factors associated with the risk of positive blood culture in neonatal foals presented to a referral center (2000-2014). J Vet Intern Med 2020; 34:2738-2750. [PMID: 33044020 PMCID: PMC7694804 DOI: 10.1111/jvim.15923] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Revised: 09/17/2020] [Accepted: 09/22/2020] [Indexed: 01/12/2023] Open
Abstract
Background 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. Objectives Historical as well as maternal and foal physical examination findings will predict risk of BSI in neonatal foals. Animals 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 and 286 controls) foals <14 days of age were studied. Risk of a foal having a BSI was increased in foals with umbilical disease (adjusted odds ratio [OR], 11.01; P = .02), hypoglycemia (adjusted OR, 13.51; P = .03), and the combined presence of umbilical disease and low hematocrit (adjusted OR, >999.99; P = .04). Factors not found to be risk factors for development of BSI included prematurity, hypothermia, abdominal disease, diarrhea, failure of passive transfer, and maternal uterine infection. Conclusions and Clinical Importance Several historical and physical examination findings increase the risk of foals being blood culture positive at presentation to the hospital. This knowledge may aid early identification of blood culture status, thus aiding in treatment decisions.
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Affiliation(s)
- Martin Furr
- College of Veterinary Medicine, Oklahoma State University, Stillwater, Oklahoma, USA
| | - Harold McKenzie
- Virginia-Maryland College of Veterinary Medicine, Virginia Tech, Blacksburg, Virginia, USA
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26
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Sanmartí J, Armengou L, Viu J, Alguacil E, Civit S, Ríos J, Jose-Cunilleras E. Plasma iron concentrations and systemic inflammatory response syndrome in neonatal foals. J Vet Intern Med 2020; 34:1325-1331. [PMID: 32297679 PMCID: PMC7255657 DOI: 10.1111/jvim.15770] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Accepted: 03/13/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Sparse information regarding plasma iron concentration in neonatal foals and its utility as an inflammatory marker in this population has been published. OBJECTIVES To determine the physiologic plasma iron concentration in neonatal foals. To assess its utility as an inflammatory marker to predict systemic inflammatory response syndrome (SIRS) and as a prognostic marker. ANIMALS Forty-seven ill neonatal foals admitted to a referral equine hospital were divided in 2 groups based on the SIRS criteria (24 SIRS and 23 non-SIRS). Two control groups of 43 hospital and 135 stud farm healthy neonatal foals were also included. METHODS Observational prospective study. Data were summarized by mean and its 95% confidence interval and absolute frequency and percentage for quantitative andqualitative variables. One-way ANOVA, ANCOVA (group and age effects) and Dunnett as posthoc analysis were used to compare plasma iron concentration among groups. RESULTS Neonatal foals with SIRS did not have had any statistically significant different plasma iron concentrations compared to non-SIRS (P = .56) and stud farm control group (P = .99), 172.8 μg/dL (95% CI; 126.0-219.6), 193.1 μg/dL (139.1-247.2), and 181.8 μg/dL (171.3-192.4), respectively. Plasma iron concentration had a large variability in healthy neonatal foals, and was negatively correlated with age in hospital controls (rho = -0.387) and sick neonatal foals (rho = -0.598) (P < .001). CONCLUSIONS AND CLINICAL IMPORTANCE Plasma iron was not a useful marker of SIRS in neonatal foals and was not associated with outcome.
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Affiliation(s)
- Júlia Sanmartí
- Servei de Medicina Interna Equina, Departament de Medicina i Cirurgia Animals, Facultat de Veterinària, Universitat Autònoma de Barcelona, Barcelona, Spain.,Unitat Equina, Fundació Hospital Clínic Veterinari, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Lara Armengou
- Servei de Medicina Interna Equina, Departament de Medicina i Cirurgia Animals, Facultat de Veterinària, Universitat Autònoma de Barcelona, Barcelona, Spain.,Unitat Equina, Fundació Hospital Clínic Veterinari, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Judit Viu
- Servei de Medicina Interna Equina, Departament de Medicina i Cirurgia Animals, Facultat de Veterinària, Universitat Autònoma de Barcelona, Barcelona, Spain.,Hospital Veterinario Sierra de Madrid, 28750-San Agustín de Guadalix, Madrid, Spain
| | - Eduardo Alguacil
- Unitat Equina, Fundació Hospital Clínic Veterinari, Universitat Autònoma de Barcelona, Barcelona, Spain.,Uplands Way Vets Low Road, Bressingham, IP22 2AA Diss, Norfolk, UK
| | | | - José Ríos
- Unitat de Bioestadística, Facultat de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Eduard Jose-Cunilleras
- Servei de Medicina Interna Equina, Departament de Medicina i Cirurgia Animals, Facultat de Veterinària, Universitat Autònoma de Barcelona, Barcelona, Spain.,Unitat Equina, Fundació Hospital Clínic Veterinari, Universitat Autònoma de Barcelona, Barcelona, Spain
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27
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Stewart AJ, Hackett E, Bertin FR, Towns TJ. Cortisol and adrenocorticotropic hormone concentrations in horses with systemic inflammatory response syndrome. J Vet Intern Med 2019; 33:2257-2266. [PMID: 31512777 PMCID: PMC6766528 DOI: 10.1111/jvim.15620] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Accepted: 08/27/2019] [Indexed: 12/26/2022] Open
Abstract
Background Plasma adrenocorticotropic hormone (ACTH) and serum cortisol concentrations increase with illness‐associated stress. Dynamics of plasma ACTH and serum cortisol concentrations in adult horses with systemic illness are undocumented. Hypothesis/Objective To determine whether ACTH and cortisol concentrations and the ACTH/cortisol ratio vary with survival, the presence of systemic inflammatory response syndrome (SIRS), or ischemic gastrointestinal lesions at admission, or throughout hospitalization. Animals One hundred fifty‐one adult horses. Methods Prospective study measuring serum cortisol and plasma ACTH at admission and on days 2, 4, and 6 of hospitalization. Horses were grouped by outcome (survival, SIRS status, number of SIRS criteria [SIRS score], SIRS severity group, and the presence of an ischemic lesion). Differences between groups and over time for ACTH, cortisol, and ACTH/cortisol ratio were investigated with a mixed effect model. Receiving operator characteristic curves and odds ratios were calculated for survival and ischemia. Results In all groups, ACTH, cortisol, and ACTH/cortisol ratio significantly decreased over time (P < .0001). ACTH, cortisol, and ACTH/cortisol ratio were higher at admission in nonsurvivors, and ACTH and cortisol were higher in horses with ischemic lesions (P < .01). Horses with ACTH above reference interval at admission were 6.10 (2.73‐13.68 [95% confidence interval]) times less likely to survive (P < .0001). No significant difference in ACTH, cortisol, and ACTH/cortisol ratio between horses with different SIRS status, scores, or groups were detected, although nonsurvivors had a higher SIRS score (P < .0001). Conclusions and Clinical Importance Pituitary and adrenal responses are altered in nonsurviving horses and those with an ischemic gastrointestinal lesion.
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Affiliation(s)
- Allison J Stewart
- School of Veterinary Science, The University of Queensland, Gatton, Queensland, Australia.,Department of Clinical Sciences, College of Veterinary Medicine, Auburn University, Auburn, Alabama.,Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Eileen Hackett
- College of Veterinary Medicine & Biomedical Sciences, Colorado State University, Fort Collins, Colorado
| | - Francois-Rene Bertin
- School of Veterinary Science, The University of Queensland, Gatton, Queensland, Australia
| | - Taylor J Towns
- Department of Clinical Sciences, College of Veterinary Medicine, Auburn University, Auburn, Alabama
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28
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Aleman M, McCue PM, Chigerwe M, Madigan JE. Plasma concentrations of steroid precursors, steroids, neuroactive steroids, and neurosteroids in healthy neonatal foals from birth to 7 days of age. J Vet Intern Med 2019; 33:2286-2293. [PMID: 31489708 PMCID: PMC6766486 DOI: 10.1111/jvim.15618] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Accepted: 08/26/2019] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Transient hypothalamic-pituitary-adrenal axis dysfunction occurs in critically ill foals with sepsis and neonatal maladjustment syndrome (NMS). Cortisol is the most commonly measured steroid. However, a complex interaction of various steroid compounds might play a role in pathophysiology of this disorder. OBJECTIVE To identify steroid compounds present at high concentrations at birth that rapidly and steadily decrease within the first 7 days of life in healthy foals and that might be supportive diagnosis of NMS and other neonatal disorders. ANIMALS Ten healthy neonatal Quarter Horse foals (5 females and 5 males). METHODS Prospective study. Blood was collected in heparinized tubes within 30 minutes after birth, and at 12, 24, 48, 72, 96, 120, 144, and 168 hours of age. Plasma was separated and a panel of steroid compounds was analyzed using liquid chromatography-mass spectrometry. A nonlinear regression model was used to determine decay concentrations over time. Confidence intervals (CIs) were calculated and significance was set a P ≤ .05. RESULTS Five compounds were identified: pregnenolone, progesterone, deoxycorticosterone, dehydroepiandrosterone, and dehydroepiandrosterone sulfate. Pregnenolone and progesterone concentrations rapidly decreased by 24 hours of age and remained low throughout the first 7 days of life. Their half-life (95% CI) was short at 3.7 (3.4, 4.0) and 4.5 (2.8, 6.1) hours, respectively. No statistical differences in the concentrations of these compounds were found between males and females. CONCLUSIONS AND CLINICAL RELEVANCE Progesterone might be a useful marker for identifying continuous endogenous production of neuroactive steroids in foals with suspected NMS and other neonatal diseases.
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Affiliation(s)
- Monica Aleman
- Medicine and EpidemiologyUniversity of California, DavisDavisCalifornia
| | | | - Munashe Chigerwe
- Medicine and EpidemiologyUniversity of California, DavisDavisCalifornia
| | - John E. Madigan
- Medicine and EpidemiologyUniversity of California, DavisDavisCalifornia
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29
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Bohlin A, Saegerman C, Hoeberg E, Sånge A, Nostell K, Durie I, Husted L, Öhman A, van Galen G. Evaluation of the foal survival score in a Danish-Swedish population of neonatal foals upon hospital admission. J Vet Intern Med 2019; 33:1507-1513. [PMID: 31004404 PMCID: PMC6524090 DOI: 10.1111/jvim.15487] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2018] [Accepted: 03/12/2019] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND It is highly desirable to assess the probability of survival in sick neonatal foals upon admission. The foal survival score (FSS) is a published scoring system used to estimate the probability of survival in hospitalized neonatal foals <4 days old. HYPOTHESIS/OBJECTIVES To evaluate the ability of the FSS to predict survival in older foals from a geographically different area compared to the original study. ANIMALS Five-hundred ninety hospitalized neonatal foals ≤14 days of age. METHODS Retrospective Danish-Swedish multicenter study that included details of signalment, history, clinical examination, laboratory results, necropsy findings, and outcome. Scores and score variables were compared between survivors and nonsurvivors using logistic regression. The optimal cutoff and its test parameters were calculated using a receiver operator characteristic curve. RESULTS Prematurity, cold extremities, ≥2 infectious or inflammatory sites, blood glucose concentration, and total white blood cell counts were significantly associated with nonsurvival (P ≤ .02). The optimal cutoff to predict survival was ≥6, resulting in sensitivity 78%, specificity 58%, 92% positive predictive value, and 31% negative predictive value. The test performed equally well in foals <4 days old compared to those 4-14 days old. CONCLUSIONS AND CLINICAL IMPORTANCE Using the suggested optimal cutoff of ≥6, the FSS performed moderately well and may aid in early determination of prognosis for survival. However, the FSS did perform differently in another population and therefore should be assessed under local conditions so that its diagnostic potential is not overestimated.
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Affiliation(s)
- Anna Bohlin
- Evidensia Equine Specialist Hospital Helsingborg, Helsingborg, Sweden
| | - Claude Saegerman
- Faculty of Veterinary Medicine, Research Unit in Epidemiology and Risk Analysis Applied to Veterinary Sciences (UREAR-ULg), Fundamental and Applied Research for Animal and Health (FARAH) Center, University of Liege, Liege, Belgium
| | - Emma Hoeberg
- Medicine and Surgery, Department of Veterinary Clinical Sciences, University of Copenhagen, Taastrup, Denmark
| | - Alexandra Sånge
- Medicine and Surgery, Department of Veterinary Clinical Sciences, University of Copenhagen, Taastrup, Denmark
| | - Katarina Nostell
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, Ultuna, Sweden
| | - Inge Durie
- Evidensia Equine Specialist Hospital Strömsholm, Strömsholm, Sweden
| | | | - Anna Öhman
- Evidensia Equine Specialist Hospital Helsingborg, Helsingborg, Sweden
| | - Gaby van Galen
- Medicine and Surgery, Department of Veterinary Clinical Sciences, University of Copenhagen, Taastrup, Denmark
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30
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Sheats MK. A Comparative Review of Equine SIRS, Sepsis, and Neutrophils. Front Vet Sci 2019; 6:69. [PMID: 30931316 PMCID: PMC6424004 DOI: 10.3389/fvets.2019.00069] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Accepted: 02/15/2019] [Indexed: 12/15/2022] Open
Abstract
The most recent definition of sepsis in human medicine can be summarized as organ dysfunction caused by a dysregulated host response to infection. In equine medicine, although no consensus definition is available, sepsis is commonly described as a dysregulated host systemic inflammatory response to infection. Defense against host infection is the primary role of innate immune cells known as neutrophils. Neutrophils also contribute to host injury during sepsis, making them important potential targets for sepsis prevention, diagnosis, and treatment. This review will present both historical and updated perspectives on the systemic inflammatory response (SIRS) and sepsis; it will also discuss the impact of sepsis on neutrophils, and the impact of neutrophils during sepsis. Future identification of clinically relevant sepsis diagnosis and therapy depends on a more thorough understanding of disease pathogenesis across species. To gain this understanding, there is a critical need for research that utilizes a clearly defined, and consistently applied, classification system for patients diagnosed with, and at risk of developing, sepsis.
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Affiliation(s)
- M. Katie Sheats
- Department of Clinical Sciences, North Carolina State University College of Veterinary Medicine, Raleigh, NC, United States
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31
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Wright S. Highlights of recent clinically relevant papers. EQUINE VET EDUC 2018. [DOI: 10.1111/eve.12979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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32
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Wong DM, Ruby RE, Dembek KA, Barr BS, Reuss SM, Magdesian KG, Olsen E, Burns T, Slovis NM, Wilkins PA. 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; 32:1185-1193. [PMID: 29582480 PMCID: PMC5980351 DOI: 10.1111/jvim.15087] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Revised: 12/18/2017] [Accepted: 01/31/2018] [Indexed: 01/09/2023] Open
Abstract
Background 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. Objectives 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. Animals 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 scores. SIRS criteria were also evaluated. Sepsis scores and positive SIRS scores were statistically compared to foals with sepsis. Results One‐hundred and twenty‐six foals were septic and 147 sick‐nonseptic. The original and updated sepsis scores were significantly higher in septic foals as compared to sick‐nonseptic and healthy foals. The sensitivity and specificity of the updated sepsis scores to predict sepsis were not significantly better than those of the original sepsis score. One‐hundred and twenty‐seven of 273 (46.5%) foals met the original SIRS criteria and 88/273 (32%) foals met the equine neonatal SIRS criteria. The original SIRS criteria had similar sensitivity and specificity for predicting sepsis as did the 3 sepsis scores in our study. Conclusions and Clinical Importance The updated sepsis scores did not provide improved ability in predicting sepsis. Fulfilling the original SIRS criteria provided similar sensitivity and specificity in predicting sepsis as the modified sepsis score and might serve as a diagnostic aid in identifying foals at risk for sepsis.
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Affiliation(s)
- D M Wong
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Lloyd Veterinary Medical Center, Iowa State University, Ames, Iowa
| | - R E Ruby
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Lloyd Veterinary Medical Center, Iowa State University, Ames, Iowa
| | - K A Dembek
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Lloyd Veterinary Medical Center, Iowa State University, Ames, Iowa
| | - B S Barr
- Department of Internal Medicine, Rood and Riddle Equine Hospital, Lexington, Kentucky
| | - S M Reuss
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida
| | - K G Magdesian
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, California
| | - E Olsen
- Department of Clinical Sciences, New York State College of Veterinary Medicine, Cornell University, Ithaca, New York
| | - T Burns
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, Ohio
| | - N M Slovis
- McGee Medicine Center, Hagyard Equine Medical Institute, Lexington, Kentucky
| | - P A Wilkins
- Department of Veterinary Clinical Medicine, University of Illinois, Urbana, Illinois
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