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Lexington, KY, United States

Easterwood L.,Texas A&M University | Chaffin K.,Texas A&M University | Marsh P.S.,Texas A&M University | Marsh P.S.,Hagyard Equine Medical Institute | And 2 more authors.
Journal of the American Veterinary Medical Association | Year: 2010

Case Description - 66 horses were potentially exposed to phosphine (a gas) 14 hours after being fed a pelleted ration treated with aluminum phosphide. Clinical Findings - 28 horses had clinical signs of profuse sweating, tachycardia, tachypnea, pyrexia, ataxia, seizures, and widespread muscle tremors. Clinically relevant laboratory findings included hypoglycemia and high plasma concentrations of lactate and ammonia and activities of γ-glutamyl transpeptidase, aspartate aminotransferase, and alkaline phosphatase. At least 4 horses had signs consistent with hepatic encephalopathy. Necropsy findings included petechial and ecchymotic hemorrhages in multiple organs, widespread vascular congestion, hepatic lipidosis, and neuronal necrosis in the brain. Phosphine was detected in the stomachs of the 3 horses tested. Treatment and Outcome-On the farm, horses were treated with gastric lavage followed by administration of di-tri-octahedral smectite, atropine, fluids, and sedatives. Six horses were hospitalized, and lactated Ringer's solution and flunixin meglumine were administered IV Additionally, 10% dextrose, corn syrup, and di-tri-octahedral smectite were administered PO. Twenty-seven horses died within 2 days after exposure. Two survivors (1 without clinical signs of toxicosis) made a complete recovery. Clinical Relevance - Progression of clinical signs in affected horses in this report was rapid, with few treatment options available, leading to a high case fatality rate. Fumigation with aluminum phosphide is commonly performed to eliminate weevils and other insects from stored grains. When appropriate precautions are used during fumigation, risk to livestock is typically minimal.

Zabrecky K.A.,Purdue University | Zabrecky K.A.,Ohio State University | Slovis N.M.,Hagyard Equine Medical Institute | Constable P.D.,Purdue University | And 2 more authors.
Journal of Veterinary Internal Medicine | Year: 2015

Background: Accurate diagnostic markers for sepsis in neonatal foals are needed. Plasma C-reactive protein concentration (p[CRP]) and haptoglobin concentration (p[Hp]) are well-established biomarkers of infection in humans, but studies are lacking in foals. Hypotheses: p[CRP]) and p[Hp] are increased in septic foals compared to sick nonseptic and healthy control foals, and are predictive of survival. Animals: Eighty critically ill foals (40 septic, 40 sick nonseptic) and 39 healthy control foals <1 week of age. Methods: Multicenter, prospective observational clinical study. Venous blood was collected at admission from septic and sick nonseptic foals and from clinically healthy foals at 24 h of age. A diagnosis of sepsis was made based on positive blood culture or a sepsis score >11, and p[CRP] and p[Hp] were measured by using ELISA tests. Data were analyzed by using the Mann-Whitney U-test and forward stepwise multivariable linear regression. P < .05 was considered significant. Results: Plasma [CRP] was positively associated with age, serum globulin, adrenomedullin, and bilirubin concentrations, aspartate aminotransferase activity, glutamyl-transferase activity, band neutrophil count, and rectal temperature, and was increased in foals with toxic neutrophils, enterocolitis, colic, rib fractures and septic arthritis. Surprisingly, p[Hp] was lower in septic foals than in sick nonseptic foals. Neither p[CRP] or p[Hp] was predictive of survival in critically ill foals. Conclusions and Clinical Importance: Plasma [CRP] increases with inflammation in neonatal foals but is not indicative of sepsis. Single time point, admission sampling of p[CRP] and p[Hp] do not appear to be useful biomarkers for sepsis in foals. © 2015 The Authors.

Petersen M.R.,Copenhagen University | Skive B.,Copenhagen University | Christoffersen M.,Copenhagen University | Lu K.,Hagyard Equine Medical Institute | And 3 more authors.
Veterinary Microbiology | Year: 2015

Endometritis in horses caused by Streptococcus equi subspecies zooepidemicus (S. zooepidemicus) may be underdiagnosed due to traditional diagnostic methods lacking sensitivity and specificity. We serendipitously identified a bacterial growth medium (bActivate) that appeared capable of inducing growth of dormant S. zooepidemicus, which subsequently allowed detection by standard diagnostics. To assess the effect of bActivate we compared its ability to activate dormant S. zooepidemicus in a group of potentially infected subfertile mares with phosphate-buffered saline (PBS). All mares had to test negative for S. zooepidemicus on a low-volume uterine lavage, be negative on endometrial cytology and without clinical signs of endometritis to be included in the investigation. The mares were instilled with bActivate or PBS in the uterus. Growth of S. zooepidemicus was induced by bActivate in 64% (16/25) and PBS in 8% (1/12) of the mares, respectively (p < 0.002). In vitro studies supported that some strains of S. zooepidemicus were able to form persister cells tolerating 32-times of the minimal inhibitory concentration of penicillin compared to normal growing cells. Persister cells had not acquired penicillin resistance, but seemed to tolerate the antimicrobial due to dormancy. This is, to our knowledge, the first description of controlled growth induction of dormant bacteria from a subclinical infection. Moreover we demonstrated how endometritis can origin from a reservoir of dormant bacteria residing within the endometrium, and not only as an ascending infection. Further studies should aim at determining the prevalence of dormant S. zooepidemicus, impact of activation on diagnostic and treatment efficacy, uterine health and mare fertility. © 2015 Elsevier B.V.

Toth B.,Purdue University | Slovis N.M.,Hagyard Equine Medical Institute | Constable P.D.,Purdue University | Taylor S.D.,Purdue University
Journal of Veterinary Internal Medicine | Year: 2014

Background: Bacterial sepsis remains a leading cause of morbidity and mortality in neonatal foals, but accurate diagnostic and prognostic markers are lacking. Adrenomedullin (AM) is a polypeptide with diverse biologic effects on the cardiovascular system that increases in septic humans and laboratory animals. Hypotheses: Plasma AM concentration (p[AM]) is increased in septic neonatal foals compared to sick nonseptic and healthy control foals, and p[AM] is predictive of survival in septic neonatal foals. Animals: Ninety critically ill (42 septic, 48 sick nonseptic) and 61 healthy foals <1 week of age. Methods: A prospective observational clinical study was performed. Venous blood was collected from critically ill foals at admission and from healthy foals at 24 hours of age. Critically ill foals were categorized as septic or sick nonseptic based on blood culture results and sepsis score. Plasma [AM] was measured by using a commercially available ELISA for horses. Data were analyzed by using the Mann-Whitney U-test and P < .05 was considered significant. Results: Plasma [AM] was not significantly different between septic and sick nonseptic foals (P = .71), but critically ill foals had significantly increased p[AM] compared to healthy controls (P < .0001). In critically ill foals, p[AM] was not predictive of survival (P = .051). A p[AM] cutoff concentration of 0.041 ng/mL provided a test sensitivity of 91% and specificity of 54% to predict illness. Conclusions and Clinical Relevance: Plasma [AM] shows promise as a marker of health in neonatal foals, but p[AM] increases nonspecifically during perinatal illnesses and is not necessarily associated with sepsis. © 2014 by the American College of Veterinary Internal Medicine.

Liepman R.S.,Ohio State University | Dembek K.A.,Ohio State University | Slovis N.M.,Hagyard Equine Medical Institute | Reed S.M.,Rood and Riddle Equine Hospital | Toribio R.E.,Ohio State University
Equine Veterinary Journal | Year: 2015

Reasons for performing study: Serum immunoglobulin (IgG) assessment in neonatal foals is considered standard care in equine hospitals to determine immunity and overall health. However, cut-off values of IgG to predict complete or partial failure of transfer of passive immunity (FTPI) were developed 30 years ago and are largely empirical with little prospective or statistical data to support their use or association with outcome. Objectives: To critically evaluate the traditional cut-off values of IgG in the assessment of FTPI (IgG <8g/l), determine the association between various degrees of FTPI and likelihood of nonsurvival and examine whether FTPI can be predicted by serum total protein (TP), albumin and globulin in hospitalised foals. Study design: Multicentre, cross-sectional study. Methods: We evaluated clinicopathological variables in 597 foals ≤7 days old from 3 equine hospitals including serum IgG, fibrinogen, TP and albumin concentrations. Foals were divided into 3 groups by diagnosis: healthy, sick nonseptic and septic. The aforementioned variables in addition to globulin concentrations were evaluated in a subset of 118 foals. Univariate, multivariate and multinomial logistic regression were used to compute odds ratios for nonsurvival in these foals. Results: Our findings support use of the traditional cut-off value of >8g/l as adequate transfer of passive immunity (ATPI). Odds of nonsurvival increased in proportion to lower IgG concentrations. Higher TP concentrations were associated with lower likelihood of FTPI; however, higher albumin concentrations were associated with a greater likelihood of FTPI. A regression equation was created to predict IgG in foals using serum proteins. Conclusions: Serum IgG values of <8g/l in hospitalised foals were proportionally associated with mortality. We recommend immediate assessment of IgG concentrations in hospitalised foals and those with FTPI should receive prompt immunotherapy. The summary is available in Chinese - see Supporting information. © 2015 EVJ Ltd.

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