Endotoxemia Flashcards
Endotoxemia
disregulated inflammatory response
-two opposing forces at the same time (clotting and bleeding)
How does endotoxemia start?
with gram (-) infections (generally in the GI tract)
What will the inflammatory response lead to?
SIRS = systemic inflammatory response system
What can happen when the mucosal barrier is compromised?
endotoxins can be translocated into the bloodstream
What causes endotoxemia?
-over-exercise or strenuous exercise
-severe trauma
What % of colic cases become toxic?
10-40%
What horse becomes toxic faster?
foals
Can endotoxemia lead to colic?
yes
Can colic lead to endotoxemia?
yes
Pathogenesis of endotoxemia:
- translocation of endotoxins
- activation of an inflammatory response (innate immune system)
- TxA2 promote platelet aggregation (clots) which leads to PGI2 + PGE2 leading to vasodilation and hypertension (low BP)
- systemic hypotension (leads to perfusion deficits and organ failure)
- coagulopathies leads to diseminated intravascular coagulopathy
Vasoconstriction leads to…
hypertension (increased BP)
Bronchoconstriction leads to…
dyspenea (difficulty breathing) which leads to hypoxemia
Endotoxemia will quickly lead to,,,
laminitis
Other factors of pathology:
-thrombocytopenia (low platelet circulating in blood)
-hypovolemia (low circulating blood)
-myocardialdepression
-vasoplegia (floppy vessels)
What is endotoxic shock?
blood pools in areas
Clinical signs depend on..
severity and how soon the problem is addressed
What is first affected?
kidneys
Signs of kidney failure
-red urine (hematuria)
-difficulty urinating (oliguria)
-no urine (anuria)
-excess urine (polyuria)
Clinical signs
-kidney failure
-increased HR
-increased RR (bc of hypoxemia)
-mucosal discoloration
-petechias (blood clots everywhere)
-bleeding (epistaxis)
-weak pulse
-cold extremeties
-fever in beginning
-laminitis
-dysphea
-cardiac dysfunction
What happens to body temp as the disease progresses?
it decreases
How to address treatment?
address what is occurring at the time
First step of treatment
try to remove the circulating toxins
-banamine
-polymyxin B
Second step of treatment
anti-inflammatory and anti-oxidants
-DMSO
-more potent drugs
In cases of colic what is the treatment?
give profanetic drugs
-lidocaine (stimulates the intestines to move + local anesthetic + anti-inflammatory)
Other courses of treatment
-fluids
-plasma
-to dissolve coagulations - anticoagulents (heperin)
-vasopressors (norepinephrine)
-monitor and repeat necessary treatments
