Final Exam - Septic/PAS Foals Flashcards
T/F: a foal is septic until proven otherwise
true
what is bacteremia?
presence of viable bacteria in the blood stream
what is SIRS?
malignant global activation of multiple proinflammatory pathways - nonspecific innante inflammatory response
what is sepsis?
presence of a probable or documented infection together with systemic manifestations of infection
to say a neonate has SIRS, the patient must have 2 or more of the following conditions?
- fever or hypothermia
- tachycardia
- tachypnea or hypocapnia
- leukocytosis or leukopenia
- presence of bands on a blood smear
what are 3 possible risk factors for a foal developing neonatal sepsis that would be important to gather during a history?
- dystocia
- maternal illness - placentitis, vulvar discharge
- failure of passive transfer
does a normal cardiothoracic auscultation on a neonatal foal rule out pulmonary disease?
no
why is ultrasonographic evaluation of the urachus important?
need to know what structures are involved
what are the 2 most commonly affected joints in septic arthritis in the neonatal foal?
- tarsocrural
- femoropatellar
what are the pros & cons of blood culture when attempting to diagnose septicemia in a foal?
gold standard, definitive diagnosis
delayed results = delayed treatment, high false negatives due to low circulating bacterial load, low volume of blood collected, or variance in culture media & processing
what information do you need to obtain a sepsis score?
CBC, blood glucose, lactate, IgG, creatinine, clinical exam (petechiae, diarrhea, swollen joints, respiratory distress, neuro signs), historical data, presence of SIRS
what are some important considerations when choosing antimicrobials in a septic foal?
want broad spectrum, bactericidal, & IV antibiotics
FPT - has neutropenia & bad immune system
IV because gut & muscle perfusion are altered
ampicillin & amikacin
what is the main underlying issue that leads to clinical manifestation of NE?
brain damage results from:
decrease in cerebral blood flow, oxygen, hypoxia, inflammatory cascade leading to ischemia, neuronal cell death, repurfusion injury/oxidative injury
excessive intracellular calcium has profound effects (swelling)
microglia (developmental) & elevated pregnanes
what is the madigan squeeze? how does it work?
thoracic pressure is applied to a young foal in order to induce recumbency and a slow-wave sleep
believed to signal the foal to transition from sleeping in the womb to wakefulness - mimics birth canal, gives them a bit of a redo
why are septic foals at a higher risk for developing pneumonia?
abnormal perinatal development, hypoxia & SIRS cause vascular leakage, & they are immunocompromised
what are the most common pathogens of foal enterocolitis?
c. perfringens, c. difficile, salmonella, rotavirus
whats the most common pathway for a foal to develop sepsis?
enterocolitis/pneumonia
what agent is often associated with causing omphalitis?
e. coli
what is a common complication of omphalitis?
patent urachus
when may you use hyperimmune plasma?
foal that needs oncotic support, endotoxemia, or FPT
what is the shock dose for a foal?
20 ml/kg then reassess mentation, pulses, & urine
what nutritional treatment is needed for a septic foal?
enteral - indwelling NG tube needed to stimulate intestinal development at 50 kcal/kg/day
what is the prognosis of septic foals?
50-60% survival short term
what are some negative prognostic factors in septic foals?
gram negative or mixed infections, septic arthritis, significant elevations in bands or creatinine, concurrent meningitis
