Papers, reviews Flashcards
can mares abort because of reactivation of latent HErpes1?
Is a mare that aborted bc pf EHV1 likely to do so in their future pregnancies?
no documentation of abortions caused by reactivation of latent infection, but possible
The virus is cleared rapidly from the reproductive tract following abortion and it is rare for mares to abort due to EHV-1 infection in consecutive pregnancies
What do herpes 1 aborted fetuses grossly look like?
Fetuses from abortions caused by EHV-1 are usually minimally autolysed and fetal membranes often appear grossly normal
Does EVA infection always cause disease?
Infection is predominantly subclinical, while very young, aged, debilitated and immunocompromised horses are more predisposed to its clinical manifestations
EIA
EVA
can mare transmit disease to her foal?
EIA: yes via placenta and via colostrum
EVA: no evidence - but foals die anyways or are aborted
When does abortion occur with EVA infection?
How does the fetus look like?
Abortion is known to occur between 3 to 10 months of gestation (Balasuriya, 2014).
The aborted fetus is usually free of lesions, and is usually fresh but sometimes autolyzed (
Which agents cause bacterial placentitis and how?
Misc causes of placentitis more frequent in the US and Australia?
Bacterial placentitis is most commonly ascending and caused by (in order of frequency of detection)
- Streptococcus equi subsp. zooepidemicus,
- Escherichia coli,
- Pseudomonas spp.,
- Klebsiella spp. and
- Staphylococcus spp
US: nocardioform placentitis: signature signs early lactation, often caused by actinomycetes but also others
AU: Placentitis associated with caterpillar setae ingestion
Does Herpes 1 survive in the environment?
not very long, couple of days
How does Leptospirosis influence pregnancy?
Is the fetus infectious?
can lead to abortion, to birth of weak foals or birth of healthy foals
if lesions, then abscesses in the liver and kidney
Mares can shed leptospires in their urine for up to 14 weeks following abortion.
incidence of abortion due to twin pregnancies
1.5-6% of all abortions
what is a red bag delivery and what are possible consequences?
Failure of the chorioallantois to rupture
common sequela to ascending placentitis due to increased thickness of the membranes in the area of the cervical star.
- compromised foals
- death
- due to the mare’s placentitis, and/or as a result of
- hypoxia if the remaining placenta is detached before the chorioallantois is ruptured.
Meconium staining suggests
fetal stress in utero or during parturition.
Incidence of NI in
TBs
Standardbreds
mules
Only approximately
- 1% of Thoroughbred foals and
- 2% of Standardbred foals
develop NI despite the incidence of alloantibody production in mares being estimated as 10% in Thoroughbred mares and 20% in Standardbred mare
- mules: 10%
Which donors are fit for blood transfusion for mules?
Can the mother be used for transfusions to their foals in NI
For mule foals any horse erythrocyte donor should be compatible, but whole blood from mares previously bred to donkey stallions should not be used
mares can be used if erythrocytes are washed
otherwise use a cross match donour
How can NI be tested before it occurs?
what is the consequence after a mare had a foal with NI?
- cross-matching the mare and foal, or more simply,
- jaundiced foal agglutination (JFA) test which looks for agglutination of foal erythrocytes when added to the mare’s colostrum
Ideally mares should not be bred back to the same stallion if a foal with NI has resulted from this breeding combination.
what is considered to be the first-line choice for treatment of neonatal sepsis? And why?
Ampicillin and aminoglycosides
IM penicillin -> low plasma concentrations and inj reactions
IV penicillin better BUT
aminopenicillins cover some gram neg in addition
When can i give oral penicillins?
Amoxicillin clavulanate
can be used orally for the treatment of bacterial infections in
young foals (up to 4 months of age)
as it can attain adequate plasma levels
clavulanic acid protects against beta lactamase
does penicillin target pseudomonas?
enterococcus?
Pseudomonas: only ticarcillin
(=extended-spectrum carboxypenicillin)
Enterococcus: f.e. ampicillin
aminopenicillins have higher sens to Enterococcus sp.
Enterokokken sind…
gram positive Kokken, fak anaerob
ist strep sehr ähnlich
gehört zu den firmicutes so wie Staph und Strep
What are carbapenems?
Use in foals?
Beta-lactam antimicrobials
f.e. Imipenem
critical importance in human health so dont use
Cephalosporins and use in foals
bactericidal and time-dependent
broad spectrum: good Gram-positive coverage with increasing Gramnegative activity in the later generations
CRITICAL IMPORTANCE HUMAN HEALTH
do not penetrate cells
when is ceftiofur use indicated in foals? DOSE?
Rather IV? Or is IM and SC also ok?
neonatal sepsis when other nonprotected drugs are inappropriate,
usually in the case of renal dysfunction - 2,2mg/kg
BUT: many neonatal sepsis isolates resistant to ceftiofur
can achieve adequate plasma levels after intramuscular or subcutaneous injection
so use if no venous access
Do cephalosporins cross the BBB?
THIRD generation cephalosporins
f.e. ceftriaxone and cefotaxime
indicated for meningitis
Foals have a high body water content and the high volume of distribution.
What does that mean for aminoglycoside dosing?
Higher doses needed.
but NOT more often bc renal tubular cells die if subsequent admin of aminoglycosides when they are not yet done with metabolisation
Which drugs are generally superior for regional use?
concentration dependent drugs (like aminoglyc)
Do all aminoglycosides have renal side effects?
Amikacin is less likely to be associated with renal side effects compared to gentamicin.
fluorchiolone use in foals?
toxicity to developing articular cartilage (Vivrette et al. 2001). This effect is thought to be less when using marbofloxacin compared to enrofloxacin.
BUT excellent tissue penetration
and
Marbofloxacin has also been used to treat macrolide-resistant Rhodococcus equi infections.
side effects macrolides
associated with fatal enterocolitis in adults
associated with a reduced ability to sweat
(anhydrosis or hypohydrosis).
which drugs can be combined with rifampin?
spectrum?
- Macrolides (except Clarithromycin) for Rhodo *
- TMPS
- Doxycyclin
for treatment of osteomyelitis or umbilical infections
has narrow gram pos activity and quickly build up resistance (dont use alone); new studies: SID ok
*!!!!rifampin + clarithromycin > decreased plasma and pulmonary epithelial fluid cell concentrations of clarithromycin (Peters et al. 2012) due to inhibition of intestinal uptake transporters.!!!!!
Does TMPS target enterococcus?
lack of efficacy against Enterococcus spp. (Magdesian 2017)
Does TMPS penetrate puss?
poorly active in purulent material (Haggett 2008).
Dosing of Metro in foals
longer elimination half-life in foals compared with adults and should be used at a lower dose (Swain et al. 2014).
treats anaerobes in foals as well
Treatment against sepsis has been chosen according to culture and susceptibility testing.
The ABs dont improve the status of the foal after 48 hour treatment.
> whats next?
- isolation rates and antimicrobial susceptibility profiles from bacteria isolated from foals with sepsis after > 48h of hospitalisation differ significantly from those collected at hospital admission (Theelen et al. 2020).
- BUT ALSO not possible to predict antimicrobial susceptibility of bacteria isolated from foals after > 48h of hospitalisation
>>> no general recommendation but maybe better to retest?
Which test needs to be performed to determine the Minimum Inhibitory Concentration of an AB?
microdilution susceptibility testing
= GOLD standard of susc testing
If the MIC is below the breakpoint, an organism is considered to be
susceptible
If the MIC is above the breakpoint, an organism is considered to be
resistant
Antimicrobials that are of critical importance to human health
- 3rd-, 4th- and 5th-generation cephalosporins,
- fluoroquinolones and
- carbapenems
potential marker for identifying continuous endogenous production of neuroactive steroids in sick neonatal foals
aleman: progesteron
normally rapidly decreased by 24 hours of age and remained low throughout the first 7 days of life
half time of 4 hiours
Are triglizerides high or low in neonatal foals?
- highest in healthy neonatal foals aged 1–2 days, and in
- nonsurviving sick foals and those with positive bacterial cultures.
- Age was associated with triglyceride concentration regardless of health status.
Glucose and insulin regulation in foals and dams <2weeks postpartum
main findings?
- foals: wide variation
- Mares developed transient insulin resistance in the immediate post-partum period.
Factors associated with long-term athletic outcome in TB neonates admitted to an ICU
chidlow
Foals hospitalised due to
- prematurity/dysmaturity or
- orthopaedic disorders
were less likely to race than their maternal siblings and those that did race had decreased performance.
SMALL SAMPLE SIZE
Venous blood gas parameters, electrolytes, glucose and lactate concentration in sick neonatal foals:
direct venipuncture versus push-pull technique
PP technique appears to be acceptable for collection of blood samples for all parameters
(venous blood gas parameters, as well as electrolytes, glucose and lactate in sick neonatal foals)
Which adrenocortical steroids can be useful to assess prognosis in foals?
- 17α-OH-progesterone response (severity and outcome
- cortisol response (outcome i think)
to administration of ACTH
>>> suggest adrenocortical dysfunction
Oxidative state in equine neonates:
Anti- and pro-oxidant balance?
pro-oxidant balance
during the first 168 hours after birth in equine neonates
Which laboratory parameter was associated with hyponatremic neuro signs in foals?
Does the speed of correction (if <10mmol/L/day) influence neuro signs?
were sodium levels associted with outcome?
Schwarz und slovis
- BUN
- no
- no, not at any point. but occurence of neuro signs was.
sefulness of digital and optical refractometers for the diagnosis of failure of transfer of passive immunity in neonatal foals
230 foals
rapid, inexpensive screening tests with good sensitivity
does it make any difference if I transfuse 1 or 2 liters of Rhodo hyperimmune plasma to foals
odds of pneumonia were 2.4-fold higher for foals transfused with 1 L of REHIP than for foals transfused with 2 L
but study included also presumptive cases of Rhodo
(ultrasonographic evidence of pulmonary abscesses or consolidations >1 cm)
True or false?
The equine fetus gains 75% of its final birth weight between mid and late gestation
True
Is BMI of the dam related to body condition of the foal at birth?
No
only in very extreme cases
True or False
the weight specific rates of fetal glucose uptake increase progressively towards term
False
glucose uptake declines
How does Maternal obesity influence glucose metabolism of the foal and when?
Glucose intolerance
Insulin resistance
at 6–18 months
treatment of portosystemic shunt in foals
broadspectrum antimicrobials and metronidazole,
anti-inflammatory agents,
lactulose and
intravenous fluids
then: surgery (3 succesful extrahepatic)
diagnosis of portosystemic shunt in foals
Presumptive diagnosis
- serum bile acid and blood ammonia
- clinical: neuro signs, failure to thrive
Definitive diagnosis:
- computed tomography angiography,
- mesenteric vein portography,
- splenic portography,
- transcolonic sodium pertechnetate Tc 99m scintigraphy and ultrasonography
which is the correct term for all forms of dummy foal diseases?
Neonatal encephalopathy
Phases of hypoxic ischemic encephalopathy
- phase: hypoxic events…??
2. phase = delayed neuronal cell death.
associated with reperfusion injury (oxidative stress), excitotoxicity, excessive intracellular calcium, activation of enzymes and multiple pathways, cytotoxic actions of microglia, inflammation and apoptosis
Which factors are involved in the development of neonatal encephalopathy?
we don’t know, most likely multifactorial f.e.
- elevated pregnanes
- hypoxia
- inflammatory mediators
- involvement of microglia suspected in humans
- ….
Clinical signs of Perinatal asphyxia syndrome
neuro: generalised weakness, lack of interest in the dam, lack of suckle reflex, inability to lie down, recumbency and seizures
others: ileus, enterocolitis, decreased cardiac output or decreased renal output
Category 1: born normal, within 48 h dummy > good progn.
Category 2: abnormal from birth > less survival
Are there pathognomonic clinicopathological findings in PAS?
NO
- 32% PAS foals: increased CREA
- 61% PAS foals: increased CK
- Increases in serum creatinine (>309.4 umol/l) and/or
- low blood glucose before suckling (<1.94–2.5 mmol/l)
have been associated with placental insufficiency and an increase in PAS
effects of incomplete tarsal ossification on neonatal TBs future racing performance
- Grade 1 and 2 ossification: usually premature (gestation length <325 days)
- Grades 2 and 3 ossification were significantly less likely to race than their maternal siblings, and
- Grade 1, 2, 3 and 4 foals earned less money.
Alternative treatment of Rhod equi pneumonia in foals (other than macrolides + rifampin)
Gallium maltolate
- safe for use in foals,
- efficacy is comparable to traditional antimicrobial therapy to treat presumed R. equi pneumonia in naturally infected foals (Cohen et al. 2015).
- evidence is still lacking regarding the synergistic effects
bacteria mistake gallium for iron
> impaired iron dependent enzyme synthesis and other
Association between antimicrobial treatment of subclinical pneumonia in foals and selection of macrolide- and rifampicin-resistant Rhodococcus equi strains at horse-breeding farms in central Kentucky
10 TUS versus 10 non-TUS farms
the sum of the mean soil concentrations of MRRE was
significantly higher for TUS farms (8.85 log10-transformed CFUs/g)
versus
non-TUS farms (7.37 log10-transformed CFUs/g).
*macrolide + rifampicin-resistant Rho equi strains (MRRE)
** thoracic ultrasonographic screening (TUS) to diagnose subclinical disease
Septic arthritis in foals occurs in four different forms depending on the specific anatomical location of the inoculated bacteria:
Type S: haematogenous inoculation of the synovial membrane
Type E: haematogenous inoculation of bacteria in the epiphysis
Type P: haematogenous inoculation of the physis
Type T: via trauma with direct external inoculation
***entry of bacteria is most often via the lungs, GI or umbilicus
Septic arthritis in foals: most dominant bac
- E. coli,
- Actinobacillus spp,
- Klebsiella spp,
- Staphylococcus spp,
- Streptococcus spp and
- Rhodococcus equi
blood supply to the metaphysis
difference between adults and foals
- adult: nutrient artery
- foal: transphyseal vessels supplying the metaphyseal side of the physis
transphyseal vessels close within the first 2 weeks of life >>> nutrient artery
Which joints are most commonly affected with septic arthritis, physitis and osteomyelitis (SAPO)
tarsocrural (oberstes Sprung)
femoropatellar,
fetlock and
elbow joints
septic arthritis, physitis and osteomyelitis (SAPO)
how many joints are normally affecte?d
- 40% : only one affected joint, approximately
- 40% two affected joints, and
- 20% have more than two affected structures
septic arthritis, physitis and osteomyelitis (SAPO)
- is the synovial cavity consistently septic?
E- and P-type septic arthritis may not always lead to sepsis of the synovial cavity itself
Evidence based parameters in synovial fluid helping to diagnose septic arthritis in foals?
- TP
- WBC
- WBC diff
- SAA
- glucose
- D-dimer
- myeloperoxidase
- neutrophil gelatinase-associated lipocalin (NGAL)
Describe synovial fluid
normal
septic arthritis
Suggestive of Type P or E septic arthritis
normal:
- clear yellow and viscous
- WBC: <0,5 x 10^9 cells/L
- Diff WBC <50-60%
- TP <25 g/L
Septic arthritis
- Turbid yellow to orange
- >20 x 10^9 cells/L
- >85% neutrophils
- >30-40 g/L
Suggestive of Type P or E septic arthritis
- From slightly unclear to opaque
- 2-15 x 10^9 cells/L
- 75-90% neutrophils
- >25 g/L
how to inoculate synovial fluid for bacterial culture
several studies have shown that
initial inoculation in blood culture media may yield a significantly higher proportion of bacterial growth
(up to 79%),
compared to direct agar culture which might yield bacterial growth in as low as 37.5% of confirmed septic case
how sensitive is bacterial culture in detecting synovial sepsis?
only 45-85.7% growth rates from septic joints
((Sampling of both blood and SF for culture will increase the likelihood of a positive culture from a septic patient.))
Which blood parameters have been suggested to be an indicator of physeal or epiphyseal osteomyelitis in foals
Plasma fibrinogen concentrations higher than 9 g/L
consensus statement
definitive diagnosis of bronchopneumonia caused by R. equi should be based on
- culture or
- amplification of the vapA gene via PCR
from tracheobronchial aspirate (TBA)
obtained from a foal with one or more of the following:
(1) clinical signs of lower respiratory tract disease;
(2) cytological evidence of septic airway inflammation; or
(3) radiographic or ultrasonographic evidence of bronchopneumonia
diagnosis of Rhod equi enterocolitis
The diagnosis of enterocolitis caused by R. equi is
problematic
because isolation of R. equi from feces cannot be taken as evidence of enterocolitis caused by R. equi
Serology in diagnosis of R equi pneumonia
The current state of knowledge precludes serology to be used as a diagnostic test for R. equi pneumonia.
Consensus 2011
Virulence plasmid of R equi
vapA
R. equi pneumonia:
comsistent feacal shedding?
NO
Are there superior macrolides in the treatment of R equi?
Advantages of azithromycin and clarithromycin over erythromycin in foals include considerably
- enhanced oral bioavailabilities especially in the absence of fasting,
- prolonged halflives, and
- much higher concentrations in pulmonary epithelial lining fluid (PELF) and bronchoalveolar cells
Activity of macrolides against R equi time or concentration dependent?
MIC90 for the three macrolides?
Which macrolide should you use?
time-dependent activity against R. equi in vitro.
MIC90 is
- Clari: 0.12
- Ery: 0.25 (old)
- Azi: 1.0 ug/mL
In a retrospective study, the combination clarithromycin-rifampin was significantly more effective than erythromycin-rifampin or azithromycinrifampin, especially in foals with severe radiographic lesions. BUT rifampin seems to decrease concentrations of clar. in tissues and blood………………
how does resistance against rifampin develop?
through mutations in the
RNA polymerase beta subunit
encoded by the rpoB gene
if R.equi is resistant to one macrolide, should you try another?
R. equi isolates resistant to erythromycin, clarithromycin, or azithromycin are almost invariably resistant to the other 2 macrolides.
how long does R equi treatment usually last?
which side effects?
3 and 12 weeks
frequently causes diarrhea (usually self limiting)
prognosis for performance after successful treatment of uncomplicated R. equi pneumonia
excellent
The odds of developing R. equi pneumonia appear to be related to
the density of mares and foals per acre at horse breeding farms
Chemoprophylaxis with gallium maltolate (30 mg/kg; PO; q24 h for the first 14 days of life) against R equi
failed to reduce the incidence of R. equi pneumonia in a placebo-controlled trial of 438 foals at 12 farms in the United States.82
consensus 2011
Do Penicillins penetrate bone and synovia
Penicillins not very well
amikacin yes
Does Doxycycline have good intracellular penetration?
yes
so does oxytetra and all macrolides
which antibiotics are inactivated by necrotic tissue or puss?
Cephalosporines: Ceftiofur and Cefquinom
Gentamicin
TMPS
procain peni and Na/K peni
Which local analgesic can be used intrarticularly with foals?
Mepivacaine is the drug of choice,
since lidocaine and bupivacaine are more likely to cause articular cartilage damage (Adler et al. 2020).
short term and long term survival for foals with SAPO
short-term survival : between 42 and 84%.
Of those foals, long-term survival has been reported to be up to 92%, and euthanasia after discharge was often unrelated to the SAPO diagnosis (
Which factors influence outcome of SAPO positively?
- Early treatment
the first 24 h after onset of clinical signs is the critical time frame (93% to 66% drop in prognosis)
- 25% increase of probability of survival to discharge for every 1 g/L increase in plasma fibrinogen concentration (HepworthWarren et al. 2015).
Which factors influence outcome of SAPO negatively? 8
- <30 days of age at time of diagnosis
- critically ill foals
- involvement of multiple bones or joints
- Degenerated neutrophils
- high Syn Fluid neutrophil count
- intra-articular Gram-negative bacteria
- mixed bacterial infection
- culture of Salmonella from SF
prognosis for performance after successful SAPO treatment in foals
mixed evidence
recent: 62%, comparable to results seen in adult horses treated for septic arthritis (Wright et al. 2017)
BUT in a s_port horse population, only 28%_ of treated foals eventually performed as intended as adults.
neg association:
- multiple joints are septic (no assoc w number of bones involved!)
- synovial cell counts at admission exceeding 60,000 WBC/mm3
early and late imaging findings for P type SAPO in foals
- irregularity of the physeal margin and/or widening of the physis that progresses to lysis of the metaphyseal and epiphyseal trabecular bone
- irregular regions of bone loss with sclerosis around and likely an irregular periosteal reaction
P and E-type lesions
radiographic appearance
E-type: poorly defined or irregularly shaped regions of lysis along the chondral surface, might communicate with articular margin
P-type pathology has a similar appearance to Etype with
irregular regions of lysis, but they communicate with the physeal margin instead of the articular margin.
, radiographic sensitivity for bone loss
low,
requiring a 30-50% reduction in bone density for it to be radiographically visible
much higher sensitivity of CT for detecting decreased bone density
Variables significantly associated with nonsurvival in 94 hospitalised foals diagnosed with neonatal encephalopathy
- total calcium concentration,
- serum activity of alkaline phosphatase,
- recumbency,
- number of concurrent diseases, and
- use of vasopressors/inotropes
Digestible energy requirements for pregnant mares
How muh crude protein do they need?
Which minerals are essential?
Digestible energy requirements for mares increase during late gestation over 8 months and remain at the level of
- 110% for 9 months
- 115% for 10 months and
- 130% for 11 months
in comparison to the maintenance requirement (100%).
44 g of crude protein /mcal of digestible energy in late gestation
Calcium, Phosphorus, (maybe Se)
Mares’ progesterone levels (P4) during pregnancy
What do abnormalities in P4 concentrations indicate?
gradual increase in 2./3. trimesters up to the level of 2–12 ng/mL.
last week before parturition: progesterone peak
- sudden P4 decrease: acute condition, such as colic, uterine torsion, mare stress,…
- rapid P4 increase (<320d): possibility of placental pathology
- lack of P4 prior to delivery: poisoning with fescue grass or tall fescue
How can oestrogen be used to predict fetal health during pregnancy
Between 150 and 280 days of pregnancy
total oestrogens concentration >1000 ng/mL
if lower: stress or fetal weakness
under 500: might be fetal death
Which hormone correlates with placental health during pregnancy?
Relaxin
Which phase of parturition is critical for foal survival?
second phase (30 minutes)
every 10 min of delay: increases foals death
- by 10% during the delivery
- by 16% after birth
only 11% survive if second stage > 60 min
foal heat diarrhea
usually a self-limiting condition in foals aged
5 days to 15 days.
It occurs in 75% to 80% of neonatal foals and usually
lasts 3 days to 4 days
which group of rotavirus is associated with disease in horses?
Only group A has been associated with horse infection
Which viral enterotoxin is responsible for the hypersecretory component of RotaVirus diarrhea
nonstructural glycoprotein 4 (NSP4)
how long does virus shedding after rotavirus infection persist?
up to 12 days
Which C perf is isolated most commonly from foals?
which one is associated with highest mortality?
type A
type C
Which diagnostic tests provides the strongest evidence of C perf infeciron in foals?
ELISA and toxin gene PCR
rotavirus: which type´of PCR for detection?
RT-PCR
S westeri detection in feces trhough
treatment?
fecal flotation
(oxibendazole [15 mg/kg] or ivermectin [0.2 mg/kg]
Common infectious agents of foal diarrhea sorted by age range of foals
before which age is L. intracellularis not detectable in foals?
Salmo at any age
< Two weeks
Foal heat diarrhea // C perfringens // C difficile // Rota // Septicemia Cryptosporidium Neonatal asphyxia necrotizing enterocolitis
Two weeks–two months
Rotavirus Cryptosporidium Salmonella spp S westeri
> Two mo
L intracellularis S westeri N risticii
L.intracellularis only in foals >4months
Common infectious agents of foal diarrhea sorted by age range of foals
before which age is L. intracellularis not detectable in foals?
Salmo at any age
< Two weeks
Foal heat diarrhea // C perfringens // C difficile // Rota // Septicemia Cryptosporidium Neonatal asphyxia necrotizing enterocolitis
Two weeks–two months
Rotavirus Cryptosporidium Salmonella spp S westeri
> Two mo
L intracellularis S westeri N risticii
L.intracellularis only in foals >4months
Lactation can be induced with
dopamine D2 agonists
Drugs administered to mare’s for foal adoption
PGF2a
ACP
Etiology and sequelae of surviving interstitial pneumonia in foals
Acute interstitial pneumonia seems based on a multifactorial aetiology.
Lungs from foals that have survived acute interstitial pneumonia appear to be able to regenerate completely, leaving no permanent changes.
Short-term outcome and risk factors for post-operative complications following umbilical resection in 82 foals (2004–2016)
89.0% survived to discharge.
urachus = most commonly affected structure being patent and/or infected in 84.1% of cases.
decreased survival with
- preoperative septic arthritis and/or physitis
post OP complications:
- FPIT
- longer anaesthesia times
Indications for medical therapy or surgical therap in umbilical infections
Antimicrobial therapy alone when the infection is _localised to the external urachal remnan_t and NO sepsis or other sites of infection [8,9].
Surgery when sepsis is present and particularly in situations of clinical decline despite antimicrobial therapy
which sepsis score is currently aktuell in foals?
a positive blood culture
or
a sepsis score ≥12, developed by Brewer et al.
(Brewer and Koterba 1988)
93% sensitivity and 86% specificity
The updated sepsis scores did not provide improved ability in predicting sepsis
which antibiotics cross the equine placenta
b-Lactam antimicrobials, aminoglycosides and potentiated sulphonamides
can enrofloxacine cause damage to the unborn fetus when administered to the late pregnant dam?
administration of enrofloxacin in late pregnant mares did not cause tendinopathies or articular damage in the resulting foals examined at 5 weeks of age
in a recent study investigating NE in hopsitalised foals, which clinical sign was predoinant?
abnormal udder seeking (59%)
abnormal suckle (55%), inability to stand (42%), abnormal gastrointestinal motility (37%), abnormal consciousness (34%) and seizure activity (22%)
impact on outcome of NE with
therapies targeting the central nervous system
such as mannitol, magnesium sulphate, vitamin E or DMSO
overall NE survival rate?
did not differ significantly
between survivors and nonsurvivors
overall survival rate of 80% to hospital discharge.
Jockey club:
later performance of hospitalised versus non hospitalised foals
Previously hospitalised foals were significantly less likely to race with
68% of hospitalised registered foals racing
as compared to 79% of their 880 siblings
