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