Lactate to Albumin Ratio Is Not Predictive of Outcome in Septic Dogs: A Retrospective Case-Control Study.

The objective of this study was to investigate the value of the lactate to albumin ratio (L:A) as a prognostic marker for mortality in septic dogs. A single-center retrospective case-control study based on clinical record review was conducted at an academic teaching hospital. All records were extracted for diagnoses of bacterial sepsis, septic peritonitis, septic shock, or septicemia between February 2012 and October 2021. The study included 143 dogs. The most commonly identified sepsis diagnoses in dogs were septic peritonitis (55%; 78/143), unclassified sepsis (20%), and sepsis secondary to wounds or dermatological conditions (10%; 15/143). Median lactate and albumin for all dogs at presentation were 2.80 mmol/L and 2.6 g/dL, respectively; the median L:A ratio was 1.22. No clinically or statistically significant differences in lactate (P = 0.631), albumin (P = 0.695), or L:A (P = 0.908) were found between survivors and nonsurvivors.

Borna disease in an adult free-ranging Eurasian beaver (Castor fiber albicus).

Borna disease (BD) associated with a peracute bacterial septicaemia with Escherichia coli was diagnosed in an adult female, naturally infected, free-ranging Eurasian beaver of the subspecies Castor fiber albicus, clinically characterized by weight loss, depression, weakness and gurgled peristaltic sounds. The beaver was euthanized humanely. Necropsy and light microscopy revealed a non-purulent meningoencephalitis with typical mononuclear perivascular cuffs and parenchymal infiltrates. The diagnosis of BD was confirmed by detection of viral antigen and RNA by immunohistochemistry and reverse transcription-polymerase chain reaction (RT-PCR). The PCR product was sequenced and cluster analysis revealed a close relationship between endemic clusters in Saxony-Anhalt. This is the first report of naturally occurring BD in a free-ranging Eurasian beaver.

Defining sepsis in small animals.

OBJECTIVE: To discuss the definitions of sepsis in human and veterinary medicine. DESIGN: International, multicenter position statement on the need for consensus definitions of sepsis in veterinary medicine. SETTING: Veterinary private practice and university teaching hospitals. ANIMALS: Dogs and cats. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Sepsis is a life-threatening condition associated with the body's response to an infection. In human medicine, sepsis has been defined by consensus on 3 occasions, most recently in 2016. In veterinary medicine, there is little uniformity in how sepsis is defined and no consensus on how to identify it clinically. Most publications rely on modified criteria derived from the 1991 and 2001 human consensus definitions. There is a divergence between the human and veterinary descriptions of sepsis and no consensus on how to diagnose the syndrome. This impedes research, hampers the translation of pathophysiology insights to the clinic, and limits our abilities to optimize patient care. It may be time to formally define sepsis in veterinary medicine to help the field move forward. In this narrative review, we present a synopsis of prior attempts to define sepsis in human and veterinary medicine, discuss developments in our understanding, and highlight some criticisms and shortcomings of existing schemes. CONCLUSIONS: This review is intended to serve as the foundation of current efforts to establish a consensus definition for sepsis in small animals and ultimately generate evidence-based criteria for its recognition in veterinary clinical practice.

Association of the neutrophil-lymphocyte ratio with outcome in sick hospitalized neonatal foals.

BACKGROUND: The neutrophil-lymphocyte ratio (NLR) in human medicine is an objective biomarker that reflects prognosis. The NLR as an independent biomarker to help predict nonsurvival in hospitalized neonatal foals has not been thoroughly interrogated. OBJECTIVES/HYPOTHESIS: Retrospectively evaluate if the NLR at admission is associated with nonsurvival in sick hospitalized foals <4 days old. We hypothesized that a lower NLR will be associated with nonsurvival. ANIMALS: One thousand one hundred ninety-six client-owned foals <4 days old of any breed and sex: 993 hospitalized foals and 203 healthy foals. METHODS: Retrospective multicenter study. Medical records of foals presenting to 3 equine referral hospitals were reviewed. Foals were included if they had complete CBCs, sepsis scores, and outcome data. The NLR was calculated by dividing the absolute neutrophil count by the absolute lymphocyte count. Data were analyzed by nonparametric methods and univariate analysis. RESULTS: Of the 993 sick hospitalized foals, 686 were sick nonseptic and 307 were septic. The median NLR was lower in sick hospitalized foals (median [95% confidence interval], 3.55 [0.5-13.9]) compared with healthy foals (6.61 [3.06-18.1]). Septic foals had the lowest NLR (2.00 [0.20-9.71]). The NLR was lower in nonsurviving (1.97 [1.67-2.45]) compared with surviving foals (4.10 [3.76-4.33]). Nonsurviving septic foals had the lowest NLR (1.47 [1.70-3.01]). Foals with a NLR of <3.06 or <1.6 at admission had odds ratio of 3.21 (2.24-4.29) and 4.03 (2.86-5.67) for nonsurvival, respectively. CONCLUSIONS AND CLINICAL IMPORTANCE: A NLR < 3.06 at admission in sick hospitalized foals is readily available and clinically useful variable to provide prognostic information.

RETROSPECTIVE ANALYSIS OF BLOOD CULTURES AND THEIR ASSOCIATION WITH CLINICAL FINDINGS AND OUTCOME IN GREEN SEA TURTLES (CHELONIA MYDAS) AT A FLORIDA SEA TURTLE REHABILITATION FACILITY, 2017-2020.

Septicemia is commonly suspected of sea turtles entering rehabilitation. However, blood culture results of green sea turtles (Chelonia mydas) are infrequently reported in the literature. Aerobic blood cultures were performed for intake examinations of 167 green sea turtles undergoing rehabilitation at Brevard Zoo's Sea Turtle Healing Center, Melbourne, Florida, USA from 2017 to 2020. The incidence of positive cultures during intake examinations was 24% (40/167). The most common bacterial isolates identified were Vibrio alginolyticus, Shewanella algae, Achromobacter xylosoxidans, Photobacterium damselae, Sphingomonas paucimobilis, and Vibrio parahaemolyticus. There was a statistically significant association (P < 0.05) between culture status and evidence of external injury. There was no significant association between culture status and Caryospora-like coccidia infection, or fibropapillomatosis. Culture-positive turtles had significantly lower (P < 0.05) total white blood cell, lymphocyte, monocyte, total protein, albumin, and calculated globulin values compared to turtles with negative blood cultures. Significantly more culture-positive turtles died in rehabilitation compared to culture-negative (P = 0.042). Positive blood cultures suggestive of septicemia are commonly found during intake examinations at a Florida sea turtle rehabilitation facility.

Edwardsiella tarda Causing Septicemia in a Wild Crested Ibis (Nipponia nippon).

An adult Crested Ibis (Nipponia nippon) was found moribund in the Qinling area of China. Postmortem examination and histopathological analysis revealed lung inflammation and multi-organ hemorrhage. Bacterial isolation and whole-genome sequencing confirmed Edwardsiella tarda infection.

Establishment of a reference interval for thiamine concentrations in healthy dogs and evaluation of the prevalence of absolute thiamine deficiency in critically ill dogs with and without sepsis using high-performance liquid chromatography.

OBJECTIVE: To determine the normal reference interval (RI) for thiamine concentrations in healthy dogs and investigate the prevalence of thiamine deficiency in critically ill dogs with and without sepsis. DESIGN: Prospective, observational, multicenter study, conducted between 2019 and 2021. SETTING: Two veterinary university teaching hospitals. ANIMALS: A total of 109 dogs were enrolled into 3 groups: 40 healthy dogs, 33 dogs with suspected or confirmed sepsis and evidence of tissue hypoperfusion (Doppler blood pressure ≤90 mm Hg or plasma lactate ≥3 mmol/L), and 36 dogs with other critical illnesses and evidence of tissue hypoperfusion. INTERVENTIONS: For each dog, CBC, serum biochemistry, plasma lactate concentration, whole-blood thiamine concentration, blood pressure, vital parameters, Acute Patient Physiologic and Laboratory Evaluation (APPLE)fast score, and clinical outcomes were recorded, alongside basic patient parameters and dietary history. Whole-blood thiamine pyrophosphate (TPP) concentrations were measured using high-performance liquid chromatography. MEASUREMENTS AND MAIN RESULTS: The RI for whole-blood TPP in healthy dogs was 70.9-135.3 µg/L. Median TPP concentrations were significantly lower in septic dogs compared to healthy controls (P = 0.036). No significant difference in median TPP concentrations was found between septic dogs and nonseptic critically ill dogs, or between healthy dogs and nonseptic critically ill dogs. TPP concentrations were below the normal RI in 27.3% of septic dogs, compared to 19.4% of nonseptic critically ill dogs (P = 0.57). No correlations were found between TPP concentrations and lactate concentrations, age, body condition scores, time since last meal, RBC count, serum alanine aminotransferase, APPLEfast scores, or patient outcomes. CONCLUSIONS: TPP concentrations were significantly lower in septic dogs compared to healthy controls, with an absolute thiamine deficiency found in 27.3% of septic dogs. The established TPP RI allows for further investigation of thiamine deficiency in critically ill dogs.

Organ distribution and early pathogenesis of Streptococcus equi subsp. zooepidemicus in swine.

Streptococcus equi subsp. zooepidemicus is an emerging pathogen of pigs, resulting in high-mortality outbreaks of septicaemia and abortions. Here, we investigated the early pathogenesis of S. zooepidemicus in pigs following oronasal inoculation. Fourteen pigs were inoculated with live cultures of S. zooepidemicus ST-194, and monitored at 2,4, 8, and 24 h post-inoculation. Necropsies were performed to assess gross lesions and collect samples for bacterial culture and PCR analysis at each time point. Our findings revealed that S. zooepidemicus was detectable in various organs as early as 2 h post-inoculation, including liver and spleen, demonstrating rapid dissemination within the host. Tonsil samples consistently harboured live S. zooepidemicus throughout the study period, suggesting their potential for epidemiological sampling and diagnostics. Moreover, the presence of varying bacterial loads in mesenteric lymph nodes indicated persistence, replication, and a potential source for shedding. Further studies are required to determine the initial site of replication.

Abdominal perfusion in canine patients with pyometra and sepsis evaluated by Doppler and contrast-enhanced ultrasound.

BACKGROUND: Sepsis is a condition characterized by organic dysfunction, leading to hemodynamic instability and high morbidity and mortality rates in humans and animals. Early identification of perfusion changes and appropriate management of sepsis are crucial for improving patient prognosis. Currently, the Systemic Inflammatory Response Syndrome (SIRS) and Sequential Organ Failure Assessment (SOFA) scores are widely studied for sepsis identification and evaluation of organ dysfunction. However, these scores do not assess gastrointestinal involvement, which is common in this condition. Contrast-enhanced ultrasound (CEUS) and Doppler have been considered promising diagnostic techniques for detecting changes in vascularization and microcirculation in a non-invasive and safe manner, particularly in the gastrointestinal system. This study aimed to evaluate duodenal perfusion using CEUS, as well as abdominal aortic and cranial mesenteric artery blood flow using Doppler ultrasound, and systolic arterial pressure (SAP) in 17 bitches with pyometra and in 10 healthy animals. RESULTS: The variables were compared between the pyometra and control groups, as well between patients with and without sepsis determined by the SOFA or SIRS scores. Pyometra was found to cause a reduction in abdominal aortic blood flow volume, aortic peak systolic velocity, and resistivity index as evaluated by Doppler ultrasound. Patients with sepsis according to the SOFA criteria only presented lower SAP. In contrast, sepsis animals identified by the SIRS score exhibited lower SAP, aortic peak systolic velocity, aortic blood flow volume, and aortic resistivity index and additionally, higher peak intensity of contrast in the duodenal wall. CONCLUSIONS: Pyometra causes a reduction in abdominal aortic blood flow, which is more pronounced in animals with sepsis identified by the SIRS criteria. These animals also exhibited a decrease in systolic blood pressure and an increase in duodenal perfusion, as evident by CEUS. However, these changes were not observed in patients with sepsis identified by the SOFA criteria. The alterations in intestinal perfusion observed in animals with sepsis indicate the presence of inflammation or dysfunction. In this regard, CEUS proves to be a valuable technique for detecting subtle changes in tissue hemodynamics that may not be apparent in conventional exams.

Sepsis-induced cardiomyopathy in animals: From experimental studies to echocardiography-based clinical research.

The term "sepsis-induced cardiomyopathy" (SIC) is used to describe transient cardiac dysfunction in septic patients. However, there is no universally accepted definition of SIC; a reduction in left ventricular ejection fraction (LVEF) is often used. In addition to systolic dysfunction, diastolic dysfunction is now recognized as an essential component of SIC. It can be emphasized that previous animal experiments played an essential role in revealing SIC and hemodynamic instability in sepsis and septic shock. The diagnostic and prognostic capabilities of echocardiography for the assessment of SIC have been extensively studied since its introduction into intensive care clinical practice. Recent studies in dogs, calves, and horses have shown that left and right ventricular systolic dysfunction, left ventricular diastolic dysfunction, and circulatory dysfunction can occur in sepsis, severe sepsis, and septic shock in animals. Echocardiographic variables have also shown that indices of left and right ventricular dysfunction and circulatory failure are valuable indicators of mortality in septic animals.

Cardiomyopathie induite par la septicémie chez l'animal : des études expérimentales à la recherche clinique basée sur l'échocardiographie. Le terme « cardiomyopathie induite par la septicémie ¼ (SIC) est utilisé pour décrire un dysfonctionnement cardiaque transitoire chez les patients septiques. Cependant, il n'y a pas de définition universellement acceptée du SIC; une réduction de la fraction d'éjection ventriculaire gauche (FEVG) est souvent utilisée. En plus de la dysfonction systolique, la dysfonction diastolique est maintenant reconnue comme une composante essentielle du SIC. On peut souligner que les expérimentations animales antérieures ont joué un rôle essentiel dans la révélation du SIC et de l'instabilité hémodynamique dans la septicémie et le choc septique. Les capacités diagnostiques et pronostiques de l'échocardiographie pour l'évaluation du SIC ont été largement étudiées depuis son introduction dans la pratique clinique des soins intensifs. Des études récentes sur des chiens, des veaux et des chevaux ont révélé qu'un dysfonctionnement systolique ventriculaire gauche et droit, un dysfonctionnement diastolique ventriculaire gauche et un dysfonctionnement circulatoire peuvent survenir dans la septicémie, la septicémie sévère et le choc septique chez les animaux. Les variables échocardiographiques ont également démontré que les indices de dysfonctionnement ventriculaire gauche et droit et d'insuffisance circulatoire sont des indicateurs précieux de la mortalité chez les animaux septiques.(Traduit par Dr Serge Messier).

Citrobacter koseri related abortion and fetal septicemia in cattle.

A 31-month-old Holstein dairy cow aborted at 224 days of gestation with ejection of cheese-like lochia. Citrobacter koseri, which commonly exists in the normal flora of human and animal digestive tracts, was isolated from aborted fetal tissues (liver, spleen, kidney, heart, lung, cerebrum, and skeletal muscle) and fetal membranes. Histopathological examination revealed suppurative fibrinous meningoencephalitis of the cerebrum, cerebellum, and brainstem; suppurative bronchopneumonia; suppurative chorioamnionitis; and fibrous splenic serositis. Numerous gram-negative bacilli were detected in the cytoplasm of macrophages and/or neutrophils in these lesions. Bacteriological investigation and immunohistochemical staining identified the bacilli as C. koseri. This is the first report of cattle abortion caused by C. koseri infection in dairy cattle.

Isolation, characterization, and experimental infection of Streptococcus gallolyticus subspecies pasteurianus from commercial turkeys with acute septicemia: a pilot study.

Streptococcus gallolyticus (SG) is a Gram-positive cocci found as commensal gut flora in animals and humans. SG has emerged as a cause of disease in young poults between 1 and 3 wk of age. SG is associated with septicemia resulting in acute mortality with no premonitory signs in turkeys. Three SG isolates were obtained from clinical field cases of acute septicemia of commercial turkeys and used in three independent experiments. In Experiment 1, embryos were inoculated 25 d of embryogenesis with varying concentrations of SG1, SG2, or SG3. In Experiment 2, day of hatch, poults were inoculated with varying concentrations using different routes of administration of SG1, SG2, or SG3. In Experiment 3, day of hatch, poults were inoculated with only isolate SG1 using different paths. Poults were randomly selected for necropsy on d 8 and d 15 and sampled to collect spleen, heart, and liver for SG on d 21, the remaining poults were necropsied and cultured. Samples were plated on Columbia nalidixic acid and colistin agar (CNA) (40°C, 18-24 h). Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) confirmed suspect colonies. Data were analyzed using the chi-square test of independence, testing all possible combinations to determine significance (P < 0.05). Weight data were subjected to ANOVA using JMP with significance (P < 0.05). No differences were found in BW or BWG on d 0, 8, 15, or 22. Splenomegaly, focal heart necrosis, and pericarditis were observed in all groups in experiments 1 through 3. In Experiment 3, only airsacculitis was observed in a negative control in separate isolation (P > 0.05). On d 21 of Experiment 3, increased (P < 0.05) recovery of SG from spleens were observed in co-housed negative controls, as well as poults challenged by oral gavage (P > 0.05 for d 7 and d 14). These results confirm numerous previous studies indicating that SG subsp. pasteurianus is a primary infectious microorganism that causes septicemia in young poults.

Equine synovial sepsis laboratory submissions yield a low rate of positive bacterial culture and a high prevalence of antimicrobial resistance.

OBJECTIVE: To investigate (1) variables associated with the likelihood of obtaining a positive culture, (2) commonly isolated microorganisms, and (3) antimicrobial resistance patterns of isolates from horses with presumptive synovial sepsis. SAMPLES: Synovial fluid, synovium, and bone samples from equine cases with presumptive synovial sepsis submitted to the Cornell University Animal Health Diagnostic Center from 2000 to 2020 for microbial culture and antimicrobial sensitivity testing. PROCEDURES: Univariable and multivariable analyses were performed to determine the effect of variables on the likelihood of positive culture. Frequency distributions for isolated organisms and antimicrobial resistance were generated. Multidrug resistance patterns and associations were assessed with association rule mining. RESULTS: The positive culture rate for all samples was 37.4%, while the positive culture rate among samples confirmed to be septic by a combination of clinical pathological variables and case details was 43%. Blood culture vial submissions were 1.7 times more likely to yield a positive culture compared to samples submitted in a serum tube. Structure sampled, tissue submitted, and horse age were associated with a positive culture. Staphylococcus spp (23.7%), Streptococcus spp (22.4%), and Enterococcus spp (9.67%) were commonly isolated. Multidrug resistance prevalence decreased from 92% (2000 to 2009) to 76% (2010 to 2020) of gram-negative isolates and 60% (2000 to 2009) to 52% (2010 to 2020) of gram-positive isolates. CLINICAL RELEVANCE: The positive culture rate from synovial fluid submissions with traditional sampling and culture methods remains low and may be optimized by submitting samples in blood culture vials. Overall, antimicrobial resistance was frequently observed but did not increase from the first to second decade for most genera.

The role of nutritional-immunological indices in estimating serum LPS and antioxidant enzyme activity and sepsis status in female dogs with pyometra caused by E. coli.

The aim of this study was to diagnose pyometra and related sepsis status using cost-effective nutritional-immunological indices, antioxidants, and toxin levels in dogs and to investigate the utility of the indices in predicting toxin and antioxidant status. A total of 29 dogs were enrolled into the present study. Among these, 9 female dogs in their diestrus stages, were allocated for elective ovariohysterectomy. The pyometra group was also separated into two subgroups as Sepsis (+) and Sepsis (-). Blood samples were collected into two tubes containing EDTA for hematological analysis; without anticoagulant for serum progesterone, LPS concentration, and antioxidant levels at the time of diagnosis. Bacteriological and tissue samples of the uterus were collected after the ovariohysterectomy. Antioxidant activity, progesterone, and toxin concentration were determined by using commercial ELISA kits. Statistical analyses were performed using Stata version 16.1 and MedCalc 16 statistical software. Receiver operating characteristics curves were used for the threshold for evaluating pyometra and sepsis status. Pairwise comparisons were carried out of the area under the curve (AUC) for thresholds of nutritional immunologic indices (hemoglobin, albumin, lymphocyte, platelet (HALP) score; prognostic nutritional index (PNI); Albumin hemoglobin index (AHI)), serum LPS and antioxidant activity. Linear regression model was used for the estimation of serum LPS and antioxidant activity by using indices. Mean serum progesterone, LPS concentrations, and Nitric Oxide (NO) production were greater, while serum superoxide dismutase (SOD), tissue SOD, and glutathione peroxidase (GPx) activities were lower in dogs with pyometra. All nutritional-immunologic indices were lower in pyometra cases. Nutritional-immunologic indices (AUC of HALP:0.759; PNI:0.981; AHI 0.994), NO (AUC: 0.787) and SOD (AUC: 0.784) levels were useful for pyometra diagnosis. AHI and LPS were useful for the determination of sepsis status with the AUC values of 0.850 and 0.740, respectively. While AHI was useful for the estimation of serum LPS and NO concentration (p < 0.001), PNI was useful for serum SOD concentration (p = 0.003). In conclusion, PNI, HALP and AHI can be used in the diagnosis of pyometra, however, only AHI and LPS levels can be used in the diagnosis of sepsis. SOD and NO can be used to determine pyometra but have no effect on determining sepsis status. Additionally, the estimation of the levels of serum LPS, NO, and SOD activities can be done using the AHI and PNI values.

Synovial sepsis diagnostics and antimicrobial resistance: a one-health perspective.

This article, as part of the Currents in One Health series, reviews the current state of diagnostics for synovial sepsis. Synovial sepsis is a condition that affects veterinary and human medicine and requires coordinated efforts from both parties, as well as environmental considerations to accurately diagnose and preserve effective treatments. The article discusses best practices to identify the causative agent in septic synovitis, trends in bacterial identification and antimicrobial resistance patterns across common bacterial species, and a one-health perspective to optimize diagnostics across species. Antimicrobial resistance is a challenge facing both human and veterinary medicine and requires mindful and attentive prescribing to reduce the development of antimicrobial resistance and preserve antimicrobials for future application. The current standard of care for bacterial identification in veterinary practice is culture and antimicrobial susceptibility; however, positive culture rates from synovial sepsis cases often remain < 50%. Recent developments in advanced bacterial identification present opportunities for improved bacterial identification in synovial sepsis. Increased bacterial isolation will also help guide empirical antimicrobial therapy. Utilizing information and recommendations from both the human and veterinary literature will improve timely and accurate bacterial identification and therefore rapid and effective treatment of synovial sepsis across species and limit the development of antimicrobial resistance.

Red blood cell distribution width to platelet ratio in neonatal foals with sepsis.

BACKGROUND: Rapid and accurate markers to aid diagnosis of sepsis are needed in neonatal foals. The CBC variable red blood cell distribution width (RDW) to platelet ratio (RPR) is associated with inflammatory response and linked to poor outcomes of sepsis in human patients. HYPOTHESIS: Explore the correlation of RPR with sepsis in neonatal foals and evaluate RPR predictive and prognostic value. ANIMALS: Three hundred seventeen hospitalized neonatal foals ≤7 days of age that had a CBC and physical exam performed at admission between 2012 and 2021. METHODS: Retrospective case-control study. Clinical records were used to calculate sepsis scores and define groups. Red blood cell distribution width to platelet ratio was calculated and compared between groups (septic vs nonseptic) based on Kruskal-Wallis and Wilcoxon signed-rank tests. A multivariate logistic regression model to predict sepsis was created. The cutoff for RPR was obtained based on the maximal Youden Index. The Kaplan-Meier method and the log-rank test were used to estimate survival curves and compare survival rates based on RPR. RESULTS: Red blood cell distribution width to platelet ratio was significantly higher in septic foals (Median = 0.099, confidence interval [CI] [0.093; 0.108]) than in sick nonseptic (0.085, CI [0.083; 0.089]) and healthy foals (0.081, CI [0.077; 0.086]; P < .0001). Red blood cell distribution width to platelet ratio was able to predict sepsis with high accuracy (AUC = 82.1%). The optimal RPR cutoff for sepsis was 0.09. CONCLUSIONS AND CLINICAL IMPORTANCE: Red blood cell distribution width to platelet ratio calculation is practical, inexpensive, and based on CBC-derived data. Calculation of RPR along with CBC can aid in the diagnosis of sepsis and estimation of outcome.

Erysipelothrix rhusiopathiae Infection Associated with Swollen Head Syndrome in a Broiler Breeder Flock in North Georgia.

An unusual case of swollen head syndrome in a 55-wk-old broiler breeder flock was identified in north Georgia in the summer of 2019. The presenting complaint was elevated mortality and visibly swollen heads. Necropsy of affected birds on the farm primarily revealed signs of bacterial septicemia, with few large scab lesions near the vent area. Bacterial culture analysis identified multiple organisms, but the primary organism of interest was identified as Erysipelothrix rhusiopathiae, cultured from affected liver, lung, sinuses, and one swollen wattle of birds in the affected house. Histopathologic analysis identified gram-positive rod-shaped bacteria in the spleen and liver (consistent with bacterial septicemia) confirmed with special staining (Brown & Hopps Gram stain). These organisms were noted to be consistent with E. rhusiopathiae; E. rhusiopathiae infection in broiler breeder chickens is a rare occurrence and is primarily associated with turkeys and/or swine production systems.

Reporte de caso- Infección por Erysipelothrix rhusiopathiae asociada con el síndrome de cabeza hinchada en un pollo de engorde. En el verano del 2019, se identificó un caso inusual de síndrome de cabeza hinchada en una parvada de reproductoras de pollos de engorde de 55 semanas de edad en el norte de Georgia. Las observaciones iniciales incluyeron mortalidad elevada y cabezas visiblemente inflamadas. La necropsia de las aves afectadas en la granja reveló principalmente signos de septicemia bacteriana, con pocas lesiones costrosas grandes cerca del área de extractores de la ventilación. El análisis de cultivos bacterianos identificó múltiples organismos, pero el principal organismo de interés fue identificado como Erysipelothrix rhusiopathiae, cultivado a partir de hígado, pulmón, senos paranasales y de una barbilla inflamada de aves en la caseta afectada. El análisis histopatológico identificó bacterias grampositivas en forma de bastón en el bazo y el hígado (compatibles con septicemia bacteriana) confirmadas con tinción especial (tinción de Gram de Brown y Hopps). Se observó que estos organismos eran compatibles con E. rhusiopathiae; La infección por E. rhusiopathiae en pollos de engorde se presenta de forma esporádica y se asocia principalmente con sistemas de producción de pavos y/o cerdos.

Use of admission serum neutrophil gelatinase-associated lipocalin (NGAL) concentrations as a marker of sepsis and outcome in neonatal foals.

BACKGROUND: Equine neonatal sepsis can be challenging to diagnose and prognosticate. Neutrophil gelatinase-associated lipocalin (NGAL), a new marker of renal damage and inflammation, can potentially be helpful. OBJECTIVES: To evaluate NGAL in neonatal foals with sepsis, and assess its relation to outcome. ANIMALS: Foals ≤ 14 days, with admission blood analysis and stored serum. METHODS: NGAL was measured on stored serum from 91 foals. Foals were scored for sepsis and survival and categorized according to sepsis status (septic, sick non-septic, healthy, and uncertain sepsis status) and outcome groups (survivors and non-survivors). The septic foals were further sub-categorized according to severity (normal sepsis, severe sepsis and septic shock). A Kruskal-Wallis test was used to compare serum NGAL concentrations in survivors and non-survivors, in the sepsis status groups, and in the sepsis severity groups. Optimal cut-off values for serum NGAL concentrations to diagnose sepsis and outcome were determined with receiver operating characteristic (ROC) curves. NGAL was compared to creatinine and SAA. RESULTS: Median serum NGAL concentrations were significantly higher in septic than non-septic foals. However, serum NGAL concentrations did not differ between sepsis severity subgroups. Serum NGAL concentrations were significantly lower in survivors than in non-survivors. Optimal cut-off values of serum NGAL concentrations were 455 µg/L (sensitivity 71.4%, specificity 100%) and 1104 µg/L (sensitivity 39.3%, specificity 95.2%) for predicting sepsis and non-survival, respectively. NGAL correlated to SAA, but not to creatinine. NGAL performed similarly to SAA to diagnose sepsis. CONCLUSION: Serum NGAL concentrations may be useful for diagnosing sepsis and predicting outcome.

Administration safety of medical-grade honey (MGH) in septic synovial structures in horses: 3 cases.

The objective of this study was to investigate the postoperative use of intrasynovial honey as an antimicrobial after treatment for synovial sepsis in horses. One colt and 2 mares were presented with acute lameness, with or without an associated wound. All 3 cases were initially managed with surgical endoscopic or tenoscopic debridement and lavage for treatment of different synovial structures. Collection of synovial fluid was consistent with synovial sepsis and this was diagnosed in each case. All horses subsequently underwent arthroscopic lavage under general anesthetic and intraarticular or intrathecal medical-grade honey (MGH) was then instilled. All 3 cases recovered well and were free from lameness at all gaits. Although there is extensive research about the antimicrobial properties of honey and growing interest in the biocompatibility of honey in joints with the use of honey hydrogels in human medicine, the research in veterinary medicine is lacking. There are studies describing the antimicrobial properties of honey in healing wounds in horses, but there are no published studies describing the use of honey within a synovial structure. Further research is necessary to assess the biocompatibility of honey in equine articular cartilage. In the cases described in this article, the use of honey demonstrated a safe adjunctive therapy after conventional surgical treatment for septic arthritis.

L'objectif de cette étude était d'étudier l'utilisation postopératoire du miel intrasynovial comme antimicrobien après le traitement d'une infection synoviale chez les chevaux. Un poulain et deux juments ont été présentés avec une boiterie aiguë, avec ou sans plaie associée. Les trois cas ont été initialement pris en charge par un débridement chirurgical endoscopique ou ténoscopique et un lavage pour le traitement de différentes structures synoviales. La collecte de liquide synovial était compatible avec une infection synoviale et celle-ci a été diagnostiquée dans chaque cas. Tous les chevaux ont ensuite subi un lavage arthroscopique sous anesthésie générale et du miel de qualité médicale (MGH) intra-articulaire ou intrathécal a ensuite été instillé. Les trois cas se sont bien rétablis et étaient exempts de boiterie à toutes les allures. Bien qu'il existe des recherches approfondies sur les propriétés antimicrobiennes du miel et un intérêt croissant pour la biocompatibilité du miel dans les articulations avec l'utilisation d'hydrogels de miel en médecine humaine, la recherche en médecine vétérinaire fait défaut. Il existe des études décrivant les propriétés antimicrobiennes du miel dans la cicatrisation des plaies chez les chevaux, mais aucune étude publiée ne décrit l'utilisation du miel dans une structure synoviale. Des recherches supplémentaires sont nécessaires pour évaluer la biocompatibilité du miel dans le cartilage articulaire équin. Dans les cas décrits dans cet article, l'utilisation du miel a démontré une thérapie d'appoint sûre après le traitement chirurgical conventionnel de l'arthrite septique.(Traduit par Docteur Serge Messier).

Serum concentrations of secretory leukocyte protease inhibitor and IL6 can predict the onset of sepsis in pyometra bitches.

As onset of sepsis adversely affects the prognosis of canine pyometra, finding biomarkers that would distinguish sepsis status would be useful in the clinical management. Accordingly, we hypothesized that differential expression of endometrial transcripts and circulating concentration of certain inflammatory mediators would discriminate pyometra-led sepsis (P-sepsis+) from those of pyometra without sepsis (P-sepsis-). Bitches with pyometra (n = 52) were classified into P-sepsis+ (n = 28) and P-sepsis- (n = 24) based on vital clinical score and total leukocyte count. A group of non-pyometra bitches (n = 12) served as control. The relative fold changes in the transcripts of IL6, IL8, TNFα, IL10, PTGS2, mPGES1 and PGFS, SLPI, S100A8, S100A12 and eNOS were determined by quantitative polymerase chain reaction. Furthermore, the serum concentrations of IL6, IL8, IL10, SLPI and prostaglandin F2α metabolite (PGFM) were assayed by ELISA. The relative fold changes in S100A12 and SLPI and mean concentrations of IL6 and SLPI were significantly (p < .05) higher in P-sepsis+ than that of P-sepsis- group. Receiver operating characteristic analysis revealed that serum IL6 had a diagnostic sensitivity of 78.6% and a positive likelihood ratio (LR+) of 2.09, at a cut-off value of 15.7 pg/mL to diagnose P-sepsis+ cases. Similarly, serum SLPI had a sensitivity of 84.6% and an LR+ of 2.23, at a cut-off value of 2.0 pg/mL. It was concluded that SLPI and IL6 would serve as putative biomarkers for pyometra-led sepsis in bitches. Monitoring SLPI and IL6 would be a useful adjunct to the established haemato-biochemical parameters in customizing the treatment strategies and arriving at the decision for management of pyometra bitches with critical illness.