Characterization of hypertriglyceridemia and response to treatment with insulin in horses, ponies, and donkeys: 44 cases (1995-2005).

OBJECTIVE: To characterize signalment, clinical signs of disease, and clinical response to insulin in equids with hypertriglyceridemia. DESIGN: Retrospective case series. ANIMALS: 20 horses, 17 ponies, and 7 donkeys with hypertriglyceridemia. PROCEDURES: For analysis of medical record data, horses, donkeys, and ponies with multiple serum or plasma triglycerides measurements were separated into groups. Hypertriglyceridemic equids that were (HT-I; n = 14) or were not (HT-N; 10) treated with insulin consisted of equids with an initial triglycerides concentration > 44 mg/dL but < 500 mg/dL. Equids with an initial triglycerides concentration > 500 mg/dL, all of which were treated with insulin, constituted the lipemic group (LIP-I; 20). Each group included a full range of ages. Pretreatment and posttreatment values from serum or plasma biochemical analyses were compared among groups. RESULTS: No age predilection for hypertriglyceridemia was apparent. Of the 29 female equids, only 7 (24%) were lactating or pregnant. Multiple illnesses were diagnosed in hypertriglyceridemic equids, including colitis (14/44; 32%) and colic (9/44; 20%). Many breeds were affected, including 16 (36%) American Miniature Horses and 9 (20%) Arabians or Arabian crossbreds. The mean posttreatment triglycerides concentration was not significantly different from the initial value in HT-N equids (175 vs 125 mg/dL) but was significantly lower than the pretreatment triglycerides concentration in HT-I (252 vs 55 mg/dL) and LIP-I (872 vs 87 mg/dL) equids. CONCLUSIONS AND CLINICAL RELEVANCE: Equids of all ages and sexes with various diseases had hypertriglyceridemia. Insulin treatment decreased the triglycerides concentrations in affected equids.

Characterization of hypertriglyceridemia and response to treatment with insulin in llamas and alpacas: 31 cases (1995-2005).

OBJECTIVE: To evaluate camelids with hypertriglyceridemia with regard to signalment, clinical features of disease, and response to treatment with insulin. DESIGN: Retrospective case series. ANIMALS: 23 alpacas and 8 llamas with hypertriglyceridemia. PROCEDURES: For analysis of medical record data, 20 hypertriglyceridemic camelids with multiple recorded measurements of serum or plasma triglycerides concentration were classified as follows: those with an initial triglycerides concentration > 60 to > or = 500 mg/dL that were or were not treated with insulin (HT-I and HT-N camelids, respectively) and those with an initial triglycerides concentration > 500 mg/dL that were treated with insulin (lipemic [LIP-I] camelids). Only 1 recorded triglycerides concentration was available for an additional 11 hypertriglyceridemic camelids; data from those records were included in the characterization of signalment and clinical features of disease. RESULTS: Compared with the general population of hospitalized camelids, hypertriglyceridemic camelids did not differ significantly with respect to age or sex. Of 22 female camelids, only 7 were lactating or pregnant. Serum or plasma triglycerides concentrations in HT-N and HT-I camelids did not differ significantly at admission, but triglycerides concentrations in HT-I camelids decreased significantly after insulin treatment. Posttreatment triglycerides concentrations in HT-I camelids were significantly lower than those in HT-N camelids. During the period of hospitalization, triglycerides concentrations in HT-N camelids increased, whereas those in LIP-I camelids decreased significantly. CONCLUSIONS AND CLINICAL RELEVANCE: Results indicated that hypertriglyceridemia affects llamas and alpacas of all ages and both sexes. Insulin treatment may reduce serum or plasma triglycerides concentrations in camelids with hypertriglyceridemia.

Cryptosporidiosis in 20 alpaca crias.

CASE DESCRIPTION: 20 alpaca crias (13 females and 7 males) were examined for diarrhea (n=20), weight loss (15), and poor appetite (5). Fourteen crias were between 8 and 18 days of age at time of admission. CLINICAL FINDINGS: Cryptosporidiosis was diagnosed in all crias. Common biochemical abnormalities included acidemia, hyperlactemia, azotemia, and hyperglycemia and increases in aspartate transaminase and gamma-glutamyltransferase activities. Serum sodium and chloride concentrations were high or low. Other potential gastrointestinal tract pathogens were identified in only 7 crias. TREATMENT AND OUTCOME: Supportive care was instituted, including i.v. administration of fluids with partial parenteral administration of nutrients (n=19 crias), antimicrobials (19), supplemental orally administered nutrients (11), administration of plasma (10), and insulin treatment (9). Other palliative treatments used by attending clinicians were sucralfate, flunixin meglumine, vitamin A/D/E/B complex, antiparasitic agents, antidiarrheal agents, and azithromycin. Three crias with inadequate urine production and severe azotemia were treated with furosemide administered i.v. as a bolus or as a constant-rate infusion. Treatment resulted in a successful outcome in 16 of 20 crias. Weight loss and refractory azotemia were common in nonsurvivors but not in surviving crias. CLINICAL RELEVANCE: Findings suggested that Cryptosporidium spp may be a diarrheal pathogen of unweaned alpaca crias that may be more widespread than has been recognized and can become endemic on some farms. Metabolic derangements were unpredictable and should be determined by biochemical analysis before fluid and electrolyte replacement is initiated. Cryptosporidiosis has zoonotic potential, and the infection can be self-limiting in alpacas receiving supportive treatment.

Eimeria macusaniensis infection in 15 llamas and 34 alpacas.

CASE DESCRIPTION: 15 llamas and 34 alpacas between 3 weeks and 18 years old with fecal oocysts or intestinal coccidial stages morphologically consistent with Eimeria macusaniensis were examined. Nineteen of the camelids were admitted dead, and 30 were admitted alive. Camelids admitted alive accounted for 5.5% of all camelid admissions during this period. CLINICAL FINDINGS: Many severely affected camelids had signs of lethargy, weight loss, decreased appetite, and diarrhea. Camelids with clinical infection also commonly had evidence of circulatory shock, fat mobilization, and protein loss. Nonsurviving camelids also had evidence of shock, edema, bile stasis, renal insufficiency, hepatic lipidosis, muscle damage, relative hemoconcentration, and sepsis. Postmortem examination frequently revealed complete, segmental replacement of the mucosa of the distal portion of the jejunum with coccidial meronts and gamonts. For 17 of 42 camelids, results of initial fecal examinations for E macusaniensis were negative. TREATMENT AND OUTCOME: Most camelids admitted alive were treated with amprolium hydrochloride, plasma, and various supportive treatments. Fifteen of the 30 treated camelids died or were euthanized. CLINICAL RELEVANCE: Findings suggest that E macusaniensis may be an important gastrointestinal tract pathogen in camelids of all ages. Clinical signs were frequently nonspecific and were often evident before results of fecal examinations for the parasite were positive. As with other coccidia, severity of disease was probably related to ingested dose, host immunity, and other factors. The clinical and herd relevance of positive fecal examination results must be determined.

Panniculitis in a horse with peripancreatitis and pancreatic fibrosis.

A 22-year-old pinto mixed breed mare was admitted for evaluation of severe colic signs and gastric reflux. Multiple nonpainful, variably sized hard masses were palpated in the subcutis over the thorax, abdomen, and hindquarters of the horse. The mare was diagnosed with sterile peritonitis and had systemically high gamma-glutamyltransferase, amylase, and lipase. Three days into treatment she became febrile with signs of persistent and mild abdominal discomfort; euthanasia was elected. Necropsy revealed peripancreatitis, pancreatic fibrosis, abdominal steatitis and panniculitis. Panniculitis associated with peripancreatitis has been described in humans and dogs but not in horses. Pathogenic models for this entity are discussed.