Septicaemia - Foal - Revision history

Bara at 18:05, 31 July 2012

2012-07-31T18:05:17Z

Bara: moved Septicaemia - Foals to Septicaemia - Foal

2011-08-22T16:37:07Z

moved Septicaemia - Foals to Septicaemia - Foal

Bara at 16:30, 22 August 2011

2011-08-22T16:30:22Z

Bara: /* Signalment */

2011-08-22T16:28:29Z

Signalment

Bara at 16:27, 22 August 2011

2011-08-22T16:27:44Z

Siobhanbrade at 09:55, 1 August 2011

2011-08-01T09:55:59Z

Siobhanbrade at 20:44, 27 July 2011

2011-07-27T20:44:57Z

Siobhanbrade at 18:21, 27 July 2011

2011-07-27T18:21:35Z

Siobhanbrade: Created page with "==Introduction== Septicaemia in the foal is a serious and life-threatening condition that requires prompt diagnosis and treatment. It is caused by the presence of bacteria, or b..."

2011-07-24T12:12:15Z

Created page with "==Introduction== Septicaemia in the foal is a serious and life-threatening condition that requires prompt diagnosis and treatment. It is caused by the presence of bacteria, or b..."

New page

==Introduction==
Septicaemia in the foal is a serious and life-threatening condition that requires prompt diagnosis and treatment. It is caused by the presence of bacteria, or bacterial toxins in the blood. The infection can either be localised (ie to the joints or umbilicus) or generalised, with systemic signs.

Several bacteria can cause septicaemia, including grams negative organisms such as ''E-coli'', ''Actinobacillus'', and ''Klebsiella'' species,and gram positive organisms such as ''Streptococcus'' and ''Staphylococcus'' species. Occasionally anaerobic organisms such ''Clostridium'' species may also cause disease.

==Signalment==
Infection is via haematogenous spread following infection via the placenta, umbilicus, lungs or GI tract. Foals may be affected as early as the

Predisposing factors include:
* Failure of passive transfer - due to failure of the foal to suckle adequate quantities of colostrum, or low volume/poor quality colostrum produced by the dam.
* Dystocia
* Premature/Dysmature foal
* Over-crowding and poor hygiene
* Artificial severance and ligation of the umbilicus
* Failure to treat the umbilicus immediately after birth (with tincture of iodine)

==Clinical Signs==
Foals in the early stages of clinical disease may not show any specific signs, instead appearing 'off-suck' (inspecting the dams udder can give some indication of when the foal last suckled). This may be accompanied by lethargy, malaise, frequent recumbancy and pyrexia. The bacteria may localise in different organs, producing clinical signs directly related to that organ:

* Ocular localisation produces '''hypopyon''' and '''iritis'''
* Integumentary localisation produces '''anasarca'''
* Locomotor localisation produces '''joint effusion and/or septic arthritis'''
* Cardiac localisation produces '''tachycardia'''
* Respiratory localisation produces '''polypnoea'''
* Gastrointestinal localisation produces '''ileus, colic and diarrhoea'''
* Urogenital localisation produces '''anuria'''
* Neurological localisation produces '''seizures and depression'''

The disease may then advance to '''septic shock'''. Clinical signs include prolonged recumbancy, depression, dehydration, and tachycardia with cold extremities, weak thready pulses, slow capillary refill time and muddy mucous membranes, indicative of hypotension. Dependant on the organs affected, signs of individual or multiple organ dysfunction may be present.

Clinical signs can progress very rapidly therefore prompt recognition is necessary.

==Diagnosis==
Septicaemia scoring....
Clinical signs and history.
Individual tests eg US,arthrocentesis etc related to organs affected
Bloods neutropaenic with toxic change
FPT measurements - serum IgG.....
Positive blood culture confirms but negative does not rule it out

==Treatment==
The foal should be immediate treated with broad spectrum IV antibiotics until culture results are known. Multiple plasma transfusions may be required to raise IgG serum levels, and IV fluid therapy should be administered to treat endotoxic shock. Nutritional support is necessary, either by helping the foal suckle the dam or administration of the dams milk (or a substitute) via nasogastric tube. In addition, glucose levels should be measured frequently and dextrose added to the IV fluid therapy if necessary. The use of anti-endotoxin drugs (flunixin, anti-prostoglandin, polymyxin B) as an adjunct treatment has also been reported.

General supportive care, recumbant foal management and TLC is also necessary - this may continue for several weeks after infection. Organ-specific treatments such as joint lavage may also be needed.

If the umbilicus is a localised source of infection, it can surgically resected to reduce the spread of infection to distant organs.

==Prevention==
* Ensuring adequate intake of colostrum in the first 12-24 hours of life. Levels can be checked by measuring serum IgG (>800mg/dl)
* Appropriate treatment of the umbilicus with tincture of iodine promptly after birth.
* Providing a clean, warm and well ventilated environment for the neonate.

==Prognosis==
Dependant on the severity of clinical signs and the individual organs affected. Early recognition and aggressive treatment are key to an improved prognosis.

==References==
Merck & Co (2009) '''The Merck Veterinary Manual''' (Ninth Edition), ''Merial''

Captain M. Horace Hays FRCVS '''Veterinary Notes for Horse Owners''' (Revised Edition), ''Stanley Paul''

RVC staff (2009) '''Urogenital system''' RVC Intergrated BVetMed Course, ''Royal Veterinary College''

Mair, TS & Divers, TJ (1997) '''Self-Assessment Colour Review Equine Internal Medicine''' ''Manson Publishing Ltd''

[[Category:To Do - Siobhan Brade]]

@@ Line 1: / Line 1: @@
 ==Introduction==
 '''Septicaemia''' in the foal is a '''serious''' and '''life-threatening''' condition that requires '''prompt diagnosis''' and '''treatment'''. It is caused by the presence of '''bacteria''', or '''bacterial toxins''' in the '''blood'''. The infection can either be localised (ie to the joints or umbilicus) or generalised, with systemic signs.
@@ Line 68: / Line 69: @@
 {{review}}
 [[Category:Cardiovascular Diseases - Horse]]
 [[Category:Expert Review - Horse]]

@@ Line 8: / Line 8: @@
 Predisposing factors include:
-* [[Failure of Passive Trnasfer|'''Failure of passive transfer''']] - due to failure of the foal to suckle adequate quantities of colostrum, or low volume/poor quality colostrum produced by the dam.
+* [[Failure of Passive Transfer|'''Failure of passive transfer''']] - due to failure of the foal to suckle adequate quantities of colostrum, or low volume/poor quality colostrum produced by the dam.
 * [[Dystocia - Horse|'''Dystocia''']]
 * '''Premature/Dysmature foal'''

@@ Line 2: / Line 2: @@
 '''Septicaemia''' in the foal is a '''serious''' and '''life-threatening''' condition that requires '''prompt diagnosis''' and '''treatment'''. It is caused by the presence of '''bacteria''', or '''bacterial toxins''' in the '''blood'''. The infection can either be localised (ie to the joints or umbilicus) or generalised, with systemic signs.
-Several bacteria can cause septicaemia, including grams negative organisms such as '''''E-coli''''', ''Actinobacillus'', and ''Klebsiella'' species,and gram positive organisms such as '''''Streptococcus''''' and ''Staphylococcus'' species. Occasionally anaerobic organisms such ''Clostridium'' species may also cause disease.
+Several bacteria can cause septicaemia, including grams negative organisms such as '''''[[E. coli]]''''', [[:Category:Actinobacillus species|''Actinobacillus'']], and ''[[Klebsiella]]'' species,and gram positive organisms such as [[:Category:Streptococcus species|'''''Streptococcus''''']] and [[:Category:Staphylococcus species|''Staphylococcus'' species]]. Occasionally anaerobic organisms such [[:Category:Clostridium species|''Clostridium'' species]] may also cause disease.
 ==Signalment==
@@ Line 8: / Line 8: @@
 Predisposing factors include:
-* '''Failure of passive transfer''' - due to failure of the foal to suckle adequate quantities of colostrum, or low volume/poor quality colostrum produced by the dam.
+* [[Failure of Passive Trnasfer|'''Failure of passive transfer''']] - due to failure of the foal to suckle adequate quantities of colostrum, or low volume/poor quality colostrum produced by the dam.
-* '''Dystocia'''
+* [[Dystocia - Horse|'''Dystocia''']]
 * '''Premature/Dysmature foal'''
 * '''Over-crowding and poor hygiene'''
@@ Line 19: / Line 19: @@
 * Cardiac localisation produces '''tachycardia'''
-* Gastrointestinal localisation produces '''ileus, colic and diarrhoea'''
+* Gastrointestinal localisation produces '''ileus, [[:Category:Colic in Horses|colic]] and diarrhoea'''
-* Integumentary localisation produces '''anasarca'''
+* Integumentary localisation produces [[Oedema|'''anasarca''']]
 * Locomotor localisation produces '''joint effusion and/or septic arthritis'''
-* Neurological localisation produces '''seizures and depression'''
+* Neurological localisation produces '''[[seizures]] and depression'''
 * Ocular localisation produces '''hypopyon''' and '''iritis'''
 * Respiratory localisation produces '''polypnoea'''
@@ Line 34: / Line 34: @@
 Definitive diagnosis is by '''positive blood culture''', however a negative blood culture does not rule out septicaemia. As the foal may deteriorate quickly and the results of the blood culture are not immediate, a provisional diagnosis of neonatal septicaemia is made using a '''sepsis scoring''' system. This combines the all the physical findings and in-house test results to provide an overall clinical picture and sepsis score that then guides treatment prior to the return of the blood culture results.
-Aspects incorporated in the sepsis scoring system are; the clinical signs and history, the results of individual tests (for example ultrasound on the umbilicus and joint arthrocentesis), haematology showing a [[Neutropenia|neutropaenia]] with toxic change, and [[FPT]] measurements - serum IgG levels of less than 4 g/litre indicate failure of passive transfer. Levels of 4g/litre and above are acceptable when coupled with good hygiene. An IgG level of 8 g/litre or more indicates successful transfer of maternal antibodies.
+Aspects incorporated in the sepsis scoring system are; the clinical signs and history, the results of individual tests (for example ultrasound on the umbilicus and joint arthrocentesis), haematology showing a [[Neutropenia|neutropaenia]] with toxic change, and [[FPT]] measurements - serum [[IgG]] levels of less than 4 g/litre indicate failure of passive transfer. Levels of 4g/litre and above are acceptable when coupled with good hygiene. An IgG level of 8 g/litre or more indicates successful transfer of maternal antibodies.
 ==Treatment==
-If septicaemia is suspected the foal should be '''immediate''' treated with '''broad spectrum IV antibiotics''' until culture results are known. Multiple '''plasma transfusions''' may be required to raise '''IgG''' serum levels, and '''IV fluid therapy''' should be administered to treat endotoxic shock. '''Nutritional support''' is necessary, either by helping the foal suckle the dam or administration of the dams milk (or a substitute) via nasogastric tube. In addition, '''glucose levels''' should be measured frequently and dextrose added to the IV fluid therapy if necessary. The use of '''anti-endotoxin drugs''' (flunixin, anti-prostoglandin, polymyxin B) as an adjunct treatment has also been reported.
+If septicaemia is suspected the foal should be '''immediately''' treated with '''broad spectrum IV antibiotics''' until culture results are known. Multiple '''plasma [[:Category:Transfusion Medicine|transfusions]]''' may be required to raise '''IgG''' serum levels, and '''IV [[:Category:Fluid Therapy|fluid therapy]]''' should be administered to treat endotoxic shock. '''Nutritional support''' is necessary, either by helping the foal suckle the dam or administration of the dams milk (or a substitute) via nasogastric tube. In addition, '''glucose levels''' should be measured frequently and dextrose added to the IV fluid therapy if necessary. The use of '''anti-endotoxin drugs''' (flunixin, anti-prostoglandin, polymyxin B) as an adjunct treatment has also been reported.
-'''General supportive care''', '''recumbant foal management''' and '''TLC''' is also necessary - this may continue for several weeks after infection. '''Organ-specific treatments''' such as joint lavage with joint sepsis and oxygen therapy with pneumonia may also be needed.
+'''General supportive care''', '''recumbant foal management''' and '''TLC''' (tender loving care) is also necessary - this may continue for several weeks after infection. '''Organ-specific treatments''' such as joint lavage with joint sepsis and oxygen therapy with [[pneumonia]] may also be needed.
-If the umbilicus is a localised source of infection, it can surgically resected to reduce the spread of infection to distant organs.
+If the umbilicus is a localised source of infection, it can be surgically resected to reduce the spread of infection to distant organs.
 ==Prevention==
 * Ensuring adequate intake of '''colostrum''' in the first 12-24 hours of life. Levels can be checked by measuring serum IgG (>800mg/dl)
-* Appropriate treatment of the '''umbilicus''' with tincture of iodine promptly after birth.
+* Appropriate treatment of the '''umbilicus''' with tincture of iodine promptly after birth
-* Providing a '''clean''', '''warm''' and '''well ventilated''' environment for the neonate.
+* Providing a '''clean''', '''warm''' and '''well ventilated''' environment for the neonate
 ==Prognosis==
-Dependant on the severity of clinical signs and the individual organs affected. '''Early recognition and aggressive treatment''' are key to an improved prognosis.
+Prognosis is dependant on the severity of clinical signs and the individual organs affected. '''Early recognition and aggressive treatment''' are key to an improved prognosis.
 ==References==
@@ Line 62: / Line 62: @@
 Stoneham, S (1997) '''Collection and administration of plasma to a new born foal''' ''In Practice 1997 19: 384-38''
-[[Category:To Do - Siobhan Brade]]
-[[Category:To Do - Manson review]]
+{{review}}

@@ Line 1: / Line 1: @@
 ==Introduction==
-Septicaemia in the foal is a serious and life-threatening condition that requires prompt diagnosis and treatment. It is caused by the presence of bacteria, or bacterial toxins in the blood. The infection can either be localised (ie to the joints or umbilicus) or generalised, with systemic signs.
+'''Septicaemia''' in the foal is a '''serious''' and '''life-threatening''' condition that requires '''prompt diagnosis''' and '''treatment'''. It is caused by the presence of '''bacteria''', or '''bacterial toxins''' in the '''blood'''. The infection can either be localised (ie to the joints or umbilicus) or generalised, with systemic signs.
-Several bacteria can cause septicaemia, including grams negative organisms such as ''E-coli'', ''Actinobacillus'', and ''Klebsiella'' species,and gram positive organisms such as ''Streptococcus'' and ''Staphylococcus'' species. Occasionally anaerobic organisms such ''Clostridium'' species may also cause disease.
+Several bacteria can cause septicaemia, including grams negative organisms such as '''''E-coli''''', ''Actinobacillus'', and ''Klebsiella'' species,and gram positive organisms such as '''''Streptococcus''''' and ''Staphylococcus'' species. Occasionally anaerobic organisms such ''Clostridium'' species may also cause disease.
 ==Signalment==
-Infection is via haematogenous spread following infection via the placenta, umbilicus, lungs or GI tract. Foals may be affected as early as the first 12 hours after birthday.
+Disease is caused following '''haematogenous''' spread of infection via the '''placenta''', '''umbilicus''', '''lungs''' or '''GI tract'''. Foals may be affected as early as the first 12 hours after birth.
 Predisposing factors include:
-* Failure of passive transfer - due to failure of the foal to suckle adequate quantities of colostrum, or low volume/poor quality colostrum produced by the dam.
+* '''Failure of passive transfer''' - due to failure of the foal to suckle adequate quantities of colostrum, or low volume/poor quality colostrum produced by the dam.
-* Dystocia
+* '''Dystocia'''
-* Premature/Dysmature foal
+* '''Premature/Dysmature foal'''
-* Over-crowding and poor hygiene
+* '''Over-crowding and poor hygiene'''
-* Artificial severance and ligation of the umbilicus
+* '''Artificial severance and ligation of the umbilicus'''
-* Failure to treat the umbilicus immediately after birth (with tincture of iodine)
+* '''Failure to treat the umbilicus immediately after birth''' (with tincture of iodine)
 ==Clinical Signs==
-Foals in the early stages of clinical disease may not show any specific signs, instead appearing 'off-suck' (inspecting the dams udder can give some indication of when the foal last suckled). This may be accompanied by lethargy, malaise, frequent recumbancy and pyrexia. The bacteria may localise in different organs, producing clinical signs directly related to that organ:
+Foals in the early stages of clinical disease may not show any specific signs, instead appearing ''''off-suck'''' (inspecting the dams udder can give some indication of when the foal last suckled). This may be accompanied by '''lethargy''', '''malaise''', frequent '''recumbancy''' and '''pyrexia'''. The bacteria may '''localise''' in different organs, producing clinical signs directly related to that organ:
 * Ocular localisation produces '''hypopyon''' and '''iritis'''
@@ Line 30: / Line 30: @@
 The disease may then advance to '''septic shock'''. Clinical signs include prolonged recumbancy, depression, dehydration, and tachycardia with cold extremities, weak thready pulses, slow capillary refill time and muddy mucous membranes; indicative of hypotension. Dependant on the organs affected, signs of individual or multiple organ dysfunction may be present.
-Clinical signs can progress very rapidly therefore prompt recognition is necessary.
+Clinical signs can '''progress''' very '''rapidly''' therefore prompt recognition is necessary.
 ==Diagnosis==
-Definitive diagnosis is by positive blood culture, however a negative blood culture does not rule out septicaemia. As the foal may deteriorate quickly and the results of the blood culture are not immediate, a provisional diagnosis of neonatal septicaemia is made using a sepsis scoring system. This combines the all the physical findings and in-house test results to provide an overall clinical picture and sepsis score that then guides treatment prior to the return of the blood culture results.
+Definitive diagnosis is by '''positive blood culture''', however a negative blood culture does not rule out septicaemia. As the foal may deteriorate quickly and the results of the blood culture are not immediate, a provisional diagnosis of neonatal septicaemia is made using a '''sepsis scoring''' system. This combines the all the physical findings and in-house test results to provide an overall clinical picture and sepsis score that then guides treatment prior to the return of the blood culture results.
 Aspects incorporated in the sepsis scoring system are; the clinical signs and history, the results of individual tests (for example ultrasound on the umbilicus and joint arthrocentesis), haematology showing a [[Neutropenia|neutropaenia]] with toxic change, and [[FPT]] measurements - serum IgG levels of less than 4 g/litre indicate failure of passive transfer. Levels of 4g/litre and above are acceptable when coupled with good hygiene. An IgG level of 8 g/litre or more indicates successful transfer of maternal antibodies.
 ==Treatment==
-If septicaemia is suspected the foal should be immediate treated with broad spectrum IV antibiotics until culture results are known. Multiple plasma transfusions may be required to raise IgG serum levels, and IV fluid therapy should be administered to treat endotoxic shock. Nutritional support is necessary, either by helping the foal suckle the dam or administration of the dams milk (or a substitute) via nasogastric tube. In addition, glucose levels should be measured frequently and dextrose added to the IV fluid therapy if necessary. The use of anti-endotoxin drugs (flunixin, anti-prostoglandin, polymyxin B) as an adjunct treatment has also been reported.
+If septicaemia is suspected the foal should be '''immediate''' treated with '''broad spectrum IV antibiotics''' until culture results are known. Multiple '''plasma transfusions''' may be required to raise '''IgG''' serum levels, and '''IV fluid therapy''' should be administered to treat endotoxic shock. '''Nutritional support''' is necessary, either by helping the foal suckle the dam or administration of the dams milk (or a substitute) via nasogastric tube. In addition, '''glucose levels''' should be measured frequently and dextrose added to the IV fluid therapy if necessary. The use of '''anti-endotoxin drugs''' (flunixin, anti-prostoglandin, polymyxin B) as an adjunct treatment has also been reported.
-General supportive care, recumbant foal management and TLC is also necessary - this may continue for several weeks after infection. Organ-specific treatments such as joint lavage with joint sepsis and oxygen therapy with pneumonia may also be needed.
+'''General supportive care''', '''recumbant foal management''' and '''TLC''' is also necessary - this may continue for several weeks after infection. '''Organ-specific treatments''' such as joint lavage with joint sepsis and oxygen therapy with pneumonia may also be needed.
 If the umbilicus is a localised source of infection, it can surgically resected to reduce the spread of infection to distant organs.
 ==Prevention==
-* Ensuring adequate intake of colostrum in the first 12-24 hours of life. Levels can be checked by measuring serum IgG (>800mg/dl)
+* Ensuring adequate intake of '''colostrum''' in the first 12-24 hours of life. Levels can be checked by measuring serum IgG (>800mg/dl)
-* Appropriate treatment of the umbilicus with tincture of iodine promptly after birth.
+* Appropriate treatment of the '''umbilicus''' with tincture of iodine promptly after birth.
-* Providing a clean, warm and well ventilated environment for the neonate.
+* Providing a '''clean''', '''warm''' and '''well ventilated''' environment for the neonate.
 ==Prognosis==
-Dependant on the severity of clinical signs and the individual organs affected. Early recognition and aggressive treatment are key to an improved prognosis.
+Dependant on the severity of clinical signs and the individual organs affected. '''Early recognition and aggressive treatment''' are key to an improved prognosis.
@@ Line 65: / Line 65: @@
 [[Category:To Do - Siobhan Brade]]

← Older revision	Revision as of 16:37, 22 August 2011
(No difference)