Endotoxaemia in the horse

Abstract

Summary Endotoxins are non‐protein fragments of the cell wall of Gramnegative bacteria. They must be absorbed into the circulation to produce disease and systemic effects are similar, regardless of bacterial source. Absorption of endotoxins occurs in obstructive bowel disease and may play a significant part in determining the severity of the disease. Many of the responses to experimentally administered endotoxin are identical to those of bowel diseases of the horse and include circulatory, haematological and metabolic alterations. Therapeutic approaches are indirect and include many drugs currently employed in equine practice. The agents are directed toward mediators of the disease rather than the endotoxins themselves and include fluids, corticosteroids, anti‐inflammatory drugs, energy sources and vasoactive drugs. The rationale for use and dosages are discussed. Résumé Les endotoxines sont des fragments non protéiques de la paroi cellulaire des bactéries Gram‐. Ils doivent être entraînés par la circulation sanguine pour engendrer des maladies et les effets systémiques sont semblables, quelle que soit la source bactérienne. L'absorption d'endotoxines se produit lors d'obstruction intestinale et cela peut jouer une part importante dans la sévérité de la maladie, Bien des résultats faisant suite à l'administration expérimentale d'endotoxines sont identiques à ceux constatés lors d'obstruction intestinale chez le cheval, et comportent des altérations métaboliques, hématologiques et circulatoires. Les démarches thérapeutiques sont indirectes et utilisent de nombreux médicaments d'emploi courant en médecine équine. Les agents thérapeutiques sont utilisés contre les relais de la maladie à défaut de pouvoir agir contre les endotoxines elles mêmes; ils comportent des solutés, des corticostéroîdes, des anti inflammatoires, des sources énergétiques et des agents vaso actifs. On en discute les dosages et l'emploi. Zusammenfassung Endotoxine sind eiweissfreie Fragmente der Zellwand gramnegativer Bakterien. Um Krankheitszeichen hervorrufen zu können, müssen sie in die Zirkulation absorbiert werden, unabhängig von der bakteriellen Quelle. Eine Endotoxinabsorption ergibt sich bei obstruktiven Darmkrankheiten; sie kann den Grad einer Erkrankung signifikant beeinflussen. Viele der mit experimentell verabreichtem Endotoxin ausgelösten Zeichen sind mit denjenigen von Darmerkrankungen des Pferdes identisch. Sie umfassen zirkulatorische, haematologische und metabolische Veränderungen. Die Behandlung erfolgt indirekt mit vielen der in der Pferdepraxis üblichen Medikamente. Die Mittel richten sich gegen die Krankheitsmediatoren und nicht gegen die Endotoxine selbst; sie umfassen Flüssigkeiten, Corticosteroide, Entzündungshemmer, Energiespender und vasoaktive Substanzen. Die Rationalität von Gebrauch und Dosierungen wird besprochen.

Lipopolysaccharide infusion up-regulates hepcidin mRNA expression in equine liver

“…17,18,20 The physical charts of all studied horses classified the clinical signs according to a previously standardized clinical score (CS) that included 4 grades: 0 ¼ normal, 1 ¼ mild response, 2 ¼ moderate response, and 3 ¼ severe response. 17,18,20 These assessments were performed as follows: at baseline (sampling time: 0 h immediately before LPS infusion), 2,4,6,8,10,12,16,18,20,24,30,36,42,48,60,72,96,120,144,168,192, 216 and 240 h PI.…”

Incidence, diagnosis and treatment of postoperative complications in colic cases

“…Much has been written on the treatment of shock and detailed recommendations are given in several reviews (Waterman 1977;Burrows 1981;Moore, Garner, Shapland and Schaub 1981b;Rose 1981;Hood 1982). No single case is identical to another but some guidelines do exist.…”

“…Other drugs with similar actions, for example, isoxsuprine, may also be useful. These and other possible treatments were reviewed by Colles and Jeffcott (1977). If endotoxaemia or hypoperfusion is suspected, preventative therapy should be started which should include the use of heparin.…”

Quality Control of Compounded Crystalloid Fluids for Intravenous Delivery to Horses

“…Clinical susceptibility to endotoxin in horses is widely accepted by equine practitioners and has been described in specific experimental scenarios . Low concentrations of endotoxin in IV fluids can cause clinical signs that include pyrexia, sweating, diarrhea, and leukopenia . Equine patients often receive large volumes of crystalloid fluids IV during surgery to maintain blood pressure or to replace large deficits during the medical treatment of dehydration caused by colitis or other illnesses.…”

“…Equine patients often receive large volumes of crystalloid fluids IV during surgery to maintain blood pressure or to replace large deficits during the medical treatment of dehydration caused by colitis or other illnesses. This highlights the importance of maintaining sterility and knowing if, and to what extent, endotoxin is likely to be a contaminant of a particular IV fluid source . Because clinicians use electrolyte concentrations in crystalloid IV fluids as starting points to correct electrolyte derangements and acid‐base disorders in patients, being able to confidently rely on electrolyte concentrations in IV fluids used therapeutically is a crucial factor for patient management.…”