Prognostic Value of Clinicopathologic Variables Obtained at Admission and Effect of Antiendotoxin Plasma on Survival in Septic and Critically Ill Foals

Abstract

This prospective study compared survival rates of critically ill and septic foals receiving 1 of 2 different types of commercial equine plasma and analyzed admission variables as possible predictors of survival. Standardized clinical, hematologic, biochemical, and hemostatic admission data were collected and foals received either conventional commercially available hyperimmune equine plasma or equine plasma specifically rich in antiendotoxin antibodies in a double-blinded, coded fashion. Sepsis was defined as true bacteremia or sepsis score >11. Overall survival rate to discharge was 72% (49/68). Foals that were nonbacteremic and demonstrated a sepsis score of < or = 11 at admission had a 95% (18/19) survival rate. The survival rate to discharge for septic foals was 28/49 (57%), with truly bacteremic foals having a survival rate of 58% (14/24), whereas that for nonbacteremic, septic foals was 56% (14/25). Sensitivity and specificity for sepsis score >11 as a predictor of bacteremia were 74 and 52%, respectively. For the entire study population, a higher survival rate to discharge was documented for those foals receiving hyperimmune plasma rich in antiendotoxin antibodies (P = .012, odds ratio [OR] 6.763, 95% confidence interval [CI]: 1.311, 34.903). Administration of plasma rich in antiendotoxin antibodies also was associated with greater survival in septic foals (P = .019, OR 6.267, 95% CI: 1.186, 33.109). Statistical analyses demonstrated that, among 53 clinical and clinicopathologic admission variables, high sepsis score (P < .001), low measured IgG concentration (P = .01), high fibrinogen concentration (P = .018), low segmented neutrophil count (P = .028), and low total red blood cell numbers (P = .048) were the most significant predictors of overall mortality.

Diseases in neonatal foals. Part 2: Potential risk factors for a higher incidence of infectious diseases during the first 30 days post partum

“…Low erythrocyte count 12-48 h after birth was found to be a risk factor for neonatal foals to develop systemic disease with diarrhoea. Peek et al (2006) observed that a low total RBC count was a statistically significant predictor of overall foal mortality and that this could reflect anaemia, low-grade haemolysis or granulocytic and erythropoetic precursor suppression. Rossdale (1972) reported that a subnormal RBC count and haemoglobin content may be due to a reduced haemopoietic activity caused by bacterial toxins.…”

A review of equine sepsis

“…Despite substantial advances in medical management, sepsis continues to represent a leading cause of illness and death in horses (Hoffman et al 1992;Cohen et al 1994;Werners et al 2005;Peek et al 2006). The body's systemic inflammatory response to microbial invasion can lead to rapid deterioration despite pathogen control, which presents a challenge to equine practitioners.…”

Any use in proteomics for low-tech approaches? Detecting fibrinogen chains of different animal species in two-dimensional electrophoresis patterns

“…The issue most often on focus is however, by far, bacterial infection -especially in respiratory diseases [34,[36][37][38][39][40][41] -and such of its short-or long-term sequelae as septic shock with coagulopathy [42][43][44][45], laminitis [46], or osteomyelitis [47].…”