Eperythrozoon infection in swine: effect on the acid-base balance and the glucose, lactate and pyruvate content of venous blood

The influence of latent and of splenectomy-induced clinically manifest Eperythrozoon suis infection on the following parameters of the carbohydrate metabolism and the acid-base status was tested in venous blood of German Landrace pigs: Levels of glucose, lactic and pyruvic acid, blood-pH, base excess, actual bicarbonate concentration, standard bicarbonate concentration, pCO2, pO2. The latent E. suis infection resulted in a consistent decrease of blood glucose level. 23 days after infection, blood glucose was reduced by 25% of the initial value. The other parameters were not changed by latent E. suis infection. Acute Eperythrozoonosis induced severe hypoglycaemia (means Gluc, = 39.7 mg/dl and blood acidosis (means pH = 7.13). In vitro experiments showed that break-down of glucose in E. suis infected blood occurs very rapidly. There was no significant reduction of the glucose concentration in control blood that had been treated accordingly. There was an increase of lactic acid (means = 62.7 mg/dl), pyruvic acid (means = 1.86 mg/dl), and pCO2 (means = 82.1 mm Hg). The concentrations of actual bicarbonate (means = 24.8 mmol/l) and standard bicarbonate (means = 20.9 mmol/l) were lowered, and there was a negative base excess (means = -3.56 mmol/l). The ratio of lactic and pyruvic acid changed from 11:1 to 30:1. It seems likely that E. suis itself is able to metabolize glucose. Acidosis is considered to result from both the increase of lactic acid (metabolic component) and an impairment of pulmonary gas exchange (respiratory component).     

Simple acid-base disorders

The body regulates pH closely to maintain homeostasis. The pH of blood can be represented by the Henderson-Hasselbalch equation: pH = pK + log [HCO3-]/PCO2 Thus, pH is a function of the ratio between bicarbonate ion concentration [HCO3-] and carbon dioxide tension (PCO2). There are four simple acid base disorders: (1) Metabolic acidosis, (2) respiratory acidosis, (3) metabolic alkalosis, and (4) respiratory alkalosis. Metabolic acidosis is the most common disorder encountered in clinical practice. The respiratory contribution to a change in pH can be determined by measuring PCO2 and the metabolic component by measuring the base excess. Unless it is desirable to know the oxygenation status of a patient, venous blood samples will usually be sufficient. Metabolic acidosis can result from an increase of acid in the body or by excess loss of bicarbonate. Measurement of the "anion-gap" [(Na+ + K+) - (Cl- + HCO3-)], may help to diagnose the cause of the metabolic acidosis. Treatment of all acid-base disorders must be aimed at diagnosis and correction of the underlying disease process. Specific treatment may be required when changes in pH are severe (pH less than 7.2 or pH greater than 7.6). Treatment of severe metabolic acidosis requires the use of sodium bicarbonate, but blood pH and gases should be monitored closely to avoid an "overshoot" alkalosis. Changes in pH may be accompanied by alterations in plasma potassium concentrations, and it is recommended that plasma potassium be monitored closely during treatment of acid-base disturbances.     

Hypoglycemia: a factor associated with low survival rate of neonatal piglets infected with transmissible gastroenteritis virus.

The main purpose of this work was to study changes in the balance of fluids, electrolytes and blood metabolites in neonatal piglets with severe transmissible gastroenteritis. Six two day old conventional piglets were infected with transmissible gastroenteritis virus while six others were used as normal controls. Blood samples were collected in heparin when the infected piglets were moribund. The following variables were measured: packed red cell volume, total plasma protein and bicarbonate, blood pH, blood urea nitrogen and plasma glucose, creatinine, chloride, inorganic phosphorus, sodium, potassium, magnesium and calcium. Vomiting and diarrhea appeared 12 to 24 hours postinoculation in the infected piglets and they were moribund one or two days later. Before becoming moribund, most of the piglets fell rapidly into a lethargic and comatose state. The most evident changes in their blood variables were an increase in packed cell volume, total protein, blood urea nitrogen, phosphorus and magnesium levels and a decrease in pH and bicarbonate concentration as well as a severe hypoglycemia. The results suggest that severe hypoglycemia coupled with metabolic acidosis and dehydration might be an important factor contributing to the high mortality rates caused by transmissible gastroenteritis in neonatal piglets. The hypoglycemia results from a combination of the inadequate glucose metabolism inherent to neonatal piglets and the acute maldigestion and malabsorption resulting from the diffuse and severe villous atrophy induced by the virus.     

Eperythrozoon infection in swine as a disease factor

Infection with Eperythrozoon suis (E. suis) normally takes a latent course and depends on various factors. Only animals suffering extreme stress show clinically manifest attacks with anemia, fever and occasionally jaundice. Stress in the form of high animal-concentration in the stables, poor climatic conditions, change of stables or food or chronic general diseases predispose the pigs to clinical illness. The diagnosis of E. suis infection is made difficult by the prevalence of general diseases in the stocks. Experimental infections have shown that also latent infections with E. suis cause partly significant deviations in the red and white blood cell count as well as in the glucose and acid-base balance and lead to serologically detectable immune reactions which could be used as a basis for stock-diagnosis. It is still unknown to what extent infection with E. suis represents a factor in the manifestation of other complex diseases. Some observations, however, give reason to believe that Eperythrozoonosis as a basis infection is itself a precursor for the manifestation of widespread infectious diseases.     

In vitro and in vivo glucose consumption in swine eperythrozoonosis

One complication of swine eperythrozoonosis is the hypoglycemia that occurs during parasitemia. To determine the cause of the hypoglycemia, we studied glucose consumption in splenectomized pigs infected with Eperythrozoon suis. With the rapid rise of erythroparasites, the in vitro glucose consumption of parasited whole blood increased dramatically, and hypoglycemia developed. Because mature porcine erythrocytes are impermeable to glucose, the increased glucose consumption is most logically the result of E. suis metabolism. Iodoacetamide and sodium fluoride (which inhibit glycolysis), but not sodium cyanide (which prevents cellular respiration), and tetracycline (which is used to treat eperythrozoonosis) inhibited glucose consumption. In vivo glucose turnover studies before infection and during peak parasitemia indicated an increased glucose production by infected pigs during parasitemia. The results suggest that hypoglycemia occurs during swine eperythrozoonosis because the parasite uses glucose faster than the gluconeogenic pathways can provide it.     

Mixed acid-base disorders

Mixed acid-base disturbances are combinations of two or more primary acid-base disturbances. Mixed acid-base disturbances may be suspected on the basis of findings obtained from the medical history, physical examination, serum electrolytes and chemistries, and anion gap. The history, physical examination, and serum biochemical profile may reveal disease processes commonly associated with acid-base disturbances. Changes in serum total CO2, serum potassium and chloride concentrations, or increased anion gap may provide clues to the existence of acid-base disorders. Blood gas analysis is usually required to confirm mixed acid-base disorders. To identify mixed acid-base disorders, blood gas analysis is used to identify primary acid-base disturbance and determine if an appropriate compensatory response has developed. Inappropriate compensatory responses (inadequate or excessive) are evidence of a mixed respiratory and metabolic disorder. The anion gap is also of value in detecting mixed acid-base disturbances. In high anion gap metabolic acidosis, the change in the anion gap should approximate the change in serum bicarbonate. Absence of this relationship should prompt consideration of a mixed metabolic acid-base disorder. Finding an elevated anion gap, regardless of serum bicarbonate concentration, suggests metabolic acidosis. In some instances, elevated anion gap is the only evidence of metabolic acidosis. In patients with hyperchloremic metabolic acidosis, increases in the serum chloride concentration should approximate the reduction in the serum bicarbonate concentration. Significant alterations from this relationship also indicate that a mixed metabolic disorder may be present. In treatment of mixed acid-base disorders, careful consideration should be given to the potential impact of therapeutically altering one acid-base disorder without correcting others.     

THE EFFECT OF EPERYTHROZOON OVIS INFECTION ON THE GLUCOSE LEVEL AND SOME ACID-BASE FACTORS IN THE VENOUS BLOOD OF SHEEP

Eperythrozoon ovis infected sheep have low venous blood glucose levels and correspondingly increased blood lactic acid levels as compared with control sheep. Acid-base studies showed that these changes were accompanied by significant falls in venous pH, and standard bicarbonate as well as a negative base excess. All these changes were considered to result from the increased alvcolytic activity of infected erythrocytes. The acidosis and hypoglycaemia associated with E. ovis infection, while not having any apparent effect on young, well-fed sheep, could be potentially serious in pregnant ewes and in sheep on a low plane of nutrition.     

Distal renal tubular acidosis in a cat with pyelonephritis

A four-year-old castrated male domestic shorthair cat with recent onset of lethargy and depression was found to have hypokalaemia, low plasma bicarbonate concentration and a urine pH of 7. Subsequent findings of hyperchloraemic metabolic acidosis with failure to produce acid urine led to a diagnosis of distal renal tubular acidosis. Pyelonephritis associated with Escherichia coli infection of the urinary tract was also diagnosed. The urinary tract infection was eliminated by antibiotic treatment. For two years subsequently, the clinical effects of distal renal tubular acidosis have been controlled by oral administration of potassium bicarbonate, although some biochemical abnormalities have persisted.     

The Effects of Equivalent Doses of Tromethamine or Sodium Bicarbonate in Healthy Horses

Objective—To describe the effects of tromethamine, a putative treatment for metabolic acidosis, and to compare its biochemical effects with those of sodium bicarbonate.
Design—Randomized intervention study with repeated measures.
Animals—16 healthy horses, 3 to 17 years old, weighing 391 to 684 kg.
Methods—Ten horses received 3 mEq/kg tromethamine and six received 3 mEq/kg sodium bicarbonate. Samples of venous blood and cerebrospinal fluid (CSF) were collected at intervals before and after drug administration. Heart rate and breathing rate were also recorded at intervals. Results—Median standard base excess increased significantly ( P < .05) from baseline immediately after both bicarbonate and tromethamine. These increases were not significantly different between treatments. Standard base excess returned toward baseline but remained significantly increased 3 hours after infusion of either treatment. After tromethamine, there was a significant decrease in plasma sodium concentration that lasted for at least 90 minutes. After sodium bicarbonate, no change in plasma sodium concentration was detected. Both sodium bicarbonate and tromethamine increased carbon dioxide tension in venous blood and CSF. Despite venous alkalemia, the pH of CSF decreased after both treatments.
Conclusions—Tromethamine and sodium bicarbonate have similar alkalinizing ability. Tromethamine causes hyponatremia, whereas both tromethamine and sodium bicarbonate increase carbon dioxide tension in venous blood and CSF.
Clinical Relevance—If hyponatremia, hypercarbia, and acidosis of the CSF occur after tromethamine is given to horses with existing metabolic acidosis, some of the potential advantages of tromethamine may prove theoretical rather than practical.     

猪附红细胞体致病机理的研究进展

作者综述了猪附红细胞体的致病机理,其主要包括4个方面:①猪附红细胞体引起红细胞膜改变,导致自身免疫溶血性贫血;②使机体产生自身抗体即M型冷凝素,导致红细胞凝集、溶解和机体Ⅱ型过敏反应;③使血液葡萄糖水平降低,机体出现酸中毒,被感染的红细胞携带氧气的能力下降,常导致机体呼吸困难;④当出现严重的寄生虫血症时,抑制猪的免疫反应。     

Ventilatory and Metabolic Compensation in Dogs With Acid-Base Disturbances

Ventilatory and metabolic compensation to acid-base disturbances is reviewed. The mechanisms for compensation as well as the values obtained from several studies using normal dogs and dogs with experimentally induced diseases are provided. Compensation is not the same in dogs and human beings. Dogs have a better ability to adapt to most respiratory disorders, and human beings adapt better to metabolic acidosis. In metabolic alkalosis and chronic respiratory acidosis there is no difference in compensation between these species. Ventilatory compensation for metabolic disorders in dogs is the same whether they have metabolic acidosis or metabolic alkalosis, whereas metabolic compensation in respiratory disturbances is less effective in acidosis. Values for the expected changes in PCO₂ in dogs with metabolic acidosis and metabolic alkalosis, and for bicarbonate concentration (HCO₃-) in dogs with acute and chronic respiratory alkalosis and acidosis are presented.     

Clinical efficacy of intravenous hypertonic saline solution or hypertonic bicarbonate solution in the treatment of inappetent calves with neonatal diarrhea

BACKGROUND: The clinical efficacy of IV administered hypertonic saline solution and hypertonic bicarbonate solution (HBS) in the treatment of inappetent diarrheic calves has not been compared yet. HYPOTHESIS: HBS is more advantageous than hypertonic saline in the treatment of calves with severe metabolic acidosis. ANIMALS: Twenty-eight dehydrated, inappetent calves with neonatal diarrhea. METHODS: In 2 consecutive clinical studies, calves were initially treated with saline (5.85%; 5 mL/kg body weight [BW] over 4 minutes; study I: N = 16) or bicarbonate solution (8.4%; 10 mL/kg BW over 8 minutes; study II: N = 12), respectively, followed by oral administration of 3 L isotonic electrolyte solution 5 minutes after injection. Clinical and laboratory variables were monitored for 72 hours. RESULTS: Treatment failed in 6 calves of study I and in 1 calf of study II as indicated by a deterioration of the general condition. All treatment failures had more severe metabolic acidosis compared with successfully treated calves before treatment. In the latter, rehydration was completed within 18 hours after injection; metabolic acidosis was corrected within 24 hours (study I) and 6 hours (study II) after injection. CONCLUSIONS AND CLINICAL IMPORTANCE: Diarrheic calves with slight metabolic acidosis (base excess [BE] >-10 mM) can be treated successfully with hypertonic saline. HBS is appropriate in calves without respiratory problems with more severe metabolic acidosis (BE up to -20 mM). Intensive care of the calves is required to ensure a sufficient oral fluid intake after the initial IV treatment.     

Effect of ammonium chloride on the bicarbonate buffer system in heat-stressed broilers

1. The effects of ammonium chloride (NH4Cl) on the bicarbonate buffer system and plasma lactate in heat-stressed broilers were investigated. 2. The infusion of a 10 g/l solution of NH4Cl into the crop during a 90 min thermoneutral period produced a metabolic acidosis resulting from a reduction in blood bicarbonate concentration. Blood bicarbonate continued to decrease in NH4Cl-treated birds and reached values which were 30% of controls by the end of a 90 min heat stress period. 3. By the end of heat stress, plasma lactate concentrations were lower in NH4Cl-infused birds than in controls.     

Evaluation of acid-base disturbances in calf diarrhoea

The severity of acid-base disturbances in diarrhoeic calves was investigated and a simple, inexpensive method of monitoring them was evaluated. The Harleco apparatus measures the 'total carbon dioxide' in a blood sample, mostly generated from the bicarbonate present, and any abnormalities are mainly due to metabolic acidosis or alkalosis. Its performance was tested against a standard blood gas analyser by comparing the results obtained by both methods with nearly 2000 blood samples from healthy or diarrhoeic calves. After technical modifications, the technique gave excellent precision and accuracy for the clinical evaluation of acid-base balance, using venous whole blood. The samples were very stable, especially at 0 degrees C, but also at room temperature. The normal range (mean +/- 1.96 sd) for total carbon dioxide in whole blood from calves was 21 to 28 mmol/litre. For samples corresponding to mild, moderate or severe acidosis, 79 per cent were correctly classified by the Harleco apparatus and only 0.1 per cent were beyond the adjacent degree of severity. After four days of diarrhoea, the calves which later died had twice the deficit in plasma bicarbonate of those which survived. As death approached, the deficit was almost three times that in surviving calves and the blood pH shortly before death was as low as 6.79 +/- 0.08. The Harleco apparatus was less successful with alkalotic samples, but metabolic alkalosis is less common and usually less severe.     

Further studies on the clinical features and clinicopathological findings of a syndrome of metabolic acidosis with minimal dehydration in neonatal calves.

A syndrome of metabolic acidosis of unknown etiology was diagnosed in twelve beef calves 7 to 31 days old. Principal clinical signs were unconsciousness or depression concomitant with weakness and ataxia. Other signs included weak or absent suckle and menace reflexes, succussable nontympanic fluid sounds in the anterior abdomen, and a slow, deep thoracic and abdominal pattern of respiration. The variation in clinical signs between calves was highly correlated (r = 0.87, P less than 0.001) with their acid-base (base deficit) status. Abnormal laboratory findings included reduced venous blood pH, pCO2 and bicarbonate ion concentration as well as hyperchloremia, elevated blood urea nitrogen, increased anion gap and neutrophilic leukocytosis with a left shift. Sodium bicarbonate solution administered intravenously effectively raised blood pH and improved demeanor, ambulation and appetite. All calves did well following a return to a normal acid-base status.     

Transfer of energy substrates across the ruminal epithelium: implications and limitations

The ruminal epithelium has an enormous capacity for the absorption of short-chain fatty acids (SCFAs). This not only delivers metabolic energy to the animal but is also an essential regulatory mechanism that stabilizes the intraruminal milieu. The epithelium itself, however, is endangered by the influx of SCFAs because the intracellular pH (pHi) may drop to a lethal level. To prevent severe cytosolic acidosis, the ruminal epithelium is able to extrude (or buffer) protons by various mechanisms: (i) a Na+/H+ exchanger, (ii) a bicarbonate importing system and (iii) an H+/monocarboxylate cotransporter (MCT). Besides pHi regulation, the MCT also provides the animal with ketone bodies derived from the intraepithelial breakdown of SCFAs. Ketone bodies, in turn, can serve as an energy source for extrahepatic tissues. In addition to SCFA uptake, glucose absorption has recently been identified as a potential way of eliminating acidogenic substrates from the rumen. At least with respect to SCFAs, absorption rates can be elevated when adapting animals to energy-rich diets. Although they are very effective under physiological conditions, the absorptive and regulatory mechanisms of the ruminal epithelium also have their limits. An increased number of protons during the state of ruminal acidosis can be eliminated neither from the lumen nor the cytosol, thus worsening dysfermentation and finally leading to functional and morphological alterations of the epithelial lining.     

Relationship between depression score and acid-base status in Japanese Black calves with diarrhea

We evaluated the relationship between depression score and acid-base status in 84 purebred and crossbred Japanese Black calves. The bicarbonate (p<0.001) and base excess concentrations (p<0.001) were significantly and negatively correlated with the depression scores of the calves. The proposed diagnostic cutoff point for a depression score that indicates severe metabolic acidosis (BE < -10 mM) is 6.5 based on analysis of the ROC curve. The sensitivity and specificity were 88.4% and 81.2%, respectively. The depression scoring system is a useful tool for evaluation of the acid-base status of purebred and crossbred Japanese Black calves. In addition, a depression score of 6.5 suggests severe metabolic acidosis and that intravenous infusion of sodium bicarbonate solution is necessary.     

Recombinant DNA probe detecting Eperythrozoon suis in swine blood

A genomic library to Eperythrozoon suis DNA was constructed in lambda gt11, and from this library, E suis clone KSU-2 was identified as a potential diagnostic probe. In hybridization experiments that used 100-microliters samples of blood collected in chaotropic salt solutions, the KSU-2 probe hybridized strongly with purified E suis organisms and blood samples from splenectomized swine that were parasitized with E suis. However, the probe under stringent conditions did not give radiographic indications of hybridizing with equine blood DNA, bovine blood DNA infected with Anaplasma marginale, canine blood DNA infected with Ehrlichia canis, feline blood DNA infected with Haemobartonella felis, or uninfected swine blood DNA.     

抗附红细胞体有效药物的筛选

以PCR检测附红细胞体呈现阳性，且镜检染虫率达909／5以上的猪血样为研究对象，选择几种附红细胞体敏感的药物(血虫净，附红净，庆大霉素，博士914，土霉素，三毒清，红弓链914，附红120，红弓链克，乌金土霉素)和对支原体敏感的恩诺沙星，对立克次氏体敏感的红霉素，采用两种方法进行体外药效试验。附红净对附红细胞体的作用效果最明显，而庆大霉素对附红细胞体基本无效，其他药物对附红细胞体也有一定杀灭效果。     

Infusion of sodium bicarbonate in experimentally induced metabolic acidosis does not provoke cerebrospinal fluid (CSF) acidosis in calves

In a crossover study, 5 calves were made acidotic by intermittent intravenous infusion of isotonic hydrochloric acid (HCl) over approximately 24 h. This was followed by rapid (4 h) or slow (24 h) correction of blood pH with isotonic sodium bicarbonate (NaHCO(3)) to determine if rapid correction of acidemia produced paradoxical cerebrospinal fluid (CSF) acidosis. Infusion of HCl produced a marked metabolic acidosis with respiratory compensation. Venous blood pH (mean ± S(x)) was 7.362 ± 0.021 and 7.116 ± 0.032, partial pressure of carbon dioxide (Pco(2), torr) 48.8 ± 1.3 and 34.8 ± 1.4, and bicarbonate (mmol/L), 27.2 ± 1.27 and 11 ± 0.96; CSF pH was 7.344 ± 0.031 and 7.240 ± 0.039, Pco(2) 42.8 ± 2.9 and 34.5 ± 1.4, and bicarbonate 23.5 ± 0.91 and 14.2 ± 1.09 for the period before the infusion of hydrochloric acid and immediately before the start of sodium bicarbonate correction, respectively. In calves treated with rapid infusion of sodium bicarbonate, correction of venous acidemia was significantly more rapid and increases in Pco(2) and bicarbonate in CSF were also more rapid. However, there was no significant difference in CSF pH. After 4 h of correction, CSF pH was 7.238 ± 0.040 and 7.256 ± 0.050, Pco(2) 44.4 ± 2.2 and 34.2 ± 2.1, and bicarbonate 17.8 ± 1.02 and 14.6 ± 1.4 for rapid and slow correction, respectively. Under the conditions of this experiment, rapid correction of acidemia did not provoke paradoxical CSF acidosis.