Positive end-expiratory pressure during colic surgery in horses: 74 cases (1986-1988).

Positive end-expiratory pressure (PEEP) was applied in 74 anesthetized, ventilated horses during colic surgery, to attempt to increase arterial oxygen tensions. In 28 horses with an initial PaO2 less than 70 mm of Hg, PEEP increased PaO2 values to a mean of 173 +/- 24 mm of Hg. Arterial oxygen content increased from 14.1 +/- 0.05 ml/dl to 17.2 +/- 0.05 ml/dl. In the remaining 46 horses, PEEP increased PaO2 from a mean value of 101 +/- 6 mm of Hg to 194 +/- 15 mm of Hg, and arterial oxygen content increased from 14.9 +/- 0.09 ml/dl to 16.9 +/- 0.07 ml/dl. Cardiovascular depression and decrease in arterial blood pressure was observed after the application of PEEP in 54 horses. These 54 horses required use of pressors (n = 8), inotropes (n = 32), or both (n = 14) to keep the mean arterial blood pressure greater than 60 mm of Hg. Combined with pharmacologic support of blood pressure, PEEP could be a useful clinical treatment of arterial hypoxemia in horses.     

Aerobic and anaerobic bacterial isolates from horses with pneumonia or pleuropneumonia and antimicrobial susceptibility patterns of the aerobes

Frequency of aerobic and anaerobic isolates in 327 aspirates and in 123 pleural fluid samples from 327 horses with pneumonia or pleuropneumonia and antimicrobial susceptibility patterns of the aerobes were reported. Of the 327 horses, 75% survived, 20% were euthanatized, and 5% died. Tracheobronchial aspirates or pleural fluid specimens from 25 of the horses did not yield growth. Of the remaining 302 horses, 221 had only aerobic organisms isolated, whereas only anaerobes were isolated from 6 of the 302 horses. The remaining 75 horses had mixed aerobic and anaerobic bacterial infections. The survival rates for horses with aerobic only isolates was twice that of horses with anaerobic isolates. The aerobic bacteria most frequently isolated were beta-Streptococcus spp, Pasteurella spp, Escherichia coli, and Enterobacter spp. The anaerobic species most frequently isolated were Bacteroides spp and Clostridium spp.     

Nosocomial infections and bacterial antibiotic resistance in a university equine hospital

A base-line study of bacteria isolated from horses admitted to the Veterinary Medical Teaching Hospital during a 6-month period was performed to determine the extent of multiresistant nosocomial infections caused by gram-negative aerobic bacteria other than Salmonella spp. Results of this study indicated that 21.9% of the 105 horses from which cultures and sensitivities were available had developed nosocomial gram-negative aerobic infections, with high rates of resistance to gentamicin, kanamycin, and trimethoprim sulfadiazine, three of the most often prescribed antibiotics in this hospital. In addition, a prospective study of antibiotic-resistant bacteria of fecal origin was performed to determine whether there was a change in the degree of antibiotic resistance of a horse's intestinal flora while the horse was hospitalized. Bacterial culturing for gram-negative lactose fermenting bacteria was done on fecal specimens collected directly from the rectum on day 1 and day 7 of a horse's hospitalization. Susceptibility testing was done on each isolant. Of the 24 paired fecal specimens obtained, Escherichia coli and Klebsiella sp isolated on day 7 were resistant to a significantly higher number of antibiotics than day 1 isolants (P = 0.003, P = 0.043, respectively).     

Susceptibility pattern of bacterial isolates in equine ulcerative keratitis: Implications for empirical treatment at a university teaching hospital in Sydney

Corneal ulceration is a common ophthalmic condition in horses. It is frequently caused by trauma to the corneal surface, followed by secondary infection by commensal or pathogenic organisms including Streptococcus equi subspecies zooepidemicus, Pseudomonas aeruginosa and Staphylococcus spp. Emerging antimicrobial resistance amongst these organisms has raised the need for appropriate antimicrobial therapy selection, to optimise treatment efficacy while minimising further antimicrobial resistance. Medical records of 38 horses presented at the University Veterinary Teaching Hospital Camden for ulcerative keratitis between 2010 and 2020 were reviewed to identify those with positive bacterial cultures and antimicrobial susceptibility profiles (13/38). Common susceptibility patterns were identified and used to guide the empirical treatment of equine bacterial corneal ulcers. Pseudomonas spp. (64.3%), Streptococcus equi subspecies zooepidemicus (14.3%) and Actinobacillus spp. (14.3%) were most commonly identified. Susceptibility to amikacin, gentamicin and ciprofloxacin was observed in 100%, 66.7% and 85.7% Pseudomonas spp. isolates respectively. Resistance to polymyxin B and neomycin occurred in 85.7% and 71.4% of Pseudomonas spp., respectively. All Streptococcus equi subspecies zooepidemicus organisms in this study were susceptible to ceftiofur, cephalexin, penicillin and ampicillin, while they were all resistant to gentamicin, neomycin, enrofloxacin and marbofloxacin. Predominating in this study, Pseudomonas spp. maintained overall aminoglycoside susceptibility despite some emerging resistance, and good fluoroquinolone susceptibility. High resistance to Polymyxin B could have arisen from its common use as first-line therapy for bacterial corneal ulcers. Although further research is required, these new findings about predominant bacteria in equine corneal ulceration in the Camden region and their antimicrobial susceptibility patterns can be used to guide the empirical treatment of bacterial corneal ulcers in horses.     

Small intestinal volvulus in 115 horses: 1988-2000

OBJECTIVE: To evaluate the historical data, signalment, clinical signs, results of laboratory analyses, treatment, and outcome of horses with small intestinal (SI) volvulus. STUDY DESIGN: Retrospective study. SAMPLE POPULATION: One hundred and fifteen client-owned horses, aged 1 month to 21 years. METHODS: Clinical signs, laboratory data, surgical or necropsy findings, and outcome for horses with SI volvulus were obtained from medical records, identified by computer search and manual review. RESULTS: There was no statistical difference in signalment between cases and the hospital population. Seventy-four percent of horses were >/=3 years. There were considerable variations in clinical signs on admission; high heart rate and signs of severe pain were not consistent features. Examination per rectum identified distended small intestine in only 69% of horses. One hundred horses had surgery, and small intestine resection was performed in 25. Eighty-four horses were recovered from surgery, and 67 horses survived to hospital discharge (80% of horses recovered from surgery, 58% of 115 horses). Forty-eight percent that were ultimately discharged had a post-operative complication and these horses had a longer average stay than horses with no complication (11 days versus 8.9 days). CONCLUSIONS: We identified 115 horses with primary SI volvulus over a 12-year period. We found that the population of horses with this lesion was older than has previously been reported and that the prognosis for post-operative survival to hospital discharge is good (80%). Post-operative complications were common, and affected approximately half the horses that were ultimately discharged from the hospital. CLINICAL RELEVANCE: This information may aid diagnosis and prognosis and guide decision making for horses with this condition.     

Antimicrobial susceptibility of bacterial isolates from 233 horses with musculoskeletal infection during 1979-1989.

Bacterial culture and susceptibility results were analysed from 233 horses with septic arthritis/tenosynovitis or osteomyelitis that developed after fracture repair. Antibiotics were deemed highly effective, effective or ineffective if > or = 85%, 70-84.9% or < 70% of the isolates were susceptible respectively. In total, 424 bacterial types were isolated; 386 were aerobic or facultative and 38 were anaerobic. Enterobacteriaceae (28.8%) were the most common bacterial group isolated, followed by non-beta-haemolytic streptococci (13.0%), coagulase-positive staphylococci (11.8%), beta-haemolytic streptococci (9.4%), and coagulase-negative staphylococci (7.3%). The remainder of the organisms were other Gram-negative (15.8%), other Gram-positive (2.3%) and miscellaneous (2.6%) bacteria. Penicillin and ampicillin were highly effective against beta-haemolytic streptococci, but were ineffective against other bacteria. Ampicillin was no more effective than penicillin against most bacteria. Amikacin was the most effective antibiotic against the wide range of bacteria isolated in this study. Amikacin was highly effective against coagulase-positive staphylococci, Enterobacteriaceae and Pseudomonas and was effective against coagulase-negative staphylococci and Actinobacillus. Gentamycin was not highly effective against any bacterial group; but was effective against coagulase-positive and negative staphylococci, Pseudomonas, Salmonella and Actinobacillus. Kanamycin was ineffective against all bacteria with the exception of Actinobacillus. Cephalothin was highly effective against beta-haemolytic streptococci, coagulase-positive staphylococci and Actinobacillus and was effective against coagulase-negative staphylococci.(ABSTRACT TRUNCATED AT 250 WORDS)     

Evolution of bacterial resistance to certain antibacterial agents in horses in a veterinary hospital

Evolution of bacterial resistance to certain antibacterial agents in horses in a veterinary hospital. A total of 255 antibiograms, conducted according to the Kirby-Bauer method from bacterial isolates collected from horses at the H?pital Vétérinaire d'Enseignement at the Université de Montréal between 1996 and 1998 were compared with the results obtained about 10 years ago with corresponding bacterial species. A significant increase in the percentage of strains resistant to trimethoprim-sulfamethoxazole (TMP-SXT), penicilline, tetracycline, and to gentamicin was observed. The percentages of isolates of Actinobacillus spp. and coagulase-positive staphylococci resistant to TMP-SXT increased from 0% to 17% and from 0% to 33%, respectively, (P < 0.05). The percentage of isolates of Actinobacillus spp resistant to penicilline also increased from 33% to 73% (P < 0.05). Regular monitoring of the evolution of bacterial resistance to antibacterial agents is indispensable in a hospital structure. The adoption of "good antibiotherapy practices" is essential to guarantee a decrease in the risks of selection and dissemination of a resistant bacterial strain.     

Trends of antimicrobial resistance in bacterial isolates from a small animal referral hospital

A longitudinal, retrospective investigation was made of antimicrobial resistance in bacterial isolates obtained from clinical cases in a small animal hospital between 1989 and 1997. Isolates of Escherichia coli and Staphylococcus species were used as Gram-negative and Gram-positive indicator organisms, respectively, and the annual prevalence of antimicrobial resistance was calculated for each organism to each of nine (for E coli) and 11 (for Staphylococcus species) appropriate antimicrobials, including enrofloxacin. Using a chi-square test for trend, statistically significant, rising trends were identified in the resistance of E coli to amoxycillin (P=0.04), clavulanate-amoxycillin (P<0.01) and streptomycin (P<0.01), and in the resistance of Staphylococcus species to erythromycin (P<0.01). There was an equivocal, rising trend for the resistance of Staphylococcus species to cephalexin. No significant trends were apparent for any of the other 15 organism/drug interactions. The annual prevalence of multiple drug resistance was calculated for E coli, Proteus species, Pseudomonas species, staphylococci and streptococci, but no statistically significant trends were identified.     

Cholelithiasis in horses: ten cases (1982-1986)

Ten horses with clinical signs consistent with cholelithiasis were evaluated. Fever, icterus, mild intermittent colic, and weight loss were reported. Clinical laboratory abnormalities included leukocytosis, hyper-proteinemia, and hyperfibrinogenemia. Gamma glutamyltransferase and liver isoenzyme of lactate dehydrogenase activities also were high. Choleliths were observed via ultrasonography of the liver in 5 of the 8 horses evaluated, and increased echogenicity of the hepatic parenchyma and dilated bile ducts were observed in all horses. Seven horses were treated medically, 5 of which died or were euthanatized. Three horses were treated surgically, of which only 1 survived. Cholelith composition varied, but cholesterol, calcium bilirubinate, and mixed bile pigments were most commonly observed.     

Pericarditis in horses: six cases (1982-1986)

Records of 6 horses with pericarditis were reviewed. Septic pericarditis was suspected in all horses, based on historic and clinical findings. In horses 1, 2, and 4, cytologic examination of the pericardial effusion revealed acute inflammation with severe neutrophil degeneration. In horses 3 and 5, cytologic examination of pericardial fluid revealed subacute inflammation with degenerated neutrophils, and in horse 6, chronic active inflammation, with well preserved neutrophils. In horses 1 and 3, bacteria were identified on cytologic examination of pericardial fluid. Results of microbiologic cultures of pericardial fluid were positive in horse 3. All horses were treated with broad-spectrum antibiotics. An indwelling pericardial catheter was used to lavage and directly administer antibiotics into the pericardial sac. Horses 1, 4, 5, and 6 survived, horse 2 died of unrelated causes, and horse 3 was euthanatized at the owner's request. Surviving horses returned to athletic performance.     

Keratomas in horses: seven cases (1975-1986)

The diagnosis of keratoma in 7 horses and their treatment and outcome were evaluated. Horses were 2 to 20 years old, of various breeds, and were intact or castrated males. All were lame, and 6 horses had had previous injuries of the affected hoof that had not responded to prior treatments. Only 1 hoof was affected in each horse. Keratomas were beneath the hoof wall (6 horses) or sole (1 horse). Radiographically, a circular or semicircular defect with a discrete margin was present in the distal portion of the third phalanx in 3 horses. Grossly, keratomas were firm solitary masses (1.5 to 5 cm diameter); gray, tan, or yellow; and oval or conical. Keratomas were excised from beneath the hoof wall by removing a section of hoof wall (5 horses) or by undermining the wall beginning at its junction with the sole (1 horse). A keratoma beneath the sole in 1 horse was excised by excavating the sole to the level of the palmar surface of the third phalanx. Keratoma was verified microscopically by the presence of characteristic rings of squamous epithelial cells with abundant keratin. Purulent exudate and inflammatory infiltrate often were present concurrently, reflecting an associated localized infection. Aftercare included daily application of an antiseptic iodine solution and foot bandages, and shoeing with a treatment plate several weeks after surgery. Hoof and sole defects healed completely between 6 months and 1 year. By 1 year after surgery, 6 horses were sound, and keratoma had not recurred.     

Ileocecal intussusception in horses: 26 cases (1981-1988)

The case records of 26 horses with ileocecal intussusception over a 7-year period were reviewed to determine clinical features of the disease and response to treatment. The median age of horses with ileocecal intussusception was 1 year and ranged from 2 weeks to 19 years. There was no apparent gender or breed predisposition to this disease. An acute form of ileocecal intussusception was diagnosed in 19 horses with signs of moderate to severe abdominal pain of less than or equal to 24 hours' duration, and a chronic form was diagnosed in 7 horses with signs of intermittent, mild to moderate abdominal pain of more than 3 days' duration. Horses with chronic ileocecal intussusception had a history of weight loss or failure to gain weight, slow growth, poor appetite, low-grade pyrexia, and postprandial signs of abdominal pain. At surgery, the involved segments of intestine (intussusceptum and intussuscipiens) in chronic cases were 2 to 10 cm long, and the ileum and much of the distal portion of the jejunum were flaccid, dilated, and thick walled. In the acute cases, the length of involved intestine ranged from 6 to 457 cm. Whereas only 1 of 7 chronic intussusceptions (14%) could be reduced, 9 of 19 (47%) acute intussusceptions were reducible. Surgical treatment included resection and jejunocecostomy (6 horses), partial resection through a cecotomy and a side-to-side jejunocecostomy (2 horses), and a side-to-side ileocecostomy or jejunocecostomy without resection (12 horses, 7 of which had chronic intussusception). Six horses with acute intussusception were euthanatized before or during surgery.(ABSTRACT TRUNCATED AT 250 WORDS)     

Protozoal encephalomyelitis in horses: 82 cases (1972-1986)

Medical records of 82 horses with clinical signs of neurologic disease and histologic lesions suggestive of protozoal encephalomyelitis were reviewed. The presence of a protozoan parasite in the CNS was not influenced by prior treatment of the horse with corticosteroids. Prior treatment of horses with trimethoprim-sulfonamide alone or in combination with pyrimethamine resulted in a decreased number of horses in which a protozoan parasite was detected in the CNS at necropsy. The mean age of affected horses was 3.62 +/- 2.78 years, with male and Standardbred horses being overrepresented, compared with that of the hospital population of horses that were studied at the same time.     

Ultrasonography as a diagnostic aid in horses with anaerobic bacterial pleuropneumonia and/or pulmonary abscessation: 27 cases (1984-1986)

The medical records of 83 horses with pleuropneumonia and/or pulmonary abscessation, in which thoracic sonography was used, were reviewed. The sonograms of these horses were reviewed retrospectively for free gas echoes within pleural or abscess fluid. Anaerobic infection was confirmed in 27 horses, and gas echoes were observed in 21 horses. There was a significant (P less than 0.001) correlation between the observation of gas echoes and anaerobic infection in horses with pleuropneumonia and/or pulmonary abscessation. A foul odor to the breath or pleural fluid was significantly (P less than 0.001) associated with anaerobic infection. Poor survival rates were associated with gas echoes or a foul odor to the breath or pleural fluid, both of which were associated with anaerobic infection. Gas echoes within pleural or abscess fluid were found to be a sensitive and specific indicator of anaerobic infection, as was a putrid odor to the breath or pleural fluid. Evaluation for gas echoes and foul odor had better predictive value than did evaluation for gas echoes or foul odor alone. Gas echoes within pleural or abscess fluid is highly suggestive of anaerobic infection. Ultrasonography should be performed repeatedly in horses with pleuropneumonia to assess the progression or resolution of pleural and parenchymal disease. The detection of gas echoes on subsequent ultrasonograms may indicate the development of anaerobic infection.     

Heterotopic polyodontia in horses: nine cases (1969-1986)

Nine horses with heterotopic polyodontia, examined at Purdue University since 1969, were treated surgically and had a favorable outcome. Six of the horses had received prior medical or surgical treatment, but without success. An understanding of the congenital nature of the problem contributed to an accurate diagnosis in each case. General anesthesia, aseptic technique, removal of all aberrant tissue, and wound suture for primary healing appeared to be essential for preserving ear function and obtaining an effective treatment.