Factors associated with Salmonella shedding among equine colic patients at a veterinary teaching hospital

OBJECTIVE: To evaluate factors potentially associated with fecal Salmonella shedding among equine patients hospitalized for colic at a veterinary teaching hospital and to determine the effects of probiotic treatment on fecal Salmonella shedding and clinical signs. DESIGN: Longitudinal study and controlled trial. ANIMALS: 246 equine colic patients. PROCEDURE: History and medical information were obtained from patient records. Fecal and environmental samples were submitted for aerobic bacterial culture for Salmonella enterica. Fifty-one patients were treated with a commercially available probiotic; 46 were treated with a placebo. Logistic regression was used to evaluate data. RESULTS: Salmonella organisms were detected in feces from 23 (9%) patients at least once during hospitalization. Patients were more likely to shed Salmonella organisms if diarrhea was evident < or = 6 hours after hospitalization and duration of hospitalization exceeded 8 days (odds ratio [OR], 20.3), laminitis developed during hospitalization (OR, 12.0), results of nasogastric intubation were abnormal (OR, 4.9), leukopenia was evident < or =6 hours after hospitalization (OR, 4.6), or travel time to the teaching hospital exceeded 1 hour (OR, 3.5). Horses treated with the probiotic did not differ from control horses in regard to likelihood of fecal Salmonella shedding (OR, 1.5) or prevalence of clinical signs. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that certain risk factors are associated with fecal shedding of S enterica among equine patients hospitalized at a veterinary teaching hospital because of colic and that pathogen monitoring in patients and the hospital environment and use of barrier nursing precautions for equine colic patients are beneficial.     

Risk factors associated with fecal Salmonella shedding among hospitalized horses with signs of gastrointestinal tract disease

OBJECTIVE: To estimate prevalence of and identify risk factors for fecal Salmonella shedding among hospitalized horses with signs of gastrointestinal tract disease. DESIGN: Cross-sectional study. ANIMALS: 465 hospitalized horses with gastrointestinal tract disease. PROCEDURE: Horses were classified as positive or negative for fecal Salmonella shedding during hospitalization by means of standard aerobic bacteriologic methods. The relationship between investigated exposure factors and fecal Salmonella shedding was examined by means of logistic regression. RESULTS: The overall prevalence of fecal Salmonella shedding was 13%. Salmonella serotype Newport was the most commonly isolated serotype (12/60 [20%]), followed by Anatum (8/60 [13%]), Java (13%), and Saint-paul (13%). Foals with gastrointestinal tract disease were 3.27 times as likely to be shedding Salmonella organisms as were adult horses with gastrointestinal tract disease. Adult horses that had been treated with antimicrobial drugs prior to hospitalization were 3.09 times as likely to be shedding Salmonella organisms as were adult horses that had not been treated with antimicrobial drugs prior to hospitalization. Adult horses that underwent abdominal surgery were 2.09 times as likely to be shedding Salmonella organisms as were adult horses that did not undergo abdominal surgery. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that a history of exposure to antimicrobial drugs prior to hospitalization and abdominal surgery during hospitalization were associated with Salmonella shedding in adult horses with gastrointestinal tract disease. Foals with gastrointestinal tract disease were more likely to shed Salmonella organisms than were adult horses with gastrointestinal tract disease.     

Fecal shedding of Salmonella spp by horses in the United States during 1998 and 1999 and detection of Salmonella spp in grain and concentrate sources on equine operations

OBJECTIVE: To estimate prevalence of fecal shedding of Salmonella spp among horses in the US horse population and prevalence of Salmonella spp in grain or other concentrate used as horse feed on equine operations in the United States. DESIGN: Cross-sectional survey. SAMPLE POPULATION: Horses on 972 operations in 28 states. PROCEDURE: Fecal samples were collected from horses resident at each operation. Only a single sample was collected from any individual horse; number of horses from which samples were collected on each operation was determined on the basis of number of horses on the operation. A single sample of grain or concentrate was also collected from each operation. All samples were tested for Salmonella spp by means of bacterial culture. RESULTS: Overall, 0.8% (SE, 0.5) of resident horses shed Salmonella spp in their feces. The overall prevalence of operations positive for fecal shedding of Salmonella spp (i.e., operations with > or = 1 horse shedding Salmonella spp in its feces) was 1.8% (SE, 0.7). Prevalence of grain or other concentrate samples positive for Salmonella spp was 0.4%. Serotypes of Salmonella spp that were identified in grain or other concentrate were not those typically associated with clinical disease in horses. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that the national prevalence of fecal shedding of Salmonella spp by horses in the United States was 0.8%, and that prevalence of Salmonella spp in grain or other concentrate used for horse feed was 0.4%.     

Evaluation of a PCR to detect Salmonella in fecal samples of horses admitted to a veterinary teaching hospital.

The diagnostic accuracy of a PCR used to identify horses shedding Salmonella spp. in their feces during hospitalization was estimated, relative to bacterial culture of serially collected fecal samples, using longitudinal data. Five or more fecal samples were collected from each of 116 horses admitted as inpatients, for reasons other than gastrointestinal disease, between July 26, 2001 and October 25, 2002. All 873 fecal samples collected were tested with a PCR based on oligonucleotide primers defining a highly conserved segment of the histidine transport operon gene of Salmonella typhimurium, and each sample was cultured for Salmonella spp. One or more samples from 87 (75%) horses were PCR positive, and Salmonella was cultured from 1 or more samples from 11 (9.5%) horses. All culture-positive horses had at least 1 PCR-positive result, whereas only 29 (28%) culture-negative horses were PCR negative on all fecal samples tested. The PCR was most specific, relative to bacterial culture of serially collected fecal samples, when used to test samples from Quarterhorse or breeds other than Thoroughbred or Standardbred, or from clinical (vs. healthy, accompanying horses) cases. Overall, the PCR had the greatest agreement (70%), compared with bacterial culture of serially collected fecal samples, using a cutoff of 2 or more positive PCR test results to define a Salmonella-positive horse. The reasons why some fecal samples, from which Salmonella organisms cannot be isolated, are PCR positive need to be determined before the PCR can be incorporated into Salmonella surveillance programs for hospitalized equine populations.     

Long-term survival of equine surgical colic cases. Part 1: patterns of mortality and morbidity

Postoperative complications and mortality can occur many weeks or months after colic surgery. We are interested in the long-term outcome of these cases. This study documents patterns of mortality and morbidity among 341 horses that recovered from colic surgery March 1998-August 2000. The progress of each horse was rigorously followed by periodic telephone and postal questionnaires. Event time data were recorded for each animal and a total of 321 horse years of survival, together with death from all causes, colic-related death and various postoperative complications. Postoperative survival (of all horses excluding grass sickness cases) was triphasic over the first 600 days and there was marked mortality in the first 10 days postoperatively. The probability of survival postoperatively decreased to 0.87 by 10 days, 0.82 by 100 days and declined slowly to 0.75 at 600 days. Horses suffering from epiploic foramen entrapment had a significantly reduced probability of postoperative survival (RR = 2.1, P = 0.033). The causes of death for 104 horses that died postoperatively and the prevalence of postoperative complications are recorded for the study population. Postoperative colic was the most prevalent complication with 100 horses (29%) suffering one or more episodes. However, only 16 horses (4.6%) suffered 3 or more episodes. The incidence of postoperative colic was 0.55 episodes/horse year at risk. This study provides data that will inform the prognosis for postoperative colic cases and identifies epiploic foramen entrapment as carrying a worse prognosis for survival than other strangulating lesions.     

Identification of predictors of salmonella shedding in adult horses presented for acute colic

Background

Colic has been associated with shedding of Salmonella. Horses with salmonellosis typically develop diarrhea, fever, and leukopenia. Overlooking additional predictors may result in failure to detect shedding horses and increase environmental contamination.

Objectives

Evaluate associations between signalment and clinicopathologic data during early hospitalization and Salmonella shedding in horses treated for acute colic.

Animals

Horses with acute colic admitted to a referral hospital. A total of 59 horses shedding Salmonella compared to 108 Salmonella‐negative horses.

Methods

Retrospective case‐control study evaluating patient and Salmonella culture data. Associations between variables and Salmonella shedding were identified using logistic regression. Two multivariable models were developed pertaining to (1) information available within 24 hours of admission and (2) clinical findings that developed later during hospitalization.

Results

Variables retained for multivariable model 1 indicated that Warmbloods and Arabians had increased odds for shedding Salmonella, as did horses requiring surgery (OR, 2.52; 95% CI, 1.10–5.75) or having more severe gastrointestinal disease (OR, 2.59; 95% CI, 1.08–6.20). Retained variables for model 2 demonstrated that horses that were treated surgically (OR, 1.60; 95% CI, 0.70–3.62), developed fever >103°F (OR, 2.70; 95% CI, 0.92–7.87), had abnormal leukocyte count (OR, 1.38; 95% CI, 0.61–3.09), or became inappetent and lethargic (OR, 16.69; 95% CI, 4.08–68.24) had increased odds for shedding Salmonella.

Conclusions and Clinical Importance

In horses with acute colic that present without signs of diarrhea, fever, or leukopenia, additional predictors associated with shedding Salmonella could be used to more promptly identify horses likely to shed organisms .     

Fecal Shedding of Salmonella in Horses Admitted to a Veterinary Teaching Hospital

Fecal samples were collected from 724 horses admitted to, and 232 horses hospitalized at, a veterinary teaching hospital between October 2000 and June 2001, and cultured for Salmonella. Salmonella was isolated on 24 occasions from 12 horses. S. Newport was the most commonly isolated serotype. The estimated prevalence (95% confidence interval [CI]) of Salmonella shedding on admission was 0.5% (0.1, 2.0). The estimated incidence rate of Salmonella shedding during hospitalization was 4.3% (95% CI, 2.2-8.1). The highest incidence of Salmonella shedding during hospitalization occurred during June 2001, but no significant (P > .5) temporal clusters of horses shedding Salmonella were detected.Horses shed Salmonella in their feces at a low rate. Horses shedding Salmonella occurred only sporadically and no obvious serotype pattern was observed. The occurrence of fecal shedding probably reflected the prevalence of inapparent Salmonella infection in the hospital source population, providing a baseline against which future potential outbreaks can be identified.

Introduction

Infection of horses by Salmonella organisms is a serious health issue. It is particularly troubling when outbreaks occur in hospitalized patients because these outbreaks can result in substantial economic losses and have a major impact on the welfare of patients.[1] Establishments with a high-density of horses, including veterinary teaching hospitals (VTHs) and private veterinary clinics, [1 and 2] are most vulnerable to outbreaks of disease attributable to Salmonella infection. Host susceptibility and environmental persistence of Salmonella are also factors contributing to outbreaks.Estimates of the prevalence of Salmonella-shedding horses admitted to veterinary hospitals have generally been made under outbreak conditions.[1] For example, between 1971 and 1982, 245 hospitalized horses (1.7%) at the University of California were found to shed Salmonella.[3 and 4] Three major outbreaks occurred during the study period, with no apparent periodicity. Between 1996 and 1999, 35 hospitalized horses (5.5%) at the Michigan State University were found to shed Salmonella.[5] One major outbreak occurred during the study period. Only one national survey of nonhospitalized horses in the United States for Salmonella infection has been undertaken: the prevalence of fecal shedding of Salmonella was estimated to be 0.8%, and the farm prevalence of shedding was 1.8%.[6]Many factors have been associated with the risk of Salmonella isolation from hospitalized horses, including diarrhea, fever, change in diet, large colon impaction, colic, withholding feed, feeding bran mash, antibiotic treatment, intubation with nasogastric tubes, and average daily ambient temperature.[7, 8, 9 and 10] Many of theses factors are thought to operate primarily through the effect of stress, increasing the susceptibility of horses to infection. Also, if a horse is infected by Salmonella but not shedding the organisms in its feces, the presence of stressors may reactivate fecal shedding. Most studies that have been conducted on risk factors for Salmonella shedding in horses have included horses with clinical salmonellosis, with or without inclusion of horses inapparently infected by Salmonella.[7, 8 and 10] Risk factors for Salmonella fecal shedding versus clinical salmonellosis have not been clearly delineated.An outbreak (epidemic) of disease can be defined as “an occurrence of disease in excess of its anticipated frequency.”[11] To more effectively identify future outbreaks of Salmonella infection in hospitalized horses, it is necessary to have accurate estimates of the prevalence of endemic fecal shedding of Salmonella in horses admitted to VTHs, and the incidence of fecal shedding during hospitalization. The aims of this study were to estimate the prevalence of fecal shedding in horses admitted to a VTH, to estimate the incidence of fecal shedding during hospitalization, and to describe the seasonal distribution of fecal Salmonella-shedding prevalence and incidence.

Materials and Methods

Study Design

Fecal samples were collected from horses admitted to the Purdue University VTH between October 12, 2000 and June 30, 2001. Horses admitted as inpatients were sampled at least on the day of admission, the day after admission, the day of discharge, and once or more in between. All horses admitted to the VTH during the study period were eligible to be sampled. In the case of mares accompanying sick foals, samples were also collected from the mare. Fecal samples were collected generally from freshly voided fecal material in stalls. Samples were stored at 4°C for up to 24 hours before processing.

Data Collection

For all horses included in the study, date of examination (outpatients) or date of hospitalization (inpatients) was recorded. For inpatients, date of discharge or date of death was also recorded. Horse characteristics were recorded as part of each horse's medical record, and included date of birth, sex (mare, stallion, gelding), and specific breed. The outcome of each admission (discharged alive, died, euthanized) and whether a necropsy was performed were also recorded. The number of samples collected per horse was recorded in a laboratory-reporting system, but specific date of collection of each sample (except for the first and last samples collected) was not routinely recorded.

Bacteriologic Cultures

All fecal samples were cultured for Salmonella species using standard techniques. Specimens were streaked onto brilliant green (BG) and xylose-lysine-tergitol (XLT-4) plates, and approximately 10 g of fecal material was put into 100 mL of tetrathionate Hajna broth. BG plates were incubated at 35° to 37°C for 18 to 24 hours and XLT-4 plates were incubated for 24 to 48 hours. Tetrathionate broth was incubated at 35° to 37°C for 24 to 48 hours, and then streaked to BG and XLT-4 plates. These plates were incubated as previously described. Suspect colonies on plates were subcultured and further identified by the Vitek GNI system. All Salmonella isolates were speciated and serotyped (National Veterinary Services Laboratory, Ames, Ia).

Data Analysis

The total number of horses examined (admissions), the total number of examinations (including admissions), the total number of horses hospitalized during the study period, and the number of samples collected per horse were calculated (Excel 2000, Microsoft Corp, Redmond, Wash) from recorded information. The frequency distributions of admissions (1-6) per horse, sex, breed, and patient outcome were calculated based on owner/horse identity and hospital record number, and the frequency distribution of number of samples collected per horse (nil to 8) was calculated from laboratory records and owner/horse identification and laboratory submission number. Length of hospitalization (days) was calculated from recorded date of hospitalization and date of discharge information, and was summarized by median and mean lengths of hospitalization and 95% confidence intervals (CIs), based on the Wilcoxon test (Minitab for Windows, Minitab Inc, State College, Penn) and the normal distribution (Statistix for Windows, Analytical Software, Tallahassee, Fla), respectively. Normality of the distributions of lengths of hospitalization and age were tested using the normal probability plot and Wilks-Shapiro statistic (Statistix).To estimate the incidence of Salmonella shedding, only hospitalized horses that were sampled on at least three occasions were included, because the sensitivity of culture is suboptimal and repeated attempts to culture Salmonella are necessary to increase the sensitivity of this technique.[12] The total number of days at-risk of shedding Salmonella was calculated as the sum of lengths of hospitalization. The incidence density rate (true incidence) of Salmonella shedding was calculated as

(No. horses detected shedding Salmonella)/(total No. horse-days at-risk)

and expressed as the number of horses shedding Salmonella per 1000 horse-days at-risk. For example, if 10, 10, and 30 horses were hospitalized for periods of 3, 6, and 9 days each, horse-days at-risk would be (10.3)+(10.6)+(30.9) = 360. If one case of Salmonella-shedding was detected in this group, the estimated incidence density rate would be one per (1000/360) 1000 horse-days AT-RISK = 2.8 per 1000 horse-days at-risk. Horses that were culture-positive on the first sampling were not considered incident cases of Salmonella-shedding, and therefore were not included in the numerator of the incidence density rate. Horses shedding Salmonella after hospitalization were assumed to have commenced shedding at the midpoint of their hospitalization, and therefore contributed half their length of hospitalization to the rate denominator. A 95% CI for the estimated incidence density rate was calculated assuming shedding Salmonella to be Poisson distributed.[13] Incidence-density rates were also calculated for each month of the study, the contribution of each horse to each month's horse-days at-risk being calculated on the basis of date of hospitalization and date of discharge information. Cumulative incidence (risk) rate (%) was calculated as described for the incidence density rate, except that the denominator used was the number of horses at-risk of Salmonella-shedding when hospitalized. For cumulative incidence rate, a 95% CI was calculated based on the binomial distribution.[14]The prevalence of Salmonella-shedding in horses admitted to the VTH was calculated as

(No. horses detected shedding Salmonella by culturewhen admitted)/(total No. horses admitted and sampled)

Ninety-five percent CIs for prevalence estimates were calculations based on the binomial distribution.[14]The temporal clustering of horses shedding Salmonella was investigated using the scan statistic.[15] For horses shedding Salmonella after hospitalization, the midpoint of their length of hospitalization was used as the date of first occurrence of Salmonella-shedding. The population at-risk used in these analyses was the monthly total number of horse-days at-risk. The occurrence of horses shedding Salmonella was assumed to be Poisson distributed, so the expected number of horses shedding Salmonella in any given time period was proportional to the incidence of Salmonella-shedding during the entire study period. The study period was scanned for clusters of horses shedding Salmonella using a scanning window of as much as 50% (130 days) of the time period (SatScan, Bethesda, Md).

Results

Between October 12, 2000 and June 30, 2001, 724 horses were admitted to the VTH. Six hundred and thirty-two horses (87.3%) were admitted only once during the study period; 69 (9.5%), 15 (2.1%), 2 (0.3%), 5 (0.7%), and 1 (0.1%) horses were admitted on 2, 3, 4, 5, and 6 separate occasions, respectively. Length of hospitalization was not recorded for 2 horses. Three-hundred and sixty (42.3%) of the 854 admissions performed did not result in hospitalization of the horse. The distribution of length of hospitalization of all horses hospitalized during the study is shown in Figure 1. The median and mean lengths of hospitalization (95% CI) were 3.0 (2.5, 3.5) and 4.3 (3.8, 4.7) days, respectively. The minimum and maximum lengths of hospitalization were 1 and 57 days. The distribution of lengths of stay was nonnormally distributed (Wilks-Shapiro statistic, 0.7317).     

Prevalence of Clostridium perfringens enterotoxin and Clostridium difficile toxin A in feces of horses with diarrhea and colic.

OBJECTIVE: To determine prevalence of clostridial enterotoxins in feces of horses with diarrhea and colic, and to determine whether an association exists between detection of clostridial enterotoxins in feces and development of diarrhea as a complication of colic. DESIGN: Prospective case series and case-control study. ANIMALS: 174 horses with diarrhea, colic, or problems not related to the gastrointestinal tract. PROCEDURE: Horses were assigned to 1 of 4 groups: colic with diarrhea (group 1; n = 30); colic without diarrhea (group 2; 30); diarrhea without colic (group 3; 57); and control (group 4; 57). Feces were evaluated by use of ELISA to detect Clostridium perfringens enterotoxin (CPE) and C difficile toxin A (TOXA). Frequency of detection of CPE or TOXA in groups 1 and 3 was compared with that in groups 2 and 4, respectively. RESULTS: Prevalence of enteric clostridiosis in horses in group 3 was 25%. Clostridium perfringens enterotoxin was detected in 9 of 57 (16%), TOXA in 8 of 57 (14%), and both toxins in 3 of 57 (5%) fecal samples collected from these horses. Neither toxin was detected in feces of the age-matched horses in group 4. Clostridial enterotoxins were detected in feces of 7 of 60 (12%) horses with colic (groups 1 and 2), however, a significant association was not found between detection of enterotoxins in feces and development of diarrhea as a complication of colic. CONCLUSIONS AND CLINICAL RELEVANCE: Clostridia are important etiologic agents of diarrhea in horses. Additionally, changes in intestinal flora of horses with colic may allow for proliferation of clostridia and elaboration of enterotoxins regardless of whether diarrhea develops.     

Longitudinal study of Clostridium difficile and antimicrobial susceptibility of Escherichia coli in healthy horses in a community setting

Point prevalence studies have reported carriage rates of enteric pathogens in healthy horses, but longitudinal data are lacking. Commensal E. coli is an indicator organism to evaluate antimicrobial resistance of enteric bacteria, yet there are limited data for horses. The objectives of this study were to investigate and molecularly characterize isolates of Clostridium difficile, Clostridium perfringens and Salmonella, collected sequentially over a one year period, and to determine the antibiotic susceptibility profile for E. coli. Fecal samples were collected monthly from 25 adult horses for one year. Selective cultures were performed for all above bacteria. C. difficile isolates were characterized via PCR toxin gene profiling and ribotyping. Broth microdilution was performed to assess antimicrobial susceptibility profiles of E. coli. Toxigenic Clostridium difficile was isolated from 15/275 (5.45%) samples from 10/25 (40%) horses. Four horses were positive at multiple sampling times but different ribotypes were found in three. Ribotypes included 078 (n=6), 001 (n=6) and C (n=3). C. perfringens was not isolated, nor was Salmonella. E. coli was isolated from 232/300 (77%) fecal samples. Resistance to ≥1 and ≥ 3 antimicrobials was present in 31/232 (13.4%) and 6/232 (2.6%) respectively. Only two horses shed the same strain of toxigenic C. difficile for more than one month, indicating that shedding is transient. The high number of ribotype 078 is consistent with recent emergence of this strain in the local horse population. The low prevalence of antibiotic resistance in commensal E. coli suggests that healthy horses are not likely a major reservoir of resistance for enteric bacteria.     

Analysis of Sodium Carboxymethylcellulose Administration and Related Factors Associated with Postoperative Colic and Survival in Horses with Small Intestinal Disease

Objective— To analyze the effect of the intraoperative use of sodium carboxymethylcellulose (CBMC) and related perioperative factors on postoperative colic and survival in horses that had abdominal surgery for colic.
Study Design— Retrospective study.
Animals— Horses (n=203) that had surgery for small intestinal disease; 33 horses had intraoperative administration of CBMC.
Methods— Information was obtained from medical records for 170 horses that had surgery for colic before use of CBMC and 33 horses that had intraoperative CBMC. Kaplan–Meier survival curves were used to estimate median survival time and a Cox proportional hazards model was used to estimate the hazard ratio for the effect of CBMC and other perioperative variables on survival.
Results— Seventy-five percent of horses administered CBMC survived to 180 days, whereas 75% of untreated horses survived 8 days (median survival time=18 days). Horses not administered CBMC were twice as likely to die compared with horses administered CBMC. Horses that had postoperative ileus (POI) were 1.4 times more likely to die than horses without ileus. Similarly, horses with signs of colic after surgery were 1.3 times more likely to die than horses without postoperative signs of colic.
Conclusions— CBMC administration is seemingly protective against death and prolongs survival when used intraoperatively in horses with small intestine disease, particularly horses with postoperative colic or POI. Both POI and colic increased risk of death after surgery.
Clinical Relevance— Intraoperative administration of CBMC in horses that have surgery for small intestinal disease may improve survival, possibly by reducing early adhesion formation.     

Di-tri-octahedral smectite for the prevention of post-operative diarrhea in equids with surgical disease of the large intestine: Results of a randomized clinical trial

The aim of this study was to evaluate the effects of a commercially available di-tri-octahedral (DTO) smectite product on clinical signs and prevalence of post-operative diarrhea in horses with colic associated with disease of the large intestine. Sixty-seven horses with surgical disease of the large intestine were randomly assigned to be treated with DTO smectite (n = 37; 0.5 kg via nasogastric intubation every 24 h for 3 days post-operatively) or a placebo (n = 30). The effect of treatment on fecal scores and clinical and hematological parameters, including heart rate, mucous membrane color, temperature, total white blood cell count, total neutrophil count and total plasma protein values, were determined.Horses treated with DTO smectite had a significant reduction in the prevalence of post-operative diarrhea (10.8%), compared with controls (41.4%). A significant improvement in mucous membrane color was observed 72 h post-operatively in horses receiving treatment, compared with placebo. Administration of DTO smectite to colic patients with disease of the large intestine reduced the occurrence of diarrhea in the early post-operative period.     

Evaluation of Fecal Sand Clearance in Horses With Naturally Acquired Colonic Sand Accumulation With a Product Containing Probiotics,Prebiotics, and Psyllium

Consumption of sand and dirt in horses can cause chronic diarrhea and colic because of irritation and obstruction of the gastrointestinal tract of horses. Prevention has primarily focused on changes in management to reduce the intake of sand and feeding of psyllium products. The purpose of this study was to evaluate the efficacy of a product containing probiotics, prebiotics, and psyllium in the clearance of colonic sand in horses with naturally acquired sand accumulation using a randomized, placebo-controlled, blinded clinical trial format. After identification of 10 horses with sand accumulation as determined by both auscultation and abdominal radiography, quantitative assessment of changes in colonic sand content in response to management changes combined with treatment with the probiotic/psyllium product or no treatment was assessed by blinded observers. Fecal sand output was monitored in both groups via sand sedimentation analysis of fecal samples every 3 days for 35 days and with pre- and post-treatment abdominal radiography. There was a significant reduction in sand accumulation in both treatment and control groups, but there were no significant differences between treatment and control groups in clearance of colonic sand as measured by both fecal sand sedimentation and quantitative radiography.     

The Prevalence of Aeromonas Species in Feces of Horses with Diarrhea

Feces collected from 40 horses with diarrhea and 34 horses without diarrhea were examined to determine if an association existed between isolation of Aeromonas spp. and diarrhea. Samples were also examined for Salmonella spp., and identification of viruses and parasite ova. Neither Salmonella spp. nor Aeromonas spp. were isolated from the feces of 34 control horses. Aeromonas spp. were isolated from feces of 22 of 40 (55%) horses with diarrhea. Salmonella spp. were isolated from feces of 8 (20%) horses, and of these, 5 (12.5%) were also positive for Aeromonas spp. Twenty-nine isolates of Aeromonas spp. were recovered from the feces of 22 diarrheic horses. Of these isolates, more than 80% were susceptible on in vitro testing to amikacin, ceftiofur, chloramphenicol, and gentamicin. All isolates were susceptible to enrofloxacin. Diarrheic horses positive for Aeromonas were significantly (P = .04) older than diarrheic horses negative for Aeromonas spp. A significantly greater number of fecal samples were positive for Aeromonas spp. during March through August than samples examined in other months (P = .014). Results of this study indicate that Aeromonas spp. should be considered as a cause of diarrhea in horses.     

Potential associations between fecal shedding of Salmonella in feedlot cattle treated for apparent respiratory disease and subsequent adverse health outcomes

A prospective cohort study was used to assess whether Salmonella fecal shedding in commercial feedlot cattle treated with antimicrobials for respiratory disease was associated with subsequent adverse health outcomes. Feces were collected per rectum from cattle that were examined for apparent respiratory disease, had a rectal temperature > or = 40 degrees C, and subsequently received antimicrobial treatment. Salmonella were recovered from 918 (73.7%) of 1 245 fecal samples and weekly prevalence estimates ranged from 49 to 100% over the 3-month study. Genotypic and phenotypic characteristics of Salmonella strains in the population were determined. Serogroup E Salmonella were most common (73.3%), followed by C1 (11.0%), C3 (8.6%), and B (1.1%). Predominant serotypes were Orion (46.5%), Anatum (19.8%), Kentucky (8.7%), Montevideo (7.5%), and Senftenberg (4.9%). Few isolates (36/918) were positive for antimicrobial resistance-associated integron gene intI1. Phenotypic susceptibility was associated with isolate intI1 status. Crude re-pull, re-treatment and case fatality risks were higher for cattle that were Salmonella-positive versus -negative at initial treatment, but not statistically different on multivariable analysis. However, case fatality risk was higher for cattle shedding Group B Salmonella than for cattle shedding other serogroups. Lots (groups) with a higher Salmonella prevalence at first treatment had a higher proportion of mortalities occur in a hospital pen, higher overall re-treatment risks, and were more likely to be sampled later in the study. Results indicate a high prevalence of Salmonella in this population of cattle treated for apparent respiratory disease, but that effects associated with clinical outcomes may depend on the Salmonella strain.     

Epidemiologic study of salmonellae shedding in the feces of horses and potential risk factors for development of the infection in hospitalized horses

A study was designed to identify epidemiologic factors associated with the development and spread of salmonellae in horses in a veterinary teaching hospital, through a case-control study and a longitudinal follow-up prospective study. In the case-control study, 44 horses shedding salmonellae in feces were compared with 99 control horses not shedding salmonellae in feces; regarding breed, sex, age and initial diagnosis, none of the odds ratios for study factors was significant. The factors found to be associated with fecal shedding of salmonellae in the prospective study included diarrhea at the time of admission to the hospital, fever while hospitalized, and a change in diet while hospitalized. Horses identified to be shedding salmonellae in feces were not limited to those with clinical signs of salmonellosis; however, spread of salmonellae from a shedder without clinical signs of disease to other hospitalized horses was not identified. The most common serovars of Salmonella isolated were oranienburg and newport.     

Comparison of rectal mucosal cultures and fecal cultures in detecting Salmonella infection in horses and cattle

Bacteriologic cultures of 65 rectal mucosal samples and 335 fecal samples from 53 horses and 5 cattle shedding Salmonella were performed. Salmonella spp were isolated from 34 (52%) rectal mucosal samples, 21 (32%) concurrent fecal samples, and 150 (45%) total fecal samples. The use of rectal mucosal samples when compared with concurrently obtained fecal samples significantly (P less than 0.025) improved the ability to isolate Salmonella spp. Concurrent bacteriologic culture of rectal mucosal samples and fecal samples resulted in 39 (60%) isolations. Compared with a series of fecal samples, Salmonella was isolated significantly more often when rectal mucosa and feces were cultured concurrently. Salmonella was isolated from rectal mucosal samples when it was not isolated from feces.     

Prevalence of fecal shedding of Salmonella spp in dairy herds

OBJECTIVE: To estimate prevalence of Salmonella spp in Ohio dairy farms and to identify potential risk factors for fecal shedding of salmonellae. DESIGN: Cross-sectional study. SAMPLE POPULATION: 105 Ohio dairy farms. PROCEDURE: Individual fecal samples from all mature cows in study herds were tested for Salmonella spp by use of standard bacteriologic culture procedures. Herds were identified as infected if at least 1 cow was shedding Salmonella spp. Information regarding herd characteristics, management practices, and health history were collected. Potential risk factors for herd-level Salmonella infection were identified. RESULTS: In 31% of the study herds (95% confidence interval, 22 to 40%), at least 1 cow was shedding Salmonella spp. Six percent of 7,776 fecal samples contained Salmonella organisms; prevalence within infected herds ranged from < 1 to 97%. Herd size, use of free stalls for lactating and nonlactating cows, and use of straw bedding in nonlactating cows were significantly associated with fecal shedding of Salmonella spp, as determined by use of univariate analysis. By use of multivariate analysis, large herds were more likely to be infected than smaller herds; however, no other factors were associated with Salmonella infection after adjustment for herd size. CONCLUSIONS AND CLINICAL RELEVANCE: Subclinical shedding of Salmonella spp is common in Ohio dairy herds, although we could not identify specific interventions that may influence the prevalence of Salmonella spp on dairy farms. It appears that large herd size and intensive management may provide an environment conducive to Salmonella shedding and chronic dairy herd infection.     

Comparison of medical and surgical treatment for impaction of the small colon in horses: 84 cases (1986-1996)

OBJECTIVE: To characterize clinical findings and compare effects of treatment and outcome for horses treated medically or surgically for impaction of the small colon. DESIGN: Retrospective study. ANIMALS: 84 horses with impaction of the small colon. PROCEDURE: Medical records were reviewed for history, physical examination findings, laboratory values, treatment, response to treatment, complications, out-come, and necropsy findings. RESULTS: 47 horses were treated medically and 37 horses were treated surgically. Significant differences between groups were not identified for duration of clinical signs, physical examination findings, or laboratory values. Horses treated surgically were hospitalized longer than horses treated medically. Complications recorded during hospitalization included diarrhea, jugular thrombophlebitis, recurrent colic, fever, and laminitis. Salmonella organisms were isolated from 20 horses. Horses treated surgically were more likely to have signs of moderate abdominal pain, gross abdominal distention, and positive results for culture of Salmonella spp than horses treated medically. Follow-up information was available for 27 horses treated medically and 23 horses treated surgically. Twenty-four (72%) and 21 (75%) of the horses, respectively, survived and were being used for their intended purpose at least 1 year after treatment. CLINICAL IMPLICATIONS: Colitis may be a predisposing factor for impaction of the small colon in horses. Prognosis for horses treated surgically or medically is fair.