Acute renal disease from Leptospira interrogans in three yearlings from the same farm

Renal dysfunction due to leptospirosis has been reported infrequently in the horse. The animals in this case presentation developed an acute and persistent febrile illness that could have been attributed to a number of infectious diseases. Upon numerous subsequent clinical evaluations, detection of renal dysfunction narrowed the list of differential diagnoses. This Case Report describes 3 horses with acute renal disease from Leptospira interrogans. Pyrexia was the initial clinical sign and was refractory to antimicrobial therapy. Once azotaemia developed, leptospirosis was diagnosed as the origin of the renal dysfunction. Treatment included i.v. crystalloid fluids, diuretics, anti‐inflammatory medication, antibiotics, pentoxifylline and polysulphated glucosaminoglycan. Additionally, one of these 3 horses required a continuous infusion of vasopressors to resolve the azotaemia. Pyrexia resolved within 48 h of treatment initiation for leptospirosis. The azotaemia resolved completely after 3 months (Case 1), 3 weeks (Case 2) and 5 days (Case 3).     

Acute kidney injury in dogs: Etiology,clinical and clinicopathologic findings,prognostic markers,and outcome

BackgroundAcute kidney injury (AKI) is a common, potentially fatal condition.ObjectivesTo characterize the etiologies, clinical and clinicopathologic findings, hospitalization period, and outcome of dogs with AKI and to identify markers of negative prognosis.AnimalsTwo hundred forty‐nine client‐own dogs diagnosed with AKI and hospitalized at a veterinary teaching hospital.MethodsRetrospective study. Search of medical records for dogs with AKI.ResultsCommon clinical signs included lethargy (225/249, 90%), anorexia (206/249, 83%), and vomiting (168/249, 68%). Etiologies included ischemic/inflammatory (144/249, 58%), infectious (19/249, 8%), nephrotoxicosis (14/249, 6%), or other (13/249, 5%). Hospital‐acquired AKI was diagnosed in 9% (23/249) of the dogs. Median presentation and peak serum creatinine (sCr) concentrations were 4 mg/dL (range, 1.1‐37.9) and 4.6 mg/dL (range, 1.1‐43.1), respectively. Dogs were classified to AKI grades as follows: Grade I, 6 (2%), Grade II, 38 (15%), Grade III, 89 (36%), Grade IV, 77 (31%), and Grade V, 39 (16%). One hundred and sixty‐four (66%) dogs survived. There was a positive association between death and AKI grade (P = .009). The case fatality rate was higher among dogs with anuria compared with dogs without anuria (50% vs 28%, respectively; odds ratio [95% confidence interval]: 2.5 [1.39‐4.6]; P = .002). Forty‐seven (18.8%) dogs underwent hemodialysis, of which 60% survived.Conclusion and Clinical ImportanceTwo‐thirds of dogs with AKI survived. Hospital‐acquired AKI was common. The severity of AKI, as reflected by presence of anuria, AKI grade, and other body organs involvement, was associated with the outcome.     

Computed tomographic myelography of a foal with discospondylitis and extradural spinal cord compression due to a vertebral abscess

A one‐month‐old Quarter Horse colt presented with progressive gait abnormalities and weakness. The foal was ataxic at presentation. Radiography identified focal endplate irregularities and lysis at C6–7. Radiographic diagnosis was discospondylitis. Computed tomographic myelography was performed immediately following euthanasia and identified an extradural compressive spinal cord lesion corresponding to the site of discospondylitis. Post mortem examination findings included abscess formation at the C6–7 intervertebral space with osteomyelitis extending into the adjacent physes and subchondral bone of caudal C6 and cranial C7. The vertebral abscess extended into the ventral spinal canal at C6–7 and was identified as the cause of extradural spinal cord compression. Salmonella sp. was cultured and isolated from purulent exudate at the intervertebral space. Computed tomographic myelography has not been previously reported for assessment of discospondylitis in horses and was successful at accurately characterising spinal cord compression in addition to osteolytic changes associated with discospondylitis.     

Osteomyelitis of the scapulohumeral joint associated with Rhodococcus equi and unresponsive to antibiotherapy in a foal

This case report describes the treatment and outcome of a 3.5-month-old lame foal, with a history of pneumonia associated with Rhodococcus equi. Clinical examination identified osteomyelitis of the scapulohumeral joint. The unusual location of the Rhodococcus equi osteomyelitis unresponsive to prevention and adequate treatment led to euthanasia of the patient. Post-mortem findings confirmed bronchopneumonia due to Rhodococcus equi as well as the osteomyelitis of the scapulohumeral joint. This case highlights that Rhodococcus equi should be considered as a pathogen in extrapulmonary locations such as septic arthritis and osteomyelitis in foals with history of bronchopneumonia. Early and aggressive treatment should be considered.     

Safety and efficacy of high‐dose fomepizole compared with ethanol as therapy for ethylene glycol intoxication in cats

Objective – To determine the safety and efficacy of high‐dose fomepizole compared with ethanol (EtOH) in cats with ethylene glycol (EG) toxicosis. Design – Prospective study. Setting – University veterinary research laboratory. Animals – Thirteen cats. Interventions – Two cats received injections of high‐dose fomepizole (Study 1). Three cats received lethal doses of EG and fomepizole treatment was initiated 1, 2, or 3 hours later (Study 2). Eight cats received a lethal dose of EG and were treated with fomepizole or EtOH (Study 3). Cats treated with fomepizole received 125 mg/kg IV initially, then 31.25 mg/kg at 12, 24, and 36 hours. Cats treated with EtOH received 5 mL of 20% EtOH/kg IV initially, then every 6 hours for 5 treatments, then every 8 hours for 4 treatments. Cats also received fluids and supportive therapy as needed. Measurements and Main Results – Clinical signs were monitored and serial blood analyses performed. Cats receiving fomepizole experienced mild sedation but no biochemical evidence of toxicity. Cats receiving fomepizole for EG intoxication survived if therapy was initiated within 3 hours of EG ingestion. One of the 6 developed acute renal failure (ARF) but survived. Only 1 of the 3 cats treated with EtOH 3 hours following EG ingestion survived; 2 developed ARF and were euthanized. Cats treated 4 hours following EG ingestion developed ARF, whether treated with EtOH or fomepizole. Conclusions – Fomepizole is safe when administered to cats in high doses, prevents EG‐induced fatal ARF when therapy is instituted within 3 hours of EG ingestion, and is more effective than treatment with EtOH.     

Interferon-gamma, interleukin-4 and interleukin-10 production by T helper cells reveals intact Th1 and regulatory TR1 cell activation and a delay of the Th2 cell response in equine neonates and foals

Cytokines produced by T helper (Th) cells are important in orchestrating the immune response during health and disease. Recent reports indicated that cytokine mRNA expression in foals is often quantitatively lower than that of adult horses suggesting that foal T cells are not fully mature. Here, peripheral blood mononuclear cells from foals and adult horses were stimulated with phorbol 12-myristate 13-acetate and analyzed for intracellular interferon-gamma (IFN-γ), interleukin-4 (IL-4) and IL-10 production, representing the Th1, Th2 and regulatory T_R1 cell phenotypes respectively, by flow cytometry. In agreement with previous reports, all three cytokines were quantitatively reduced in foals compared to adults. However, the balance between Th1 and Th2 cytokines (IFN-γ/IL-4 ratio) showed a clear Th1-biased response in foals by 6 and 12 weeks of life, while similar IFN-γ/IL-10 ratios were found in foals and adult horses. By day 5 after birth, intracellular IFN-γ production by foal CD4⁺ and CD8⁺ T cells resembled that in adults. Overall, IL-4 production was low in foals. IL-4⁺ cells peaked at day 5 of age when IL-4 was mainly produced by IgE⁺ cells. Relative percentages of IL-4⁺ Th2 cells were significantly lower in foals at all time points. The data suggested that equine neonates and young foals have an impaired Th2 response, that the immune response of foals is Th1 biased, that IFN-γ production by Th and cytotoxic T cells is qualitatively similar to adult horses, and regulatory IL-10 production by T cells is developmentally mature in foals during the first three months of life.     

芩连液与白虎汤对气分证家兔肾功能损伤的疗效比较

为比较自拟方芩连液和白虎汤对气分证的疗效差别,以静脉注射内毒素(LPS)制作了气分证家兔模型,在两种药物治疗前后分别检测了血清免疫球蛋白A(IgA)、补体3(C3)、肌酐(Cr)、尿素(Urea)、尿酸(UA)和碱性磷酸酶(ALP)的含量变化,并观察了肾脏组织病理变化.结果显示,模型动物的肾脏产生了明显的病理损伤,血清Cr、IgA和C3含量都显著升高,ALP含量降低,Urea和UA无显著变化;与治疗前比较,白虎汤和芩连液的治疗使家兔肾脏组织病理损伤明显转轻,血清Cr、UA、IgA和C3含量都显著降低,Urea含量无显著变化,且白虎汤治疗组ALP显著降低,而芩连液治疗组C3显著低于对照组与模型组.结果表明,静脉注射LPS制作的气分证模型家兔肾脏组织收到明显的病理损伤,表现出IgA肾病的特征,白虎汤与芩连液对气分证家兔肾功能损伤具有一定的治疗作用,两者比较白虎汤具有更显著的疗效.     

The use of race winnings, ratings and a performance index to assess the effect of thermocautery of the soft palate for treatment of horses with suspected intermittent dorsal displacement. A case-control study in 110 racing Thoroughbreds

REASONS FOR PERFORMING THE STUDY: There have been no reports of the efficacy of thermocautery of the soft palate (TSP) assessed objectively as a treatment of intermittent dorsal displacement of the soft palate (DDSP). OBJECTIVE: To compare: racing performance of horses that underwent thermocautery of the soft palate with matched controls; and 'Racing Post ratings' (RPR) with prize money won (RE) and a performance index (PI) for each of the horses in the study. HYPOTHESIS: Thermocautery of the soft palate has no beneficial effect on racing performance and the 3 measures of performance are significantly related. METHODS: The inclusion criteria were fulfilled by 110 horses and each was matched with 2 controls. Changes in performance were compared statistically. RPR, RE and PI were analysed using a regression model. RESULTS: The percentage of horses that improved in performance following the procedure was 28-51% for the 3 measures of performance, compared to 21-53% for the matched controls. There was no significant effect of the procedure on the changes in RPR or RE. There was a significant effect of the procedure on the change in PI (P=0.015) with more treated horses achieving an improved PI and fewer acquiring a worse PI than matched control horses. The measures of performance showed significant correlation. CONCLUSIONS: Thermocautery of the soft palate alone may not be the most efficacious treatment of DDSP. POTENTIAL RELEVANCE: Production of a reliable measure of racehorse performance may be possible.