septic foal

Question 1

describe the results of the blood gas analysis

Answer 1

results indicate severe respiratory acidosis, mild metabolic acidosis and poor oxygen perfusion of the tissues

Question 2

describe the results of the haematology below

Answer 2

• low WBC count
• low neutrophils
• high band neutrophils (left shift)
• low total plasma protein
• high plasma fibrinogen

Question 3

___ sugests that successful pasive transfer of maternal antibodies has occured

Answer 3

IgG levels above 800 mg/ml

Question 4

most foals with bacterial pneumonia show the opposite, except in severe infections. this generally carries a poor prognosis

Answer 4

severe neutropaenia

Question 5

a low level of this cell type can occur in cases of stress associated with overwhelming infections

Answer 5

lymphopaenia

Question 6

____: increased numbers of immature (band) neutrophils and the presence of toxic changes in neutrophils are commonly observed in neonatal infections

Answer 6

degenerative left shift

Question 7

what pattern does this thoracic radiograph show

Answer 7

diffuse alveolar pattern: cant see borders = border obliteration and air bronchograms (alveoli are collapsed or filled with fluid

Question 8

on diffquick stain you see chains of round structures you presume to be bacteria. your blood cultures have grown aerobically and anaerobically. what type of bacteria do you think it is

Answer 8

streptococci

Question 8

list characteristics of streptococcus pneumonia

Answer 8

• non-motile
• cocci that form chains
• facultative aerobes
• alpha haemolysis
• gram positive

Question 9

how should you manage a foal with a sever bacterial pneumonia and sepsis

Answer 9

• mare should be stabled
• supportive treatment (padding, frequent turning of recumbent foal, oxygen administration, IV fluids to prevent cardiovascular collapse, nutritional support through nasogastric tube of either mothers milk or milk substitue and or parenteral nutrition = feed not via mouth)
• antibiotic therapy (kills bacteria but does not remove the pathogen associated molecular patterns and hence the immune system is still stimulated)

Question 10

what is the prognosis of a foal with severe bacterial pneumonia and sepsis

Answer 10

• poor for sepsis in neonates and fols (survival rates 50-65% in referral centres)
• recovery from neonatal sepsis depends on the severity and manifestation of the infection
• early recognition and intensive treatment of neonatal sepsis improves outcome
• if the foal survives the initial problems, it has the potential of becoming a healthy adult

Question 10

what is the order of the host response linked to sepsis and multiorgan dysfunction syndrome:
* Adapter molecules
* Bacteraemia/bacteria and bacterial products in blood stream
* Local inflammatory response
* MODS (Multiorgan dysfunction syndrome)
* PAMPs (pathogen associated molecular patterns) are recognized by host receptors especially Toll-like receptors
* Production of inflammatory mediators (cytokines, nitric oxide)
* Sepsis/SIRS
* Severe sepsis
* Signalling network
* Systemic inflammatory response

Answer 10

1. pathoged associated molecular patterns are recognized by host receptors especially toll like receptors
2. adapter molecules
3. signalling network
4. production of inflammatory mediators (cytokines, nitric oxide)
5. local inflammatory response
6. bacteraemia/bacteria and bacterial products in blood stream
7. systemic inflammatory response
8. sepsis/SIRS
9. severe sepsis
10. Multiorgan dysfunction syndrome