ENDOTOXEMIA

Question 1

These endotoxins initiate a powerful and often dysregulated immune response, which can escalate into _________, _________, and ultimately, _________.

Answer 1

systemic inflammation
circulatory collapse
septic shock

Question 2

serious systemic condition triggered by the presence of endotoxin specifically lipopolysaccharides (LPS) from the outer membrane of Gram-negative bacteria in
the bloodstream

Answer 2

Endotoxemia

Question 3

The clinical presentation is often nonspecific in early stages, making early detection challenging If not
promptly recognized and managed, the inflammatory cascade driven by endotoxins may progress rapidly, resulting in multiple organ dysfunction syndrome (MODS) and a high risk of mortality.

What condition is being referred above?

Answer 3

Endotoxemia

Question 4

This condition typically arises as a secondary complication of severe infections including pyometra, gastrointestinal perforation, septic peritonitis, or urinary tract infections.

Answer 4

endotoxemia

Question 5

A condition that may result in multiple organ dysfunction syndrome (MODS) and a high risk of mortality.

Answer 5

Endotoxemia

Question 6

Common Gram-negative bacteria involved in Endotoxemia

Answer 6

(PPEEKS)
o Proteus spp.
o Pseudomonas spp.
o Enterobacter spp.
o Escherichia coli, Klebsiella spp., Salmonella spp., etc

Question 7

These endotoxins are typically confined to the gut or localized
infection sites, but certain conditions compromise the body’s natural barriers, allowing them to
spread systemically.

Answer 7

LPS

Question 8

These endotoxins (eg. LPS) are typically confined to this organ (what organ?) or localized infection sites, but certain conditions compromise the body’s natural barriers, allowing them to spread systemically.

Answer 8

gut

Question 9

The most frequent infectious causes of endotoxemia in feline patients include:

Answer 9

• Peritonitis
• Pyometra
• Pyelonephritis
• Pneumonia
• Prostatitis
• Mastitis
• Biliary tract infections
• Intra-abdominal abscesses
• Pulmonary abscesses

Question 10

Even if bacteria aren’t found in blood, endotoxins can still enter the circulation from localized
infections, especially via these organs (what organs?). No bacteria found in the blood, but there is this toxin present (what toxin?).

Answer 10

intestines or other mucosal organs
LPS

Question 11

may serve as pathways for bacterial translocation or bloodstream invasion

Answer 11

Non-infectious medical procedures

Question 12

Non-infectious medical procedures
that may serve as pathways for bacterial translocation or bloodstream invasion. These include:

Answer 12

• Dental procedures
• Endoscopy or rectal palpation
• Venous/arterial catheters

Question 13

bacteria from the mouth can enter blood through?

Answer 13

gum damage

Question 14

This non-infectious medical procedures can disrupt gut lining or push bacteria into circulation.

Answer 14

Endoscopy or rectal palpation

Question 15

endotoxins are components of the outer membrane of what gram
bacteria which enter the bloodstream.

Answer 15

Gram-negative

Question 16

The body recognizes these endotoxins through this receptor, triggering a strong immune response.

Answer 16

pattern recognition receptors like Toll-like receptor 4 (TLR4)

Question 17

In case of Endotoxemia, immune cells release inflammatory cytokines (ENUMERATE). While these help fight infection, too much leads to systemic inflammation.

Answer 17

TNF-α, IL-1, and IL-6

Question 18

In case of immune cells release inflammatory cytokines like TNF-α, IL-1, and IL-6. While this helps fight infection, too much leads to ________.”

Answer 18

systemic inflammation

Question 19

A study looked at 29 very sick cats (with sepsis) and found the most common signs were: (ENUMERATE)

Answer 19

o Lethargy (tiredness) — 100%
o Pale gums — 100%
o Fast breathing — 72%
o Yellowing (icterus) — 72%
o Abdominal pain — 76%
o Low body temperature (hypothermia) — 59%
o Slow heart rate (bradycardia) — 66%
o Fever — 35%

Question 20

A study looked at 29 very sick cats (with sepsis) and found the most common signs: how many % experienced pale gums?

Answer 20

100%

Question 21

A study looked at 29 very sick cats (with sepsis) and found the most common signs: how many % experienced lethargy (tiredness)?

Answer 21

100%

Question 22

A study looked at 29 very sick cats (with sepsis) and found the most common signs: how many % experienced fast breathing?

Answer 22

72%

Question 23

A study looked at 29 very sick cats (with sepsis) and found the most common signs: how many % experienced Yellowing (icterus)?

Answer 23

72%

Question 24

Lab test results showed problems like:
o Low red blood cells (anemia)
o Low platelets (thrombocytopenia)
o High white blood cells with young forms (left shift)
o Low albumin and high bilirubin in the blood

What condition is this?

Answer 24

Endotoxemia

Question 25

A study looked at 29 very sick cats (with sepsis) and found the most common signs: how many % experienced Abdominal pain?

Answer 25

76%

Question 26

A study looked at 29 very sick cats (with sepsis) and found the most common signs: how many % experienced

Question 27

A study looked at 29 very sick cats (with sepsis) and found the most common signs: how many % experienced

Question 28

A study looked at 29 very sick cats (with sepsis) and found the most common signs: how many % experienced

Question 29

A study looked at 29 very sick cats (with sepsis) and found the most common signs: how many % experienced Low body temperature (hypothermia)?

Answer 29

59%

Question 30

A study looked at 29 very sick cats (with sepsis) and found the most common signs: how many % experienced Slow heart rate (bradycardia)?

Answer 30

66%

Question 31

A study looked at 29 very sick cats (with sepsis) and found the most common signs: how many % experienced Fever?

Answer 31

35%

Question 32

Lab test results showed problems like: o Low red blood cells (anemia) o Low platelets (thrombocytopenia) o High white blood cells with young forms (left shift) o Low albumin and high bilirubin in the blood What condition is this?

Answer 32

Endotoxemia

Question 33

Cats with Endotoxemia Lab test results showed problems like: (ENUMERATE)

Answer 33

o Low red blood cells (anemia) o Low platelets (thrombocytopenia) o High white blood cells with young forms (left shift) o Low albumin and high bilirubin in the blood

Question 34

The yellowing (icterus) was likely caused by red blood cell destruction (hemolysis), not Liver disease. What condition is this?

Answer 34

Endotoxemia

Question 35

In cases of Endotoxemia, the yellowing (icterus) was likely caused by _____________, not Liver disease.

Answer 35

red blood cell destruction (hemolysis)

Question 36

In cats with Endotoxemia, this organs are very sensitive to shock

Answer 36

lungs

Question 37

In cats with Endotoxemia, the lungs are very sensitive to shock, so they might? (ENUMERATE)

Answer 37

o develop pulmonary edema (fluid in the lungs) o have trouble breathing if the condition gets worse

Question 38

Diagnosis is of this condition is Often Presumptive because lab confirmation is difficult, diagnosis is often based on: o Clinical signs o Known risk factors. o Signs of SIRS or sepsis

Answer 38

Endotoxemia

Question 39

Diagnosis of Endotoxemia is often what?

Answer 39

Presumptive

Question 40

Diagnosis Endotoxemia is Often Presumptive because lab confirmation is difficult, diagnosis is often based on: (ENUMERATE)

Answer 40

o Clinical signs o Known risk factors. o Signs of SIRS or sepsis

Question 41

What is the Endotoxin Detection Special lab tests

Answer 41

Limulus amebocyte lysate [LAL] assay

Question 42

Endotoxin Detection Special lab tests exist (like the Limulus amebocyte lysate [LAL] assay), but it has disadvantages such as:

Answer 42

o Hard to use. o Not available in most vet clinics o Results are hard to interpret and don’t always match blood culture findings. o Newer tests are being developed, but they still need validation.

Question 43

- These are research tools, not used in routine practice. - High levels may suggest Systemic Inflammatory Response Syndrome (SIRS) but not specific to endotoxemia

Answer 43

Cytokine Tests (TNF-α, IL-1)

Question 44

Finding the Source of Infection (Focus of Sepsis) using imaging to locate infection such as:

Answer 44

o X-rays o Ultrasound o Echocardiography

Question 45

Finding the Source of Infection (Focus of Sepsis) Collect samples if needed such as:

Answer 45

o Peritoneal lavage o Tracheal wash / Bronchoalveolar lavage o Joint tap (arthrocentesis) o Spinal fluid (CSF)

Question 46

A condition with no specific "sign" in the body

Answer 46

endotoxemia

Question 47

when it comes to pathologic findings in endotoxemia, there’s no specific damage that clearly says ‘this is endotoxemia.’ What we usually find is damage to blood vessels, fluid buildup, and micro clots, which are signs of ______

Answer 47

SIRS

Question 48

when it comes to pathologic findings in endotoxemia, there’s no specific damage that clearly says ‘this is endotoxemia.’ What we usually find is ____, ______, and _____, which are signs of SIRS

Answer 48

damage to blood vessels, fluid buildup, and micro clots

Question 49

is usually a secondary complication, not a primary disease

Answer 49

Endotoxemia

Question 50

Why we often don't see clear signs of endotoxemia in organs during examination ?

Answer 50

it rarely leaves obvious lesions by itself

Question 51

In the case of Endotoxemia. majority of the damage is found at the site of the _______: * The uterus in pyometra *The intestines in parvovirus * The heart in endocarditis.

Answer 51

primary infection

Question 52

In the case of Endotoxemia. majority of the damage is found at the site of the primary infection: Give examples

Answer 52

* The uterus in pyometra *The intestines in parvovirus * The heart in endocarditis.

Question 53

The majority of the damage is found at the site of the primary infection. That’s why when we suspect endotoxemia, it’s important to also look for and evaluate the underlying infection that triggered it.

Question 54

Drug of Choice for Endotoxemia for skin infections

Answer 54

Beta-lactamase-resistant penicillins

Question 55

Drug of Choice for Endotoxemia for (e.g., 3rd generation) for pneumonia or intra-abdominal infections.

Answer 55

Cephalosporins

Question 56

Drug of Choice for Endotoxemia for soft tissue or intra-abdominal infections

Answer 56

Metronidazole

Question 57

Drug of Choice for Endotoxemia for pneumonia

Answer 57

Macrolides (like azithromycin)

Question 58

In supportive care for Endotoxemia, this drug may be used for managing DIC (disseminated intravascular coagulation) and preventing clotting.

Answer 58

Heparin

Question 59

Used at low doses for their anti-inflammatory effects in severe cases of Endotoxemia

Answer 59

Steroids (e.g., glucocorticoids)