Acute renal disease due to Leptospira interrogans in a weanling.
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Biomedical subjects
Publications and source records attributed to W V Bernard.
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Recent advances in veterinary diagnostics have improved our ability to diagnose and treat foal diseases. However, these advances do not replace the physical examination as the most valuable diagnostic aid available to the equine practitioner. The basic physical examination provides the majority of information needed to make a presumptive diagnosis, provide a direction for ancillary tests, and formulate a plan for emergency therapy if needed.
A Thoroughbred foal that was born after 305 days of gestation was referred 6 hours after birth. On initial examination, the foal was alert, but weak and unable to stand. Heart rate was 150 beats/min, respiratory rate was 48 breaths/min, and rectal temperature was 33 C. Leukocytosis was detected (26,000 WBC/microliters). Dysuria and passage of red urine was observed approximately 30 hours after admission. Urine collected by free catch had a 3+ reaction for blood on dipstick analysis. Examination of Warthin Starry-stained sections of allantochorion revealed organisms morphologically characteristic of leptospira spp along the chorion. Results of direct fluorescent antibody tests on section of placenta were positive for Leptospira spp. Direct fluorescent antibody testing identified leptospires in the urine of the foal. Sera from mare and foal were tested for antibodies against Leptospira spp by use of the microscopic agglutination test. High titers were identified in serum from the mare and foal.
Leptospirosis was documented as the cause of abortion in a 5-year-old mare. Leptospires were detected in tissue specimens from fetal kidneys and from placenta by histologic evaluation of silver-stained sections. Antibodies against Leptospira interrogans serovar pomona were detected in fetal serum at a titer of 1,600 by use of a microscopic agglutination test. The mare had serum titers of 6,400; 0; 400; 800; 3,200; and 6,400 to L interrogans serovars bratislava, canicola, grippotyphosa, hardjo, icterohaemorrhagiae, and pomona, respectively. A serologic survey identified titers of at least 6,400 against serovars bratislava and pomona in 5 other horses on the farm. Titers of at least 100 against serovar bratislava were detected in 53% of the horses on the farm. Leptospires were detected by direct fluorescent-antibody testing in urine samples from the mare that aborted and from 2 of the other 5 horses.
Equine clinical leptospirosis has been primarily related to uveitis and the often recurrent sequelae of ocular changes. Reports of equine hepatic and renal involvement are sporadic. More recently, serovar bratislava has been identified as a host-adapted serovar in the horse. More significantly, reports of equine abortion and stillbirth have become more frequent in the literature. This is more than likely a result of improved diagnostic techniques, not of increased prevalence of disease. In addition to abortion, equine neonatal disease is becoming more frequently recognized in association with leptospira infection. Whether leptospiral infection results in abortion or diseased foals may depend upon the stage of gestation when the mare is exposed and host immune status. Antibiotic of choice for treatment of equine leptospirosis remains speculative, as specific equine studies have not been performed. Extrapolation from other species suggests that the use of streptomycin remains a good choice of therapy for the chronic shedding state and may be used in combination with other antimicrobials for treatment of acute disease. Penicillin or potentiated penicillins and tetracycline at appropriate to high end dosages are logical choices for the treatment of acute leptospirosis.
Blood samples obtained from 13 of 100 (13%) and 6 of 91 (7%) horses at the George D. Widener Hospital for Large Animals in the months of June and October, respectively, had antibody to Borrelia burgdorferi as determined by ELISA. Horses from the states of New York, Maryland, Delaware, New Jersey, and Pennsylvania were seropositive for B burgdorferi. The frequency of antibody response in horses from New Jersey was greater (P less than 0.05) than the frequency of antibody response in horses from Pennsylvania or that of horses from the other states combined. Statistically significant difference was not found when a comparison was made between horses with serotiter and open diagnosis of neurologic or musculoskeletal disease and horses with negative serotest results and open diagnosis of neurologic or musculoskeletal disease.
A 3-year-old Standardbred stallion was admitted for treatment of acute enterocolitis. The horse improved in response to empiric treatment, but subsequently developed ventral edema, scrotal abscessation, and severe laminitis. Improvement again was seen, but on day 29 of hospitalization, the horse developed rapid heart rate and signs of abdominal pain. Exploratory celiotomy revealed complete obstruction of the descending portion of the duodenum, 20 cm caudal to the duodenal sigmoidal flexure. Three-tier duodenojejunostomy and jejunojejunostomy were performed to bypass the duodenal obstruction.
Small-intestinal intussusceptions were diagnosed in 3 foals. Cross-sectional ultrasonography through the apex of the intussusceptum revealed a target-like pattern with a thick hypoechoic rim. The thick hypoechoic rim was caused by severe edema of the entering and returning walls of the intussusceptum. At the more proximal portion of the intestines, where parietal edema was less severe, the image appeared as 2 concentric rings and an inner circular area. The outer ring and inner circular area were hypoechoic and represented the returning and the entering wall of the intussusceptum. An additional cross-sectional pattern can be described as double concentric rings, with the inner lumen represented by a central echogenic core. Longitudinal scannings of the involved intestinal section revealed a different view of the same anatomic situation, with 2 hyperechoic areas delineated by 3 stripes of hypoechoic intestine. Ultrasonography of a foal's abdomen provides a clinician with a rapid noninvasive technique that may aid in the differential that may aid in the differential diagnosis of colic. The ultrasonographic diagnosis of intussusception may improve the recognition of a surgical lesion and improve the potential for successful treatment.
Seven horses were given 0.5 mg of carbon tetrachloride/kg of body weight via a nasogastric tube. Subsequent hepatocellular damage was monitored by serum enzyme determinations of sorbitol dehydrogenase, isoenzyme 5 of lactate dehydrogenase, and aspartate transaminase activities. Creatinine kinase activity was evaluated as an indicator of muscle cell damage. Sorbitol dehydrogenase, isoenzyme 5 of lactate dehydrogenase, and aspartate transaminase activities were significantly (P less than 0.05) increased by 24 hours after carbon tetrachloride administration. Isoenzyme 5 of lactate dehydrogenase and sorbitol dehydrogenase activities returned to baseline several days before aspartate transaminase activity returned to baseline. Creatine kinase activity remained unchanged.