Biomedical subjects
Publications and source records attributed to C R Sweeney.
Tracheal mucus transport rates were measured over a 10-minute period in 20 healthy horses twice in 24 hours. The mean rate was 1.93 +/- 0.55 cm/min on day 1 and 1.99 +/- 0.49 cm/min 24 hours later. The mean difference between day 1 and day 2 (0.06 +/- 0.42 cm/min) was not significant (P = 0.55). The range on day 1 was 1.12 to 2.9 cm/min and 1.11 to 2.89 cm/min on day 2.
Water vapor-saturated air was delivered to 12 healthy, housed horses for 2 hours daily for 5 days. Treatment had no effect on tracheal mucus transport rate, bronchoalveolar lavage total and differential cell counts, blood cell counts, or plasma fibrinogen concentration.
Pathologic changes are described in 11 horses that died during racing or training; 9 died of acute pulmonary hemorrhage (exercise-induced pulmonary hemorrhage), 1 died of exsanguination, and 1 died of CNS trauma. Cardiac lesions were not found in any horse. Severe engorgement of pulmonary vessels, with hemorrhage into alveoli, airways, interstitium, and subpleural tissues, was observed in all 9 horses that died of exercise-induced pulmonary hemorrhage. Infiltration of eosinophils and/or lymphocytes around vessels and airways was seen in 6 horses. Focally extensive fibrosis was observed in the pleura and interstitium of 6 horses, and collections of siderophages were seen in the fibrous tissue and in the airways. Focal occlusion of bronchioles with inspissated mucus, such as that associated with small airway disease, was found in 4 horses. Underlying respiratory tract lesions, particularly those associated with small airway disease or bronchiolitis, may have a role in fatal pulmonary hemorrhage.
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The efficacy of water vapor-saturated air as a treatment for horses with exercise-induced pulmonary hemorrhage (EIPH) was studied. Horses selected for study (n = 14) had grade 1 or greater hemorrhage in the trachea after a minimum of 4 breezes between 0.8 and 1 km, as determined by endoscopy. Nine horses were treated with water vapor-saturated air; 5 horses were not treated. When the mean and maximal EIPH scores from the pretreatment period were compared with the mean and maximal EIPH scores from the treatment period in both treated and nontreated groups, there was no significant difference between groups. There was a suggestion of a linear relationship between exercise speed and the mean EIPH score of the first 4 breezes in all 14 horses.
Complications associated with Streptococcus equi infection developed in 15 (20.3%) of 74 horses on one farm included death, guttural pouch empyema, purpura hemorrhagica, upper respiratory tract obstruction, pneumonia, pleuropneumonia, agalactia, mesenteric lymph node abscessation, and periorbital abscessation. Death was attributed to pneumonia in 3 horses and to upper respiratory tract obstruction in 2 horses. One horse was euthanatized because of severe purpura hemorrhagica.
Aortic insufficiency was suspected in a thin 1-year-old colt with a grade IV/V decrescendo holodiastolic murmur and a bounding arterial pulse. Echocardiographic findings (diastolic fluttering of the septal leaflet of the mitral valve, left ventricular volume overload, and incomplete aortic valve closure) were diagnostic for aortic valve insufficiency. Moderately thick fibrotic aortic valve leaflets were found at necropsy. Fenestrations were found in the aortic and pulmonic valve cusps. Congenital valvular disease may have led to aortic valvular insufficiency in this horse.
A 15-year-old Quarter Horse gelding was examined because of chronic intermittent colic of 40 days' duration. The clinical signs included acute onset of depression, ptyalism, abdominal splinting, and rolling within an hour of eating. An intramural mass of the esophagus was identified during esophagoscopy. A large soft-tissue density surrounding the distal portion of the esophagus, creating a stricture, was identified on an esophagogram. With the horse slightly sedated, pleuroscopy was performed, allowing direct visualization and biopsy of the mass. The histopathologic diagnosis was squamous cell carcinoma.
Case records of 48 foals with pneumonia due to Rhodococcus equi were reviewed. Twenty of the 48 foals survived and 28 died or were euthanized. There was no significant difference between the survivors and non-survivors in the age of onset of illness, duration of illness prior to admission, the mean white blood cell (WBC) count, or the mean plasma fibrinogen content. All foals had R. equi isolated from a tracheobronchial aspirate or lung specimens obtained at necropsy. All organisms were susceptible in vitro (Kirby-Bauer) to erythromycin and gentamicin. Susceptibilities to other drugs were: trimethoprim-sulfamethoxazole (88%), tetracycline (87%), chloramphenicol (83%); 97% were resistant to cephalothin and 83% to penicillin. Thirteen of the 20 surviving foals were treated with erythromycin and/or rifampin. A decline in mortality rate was observed with the introduction of the combination of erythromycin and rifampin. None of the 17 foals treated with penicillin and gentamicin survived. Chronic, active, non-septic synovitis was confirmed in 17 foals. These foals had joint distension with mild or no apparent lameness.
A 15-year-old, Standardbred broodmare with an aortic sinus aneurysm developed rupture of the aneurysm with subsequent rupture of a tricuspid valve chorda tendinae, tricuspid regurgitation, acute right-sided congestive heart failure, and pulmonary thromboembolism. Shunting of blood from the aorta through the ruptured aneurysm into the right ventricle resulted in decreased renal perfusion and acute renal failure. Initially, treatment of the mare with analgesics, fluids, and digoxin resulted in clinical improvement, but the mare's condition deteriorated after 8 days and the mare was euthanatized due to unrelenting pain and a poor prognosis. Echocardiography was useful in diagnosis of the cardiac disease in the broodmare.
Chronic granulomatous bowel disease was diagnosed in 3 sibling Standardbred horses. Clinical signs included weight loss, loose feces, and decreased appetite in the terminal stage of the disease. Abnormal laboratory findings included hypoproteinemia and low xylose absorption. Necropsy revealed granulomatous inflammation of the intestines, mesenteric lymph nodes, and liver. Eosinophilic infiltration of the granulomatous lesions was a prominent finding in one horse. A causative agent was not detected by special histochemical staining or bacteriologic culturing.
Philippine polo and racing horses were examined for exercise-induced pulmonary hemorrhage after their competitive exercise. Exercise-induced pulmonary hemorrhage occurred in 11.1% of the polo horses and 64% of the racing horses. None of the horses had blood at the nostrils.
Serum and peritoneal fluid concentrations of metronidazole were determined in 6 healthy adult horses given the drug (25 mg/kg) by IV or oral routes. The disposition of metronidazole in horses given the drug by the IV route conformed to a 2-compartment model with a distribution half-life of 0.16 hours, an elimination half-life of 2.9 hours, and a body clearance of 0.40 +/- 0.05 L/kg/hr. The oral absorption half-life was 0.40 hours, and the bioavailability, 85.0 +/- 18.6%. Peritoneal fluid concentrations were approximately equal to serum concentrations at all times, regardless of the route of administration. On the basis of reported minimal inhibitory concentrations for anaerobic bacteria, a dosage of 15 to 25 mg/kg given orally 4 times daily was recommended.
Combined antimicrobial drug treatment was recommended for foals with Corynebacterium equi pneumonia. The preferred combination is orally administered erythromycin estolate (25 mg/kg of body weight, QID) plus rifampin (10 mg/kg, BID). Erythromycin estolate also can be combined for synergistic effect with sodium benzyl penicillin given IV (100,000 IU/kg, QID) or with ampicillin given IV (11 to 15 mg/kg, QID). A third choice is sodium benzyl penicillin IV with gentamicin IM (2.2 mg/kg, TID) or with kanamycin IM (10 mg/kg, QID). Gentamicin should be combined with penicillin G or ampicillin and not used for longer than one week without monitoring for nephrotoxicosis. Rifampin should be used only in combination with erythromycin or penicillin. Erythromycin or rifampin and gentamicin give antagonistic interactions in vitro. Chloramphenicol or trimethoprim-sulfamethoxazole may be effective if given in high doses but are not preferred drugs. Treatment response should be monitored clinically and radiographically and treatment should be continued for 2 weeks after the foal is clinically and radiographically normal.
Anaerobic bacteria are important and overlooked bacterial pathogens of the lower respiratory tract in horses. Twenty-one of 46 horses with pleuropneumonia had anaerobic bacteria isolated from pleural fluid or from tracheobronchial aspirate. Bacteroides oralis and B melaninogenicus were the anaerobes most frequently isolated. Survival was significantly less for horses from which anaerobes were isolated than for horses from which anaerobes were not isolated. Putrid odor was associated with the pleural fluid and/or breath in 62% of the horses from which anaerobes were isolated. In these horses, the survival rate was significantly less than for horses from which odoriferous specimens were not isolated.
A 3-year-old Thoroughbred filly had a pharyngeal abscess causing obstruction of the upper respiratory tract. Diagnosis was made by a combination of endoscopy, biopsy, cytology, and radiography. Treatment with antimicrobials and analgesics resulted in successful resolution of the abscess.
Two commercial systems, the API 20S (Analytab Products, Plainview, N.Y.) and the Rapid Strep (API System S.A., Montalieu-Vercieu, France), were evaluated for ease of use and accuracy in the rapid identification of group C streptococci isolated from horses. A total of 85 Streptococcus isolates were tested, including S. equi (67 isolates), S. zooepidemicus (13 isolates), and S. equisimilis (5 isolates). All S. equi and S. zooepidemicus isolates were correctly identified within 24 h by the Rapid Strep system. Specific grouping sera was necessary to distinguish between S. equisimilis and group G or L strains. The API 20S system did not provide species identification of any of these isolates. An identification of randomly selected isolates to species level was performed by conventional methods and confirmed the identification derived through the Rapid Strep system. Our results indicate that the Rapid Strep system is a valuable aid for species identification of equine isolates of group C streptococci.
Of tracheobronchial aspirates from 50 clinically healthy Thoroughbred racehorses, 4 (8%) had aerobic bacteria with recognized pathogenicity, 12 (24%) contained transient bacterial isolates, and 37 (74%) had no bacterial growth. Of tracheobronchial aspirates from 36 pastured, nonracing racehorses, 3 (8%) had bacteria with recognized pathogenicity, 23 (64%) contained transient bacteria, and 10 (28%) had no bacterial growth. Anaerobes were not isolated from 12 of 12 pastured horses. Transient bacteria were isolated more often in the pastured horses.