Simon F. Peek

Prognostic Value of Clinicopathologic Variables Obtained at Admission and Effect of Antiendotoxin Plasma on Survival in Septic and Critically Ill Foals

This prospective study compared survival rates of critically ill and septic foals receiving 1 of 2 different types of commercial equine plasma and analyzed admission variables as possible predictors of survival. Standardized clinical, hematologic, biochemical, and hemostatic admission data were collected and foals received either conventional commercially available hyperimmune equine plasma or equine plasma specifically rich in antiendotoxin antibodies in a double-blinded, coded fashion. Sepsis was defined as true bacteremia or sepsis score >11. Overall survival rate to discharge was 72% (49/68). Foals that were nonbacteremic and demonstrated a sepsis score of < or = 11 at admission had a 95% (18/19) survival rate. The survival rate to discharge for septic foals was 28/49 (57%), with truly bacteremic foals having a survival rate of 58% (14/24), whereas that for nonbacteremic, septic foals was 56% (14/25). Sensitivity and specificity for sepsis score >11 as a predictor of bacteremia were 74 and 52%, respectively. For the entire study population, a higher survival rate to discharge was documented for those foals receiving hyperimmune plasma rich in antiendotoxin antibodies (P = .012, odds ratio [OR] 6.763, 95% confidence interval [CI]: 1.311, 34.903). Administration of plasma rich in antiendotoxin antibodies also was associated with greater survival in septic foals (P = .019, OR 6.267, 95% CI: 1.186, 33.109). Statistical analyses demonstrated that, among 53 clinical and clinicopathologic admission variables, high sepsis score (P < .001), low measured IgG concentration (P = .01), high fibrinogen concentration (P = .018), low segmented neutrophil count (P = .028), and low total red blood cell numbers (P = .048) were the most significant predictors of overall mortality.

Timely diagnosis of dairy calf respiratory disease using a standardized scoring system.

Abstract Respiratory disease of young dairy calves is a significant cause of morbidity, mortality, economic loss, and animal welfare concern but there is no gold standard diagnostic test for antemortem diagnosis. Clinical signs typically used to make a diagnosis of respiratory disease of calves are fever, cough, ocular or nasal discharge, abnormal breathing, and auscultation of abnormal lung sounds. Unfortunately, routine screening of calves for respiratory disease on the farm is rarely performed and until more comprehensive, practical and affordable respiratory disease-screening tools such as accelerometers, pedometers, appetite monitors, feed consumption detection systems, remote temperature recording devices, radiant heat detectors, electronic stethoscopes, and thoracic ultrasound are validated, timely diagnosis of respiratory disease can be facilitated using a standardized scoring system. We have developed a scoring system that attributes severity scores to each of four clinical parameters; rectal temperature, cough, nasal discharge, ocular discharge or ear position. A total respiratory score of five points or higher (provided that at least two abnormal parameters are observed) can be used to distinguish affected from unaffected calves. This can be applied as a screening tool twice-weekly to identify pre-weaned calves with respiratory disease thereby facilitating early detection. Coupled with effective treatment protocols, this scoring system will reduce post-weaning pneumonia, chronic pneumonia, and otitis media.

Effect of experimental infection of cattle with bovine herpesvirus-1 (BHV-1) on the ex vivo interaction of bovine leukocytes with Mannheimia (Pasteurella) haemolytica leukotoxin.

Abstract Mannheimia (Pasteurella) haemolytica A1 produces an extracellular leukotoxin (LKT) that is reported to bind the β2-integrin CD11a/CD18 (LEA-1) on ruminant leukocytes. LKT binding induces activation, and subsequent cytolysis, of these cells. It is well known that active viral infection greatly increases the susceptibility of cattle to pasteurellosis. To better understand the mechanism by which this occurs, we investigated the effects of experimental in vivo infection of cattle with bovine herpes virus-1 (BHV-1) on the ex vivo interaction of bovine leukocytes with the M. haemolytica LKT. In this study, we demonstrated that active BHV-1 infection increased the expression of the β2-integrin CD11a/CD18 (as defined by the mAb BAT75) on bovine peripheral blood neutrophils, enhanced the binding of LKT to bronchoalveolar lavage (BAL) leukocytes and peripheral blood neutrophils, and increased the killing of BAL leukocytes and peripheral blood leukocytes by LKT. In addition, BHV-1 greatly increased the number of BAL, resulting in many more LKT-responsive cells being present in the lungs. These findings might explain in part the increased susceptibility of BHV-1 infected cattle to pneumonic pasteurellosis.

Enhanced bactericidal activity against Escherichia coli in calves fed Morinda citrifolia (Noni) puree.

BACKGROUND Although adequate colostrum intake and properly used antibiotics can provide much protection for the bovine neonate, increased antibiotic scrutiny and consumer demand for organic products have prompted investigations of natural immunomodulators for enhancing calf health. One plant-based immunomodulator, Morinda citrifolia (noni) fruit, is a well-recognized natural product that has a broad range of immunomodulatory effects. HYPOTHESIS Neonatal calves fed noni puree would demonstrate whole blood phagocytic capacity in Gram-negative and Gram-positive in vitro assays. ANIMALS Blood samples from 18 neonatal Holstein bull calves. METHODS Calves were divided into 2 groups: Group 1 comprised control calves, whereas Group 2 received 30 mL of noni puree twice a day in milk replacer. Day 0 blood samples were obtained between 36 and 48 hours of age before the first feeding of puree. Ethylenediaminetetraacetic acid anticoagulated blood was collected from each calf on days 0, 3, 7, and 14. Bactericidal assays were performed to estimate the percentage killing of Escherichia coli and Staphylococcus epidermidis. RESULTS Blood samples from noni puree-fed calves displayed significantly more E. coli bacterial killing than did controls on day 14, and although differences were not significant on days 0, 3, and 7, bacterial killing progressively increased over time. There was no significant difference between the groups for S. epidermidis killing. CONCLUSIONS AND CLINICAL IMPORTANCE The immunomodulatory effect of noni puree may prove valuable in the future as production animal antibiotic use becomes more restricted. Additional clinical trials are warranted to investigate the clinical application of noni puree in promoting calf health.

Incidence of transfusion reactions to commercial equine plasma.

OBJECTIVE To report on the incidence of transfusion reactions to commercial equine plasma in a hospital-based population of horses, to characterize these reactions and report on outcome. DESIGN Retrospective study. SETTING University teaching hospital. ANIMALS Client-owned horses referred to the University of Wisconsin. INTERVENTIONS Intravenous administration of 2 commercial equine plasma products when clinically indicated. MEASUREMENTS AND MAIN RESULTS Medical records of 107 horses that received plasma transfusions between 2003 and 2008 were evaluated. Transfusion reactions were recorded in 6 of 107 transfusions. All individuals were administered plasma from 1 commercial source. Foals <30 days of age received a hypergammaglobulinemic product and all adults received a lower IgG concentration product. No reactions were recorded in adults. In foals (<30 d) reactions were recorded in 6 of 69 cases (8.7%), all of which occurred in neonates <7 days of age (6/62; [9.7%]). The most frequent reactions were fever (4/6), tachycardia (2/6), tachypnea (2/6), and colic (2/6). All affected foals survived the reaction. There were no statistically significant differences (P<0.05) in any of the variables examined between those foals that did and those that did not experience transfusion reactions. CONCLUSION The incidence of transfusion reactions was 8.7% in foals and 0% in adult horses in our referral population. Five of 6 foals responded to medical therapy and eventually received the clinically indicated transfusion. No transfusion related mortality occurred.

Retrospective Study: Incidence of transfusion reactions to commercial equine plasma

OBJECTIVE To report on the incidence of transfusion reactions to commercial equine plasma in a hospital-based population of horses, to characterize these reactions and report on outcome. DESIGN Retrospective study. SETTING University teaching hospital. ANIMALS Client-owned horses referred to the University of Wisconsin. INTERVENTIONS Intravenous administration of 2 commercial equine plasma products when clinically indicated. MEASUREMENTS AND MAIN RESULTS Medical records of 107 horses that received plasma transfusions between 2003 and 2008 were evaluated. Transfusion reactions were recorded in 6 of 107 transfusions. All individuals were administered plasma from 1 commercial source. Foals <30 days of age received a hypergammaglobulinemic product and all adults received a lower IgG concentration product. No reactions were recorded in adults. In foals (<30 d) reactions were recorded in 6 of 69 cases (8.7%), all of which occurred in neonates <7 days of age (6/62; [9.7%]). The most frequent reactions were fever (4/6), tachycardia (2/6), tachypnea (2/6), and colic (2/6). All affected foals survived the reaction. There were no statistically significant differences (P<0.05) in any of the variables examined between those foals that did and those that did not experience transfusion reactions. CONCLUSION The incidence of transfusion reactions was 8.7% in foals and 0% in adult horses in our referral population. Five of 6 foals responded to medical therapy and eventually received the clinically indicated transfusion. No transfusion related mortality occurred.

Diagnosis and surgical treatment of an intracranial cyst in an alpaca cria.

CASE DESCRIPTION A 7-day-old female alpaca was examined because of an acute onset of diffuse central neurologic deficits. CLINICAL FINDINGS Diagnostic imaging with CT and MRI identified an intracranial cyst occupying approximately one-third to one-half of the dorsal portion of the cranial cavity, markedly displacing the cerebral hemispheres bilaterally. TREATMENT AND OUTCOME Initial surgical management via trephination and needle drainage was only transiently effective at resolving the neurologic signs. Craniotomy and drainage and removal of the cyst lining resulted in a sustained improvement in neurologic status, and the cria remained clinically normal and well grown at follow-up 5 months after surgery. CLINICAL RELEVANCE This report represented the first description of the successful treatment of an intracranial cyst in a New World camelid.

Surgical findings and outcome for dairy cattle with jejunal hemorrhage syndrome: 31 cases (2000-2007).

OBJECTIVE To describe signalment; surgical findings; short-, medium-, and long-term outcome; and recurrence rate for cattle undergoing celiotomy because of jejunal hemorrhage syndrome (JHS) and to analyze risk factors associated with outcome and recurrence. DESIGN Retrospective case series. ANIMALS 31 dairy cattle with JHS. PROCEDURES Medical records were analyzed. Follow-up information was obtained from owners of cattle surviving until discharge. RESULTS 18 of 31 (58%) cattle undergoing celiotomy survived to initial discharge. Fifteen (48%) and 13 (42%) were alive 6 and 12 months after discharge, respectively. All 5 deaths within 12 months after discharge were attributed to JHS recurrence. Survival time was 12 to 85 months for the 13 long-term survivors. Six of 7 that died > 12 months after celiotomy did so for reasons unrelated to JHS. Recurrence rate among short-term survivors was 7 of 18; 1 of these survived long-term. A significant proportion of affected cattle were Brown Swiss, compared with proportions for other breeds. Manual massage of the bowel to break down clots was associated with a significantly higher short-term survival rate than was enterectomy or enterotomy. Medium- and long-term survival rate was higher in cattle referred 24 to 48 hours after onset of signs. Length of obstructing blood clots was not associated with outcome. Other factors were not significantly associated with recurrence. CONCLUSIONS AND CLINICAL RELEVANCE Survival rates were higher than those in other reports. Prompt celiotomy and resolution by use of manual massage were associated with higher survival rates. In this population, JHS recurred in 7 of 18 short-term survivors.

Salmonella in Dairy Cattle

As an infectious, contagious pathogen, Salmonella is probably rivaled by only bovine viral diarrhea virus in its ability to cause clinical disease, such as enteritis, septicemia, pneumonia, and reproductive losses. The increasing prevalence of Salmonella, particularly Salmonella Dublin, on dairies presents new challenges to producers and veterinarians. No current discussion of bovine salmonellosis is complete without acknowledging the increasing public health concern. Increasing antimicrobial resistance among enteric pathogens brings the use of antimicrobials by veterinarians and producers under ever stricter scrutiny. This article provides a comprehensive review of Salmonella etiology, prevalence, pathogenesis, diagnostics, treatment, and control.

Idiopathic Hemorrhagic Pericardial Effusion as a Precursor to Epicardial Lymphosarcoma in Three Cows

A 2-year-old female Holstein heifer was referred for evaluation of acute onset brisket edema and jugular venous distension. The heifer was 223 days in milk and 139 days pregnant and had been producing milk at expected levels until the day before presentation. Physical examination at admission to the University of Wisconsin Veterinary Medical Teaching Hospital revealed a bright and alert individual with a rectal temperature of 100.6 F, and pulse and respiratory rates of 76 beats and 34 breaths per minute, respectively. Muffled heart sounds were present and both jugular veins were turgid, visibly distended, and displayed retrograde fill. An echocardiogram at admission using a 2.5–3.5 MHz phased array transducer from a right parasternal approach identified an approximately 8-cm distension of the pericardial sac by anechoic fluid that was evident during all phases of the cardiac cycle. Some thickening of the epicardial surface was noted with strands of more hyperechoic tissue floating on the epicardial surface with the ultrasonographic appearance of fibrin. Cardiac contractility appeared subjectively poor although functional cardiac measurements were not obtained because of the depth of pericardial fluid. A serum sample obtained at admission tested positive by both ELISA and AGID techniques for antibodies to the bovine leukosis virus (BLV). Pericardiocentesis yielded bloody fluid with a PCV of 14%, total protein concentration of 5.2 g/dL, and total nucleated cell count (TNCC) of 5.75 9 10/lL. The nucleated cells were comprised of 14% neutrophils, 64% small lymphocytes, and 22% macrophages. The lymphocytes were cytologically normal. Approximately 5.5 L of hemorrhagic pericardial fluid was removed through a 24 French chest tube placed in the left 5th intercostal space, decreasing the visible depth of pericardial fluid to approximately 2 cm. The heifer was given 0.1 mg/kg dexamethasone IV q24h for 3 days and underwent daily ultrasonographic assessment of pericardial fluid volume and subjective evaluation of cardiac function. By day 3 of hospitalization, minimal pericardial fluid remained (<10 mm) but focal areas of epicardial fibrin still could be seen. Jugular venous distension had resolved and the heifer’s heart rate was normal. It had normal appetite and milk production had improved. The heifer was returned to its farm of origin and continued to do well, producing 68 lb of milk at a subsequent test date approximately 50 days post discharge. Unfortunately, it was found dead approximately 100 days after discharge. Necropsy showed thickening of the epicardial surface of the heart with multiple fibrous attachments connecting the epicardial surface to the pericardium. The epicardial surface was matted with extensive areas of fibrosis admixed with fibrin and hemorrhage. Multiple thoracic lymph nodes were enlarged with similar multifocal white to tan infiltrates. Histologically, the epicardium was expanded with fibrosis and highly vascular papillary projections in which there were many atypical neoplastic lymphocytes alongside a mononuclear inflammatory infiltrate of small lymphocytes and plasma cells. The myocardium had areas of fibrosis but no neoplastic infiltrate. Histologically, lymphosarcoma was confirmed in the thoracic lymph nodes.