Septic Peritonitis Research Articles

Peritonitis-related bacterial infections: a large-scale case-series retrospective study in 160 domestic animals (2009-2022).

Bacterial peritonitis infections comprise a life-threatening clinical condition in domestic animals that commonly lead to sepsis and high mortality. A set of bacterial pathogens have been identified in septic peritonitis in livestock and companion animals. Nonetheless, most descriptions are restricted to case reports or limited to only one domestic species, and a restrict number of comprehensive studies involving this infection has focused on a great number of domestic animals. Here, we retrospectively investigated selected epidemiological data (with an emphasis in outcome), clinical signs, bacteriological culturing, and in vitro antimicrobial susceptibility patterns of microorganisms isolated of peritoneal fluid from 160 domestic animals (2009-2023) compatible with septic peritonitis. Bacteria were isolated from 71.9% (115/160) of the peritoneal fluid from 75 dogs (75/115 = 65.2%), 22 cats (22/115 = 19.1%), 14 horses (14/115 = 12.2%), and 4 cattle (4/115 = 3.5%). Among animals with bacterial isolation, Escherichia coli (34/115 = 29.6%), alfa-hemolytic Streptococcus (12/115 = 10.4%), Staphylococcus aureus (8/115 = 6.9%), beta-hemolytic Streptococcus (7/115 = 6.1%), and Pasteurella multocida (6/115 = 5.2%) were predominant in pure culture, in addition to a miscellaneous of other bacteria isolated in minor frequency, e.g., Pseudomonas sp., Trueperella pyogenes, Klebsiella pneumoniae, and Salmonella sp. In general, in vitro susceptibility tests of isolates revealed that florfenicol, chloramphenicol, and amoxicillin/clavulanic acid showed moderate effectivity (≥ 60%). Conversely, most of isolates exhibited resistance mainly to trimethoprim/sulfamethoxazole, enrofloxacin, and penicillin (> 60%). Additionally, multidrug resistance was found in 42.6% (49/115) of the isolates. Data related to the outcome were available in 37.4% (43/115) of animals that had bacterial isolation and, from these, the mortality rate was 79.1% (34/43), with a significant association (p < 0.036) between mortality and septic peritonitis by gram-negative bacteria. Neoplasia (7/43 = 16.3%), pneumonia/pulmonary abscess (5/43 = 11.6%), hepatitis (5/43 = 11.6%), metritis/pyometra (4/43 = 9.3%), and gall bladder rupture (3/43 = 7%) represented the probable main sources of septic peritonitis. Anorexia (34/115 = 29.6%), emesis (29/115 = 25.2%), lethargy (26/115 = 22.6%), respiratory distress (25/115 = 21.7%), ascites (20/115 = 17.4%), and fever (19/115 = 16.5%) were the most frequent clinical signs among animals with bacterial isolation. A variety of bacteria were isolated in the peritoneal fluid of animals, with a predominance of Enterobacteriaceae, streptococci, and staphylococci, highlighting the opportunistic nature of the pathogens in septic peritonitis. High in vitro multidrug resistance of isolates and high mortality of animals reinforce the need for early diagnosis and therapy based on the in vitro antimicrobial profile of the pathogens involved in septic peritonitis. Our results contribute to the etiological characterization, clinical-epidemiological findings, and vigilance of multidrug-resistant bacteria in septic peritonitis among livestock and companion animals.

Comparative Analysis of Hepatic Gene Expression Profiles in Murine and Porcine Sepsis Models.

Sepsis remains a huge unmet medical need for which no approved drugs, besides antibiotics, are on the market. Despite the clinical impact of sepsis, its molecular mechanism remains inadequately understood. Recent insights have shown that profound hepatic transcriptional reprogramming, leading to fatal metabolic abnormalities, might open a new avenue to treat sepsis. Translation of experimental results from rodents to larger animal models of higher relevance for human physiology, such as pigs, is critical and needs exploration. We performed a comparative analysis of the transcriptome profiles in murine and porcine livers using the following sepsis models: cecal ligation and puncture (CLP) in mice and fecal instillation (FI) in pigs, both of which induce polymicrobial septic peritonitis, and lipopolysaccharide (LPS)-induced endotoxemia in pigs, inducing sterile inflammation. Using bulk RNA sequencing, Metascape pathway analysis, and HOMER transcription factor motif analysis, we were able to identify key genes and pathways affected in septic livers. Conserved upregulated pathways in murine CLP and porcine LPS and FI generally comprise typical inflammatory pathways, except for ER stress, which was only found in the murine CLP model. Conserved pathways downregulated in sepsis comprise almost exclusively metabolic pathways such as monocarboxylic acid, steroid, biological oxidation, and small-molecule catabolism. Even though the upregulated inflammatory pathways were equally induced in the two porcine models, the porcine FI model more closely resembles the metabolic dysfunction observed in the CLP liver compared to the porcine LPS model. This comprehensive comparison focusing on the hepatic responses in mouse CLP versus LPS or FI in pigs shows that the two porcine sepsis models generally resemble quite well the mouse CLP model, with a typical inflammatory signature amongst the upregulated genes and metabolic dysfunction amongst the downregulated genes. The hepatic ER stress observed in the murine model could not be replicated in the porcine models. When studying metabolic dysfunction in the liver upon sepsis, the porcine FI model more closely resembles the mouse CLP model compared to the porcine LPS model.

Intra-abdominal nocardiosis and scedosporiosis in a dog: case report and literature review.

A 2-y-old, intact female, mixed-breed dog was presented to the veterinary hospital with abdominal distension, anemia, and lethargy following a chronic history of nonspecific gastrointestinal signs. CBC and serum biochemistry revealed moderate nonregenerative anemia with neutrophilia, hypoalbuminemia, hyperglobulinemia, hypoglycemia, decreased urea and creatinine, and hypercholesterolemia. Abdominal radiographs and ultrasound revealed a large heterogeneous mesenteric mass and ascites. Abdominocentesis confirmed septic peritonitis with filamentous bacteria. Fine-needle aspiration of the mass yielded pyogranulomatous inflammation and hyphae. An exploratory laparotomy revealed a large cranial abdominal mass with granulomas present throughout the abdominal cavity. Due to the poor prognosis and disseminated disease, the owner elected euthanasia. Postmortem and histologic examinations detected intralesional mycetomas and bacterial colonies within the mesenteric masses. 16S ribosomal RNA gene PCR and sequencing using formalin-fixed, paraffin-embedded sections identified Nocardia yamanashiensis, Nocardioides cavernae, and Nocardioides zeicaulis. Fungal culture, PCR, and sequencing confirmed Scedosporium apiospermum. Our report highlights the importance of molecular methods in conjunction with culture and histologic findings for diagnosing coinfections caused by infrequent etiologic agents. Additionally, we provide a comprehensive literature review of Scedosporium apiospermum infections in dogs.

Evaluation of early and systematic ultrasound examination to determine postoperative dehiscence after small intestinal surgery (114 cases in dogs and cats).

To evaluate the feasibility and reliability of early ultrasound diagnosis for postsurgical bowel dehiscence and find the most reliable ultrasound criteria for dehiscence identification. Additionally, to determine the impact of early ultrasound detection of leakage in terms of survival and duration of hospitalization. Finally, to assess the need for systematized screening or checkup of the population at risk of dehiscence only. 31 cats and 83 dogs. A retrospective, records-based study was performed on 83 dogs and 31 cats (114 total) undergoing small intestinal surgery. Epidemiologic data, clinical signs, surgical procedures, pre- and postoperative ultrasound findings at 48 to 96 hours, hospitalization duration, complications, and general outcomes were recorded. Univariate and multivariate analyses were used to identify ultrasound findings associated with dehiscence. Dehiscence was suspected by ultrasound for 0 of 31 cats and 7 of 83 dogs (2 of 49 for enterotomy and 5 of 34 for enterectomy). Every suspected dehiscence was confirmed during revision surgery except one enterectomy revision, which was declined by the owner. Neither this case nor those without ultrasound evidence of dehiscence developed clinical signs of intestinal leakage. Direct visibility of wall discontinuity, presence of gas bubbles, and liquid in vicinity of the intestinal surgical site were statistically associated with early dehiscence. Survival rate after the second surgery was 83%. Median hospitalization time after the second surgery for dehiscence was 2 days (minimum, 2 days; maximum, 4 days). Postoperative ultrasound examination between 48 and 96 hours after intestinal surgery allows early and sensitive detection of intestinal dehiscence. Survival rate after revision surgery was significantly higher than that associated with septic peritonitis.

Linear and discrete foreign body small intestinal obstruction outcomes, complication risk factors, and single incision red rubber catheter technique success in cats.

To compare survival and report perioperative complications in cats undergoing surgery for small intestinal (SI) linear (LFBO) and discrete (DFBO) foreign body obstructions (FBO). To report success of a red rubber catheter technique (RRCT) to remove LFBOs. Retrospective study. Client-owned cats (n = 169). Medical records of cats undergoing surgery for SI FBO from a veterinary teaching hospital between February 2012 and January 2023 were classified as LFBO, DFBO, or both linear and discrete FBO (BFBO). Signalment and perioperative data were collected. Preoperative hypoalbuminemia (LFBO: n = 1/6; DFBO: n = 5/6) and septic peritonitis (LFBO: n = 2/4; DFBO: n = 0/4; BFBO: n = 2/4) were rare. Intraoperative hypotension did not differ between LFBOs and DFBOs (p = .4756). RRCT was successful in 20/24 attempts of LFBO removal. Three cats were euthanized intraoperatively (LFBO: 1; DFBO: 1; BFBO: 1). Postoperatively, two cats (DFBO) experienced intestinal dehiscence and two cats (DFBO) died or were euthanized. Survival to discharge (p = 1.0000) and postoperative complications (p = .1386) did not differ between LFBOs and DFBOs. Postoperative complications and survival did not differ between cats with LFBOs and DFBOs. Intestinal dehiscence secondary to FBO in cats is rare. A RRCT can be successful in many cats with LFBOs. Cats with LFBOs and DFBOs have similar postoperative complication rates and survival to discharge when preoperative septic peritonitis is not present. Intestinal dehiscence is rare, which is important when discussing surgical prognosis with owners. A RRCT can be considered to remove LFBOs when there is concern for multiple enterotomies.

Discovery of Potent, Specific, and Orally Available NLRP3 Inflammasome Inhibitors Based on Pyridazine Scaffolds for the Treatment of Septic Shock and Peritonitis.

The NLRP3 inflammasome is a multiprotein complex that is a component of the innate immune system, involved in the production of pro-inflammatory cytokines. Its abnormal activation is associated with many inflammatory diseases. In this study, we designed and synthesized a series of NLRP3 inflammasome inhibitors based on pyridazine scaffolds. Among them, P33 exhibited significant inhibitory effects against nigericin-induced IL-1β release in THP-1 cells, BMDMs, and PBMCs, with IC50 values of 2.7, 15.3, and 2.9 nM, respectively. Mechanism studies indicated that P33 directly binds to NLRP3 protein (KD = 17.5 nM), inhibiting NLRP3 inflammasome activation and pyroptosis by suppressing ASC oligomerization during NLRP3 assembly. Additionally, P33 displayed excellent pharmacokinetic properties, with an oral bioavailability of 62%. In vivo efficacy studies revealed that P33 significantly ameliorated LPS-induced septic shock and MSU crystal-induced peritonitis in mice. These results indicate that P33 has great potential for further development as a candidate for treating NLRP3 inflammasome-mediated diseases.

Outcomes in dogs undergoing surgical correction for septic peritonitis: A retrospective study in 61 cases (2019-2022)

Outcomes in dogs undergoing surgical correction for septic peritonitis: A retrospective study in 61 cases (2019-2022)

Histologic findings of gastrointestinal biopsies and clinical outcome in dogs undergoing cholecystectomy for gallbladder mucoceles: 71 cases (2014-2021).

To determine the presence and categorise the severity of enteritis in dogs with gallbladder mucoceles, and evaluate for any associations with enteritis. This study also aimed to report clinical outcome following cholecystectomy and evaluate for associations with survival. Medical records were retrospectively reviewed (2014 to 2021) for dogs undergoing cholecystectomy and duodenal biopsy procedures for gallbladder mucocele. Signalment, bloodwork, abdominal ultrasound findings, surgical details, histology results and outcomes were reported. Surgeries were considered elective or emergent based on each dog's clinical presentation. Enteritis was categorised based on cell type and severity. Inflammation and clinical outcome were statistically evaluated. Seventy-one dogs met the study criteria. Enteritis was present in 85.9% (61/71) of cases with the majority being lymphoplasmacytic (53.5%). Twelve dogs (16.9%) underwent gastrointestinal biopsies from multiple sites, which revealed the same enteritis type at each location. A total of 87.3% (n = 62) dogs survived, including 90.4% elective and 86% emergent cases. No significant differences in enteritis severity or patient survival were found between elective and emergent cases. Septic peritonitis was diagnosed in two dogs (2.82%). Mortality was significantly associated with leukocytosis, with nonsurviving dogs having a mean WBC count of 27.6 G/L (95% confidence interval: 10.6 to 21.5). Enteritis is present in a majority of dogs with gallbladder mucocele, especially mild to moderate with lymphoplasmacytic cell type. Obtaining a duodenal biopsy had minimal impact on patient outcome. Compared to previous studies, improved survival in emergent cases was noted. Further studies with long-term follow-up are needed to determine if enteropathy-related signs persist after cholecystectomy.

Management Of Septic Shock Et Causa Secondary Peritonitis With Complications Acute Kidney Injury And Hospital Acquired Pneumonia In Treated Patients In The Intensive Care Unit

Bacground: Sepsis and Septic shock are reported to be the most common causes of death in the Intensive Care Unit (ICU). The reported incidence of sepsis in the world varies between 100-300 per 100,000 world population per year. Data in Indonesia itself is still limited. Peritonitis is a case of sepsis that often occurs. The mortality rate increases when it develops into septic shock. It can occur together with nosocomal infections. More than 40% of patients with septic shock also suffer from acute kidney injury (AKI). One case of sepsis which developed into septic shock due to secondary peritonitis, which was also complicated by acute kidney injury and hospital acquired pneumonia (HAP) was reported. Case Report: Male, 51 years old, admitted to the Intensive Care Unit with sepsis due to secondary peritonitis, underwent laparotomy. In the course of treatment, experienced septic shock, human acquired pneumonia, acute kidney injury, hyperkalemia, hypoalbuminemia. Treated for 6 days with mechanical ventilation, given antibiotics according to culture and vasopressor support. Improvement occurred on day 6, with minimal vasopressor support as well as resolution and improvement. Conclusion: Early management of critical patients regarding fluid resuscitation, mechanical ventilation management, antibiotic management, AKI management and management of HAP according to culture, is expected to reduce mortality rates and provide good outcomes

Abdominal ultrasound has inconsistent agreement with subsequent surgery or necropsy findings in dogs and cats with septic peritonitis.

To evaluate whether abdominal ultrasound correctly diagnosed septic peritonitis and correctly identified its causative lesion in dogs and cats. 84 client-owned dogs and 10 cats that underwent an abdominal ultrasound and had confirmation of septic peritonitis via exploratory laparotomy or necropsy. This retrospective case series documented abdominal ultrasound findings, surgical or necropsy findings, and method for initial diagnosis of septic peritonitis, if different from surgery or necropsy. The surgical report and necropsy findings were compared to sonography results to confirm a diagnosis of septic peritonitis. The frequency at which sonography diagnosed septic peritonitis and its causative lesion was calculated for each type of lesion pathology and organ system. Secondary aims included evaluating the effect of patient characteristics (body weight and species) on sonographic results and whether lesion type or location affected mortality. Most lesions causing septic peritonitis (70.2%) were gastrointestinal in origin and were nonneoplastic ulcerations or perforations (50%). Abdominal ultrasound diagnosed 56.3% of cases of subsequently confirmed septic peritonitis and correctly identified 67% of the causative lesions. Lesions of the gastrointestinal tract and ulcerations/perforations were the most frequent correct sonographic diagnoses and most likely to lead to a correct sonographic diagnosis of septic peritonitis. Lesions located in the hepatobiliary system and lesion types other than neoplasia or ulcerations/perforations were the most frequently missed by abdominal ultrasound. Abdominal ultrasound often fails to diagnose septic peritonitis or the underlying causative lesion, and its accuracy depends on the affected organ and type of lesion.

Retrospective evaluation of plasma transfusions in dogs undergoing general anaesthesia: 85 cases (2017–2021)

ObjectiveTo describe the use of plasma transfusion in anaesthetized dogs, specifically the triggers for use, the population administered plasma, reported adverse events and human errors associated with transfusion. Study designRetrospective observational study. AnimalsA total of 85 client-owned dogs. MethodsA search of electronic transfusion and anaesthetic records at a university teaching hospital was performed to identify dogs administered plasma during the study period (January 2017 to June 2021). Data collected included signalment, surgical procedure, intraoperative triggers for transfusion, the type of plasma, rate of transfusion and the presence of transfusion reactions, human errors or deviation from transfusion guidelines. ResultsDuring this period, 85 dogs were administered plasma. Sepsis was diagnosed in 49/85 (58%) dogs, with 42/85 (49%) animals undergoing surgery for septic peritonitis. Perianaesthetic hypotension contributed to the decision to administer plasma in 67/85 (79%) dogs. In 33/85 (39%) dogs, hypotension was the only reason for transfusion, while 31/85 (36%) had other influencing factors, most commonly hypoproteinaemia. Fresh frozen plasma was administered in 95% of cases. Only 31% of transfusions were started at a slower ‘test dose’ rate and 79% of dogs administered boluses of plasma. No definite, probable or possible transfusion reactions were identified using current veterinary guidelines. Conclusions and clinical relevancePlasma transfusions were commonly administered to dogs presenting with sepsis for haemodynamic optimization. Clinicians often chose to bolus plasma instead of initiating transfusions at the recommended initial slow starting rate. No transfusion reactions were identified; however, some reactions may have been masked by the effects of general anaesthesia and/or have been difficult to recognize in this critically ill canine population.

Unraveling host-pathogen dynamics in a murine model of septic peritonitis induced by vancomycin-resistant Enterococcus faecium

ABSTRACT Vancomycin-resistant Enterococcus faecium (E. faecium) infection is associated with higher mortality rates. Previous studies have emphasized the importance of innate immune cells and signalling pathways in clearing E. faecium, but a comprehensive analysis of host-pathogen interactions is lacking. Here, we investigated the interplay of host and E. faecium in a murine model of septic peritonitis. Following injection with a sublethal dose, we observed significantly increased murine sepsis score and histological score, decreased weight and bacterial burden, neutrophils and macrophages infiltration, and comprehensive activation of cytokine-mediated signalling pathway. In mice receiving a lethal dose, hypothermia significantly improved survival, reduced bacterial burden, cytokines, and CD86 expression of MHC-II+ recruited macrophages compared to the normothermia group. A mathematical model constructed by observational data from 80 animals, recapitulated the host-pathogen interplay, and further verified the benefits of hypothermia. These findings indicate that E. faecium triggers a severe activation of cytokine-mediated signalling pathway, and hypothermia can improve outcomes by reducing bacterial burden and inflammation.

Lactate to Albumin Ratio Is Not Predictive of Outcome in Septic Dogs: A Retrospective Case-Control Study.

The objective of this study was to investigate the value of the lactate to albumin ratio (L:A) as a prognostic marker for mortality in septic dogs. A single-center retrospective case-control study based on clinical record review was conducted at an academic teaching hospital. All records were extracted for diagnoses of bacterial sepsis, septic peritonitis, septic shock, or septicemia between February 2012 and October 2021. The study included 143 dogs. The most commonly identified sepsis diagnoses in dogs were septic peritonitis (55%; 78/143), unclassified sepsis (20%), and sepsis secondary to wounds or dermatological conditions (10%; 15/143). Median lactate and albumin for all dogs at presentation were 2.80 mmol/L and 2.6 g/dL, respectively; the median L:A ratio was 1.22. No clinically or statistically significant differences in lactate (P = 0.631), albumin (P = 0.695), or L:A (P = 0.908) were found between survivors and nonsurvivors.

Morphological Characteristics of the Results of Experimental Modeling of Septic Peritonitis

Morphological Characteristics of the Results of Experimental Modeling of Septic Peritonitis

Left medial liver lobe torsion with secondary bicavitary effusion and septic peritonitis in a dog with an acute kidney injury following ovariohysterectomy

AbstractA 7‐month‐old, spayed, female, mixed breed dog was referred for a 3‐day duration of elevated liver enzymes, azotaemia, anorexia and lethargy following ovariohysterectomy. Bloodwork showed non‐regenerative anaemia, inflammatory leukogram, moderate thrombocytopenia, severe azotaemia, severe mixed hepatopathy, hyperbilirubinemia and hypoalbuminemia. Point‐of‐care ultrasound identified free fluid and a heterogeneous mass in the mid‐ventral abdomen. Septic peritonitis was confirmed on cytology, and abdominal exploratory with left medial liver lobectomy was performed. Histopathology identified submassive hepatic necrosis and bridging fibrosis with biliary reaction, confirming a liver lobe torsion. The dog recovered perioperatively, but remained hospitalised to receive dialysis for severe renal dysfunction. The dog was transitioned to outpatient dialysis for several treatments. Unfortunately, kidney function continued to decline after dialysis was discontinued, and humane euthanasia was performed approximately 2 months postoperatively. To the authors’ knowledge, this is the first reported case of liver lobe torsion following routine ovariohysterectomy in a dog.

Diagnostic utility of the total nucleated cell count for differentiation of septic and sterile peritoneal effusions in dogs.

Rapid and accurate diagnosis of septic peritonitis is critical for initiating appropriate medical and surgical management. The aim of this study was to determine the diagnostic utility of the total nucleated cell count (TNCC), absolute neutrophil count, neutrophil percentage, and total protein (TP) to distinguish septic versus non-septic peritoneal effusions in dogs. Electronic medical records were retrospectively searched for peritoneal fluid samples from 2008 to 2018 and classified as septic or non-septic based on bacterial culture and/or cytology results. Receiver operator characteristic curves (ROCs) were used to describe the overall diagnostic utility of each test, with optimal cutpoints analyzed to dichotomize continuous variables. Positive and negative likelihood ratios were calculated at these cutpoints. A total of 166 unique samples, including 87 septic and 79 non-septic peritoneal effusions, were included. There were no significant differences in dog sex, age, or days hospitalized between groups. Septic effusions had significantly higher TP, TNCC, absolute neutrophil count, and neutrophil percentage compared with non-septic effusions. The area under the curve of the ROC curves was TNCC (0.80), absolute neutrophil count (0.80), neutrophil percentage (0.64), and TP (0.63). For TNCC and absolute neutrophil count, optimal cutoffs were 17.13 × 103 cells/μL and 19.88 × 103 cells/μL, resulting in positive and negative likelihood ratios of 2.39 and 0.28 and 2.85 and 0.28, respectively. Total nucleated cell counts and absolute neutrophil counts aid in the differentiation of septic and non-septic peritoneal effusions with similar diagnostic utility but are not sufficiently sensitive or specific to use without concurrent microscopic evaluation.

Use of liposomal bupivacaine in dogs and cats undergoing gastrointestinal surgery is not associated with a higher rate of surgical site infections or multidrug-resistant infections.

To report the rate of surgical site infections (SSIs) after clean-contaminated and dirty gastrointestinal surgery in dogs and cats that did and did not receive incisional infiltration of Nocita and report the bacteria isolated. Client-owned dogs (n = 211) and cats (78). Records of dogs and cats that underwent gastrointestinal surgery at the Matthew J. Ryan Veterinary Hospital of the University of Pennsylvania and the University of Florida Small Animal Hospital between July 1, 2020, and April 1, 2023, were reviewed for surgical procedures, presence of preoperative septic peritonitis, use of Nocita, perioperative antibiotics administered, postoperative antibiotic use, SSI development postoperatively, and aerobic bacteria isolated. 7 of 124 (5.6%) dogs that received Nocita and 9 of 87 (10.2%) that did not receive Nocita developed an SSI. No dogs presenting with septic peritonitis and given Nocita (n = 5) developed an SSI. Two of 55 (3.6%) cats that received Nocita and 1 of 23 (4%) that did not receive Nocita developed an SSI. Multidrug-resistant (MDR) Escherichia coli was the most common aerobic bacteria isolated from SSIs (n = 3), and MDR bacteria were isolated commonly from both groups (4). Use of Nocita for gastrointestinal surgery in dogs and cats is not associated with higher rates of SSI than published rates of SSI after gastrointestinal surgery. Use of Nocita in dogs with preoperative septic peritonitis is not associated with the development of SSI. MDR bacteria are commonly isolated via culture from both dogs that received Nocita and those that did not.

Pancreatitis associated with Mycoplasma felis infection in a cat

Case summary A 7-year-old domestic shorthair cat was presented for periuria, apathy, fever, inappetence, diarrhoea and vomiting. A complete blood count and biochemistry analysis revealed severe thrombocytopenia, severe azotaemia, moderate panhypoproteinemia, mildly elevated DGGR lipase activity and mildly elevated liver enzyme activity. Abdominal ultrasound showed a hypoechoic pancreas with surrounding hyperechoic fat demonstrating dirty shadowing and ascites (protein-poor transudate). The cat was treated medically for pancreatitis with fluid therapy, antiemetics and pain medication. During the hospitalisation period, the cat developed severe anaemia and received multiple whole blood transfusions yet showed no signs of clinical improvement. A repeat ultrasound examination performed after 8 days showed progressive pancreatic lesions and ongoing ascites. Analysis of the free abdominal fluid revealed neutrophilic inflammation despite low protein and cell concentration, with the presence of numerous very small, coccoid, basophilic inclusions within neutrophils, raising the concern for a septic peritonitis due to Mycoplasma species. Quantitative PCR (qPCR) confirmed the presence of Mycoplasma felis. After 10 days of hospitalisation, the cat developed refractory septic shock and was euthanased. Necropsy revealed severe necrotising pancreatitis with systemic changes consistent with sepsis and microthrombi. qPCR testing for M felis in pancreatic tissue also yielded a positive result. Relevance and novel information Although pancreatitis is a common disease in cats, this case report presents the first documented occurrence of M felis as the suspected primary pathogen causing pancreatitis in a cat.

Visualizing neutrophil extracellular traps in septic equine synovial and peritoneal fluid samples using immunofluorescence microscopy.

Septic synovitis and peritonitis are routinely diagnosed in horses based on clinical examination findings and laboratory assessment of synoviocentesis and abdominocentesis samples, respectively. Diagnosis is difficult in some cases because of an overlap in laboratory results for septic and non-septic inflammation. Neutrophil extracellular trap (NET) formation is part of the innate immune response against pathogens. Identifying and quantifying NETs, which have not been explored in clinical samples from horses with septic synovitis and peritonitis, to our knowledge, may be helpful in detecting infectious processes. Our main objective was to determine whether NETs could be visualized in septic equine synovial and peritoneal fluid cytology samples using immunofluorescence with antibodies against citrullinated histone H3 (Cit-H3) and myeloperoxidase (MPO). We analyzed 9 synovial and 4 peritoneal fluid samples. NET percentages were quantified using a simple counting technique, which is suitable for high-quality, well-preserved, and stained cytospin smears. NETs were evident in all septic samples and were absent in a non-septic sample; NETs were better visualized with Cit-H3 than with MPO immunolabeling. Overall, we believe that there is the potential for NETs and associated markers to be used to investigate and understand septic inflammation in horses.

A review of prevention and management of castration complications

SummaryDespite castration being one of the most frequently performed elective equine surgical procedures, complication rates are high and range from severe life‐threatening conditions to mild complications that are of no consequence to the horse. This article will briefly review strategies to prevent complications and surgical castration techniques before reviewing, in‐depth, the following complications: excessive scrotal swelling and seroma formation, scrotal infection, septic funiculitis, septic peritonitis, haemorrhage, evisceration, omental prolapse, pyrexia, tetanus, penile trauma, hydrocele, signs of colic and continued stallion‐like behaviour. Whilst this list of complications can be daunting, an understanding of male anatomy, castration techniques and an awareness of possible complications can reduce both the incidence and mortality of complications, should they occur. This article will consider castrations performed in both a hospital and field setting and will review complication prevention, surgical techniques of castration and the management of intraoperative and postoperative complications.