Short-term outcome of equine emergency admissions at a university referral hospital.

REASONS FOR PERFORMING STUDY: Obtaining data on emergency admission survival rates is important to provide clients with an estimate of prognosis and to identify areas in which improvements in case management can be achieved. OBJECTIVE: To determine the short-term outcome of equine emergency admissions to a university referral hospital during a 12 month period. METHODS: Short-term outcome was defined as survival to discharge or died/euthanasia during hospitalisation. The overall death (euthanasia) rate was calculated; and rate for horses with different categories of: age; admission month, day and time; presenting complaint (PC); duration of clinical signs prior to presentation; clinical pathology abnormalities; and therapy/therapeutic-related procedures performed was recorded. RESULTS: There were 918 admissions. The overall death rate was 24%. Foals (34%) and geriatric (40%) subjects had a death rate that was higher than that for mature horses (21%, referent). The death rate was highest in March (37%). Horses with a PC categorised as neurological (46%) or neonatal (41%) had the highest and as ophthalmological (5%) or trauma/skin (13%) the lowest death rates. There was no difference in death rate between different admission days or times or the duration of clinical signs prior to presentation. The death rates for horses with abnormal peritoneal fluid (71%), coagulopathy (63%), acid-base abnormalities (52%), hypoproteinaemia (47%), dehydration (43%), hypoxia/hypercapnia (48%), leucopenia (44%), electrolyte abnormalities (39%), hyperlactataemia (39%) or azotaemia (35%) were high. The death rate for horses treated with intranasal oxygen (57%), plasma (34%) or polymixin B (35%) was high and for horses undergoing laceration repair/joint (0%) or synovial cavity lavage (4%) was low. CONCLUSIONS: Age and critical illness were important contributing factors to a higher death rate. POTENTIAL RELEVANCE: Improving the understanding of disease processes in and developing treatment strategies for neonatal and geriatric patients as well as critically ill patients is required.

Streptococcal toxic shock in a horse.

A 14-year-old horse was admitted to the veterinary hospital for treatment of tachycardia and lethargy. Initial diagnoses were ventricular tachycardia and renal dysfunction. During hospitalization other findings included fever, renal failure, hepatic failure, hypotension, and intermittent ventricular arrhythmias. Bacteriologic culture of 2 blood samples collected during febrile crises 7 days apart yielded Streptococcus mitis. These culture results along with other clinical and physical examination findings fulfill the criteria for a diagnosis of streptococcal toxic shock syndrome, previously described for humans and dogs. To our knowledge this is the first reported instance of this disease in a horse.