BackgroundDespite its widespread use in equine medicine, the clinical value of the systemic inflammatory response syndrome (SIRS) concept in horses remains unknown.ObjectivesTo study the prognostic value of measures of SIRS in horses and identify the best model of severe SIRS to predict outcome.AnimalsA total of 479 consecutive adult horse emergency admissions to a private primary referral practice.MethodsProspective observational study. All adult horses admitted for emergency treatment over the study period were included. Multivariate logistic regression and stepwise model selection were used.ResultsEach of the 4 SIRS criteria was associated with outcome in this population. Thirty‐one percent of emergency cases had 2 or more abnormal SIRS criteria on admission and were defined as SIRS cases. SIRS was associated with increased odds of death (odds ratio [OR] = 8.22; 95% CI, 4.61–15.18; P < .001), an effect mainly found for acute gastrointestinal cases. SIRS cases were assigned a SIRS score of 2, 3, or 4, according to the number of abnormal SIRS criteria fulfilled on admission, and SIRS3 and SIRS4 cases had increased odds of death compared to SIRS2 cases (OR = 4.45; 95% CI, 1.78–11.15; P = .002). A model of severe SIRS including the SIRS score, blood lactate concentration, and color of the mucous membranes best predicted outcome in this population of horses.Conclusions and Clinical ImportanceSystemic inflammatory response syndrome is associated with an increased risk of death in adult horses presenting with acute gastrointestinal illnesses. The model of severe SIRS proposed in this study could be used to assess the status and prognosis of adult equine emergency admissions.

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Administration of S. boulardii may help decrease the severity and duration of clinical signs in horses with acute enterocolitis.

BackgroundBand cells and toxic neutrophils are thought to indicate acute and severe systemic illness but no studies have investigated their importance in adult equine emergency admissions.ObjectivesThe objective of this study was to evaluate the association of band cells and toxic neutrophils with systemic inflammatory response syndrome (SIRS) and outcome in horses.AnimalsOne hundred and five adult horses admitted on emergency basis to a private primary referral practice.MethodsProspective observational study with sample collection. All horses admitted on emergency basis over the study period were included in the study if they had a CBC and a blood smear collected on admission.ResultsThe detection of band neutrophils on admission was associated with the SIRS status of the horse (RR = 2.80; 95% CI = 1.57–4.99; P < .001) and with poor outcome (RR = 1.88; 95% CI: 1.05–3.37; P = .038). Similarly, the presence of a neutrophil toxic grade higher than 3 was associated with SIRS (RR = 1.71; 95% CI: 1.03–2.82; P = .034) and death (RR = 2.34; 95% CI: 1.22–4.50, P = .007). The information gained from the blood smear review could not be captured by looking at only the WBC or neutrophil count.Conclusions and Clinical ImportanceThe microscopic review of blood smears from critically ill horses to detect band cells or neutrophil toxic change is valuable and could help in assessing disease severity and prognosis in adult equine emergency admissions.