Acute thrombosis of limb arteries in horses with sepsis: five cases (1988–1998)

Abstract

Summary A hypercoagulable condition and poor perfusion to distal extremities might occur during equine endotoxaemic or septic shock, which could cause thrombosis of limb arteries. In our review, thrombosis occurred in neonatal foals in association with Gram‐negative bacteraemia. In 3 olderfoals and adults, thrombosis was associated with inflammatory bowel disease, diarrhoea and toxaemia. All patients had been treated with broad‐spectrum antibiotics, nonsteroidal anti‐inflammatory drugs and i.v. crystalloid solutions. Two horses received i.v. hyperimmune plasma. A generalised coagulopathy was not suspected prior to clinical signs of distal limb necrosis, although thrombocytopenia occurred in 4 of the 5 cases at the time of, or shortly before, thrombosis. Thrombocytopenia, possibly due to platelets adherence to exposed subendothelial collagen, which induces contact activation of the intrinsic coagulation pathway, has been described in endotoxaemic horses and foals with gastrointestinal infectious or inflammatory diseases and disseminated intravascular coagulation. Activation of procoagulants by endotoxins, decreased blood flow to the limbs and endothelial damage, may have been responsible for a hypercoagulable condition leading to thrombosis in these 5 cases. The 3 enterocolitis patients may have had increased risk of thrombosis because of loss of antithrombin III, haemoconcentration and acidosis.

Fibrin Deposits and Organ Failure in Newborn Foals with Severe Septicemia

“…The physiologic response to inflammation and sepsis includes activation of the coagulation system and inhibition of fibrinolysis. This may initiate a hypercoagulable state responsible for acute thrombosis in horses, 1,39 as well as MODS and death 39,40 . In this study, nonsurviving septic neonates had fibrin deposits in several tissues, which is consistent with presence of a hypercoagulable state.…”

Spontaneous hoof capsule loss following lacerations of the equine distal limb

“…), suggesting that other factors such as reactive vasoconstriction or hypercoaguability, in addition to inflammation and infection, may probably be required to induce spontaneous hoof capsule loss. Septicaemia and a hypercoagulable condition have already been reported to cause acute thrombosis of distal limb arteries and hoof slough in young foals (Brianceau and Divers ).…”

Consequences of endocarditis in an adult cow with a ventricular septal defect

“…Lameness due to an arterial thromboembolism (ATE) has been described in horses (Brianceau and Divers 2001) and cats (Smith and Tobias 2004). In cats with ATE, the presence of concurrent cardiac disease is the most common risk factor for ATE development and there is evidence that blood stasis is needed for the thrombus formation, which could have occurred near the tricuspid valve in this cow due to the VSD.…”