Objective—To assess awareness, perceived relevance, and acceptance of surveillance and infection control practices at a large animal referral hospital among referring veterinarians and clients who sent horses to the facility for veterinary care.
Sample—57 referring veterinarians and 594 clients.
Procedures—A 15-question survey targeting Salmonella enterica as an important pathogen of interest in horses was sent to clients who sent ≥ 1 horse to the University of Florida Large Animal Hospital for veterinary care during July 1, 2007, through July 1, 2011, and to veterinarians who had referred horses to the same hospital prior to July 1, 2011. Responses were summarized with descriptive statistics. The χ2 test and the Wilcoxon rank sum test were used to examine associations among variables of interest.
Results—Survey response rates were low (57/467 [12%] for veterinarians and 594/3,095 [19%] for clients). Significantly more (35/56 [63%]) veterinarians than clients (227/585 [39%]) were aware that the hospital operates a surveillance and infection control program. Most veterinarians (56/57 [98%]) and clients (554/574 [97%]) indicated that sampling and testing of horses to detect Salmonella shedding in feces at admission and during hospitalization was justified. In addition, on a scale of 1 (not important) to 10 (very important), veterinarians and clients indicated it was very important (median score, 10 [interquartile range, 8 to 10] for both groups) that a referral hospital operates a surveillance and infection control program.
Conclusions and Clinical Relevance—Survey results indicated that awareness of hospital surveillance and infection control practices was higher among veterinarians than clients, and these practices were considered relevant and well-accepted among participant veterinarians and clients.
Objective—To examine the relationship between abdominal surgery and nosocomial Salmonella infections and the relationship between high caseload in combination with abdominal surgery and nosocomial Salmonella infections in hospitalized horses with signs of gastrointestinal tract disease.
Procedures—To accomplish the first objective, 1 to 4 control horses were matched with each nosocomial case horse on the basis of admission date of a primary case horse. The frequency of abdominal surgery and other investigated exposure factors were compared between nosocomial case horses and control horses. For the second objective, 4 control horses were matched with each nosocomial case horse on the basis of year of admission. The frequency of high caseload (≥ 26 inpatients), abdominal surgery, and other factors was compared between nosocomial case horses and control horses.
Results—The odds of nosocomial Salmonella infection were 8 times as high (odds ratio = 8.2; 95% confidence interval = 1.11, 60.24) in horses that underwent abdominal surgery, compared with the odds for horses that did not undergo surgery. High caseload alone or in combination with abdominal surgery was not associated with increased risk of nosocomial Salmonella infection.
Conclusions and Clinical Relevance—Abdominal surgery was identified as a risk factor for nosocomial Salmonella infections in horses. Horses that undergo abdominal surgery require enhanced infection control and preventative care. Risk of nosocomial Salmonella infections may be reduced by implementation of biosecurity measures (such as the use of plastic boots, gloves, and footbaths) immediately after surgery.
Case Description—13 equids (10 horses, 2 donkeys, and 1 pony) were examined for signs of colic (n = 7), weight loss (6), anorexia (3), and diarrhea (2). Ten equids were evaluated in the fall (September to November). Seven equids had a history of persimmon ingestion.
Clinical Findings—A diagnosis of phytobezoar caused by persimmon ingestion was made for all equids. Eight equids had gastric persimmon phytobezoars; 5 had enteric persimmon phytobezoars. Gastroscopy or gastroduodenoscopy revealed evidence of persimmon ingestion in 8 of 10 equids in which these procedures were performed.
Treatment and Outcome—2 of 13 equids were euthanatized prior to treatment. Supportive care was instituted in 11 of 13 equids, including IV administration of fluids (n = 8) and treatment with antimicrobials (5), NSAIDs (5), and gastric acid suppressants (4). Persimmon phytobezoar–specific treatments included dietary modification to a pelleted feed (n = 8); oral or nasogastric administration of cola or diet cola (4), cellulase (2), or mineral oil (2); surgery (4); and intrapersimmon phytobezoar injections with acetylcysteine (1). Medical treatment in 5 of 7 equids resulted in resolution of gastric persimmon phytobezoars. Seven of 8 equids with gastric persimmon phytobezoars and 1 of 5 equids with enteric persimmon phytobezoars survived > 1 year after hospital discharge.
Clinical Relevance—Historical knowledge of persimmon ingestion in equids with gastrointestinal disease warrants gastroduodenoscopy for evaluation of the presence of persimmon phytobezoars. In equids with gastric persimmon phytobezoars, medical management (including administration of cola or diet cola and dietary modification to a pelleted feed) may allow for persimmon phytobezoar dissolution.