Objective—To determine clinical features of horses
with bacterial meningitis or brain abscesses secondary
to infectious disease processes involving the
Animals—7 adult horses.
Procedure—Medical records of Tufts University, the
University of Pennsylvania, and the Livestock Disease
Diagnostic Center (Lexington, Ky) were reviewed to
identify adult (> 12 months old) horses in which a
postmortem diagnosis of bacterial meningitis or brain
abscess had been made. Horses were included in the
study if an intracranial infection was confirmed, the
horse had a primary infectious disease process involving
the head, and there were no signs of systemic
Results—23 adult horses with bacterial meningitis or
a brain abscess were examined during the study period,
but only 7 met the criteria for inclusion in the
study. Primary sites of infection included the
paranasal sinuses, nasal cavity, periocular tissues,
and submandibular lymph nodes. Three horses died
suddenly prior to hospitalization, and 1 horse was
hospitalized but died 7 days after the onset of neurologic
abnormalities. The remaining 3 horses were
euthanatized because of a rapid deterioration in clinical
Conclusions and Clinical Relevance—Although
rare, fatal intracranial complications can develop in
horses with infectious diseases involving the head.
(J Am Vet Med Assoc 2004;224:739–742)
PROCEDURES After collection of baseline clinical and historical data, dogs were randomly assigned to receive topically applied undiluted heterologous serum (n = 22) or isotonic saline (0.9% NaCl) solution (19) along with tobramycin and atropine. Epithelial debridement (at all visits) and grid keratotomy (at visits 2, 3, and 4) of SCCEDs were performed. Ophthalmic examination including fluorescein application was performed once weekly for 4 weeks or until corneal reepithelialization. Clinicians and owners were masked to treatment group.
RESULTS No differences in baseline data were detected between treatment groups. No difficulties with medication administration, noncompliance, or adverse reactions were noted. All SCCEDs in both groups healed by 4 weeks after treatment began. Median time to reepithelialization (2 weeks) was not significantly different between serum-treated and placebo-treated eyes. Irrespective of treatment group, median time to reepithelialization was not significantly different for Boxers versus non-Boxer breeds. Direct correlations were detected between time to reepithelialization and vascularization score at study entry, vascularization score at time of reepithelialization, and ulcer area at study entry in both groups. Time to reepithelialization was not correlated with age, sex, or duration of signs in either group.
CONCLUSIONS AND CLINICAL RELEVANCE Topical application of undiluted heterologous serum was well tolerated by dogs with SCCEDs but, as an adjunct to standard treatment, did not reduce time to corneal reepithelialization.
Recent state and federal legislative actions and current recommendations from the World Health Organization seem to suggest that, when it comes to antimicrobial stewardship, use of antimicrobials for prevention, control, or treatment of disease can be ranked in order of appropriateness, which in turn has led, in some instances, to attempts to limit or specifically oppose the routine use of medically important antimicrobials for prevention of disease. In contrast, the AVMA Committee on Antimicrobials believes that attempts to evaluate the degree of antimicrobial stewardship on the basis of therapeutic intent are misguided and that use of antimicrobials for prevention, control, or treatment of disease may comply with the principles of antimicrobial stewardship. It is important that veterinarians and animal caretakers are clear about the reason they may be administering antimicrobials to animals in their care. Concise definitions of prevention, control, and treatment of individuals and populations are necessary to avoid confusion and to help veterinarians clearly communicate their intentions when prescribing or recommending antimicrobial use.