Treatment approaches to horses with acute diarrhea admitted to referral institutions: A multicenter retrospective study

Diego E. Gomez; Jamie J. Kopper; David P. Byrne; David L. Renaud; Angelika Schoster; Bettina Dunkel; Luis G. Arroyo; Anna Mykkanen; William F. Gilsenan; Tina H. Pihl; Gabriela Lopez-Navarro; Brett S. Tennent-Brown; Laura D. Hostnik; Mariano Mora-Pereira; Fernando Marques; Jenifer R. Gold; Sally L. DeNotta; Isabelle Desjardins; Allison J. Stewart; Taisuke Kuroda; Emily Schaefer; Olimpo J. Oliver-Espinosa; Gustavo Ferlini Agne; Benjamin Uberti; Pablo Veiras; Katie M. Delph Miller; Rodolfo Gialleti; Emily John; Ramiro E. Toribio

doi:10.1371/journal.pone.0313783

Treatment approaches to horses with acute diarrhea admitted to referral institutions: A multicenter retrospective study

Diego E. Gomez, Jamie J. Kopper, David P. Byrne, David L. Renaud, Angelika Schoster, Bettina Dunkel, Luis G. Arroyo, Anna Mykkanen, William F. Gilsenan, Tina H. Pihl, Gabriela Lopez-Navarro, Brett S. Tennent-Brown, Laura D. Hostnik, Mariano Mora-Pereira, Fernando Marques, Jenifer R. Gold, Sally L. DeNotta, Isabelle Desjardins, Allison J. Stewart, Taisuke KurodaEmily Schaefer, Olimpo J. Oliver-Espinosa, Gustavo Ferlini Agne, Benjamin Uberti, Pablo Veiras, Katie M. Delph Miller, Rodolfo Gialleti, Emily John, Ramiro E. Toribio^*

^*Corresponding author for this work

Section for Medicine and Surgery

Research output: Contribution to journal › Journal article › Research › peer-review

Abstract

Background This study aimed to describe and compare therapeutic approaches for horses with acute diarrhea in different geographic regions worldwide. Methods Clinical information was retrospectively collected from diarrheic horses presented to participating institutions between 2016 and 2020, including fluid therapy on admission, antimicrobial drugs, probiotics, anti-endotoxic medications, anti-inflammatory drugs, gastroprotectants, digital cryotherapy, and toxin-binding agents. Seasonal and geographic differences were investigated. Results 1438 horses from 26 participating hospitals from 5 continents were included. On admission, 65% (926/1419) of horses were administered a fluid bolus. Antimicrobial drugs were administered to 55% (792/1419) within the first 24 hours of admission, with penicillin and gentamicin being the most used combination (25%, 198/792). Horses with leukopenia (OR: 2.264, 95%CI: 1.754 to 2.921; P<0.001) or meeting systemic inflammatory response syndrome criteria (OR: 2.542, 95%CI: 1.919 to 3.368; P<0.001) had higher odds of being administered antimicrobial drugs. Other treatments administered included probiotics (15%, 215/1438), polymyxin B (13%; 187/1438), pentoxifylline (8%; 118/1438), gastroprotectants (44%; 626/ 1419), digital cryotherapy (34%; 489/1435), plasma transfusion (13%; 182/1410) and toxin-binding agents (36%; 515/1438). Limitations Due to the retrospective nature of the study, the rationale for treatment decisions was unavailable, and associations with survival could not be evaluated. Conclusions Treatments varied between hospitals from different geographic regions. Prospective clinical trials are required to evaluate the effects of various treatments on survival.

Original language	English
Article number	e0313783
Journal	PLoS ONE
Volume	19
Issue number	11
Number of pages	19
ISSN	1932-6203
DOIs	https://doi.org/10.1371/journal.pone.0313783
Publication status	Published - 2024

Bibliographical note

Publisher Copyright:
© 2024 Gomez et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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Cite this

Gomez, D. E., Kopper, J. J., Byrne, D. P., Renaud, D. L., Schoster, A., Dunkel, B., Arroyo, L. G., Mykkanen, A., Gilsenan, W. F., Pihl, T. H., Lopez-Navarro, G., Tennent-Brown, B. S., Hostnik, L. D., Mora-Pereira, M., Marques, F., Gold, J. R., DeNotta, S. L., Desjardins, I., Stewart, A. J., ... Toribio, R. E. (2024). Treatment approaches to horses with acute diarrhea admitted to referral institutions: A multicenter retrospective study. PLoS ONE, 19(11), Article e0313783. https://doi.org/10.1371/journal.pone.0313783

Gomez, DE, Kopper, JJ, Byrne, DP, Renaud, DL, Schoster, A, Dunkel, B, Arroyo, LG, Mykkanen, A, Gilsenan, WF, Pihl, TH, Lopez-Navarro, G, Tennent-Brown, BS, Hostnik, LD, Mora-Pereira, M, Marques, F, Gold, JR, DeNotta, SL, Desjardins, I, Stewart, AJ, Kuroda, T, Schaefer, E, Oliver-Espinosa, OJ, Agne, GF, Uberti, B, Veiras, P, Delph Miller, KM, Gialleti, R, John, E & Toribio, RE 2024, 'Treatment approaches to horses with acute diarrhea admitted to referral institutions: A multicenter retrospective study', PLoS ONE, vol. 19, no. 11, e0313783. https://doi.org/10.1371/journal.pone.0313783

@article{0e2c0696e3754617860f4d2e187438ae,

title = "Treatment approaches to horses with acute diarrhea admitted to referral institutions: A multicenter retrospective study",

abstract = "Background This study aimed to describe and compare therapeutic approaches for horses with acute diarrhea in different geographic regions worldwide. Methods Clinical information was retrospectively collected from diarrheic horses presented to participating institutions between 2016 and 2020, including fluid therapy on admission, antimicrobial drugs, probiotics, anti-endotoxic medications, anti-inflammatory drugs, gastroprotectants, digital cryotherapy, and toxin-binding agents. Seasonal and geographic differences were investigated. Results 1438 horses from 26 participating hospitals from 5 continents were included. On admission, 65% (926/1419) of horses were administered a fluid bolus. Antimicrobial drugs were administered to 55% (792/1419) within the first 24 hours of admission, with penicillin and gentamicin being the most used combination (25%, 198/792). Horses with leukopenia (OR: 2.264, 95%CI: 1.754 to 2.921; P<0.001) or meeting systemic inflammatory response syndrome criteria (OR: 2.542, 95%CI: 1.919 to 3.368; P<0.001) had higher odds of being administered antimicrobial drugs. Other treatments administered included probiotics (15%, 215/1438), polymyxin B (13%; 187/1438), pentoxifylline (8%; 118/1438), gastroprotectants (44%; 626/ 1419), digital cryotherapy (34%; 489/1435), plasma transfusion (13%; 182/1410) and toxin-binding agents (36%; 515/1438). Limitations Due to the retrospective nature of the study, the rationale for treatment decisions was unavailable, and associations with survival could not be evaluated. Conclusions Treatments varied between hospitals from different geographic regions. Prospective clinical trials are required to evaluate the effects of various treatments on survival.",

author = "Gomez, {Diego E.} and Kopper, {Jamie J.} and Byrne, {David P.} and Renaud, {David L.} and Angelika Schoster and Bettina Dunkel and Arroyo, {Luis G.} and Anna Mykkanen and Gilsenan, {William F.} and Pihl, {Tina H.} and Gabriela Lopez-Navarro and Tennent-Brown, {Brett S.} and Hostnik, {Laura D.} and Mariano Mora-Pereira and Fernando Marques and Gold, {Jenifer R.} and DeNotta, {Sally L.} and Isabelle Desjardins and Stewart, {Allison J.} and Taisuke Kuroda and Emily Schaefer and Oliver-Espinosa, {Olimpo J.} and Agne, {Gustavo Ferlini} and Benjamin Uberti and Pablo Veiras and {Delph Miller}, {Katie M.} and Rodolfo Gialleti and Emily John and Toribio, {Ramiro E.}",

note = "Publisher Copyright: {\textcopyright} 2024 Gomez et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.",

year = "2024",

doi = "10.1371/journal.pone.0313783",

language = "English",

volume = "19",

journal = "PLoS ONE",

issn = "1932-6203",

publisher = "Public Library of Science",

number = "11",

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TY - JOUR

T1 - Treatment approaches to horses with acute diarrhea admitted to referral institutions

T2 - A multicenter retrospective study

AU - Gomez, Diego E.

AU - Kopper, Jamie J.

AU - Byrne, David P.

AU - Renaud, David L.

AU - Schoster, Angelika

AU - Dunkel, Bettina

AU - Arroyo, Luis G.

AU - Mykkanen, Anna

AU - Gilsenan, William F.

AU - Pihl, Tina H.

AU - Lopez-Navarro, Gabriela

AU - Tennent-Brown, Brett S.

AU - Hostnik, Laura D.

AU - Mora-Pereira, Mariano

AU - Marques, Fernando

AU - Gold, Jenifer R.

AU - DeNotta, Sally L.

AU - Desjardins, Isabelle

AU - Stewart, Allison J.

AU - Kuroda, Taisuke

AU - Schaefer, Emily

AU - Oliver-Espinosa, Olimpo J.

AU - Agne, Gustavo Ferlini

AU - Uberti, Benjamin

AU - Veiras, Pablo

AU - Delph Miller, Katie M.

AU - Gialleti, Rodolfo

AU - John, Emily

AU - Toribio, Ramiro E.

N1 - Publisher Copyright: © 2024 Gomez et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

PY - 2024

Y1 - 2024

N2 - Background This study aimed to describe and compare therapeutic approaches for horses with acute diarrhea in different geographic regions worldwide. Methods Clinical information was retrospectively collected from diarrheic horses presented to participating institutions between 2016 and 2020, including fluid therapy on admission, antimicrobial drugs, probiotics, anti-endotoxic medications, anti-inflammatory drugs, gastroprotectants, digital cryotherapy, and toxin-binding agents. Seasonal and geographic differences were investigated. Results 1438 horses from 26 participating hospitals from 5 continents were included. On admission, 65% (926/1419) of horses were administered a fluid bolus. Antimicrobial drugs were administered to 55% (792/1419) within the first 24 hours of admission, with penicillin and gentamicin being the most used combination (25%, 198/792). Horses with leukopenia (OR: 2.264, 95%CI: 1.754 to 2.921; P<0.001) or meeting systemic inflammatory response syndrome criteria (OR: 2.542, 95%CI: 1.919 to 3.368; P<0.001) had higher odds of being administered antimicrobial drugs. Other treatments administered included probiotics (15%, 215/1438), polymyxin B (13%; 187/1438), pentoxifylline (8%; 118/1438), gastroprotectants (44%; 626/ 1419), digital cryotherapy (34%; 489/1435), plasma transfusion (13%; 182/1410) and toxin-binding agents (36%; 515/1438). Limitations Due to the retrospective nature of the study, the rationale for treatment decisions was unavailable, and associations with survival could not be evaluated. Conclusions Treatments varied between hospitals from different geographic regions. Prospective clinical trials are required to evaluate the effects of various treatments on survival.

AB - Background This study aimed to describe and compare therapeutic approaches for horses with acute diarrhea in different geographic regions worldwide. Methods Clinical information was retrospectively collected from diarrheic horses presented to participating institutions between 2016 and 2020, including fluid therapy on admission, antimicrobial drugs, probiotics, anti-endotoxic medications, anti-inflammatory drugs, gastroprotectants, digital cryotherapy, and toxin-binding agents. Seasonal and geographic differences were investigated. Results 1438 horses from 26 participating hospitals from 5 continents were included. On admission, 65% (926/1419) of horses were administered a fluid bolus. Antimicrobial drugs were administered to 55% (792/1419) within the first 24 hours of admission, with penicillin and gentamicin being the most used combination (25%, 198/792). Horses with leukopenia (OR: 2.264, 95%CI: 1.754 to 2.921; P<0.001) or meeting systemic inflammatory response syndrome criteria (OR: 2.542, 95%CI: 1.919 to 3.368; P<0.001) had higher odds of being administered antimicrobial drugs. Other treatments administered included probiotics (15%, 215/1438), polymyxin B (13%; 187/1438), pentoxifylline (8%; 118/1438), gastroprotectants (44%; 626/ 1419), digital cryotherapy (34%; 489/1435), plasma transfusion (13%; 182/1410) and toxin-binding agents (36%; 515/1438). Limitations Due to the retrospective nature of the study, the rationale for treatment decisions was unavailable, and associations with survival could not be evaluated. Conclusions Treatments varied between hospitals from different geographic regions. Prospective clinical trials are required to evaluate the effects of various treatments on survival.

U2 - 10.1371/journal.pone.0313783

DO - 10.1371/journal.pone.0313783

M3 - Journal article

C2 - 39565809

AN - SCOPUS:85209734576

SN - 1932-6203

VL - 19

JO - PLoS ONE

JF - PLoS ONE

IS - 11

M1 - e0313783

ER -