Disseminated Intravascular Coaggulopathy (DIC)
Disseminated intravascular coaggulopathy is a systemic condition that is characterized by the formation of ________________ throughout the vasculature.
DIC is caused by systemic infection, most commonly _________________ infections.
Infective agents cause systemic damage to the epithelial lining of the blood vessels. This results in the formation of multiple microthrombi that partially occlude the lumen of the blood vessels. Reduced perfusion leads to ischemic damage of the body tissues. In addition to ischemic damage, DIC uses up thrombocytes faster than they can be produced causing a deficit in the number of circulating thrombocytes, or thrombocytopenia. Without sufficient numbers of circulating thrombocytes there is an increased chance of ________________ into the tissues. Disseminated intravascular coaggulopathy is seen clinically as poor performance, _____________ , exercise induced pulmonary haemorrhage, thrombocytopenia, petechia into the mucous membranes, kidney failure and colic. Diagnosis is made through clinical signs and symptoms and through blood analysis showing infection and thrombocytopenia. Treatment includes heparin, IV fluids, and treatment for the underlying infection. Corticosteroids can be administered after the infection is resolved to promote the regeneration of thrombocytes.
Prognosis is guarded as _____________ is a possible outcome with DIC.
Endotoxemia
Endotoxemia is caused by the release of a lipopolysaccharide molecule called _______________.
Lipid A is found in the cell wall of Gram-negative bacteria, and acts as a toxin if it enters the horse’s blood stream. Gram-negative bacteria are normally found in the cecum of horses. If the conditions within the cecum become too _____________ the bacteria undergo bacteriolysis, releasing lipid A into the lumen of the cecum. If there is only a small amount of lipid A free in the cecum the mucus lining the wall of the cecum prevent lipid A from diffusing into the blood. If there is excessive amount of lipid A in the cecum the cecum wall becomes inflamed, weakening the protective layer of mucus. Lipid A diffuses across the wall of the cecum into the blood stream where it causes vasoconstriction and ischemia, followed rapidly by vasodilation and re-perfusion, which causes the formation of microthrombi in the peripheral vasculature. Gastrointestinal disease, septicemia and excessive intake of carbohydrate rich feeds such as wheat and barley predispose a horse for endotoxemia as these conditions are likely to cause bacteriolysis.
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