Sepsis

RE: Sepsis

Anthony Dennison — Fri, 02 Mar 2018 11:04:43 GMT

I've seen a couple of cases within the last year.

One was a pyo that we thought had only been ill for a couple of days before presentation, but it turned out it had been draining pus for about 10 days prior. Never really recovered from it's GA, really flat, then went in to DIC - couldn't get any peripheral venous access, where we tried blood was coming out and bleeding through pressure bandages.

Other was a dog that had had a TTA on a Thursday, had been ok 24hrs post op but 72hrs post op was v flat, regurgitated his food. Temp 40degC and very flat. Turned out he had a duodenal ulcer that had perforated and he then went into SIRS.

Both pretty dramatic, both minimally responsive to everything we tried.

RE: Sepsis

Evelyn Barbour-Hill — Wed, 07 Feb 2018 23:13:48 GMT

[quote user="Utlendigur"]

I thought septicaemia was equivalent to a severe bacteraemia, and sepsis (or SIRS - systemic inflammatory response syndrome) was the excessive immune response to infection/inflammation or some other trigger.

[/quote]

Well, bacteraemia means bacteria in the bloodstream, and it happens all the time (when you brush your teeth for instance). Septicaemia means bacteria actively multiplying in the bloodstream.

Sepsis as I understand it just means pretty well the same as wound infection. Hence antiseptics, and the concepts of antiseptic surgery, aseptic surgery and so on. And as a little boy, ooh, little Johnny had a cut on his finger and it went septic..... give us a look Johnny, go on, errgh...

However lately "sepsis" seems to have been adopted to mean SIRS, something quite different, and now it's been seized upon by the excitable meeja I guess its meaning has been changed forever (as with "trauma" and "gay")

RE: Sepsis

Anthony Todd — Wed, 07 Feb 2018 21:40:30 GMT

What I was hoping would emerge is a way to distinguish from my B/S experience of one, post-op, going pale and depressed, with a lower temp which I assumed was internal haemorrhage from a slipped ligature.

Judging by descriptions in the press of children with sepsis, this could easily have been sepsis.

The treatments are different so I wonder how you do tell the difference.

RE: Sepsis

Utlendigur — Wed, 07 Feb 2018 19:07:55 GMT

RE: Sepsis

Bob Russell — Wed, 07 Feb 2018 15:05:32 GMT

I was somewhat confused and likened sepsis to septicaemia and even 'blood poisoning'.

Sepsis is an immune response to infection (really an over-reaction) that leads to tissue damage. Severity varies but the most severe is septic shock (presumably what happened to the bitch spay). At this stage (and was the state the dog arrived in) the prognosis is grave.

I have seen it in earlier stages with inhalation pneumonia.

I have seen two cases in decades and a patient developed probable sepsis during a stay in a local kennels, started with coughing. This one did OK but it was touch and go for the OOH's service and the referral practice.

RE: Sepsis

Julie Innes — Wed, 07 Feb 2018 14:09:53 GMT

Interesting. As I said on the other thread we had a similar case where the dog presented with v+/D+ and was dead a few hours later. Post mortem didn't really confirm a definitive cause other than severe necrohaemmorhagic GE, with possible enterotoxin involvement. I had never seen a dog go down this rapidly.

Sepsis seems to be a right buzzword in human medicine at the moment. I agree it's a little confusing- it is the same thing as septicaemia? Is DIC involved? I watched a webinar about "shock" recently and came away completely befuddled by new definitions for things!

RE: Sepsis

Anthony Todd — Tue, 06 Feb 2018 22:34:41 GMT

Sorry Bob, didn't see you'd already started a tangent, hope you get somewhere more than mine.....