Toxic Shock (Sepsis, Septicemia and Bacteremia) in Dogs

Septicemia, sepsis, septic shock, and septic inflammatory response syndrome (SIRS) are potentially life threatening related conditions that occur after the body has been infected with a bacteria, virus, fungus, or protozoa. Non-bacterial causes of septicemia are rare.

Transient bacteremia sometimes occurs after procedures such as dental cleanings or during minor GI disease, but those bacteria are typically cleared from the bloodstream quickly and sepsis does not occur. If the body is unable to clear the bacteria, a more significant bacteremia and subsequent sepsis occurs.

Septicemia specifically refers to bacteria, or their toxins, in the bloodstream.

Sepsis is the body's extreme inflammatory response to infection.

Septic shock also known as toxic shock, refers to a severe form of sepsis that includes low blood pressure that responds poorly to attempts at correction.

SIRS is defined by a set of criteria that include unfavorable changes in body temperature, heart rate, respiratory rate, and white blood cell count.

These related conditions can be thought of as worsening states of infection and inflammation and are life threatening emergencies that require immediate intervention.

As the infection and inflammatory response worsens, symptoms also get more severe.

Multiorgan dysfunction syndrome may occur in severe cases. Left untreated, septic infections are likely to be fatal.

Infections can develop under a variety of circumstances and any infection has the potential to become septic. Dogs with pre-existing conditions, particularly those which impact the immune system, are at higher risk of developing sepsis from minor infections or illness. Improper wound management and hygiene following surgery or injury are also risk factors for sepsis.

Any introduction of infection into the bloodstream has the potential to cause septicemia, sepsis, septic shock, or SIRS. Common causes of all conditions include surgery on an infected or contaminated area of the body, overwhelming infection anywhere in the body, or insertion of a foreign object into the bloodstream (such as an intravenous catheter or drain). Animals with a compromised immune system have a greater chance of developing sepsis, septic shock, and SIRS. The chances of developing all conditions is increased the longer the foreign object is left in place.

Transient bacteremia has no symptoms while severe sepsis can have severe complications.

Immediate diagnosis and treatment is imperative for survival.

DIagnostics include:

• Blood work
• Blood pressure monitoring
• Urinalysis
• Blood culture
• Diagnostic imaging

Cultures from the site of original infection are performed if applicable.

The mainstay of treatment is antibiotic therapy. Additional therapy is aimed at correcting the changes caused by the body's inflammatory responses and providing adequate nutrition during recovery. In some cases, such as an infection in the uterus, surgical intervention is needed to remove the source of infection.

Time of initial diagnosis to discharge from the hospital varies based on where the infection is, how stable the animal is overall, and how well the infection responds to treatment. Dogs with sepsis can survive with immediate, aggressive intervention. Accurate mortality rates for septic veterinary patients is lacking, but estimates are reported between 20-68%.

Prevention includes reducing underlying predisposing causes. A common cause of sepsis in dogs is a uterine infection which can be prevented if the dog is spayed. In many cases sepsis is a result of the immune system's inability to respond to an overwhelming infection and there is no prevention.

There are no accurate estimates of prevalence in veterinary literature.

• Antibiotics
• Nutritional support
• Supportive care