Treatment:

• Principles of treatment of endotoxemia is aimed at:

1. Removal of foci of infection
2. Administration of antibiotics
3. Aggressive fluid and electrolyte therapy
4. NSAID or corticosteroids to reduce products of cyclooxygenase pathway

1. Removal of foci of infection:

• Bacterial toxins present in body system should be eliminated and infection foci should be removed.
• In case of ingestion of toxin, activated charcoal can be used to adsorb toxin preventing its absorption to bloodstream.
• Gastric lavage can be carried out in case of ingestion or hemodialysis in case of blood infection

2. Administration of antibiotics:

• Β-lactam antibiotics or aminoglycosides are useful in controlling bacterial infection and killing bacteria.
• NSAID should also be administered concurrently to remove inflammatory products and reduces pain, swelling in body.

3. Aggressive fluid and electrolyte therapy:

• Maintenance of peripheral tissue perfusion is important in treatment of endotoxemia.
• Large amount of isotonic fluids such as ringer’s lactate solution or other balanced fluid should be administered continuously over hours
• Hypertonic salines such as 7.5% NaCl rapidly increases blood volume, tissue perfusion and gives rapid response than isotonic fluids.

4. Administration of NSAID:

• These drugs suppress the production of thromboxane and prostaglandin and reduce acute hemodynamic response to endotoxemia
• Flunixin meglumine is most commonly used NASID in treatment of horses and cattle. Dose: 1.1-2.2 mg/kg, b.wt. IV/IM OD for 5 days’ maximum. In horse, it is administered @ 1.1 mg/kg, b.wt., BID, IV/IM
• Corticosteroid; dexamethasone @ 1mg/kg, b.wt., IV, OD improves tissue perfusion, decreases activation of complement, decrease neutrophil aggregation, protect against hepatic injury.