Adrenal insufficiency in a neonatal foal.
Abstract: A 3-day-old female Pinto was admitted with profuse watery diarrhea and severe hypovolemic shock. After 1 week of intensive care, the foal developed seizures associated with profound serum electrolyte abnormalities suggestive of hypoadrenocorticism. Treatment with prednisone and isotonic saline (0.9% NaCl) solution led to prompt clinical response. Premature withdrawal of prednisone resulted in relapse of clinical signs. A diagnosis of adrenal insufficiency was made on the basis of clinical signs, electrolyte abnormalities, low baseline cortisol concentration, and lack of response to administration of exogenous adrenocorticotropin. Two months later, adrenocortical function was normal and the foal was doing well clinically. Clinical signs of acute adrenal insufficiency in neonatal foals can be confused with other conditions, such as septicemia, enteritis, and ruptured urinary bladder. A persistently low serum sodium-to-potassium ratio associated with CNS malfunction should warrant investigation of adrenal gland function. Acute hypoadrenocorticism in foals may be reversible.
Publication Date: 1998-05-30 PubMed ID: 9604031
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Summary
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The study discusses a case of adrenal insufficiency diagnosed in a 3-day-old foal that was initially presented with severe diarrhea and shock, developing seizures later. Post administering treatment and withdrawal of medication, adrenal function normalized and the foal recovered.
Case Presentation and Initial Symptoms
- A 3-day-old female Pinto foal was admitted showing symptoms of profuse watery diarrhea and severe hypovolemic shock, a condition characterized by severe blood and fluid loss.
Development of New Symptoms and Initial Treatment
- A week after admission and following intensive care, the foal developed seizures which were associated with severe abnormalities in the serum electrolytes, indicating a possibility of hypoadrenocorticism, a lack of corticosteroids in the body produced by the adrenal glands.
- As part of the initial treatment, the foal was administered with prednisone, a type of corticosteroid, and an isotonic saline solution which resulted in a rapid improvement of the clinical symptoms.
Withdrawal of Medication and Relapse
- Upon premature withdrawal of prednisone, the foal experienced a relapse in its clinical symptoms.
Diagnosis and Confirmation of Adrenal Insufficiency
- Adrenal insufficiency was confirmed as the diagnosis for the foal based on its clinical symptoms, the observed abnormalities in the electrolytes, low baseline levels of cortisol, and the lack of response to exogenously administered adrenocorticotropin, a hormone that stimulates the adrenal glands.
Recovery and Follow Up
- Two months after diagnosis and treatment, the foal’s adrenocortical function returned to normal and it was in good clinical condition.
Conclusion and Recommendations
- The researchers concluded that clinical symptoms of acute adrenal insufficiency in newborn foals might be mistaken for other conditions like septicemia, enteritis, and ruptured urinary bladder.
- They suggest that if there is a persistently low serum sodium-to-potassium ratio associated with any malfunctioning in the Central Nervous System, an examination of the adrenal gland function should be warranted.
- They also observed that acute hypoadrenocorticism in foals can be reversible with appropriate treatment.
Cite This Article
APA
Couëtil LL, Hoffman AM.
(1998).
Adrenal insufficiency in a neonatal foal.
J Am Vet Med Assoc, 212(10), 1594-1596.
Publication
Researcher Affiliations
- Department of Large Animal Medicine, School of Veterinary Medicine, Tufts University, North Grafton, MA 01536, USA.
MeSH Terms
- Adrenal Cortex / physiopathology
- Adrenal Cortex Function Tests / veterinary
- Adrenal Insufficiency / diagnosis
- Adrenal Insufficiency / therapy
- Adrenal Insufficiency / veterinary
- Adrenocorticotropic Hormone
- Animals
- Animals, Newborn
- Diagnosis, Differential
- Female
- Fluid Therapy / veterinary
- Glucocorticoids / therapeutic use
- Horse Diseases / diagnosis
- Horse Diseases / physiopathology
- Horse Diseases / therapy
- Horses
- Isotonic Solutions
- Prednisone / therapeutic use
- Sodium Chloride / therapeutic use
Citations
This article has been cited 4 times.- Johnson K, Peterson J, Kopper J, Dembek K. The hypothalamic-pituitary-adrenal axis response to ovine corticotropin-releasing-hormone stimulation tests in healthy and hospitalized foals. J Vet Intern Med 2023 Jan;37(1):292-301.
- Giri JK, Magdesian KG, Gaffney PM. Insulin-dependent diabetes mellitus associated with presumed autoimmune polyendocrine syndrome in a mare. Can Vet J 2011 May;52(5):506-12.
- Hart KA, Barton MH. Adrenocortical insufficiency in horses and foals. Vet Clin North Am Equine Pract 2011 Apr;27(1):19-34.
- Wong DM, Vo DT, Alcott CJ, Stewart AJ, Peterson AD, Sponseller BA, Hsu WH. Adrenocorticotropic hormone stimulation tests in healthy foals from birth to 12 weeks of age. Can J Vet Res 2009 Jan;73(1):65-72.
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