Clinical implications of high liver enzyme activities in hospitalized neonatal foals.

This research aimed to examine if high levels of certain liver enzyme activities (γ-glutamyltransferase and sorbitol dehydrogenase) were negatively impacting the outcome for sick neonatal foals, compared to those with normal enzyme activities. Results showed that foals with high liver enzyme activities were more likely to be septic and less likely to survive, but high liver enzyme activities alone were not predictors of non-survival.

Study Objective and Methods

• The study’s main objective was to determine if high liver enzyme activities were negatively associated with survival outcomes in sick neonatal foals.
• A retrospective case-control study was performed involving 410 foals under 30 days old. Among these, 147 had high γ-glutamyltransferase and sorbitol dehydrogenase activities (case foals), while 263 had enzyme activities within standard ranges (control foals).
• Information from the foals’ medical records of their physical examination findings, as well as hematologic and serum biochemical analyses data collected at the time of admission to a veterinary teaching hospital, was reviewed.

Study Findings

• Case foals (those with high enzyme activities) had a significantly higher likelihood of either dying or being euthanized compared to control foals. The odds ratio was 2.22, indicating over twice the risk.
• Case foals were more likely to be septic, and foals with sepsis were significantly less likely to survive than non-septic foals.

Factors Impacting Survival

• Other than having high liver enzyme activities, additional factors increasing the likelihood of non-survival in case foals were a higher anion gap and a higher logarithm of aspartate aminotransferase activity.
• Interestingly, when sepsis status was accounted for, having high liver enzyme activities ceased being a significant risk factor influencing negative outcomes.

Conclusions

• The study results suggested that high liver enzyme activities were common in sick neonatal foals, especially those with sepsis.
• These foals were more likely to be septic, and septic foals had lower chances of survival than those without sepsis. However, high liver enzyme activities by themselves did not act as a reliable negative prognostic indicator.