Electrolyte disturbances in foals with severe rhabdomyolysis.

This research article investigates severe electrolyte disturbances observed in neonatal foals experiencing acute rhabdomyolysis, a condition involving the breakdown of muscle tissue. The study further highlights the related health complications such as cardiac arrhythmias and kidney damage, and suggests potential treatment options.

Research objective and findings

• The aim of the study was to put forth an understanding of electrolyte abnormalities observed in four neonatal foals suffering from acute rhabdomyolysis and pigmenturia. This condition produces profound hyperkalemia, hyponatremia, hypocalcemia, and hyperphosphatemia.
• Two foals developed rhabdomyolysis 4-6 days after being admitted due to being dysmature (immature), while the condition was already evident upon presentation in two other foals.
• The cause of rhabdomyolysis was discovered to be selenium deficiency, potentially combined with vitamin E deficiency. This deficiency might have been exacerbated by increased oxidant stress resulting from sepsis or hypoxia, along with reperfusion injury after birth.
• Significant weight gain was observed in the foals, ranging from 7 to 15% of their initial body weight within just 48 hours of contracting rhabdomyolysis.
• Cardiac arrhythmias developed in three foals characterized by spiked T waves and decreased-amplitude P waves.

Pathological findings

• An autopsy of two foals showed extensive myodegeneration and kidney damage in the form of renal tubular nephrosis.
• In one of these foals, tissue necrosis was observed in the renal cortex as well as the heart muscle.
• The breakdown of the major intracellular compartment (ICF), attributed to severe muscle tissue damage in conjunction with renal insufficiency, led to significant fluid shifts and life-threatening electrolyte imbalances.

Treatment methods discussed

• High potassium levels (hyperkalemia) were most effectively dealt with by using mineralocorticoids, ion exchange resins and loop diuretics to enhance elimination.
• Intravenous calcium, glucose, insulin, and sodium bicarbonate were used to aid the redistribution of potassium to the ICF, which was disrupted due to myonecrosis.

Conclusion and implications

• In conclusion, the study suggests that severe rhabdomyolysis should be considered when diagnosing potential causes of hyperkalemia, hyponatremia, hypocalcemia, and hyperphosphatemia in neonatal foals.
• Overall, the study provides valuable insights into the health complications and potential treatment options related to severe rhabdomyolysis and associated electrolyte imbalances in neonatal foals.