Factors associated with outcome in foals with neonatal isoerythrolysis (72 cases, 1988-2003).
Abstract: Neonatal foals with isoerythrolysis (NI) often die, but the risk factors for death have not been identified. Objective: To identify factors associated with outcome in foals with NI and to identify factors associated with death from liver failure or kernicterus in the same population. Methods: Seventy-two foals with NI examined at referral institutions. Methods: Retrospective case series. Information on signalment, clinical examination findings, laboratory testing, treatment, complications, outcome, and necropsy results were obtained. Results: The overall survival rate was 75% (54 of 72). Liver failure (n=7), kernicterus (n=6), and complications related to bacterial sepsis (n=3) were the 3 most common reasons for death or euthanasia. The number of transfusions with blood products was the factor most strongly associated with nonsurvival in a multivariate logistic regression model. The odds of liver failure developing in foals receiving a total volume of blood products >or= 4.0 L were 19.5 (95% confidence intervals [CI]: 2.13-178) times higher than that of foals receiving a lower volume (P= .009). The odds of kernicterus developing in foals with a total bilirubin >or= 27.0 mg/dL were 17.0 (95% CI: 1.77-165) times higher than that of foals with a lower total bilirubin (P= .014). Conclusions: Development of liver failure, kernicterus, and complications related to bacterial sepsis are the most common causes of death in foals with NI. Foals administered a large volume of blood products are at greater risk for developing liver failure.
Publication Date: 2008-08-11 PubMed ID: 18700857DOI: 10.1111/j.1939-1676.2008.0171.xGoogle Scholar: Lookup
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- Journal Article
Summary
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The research article discusses the factors associated with survival outcomes in foals (young horses) suffering from neonatal isoerythrolysis (NI). It was found that the volume of blood products transfused and the level of total bilirubin in foals play a key role in survival, with higher quantities leading to increased odds of developing liver failure and kernicterus.
Objective and Methods
- The research aimed to identify factors associated with survival in foals diagnosed with neonatal isoerythrolysis – a condition where the foal’s immune system destroys its own red blood cells.
- The researchers carried out a retrospective case study involving 72 foals diagnosed with NI, referred from various institutions.
- Data was collected about the foals’ general condition, laboratory test results, treatments offered, complications faced, outcomes, and findings from necropsy (autopsy for animals).
Key Findings
- The overall survival outcome was calculated to be 75%, with liver failure, kernicterus (a type of brain damage in newborns) and bacterial sepsis being the most common causes of death or euthanasia.
- The volume of blood products transfused was identified as the factor having the strongest association with non-survival.
- Foals that were given a total volume of blood products of 4.0 L or more faced odds of developing liver failure 19.5 times higher than those who received lower amounts.
- Foals with a total bilirubin level of 27.0 mg/dL or higher faced odds of developing kernicterus 17.0 times higher than those with lower bilirubin totals.
Conclusions
- The study demonstrated that liver failure, kernicterus, and complications related to bacterial sepsis were the leading causes of death in foals with NI.
- It also established that administering large volumes of blood products to these foals led to an increased risk of developing liver failure.
Cite This Article
APA
Polkes AC, Giguère S, Lester GD, Bain FT.
(2008).
Factors associated with outcome in foals with neonatal isoerythrolysis (72 cases, 1988-2003).
J Vet Intern Med, 22(5), 1216-1222.
https://doi.org/10.1111/j.1939-1676.2008.0171.x Publication
Researcher Affiliations
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL 32610, USA.
MeSH Terms
- Anemia, Hemolytic, Autoimmune / mortality
- Anemia, Hemolytic, Autoimmune / veterinary
- Animals
- Animals, Newborn
- Blood Transfusion / veterinary
- Horse Diseases / mortality
- Horses
- Kernicterus / mortality
- Kernicterus / veterinary
- Liver Failure / mortality
- Liver Failure / veterinary
- Retrospective Studies
- Treatment Outcome
Citations
This article has been cited 4 times.- Jamieson CA, Baillie SL, Johnson JP. Blood Transfusion in Equids-A Practical Approach and Review. Animals (Basel) 2022 Aug 23;12(17).
- Contreras ET, Giger U, Malmberg JL, Quimby JM, Schaffer PA. Bilirubin Encephalopathy in a Domestic Shorthair Cat With Increased Osmotic Fragility and Cholangiohepatitis. Vet Pathol 2016 May;53(3):629-32.
- Broux B, Lefère L, Deprez P, van Loon G. Plasma exchange as a treatment for hyperbilirubinemia in 2 foals with neonatal isoerythrolysis. J Vet Intern Med 2015 Mar-Apr;29(2):736-8.
- Aleman M, Madigan JE, Williams DC, Holliday TA. Brainstem auditory evoked responses in an equine patient population. Part II: foals. J Vet Intern Med 2014 Jul-Aug;28(4):1318-24.
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