Hemolytic-uremic syndrome in a postpartum mare concurrent with encephalopathy in the neonatal foal.

A research article narrates an investigation on the correlation of a postpartum mare suffering from hemolytic-uremic syndrome and signs of encephalopathy in a neonatal foal. It reports that Escherichia coli 0103:H2 – often associated with hemolytic-uremic syndrome – was isolated in the mare and the foal.

Presentation of the Mare and Foal

• The study started with the presentation of a postpartum mare and her foal for clinical examination due to fever and lethargy in the mare.
• The mare was diagnosed with endometritis, an inflammation of the inner layer of the uterus, and seemed to initially respond to treatment positively.
• On the second day in the hospital, the mare developed renal insufficiency with symptoms like reduced urine output, elevated levels of nitrogen-based waste products in the blood, breakdown of red blood cells, and reduced platelet count.
• At the same time, the foal also showed rapidly worsening symptoms in its central nervous system, ultimately leading to uncontrollable seizures.
• Despite medical intervention, both animals did not respond to the treatment and had to be euthanized for their well-being.

Postmortem Examinations and Findings

• Upon microscopic examination of the mare’s kidneys, thrombotic microangiopathy, a condition that causes blood clots in small blood vessels in the kidneys, was found.
• For the foal, the principal postmortem finding was brain edema, a condition characterized by an excessive accumulation of fluid in the brain.
• No specific cause could be attributed to these cases, which remained unconfirmed with the given data.

Isolation of Escherichia Coli 0103:H2

• The researchers were able to isolate Escherichia coli 0103:H2 from the uterus of the mare and the gastrointestinal tracts of both animals.
• E.coli 0103 and H2 strains have been implicated in human cases of hemolytic-uremic syndrome, and their presence in these animal cases suggest a possible correlation.
• According to the author’s knowledge, this was the first reported case where an organism that could potentially cause hemolytic-uremic syndrome was found in an animal displaying clinical symptoms and autopsy findings consistent with the disease.