Hypothalamic-pituitary-adrenal axis dysfunction in hospitalized neonatal foals.
Abstract: Transient hypothalamic-pituitary-adrenal (HPA) axis dysfunction occurs frequently in critically ill humans and impacts survival. The prevalence and impact of HPA axis dysfunction in critically ill neonatal foals are not well characterized. Objective: (1) HPA axis dysfunction occurs in hospitalized neonatal foals, and is characterized by inappropriately low basal serum cortisol concentration or inadequate cortisol response to exogenous adrenocorticotropic hormone (ACTH); (2) hospitalized foals with HPA axis dysfunction have more severe disease and are less likely to survive than hospitalized foals with normal HPA axis function. Methods: Seventy-two hospitalized foals and 23 healthy age-matched foals. Methods: Basal ACTH and cortisol concentrations were measured and a paired low-dose (10 microg)/high-dose (100 microg) cosyntropin stimulation test was performed at admission in hospitalized foals. HPA axis dysfunction was defined as (1) an inappropriately low basal cortisol concentration or (2) an inadequate increase in cortisol concentration (delta cortisol) after administration of cosyntropin, with cut-off values for appropriate basal and delta cortisol concentrations determined from results obtained in healthy age-matched foals. Results: Forty-six percent of hospitalized foals had an inappropriately low basal cortisol concentration and 52% had an inadequate delta cortisol concentration after administration of the 100 microg dose of cosyntropin. An inadequate delta cortisol response to the high (100 microg) dose of cosyntropin was significantly correlated with shock and multiple organ dysfunction syndrome in hospitalized foals, and with decreased survival in a subgroup of septic foals. Conclusions: HPA axis dysfunction occurs frequently in hospitalized neonatal foals, and negatively impacts disease severity and survival.
Publication Date: 2009-06-01 PubMed ID: 19496914DOI: 10.1111/j.1939-1676.2009.0323.xGoogle Scholar: Lookup
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- Journal Article
- Research Support
- Non-U.S. Gov't
Summary
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This article discusses a research that was conducted to examine the prevalence and effects of hypothalamic-pituitary-adrenal (HPA) axis dysfunction in critically ill neonatal foals. The research identified the occurrence of HPA axis dysfunction to be quite common in hospitalized neonatal foals, affecting disease severity and survival rates.
Understanding HPA Axis Dysfunction
- The HPA, or hypothalamic-pituitary-adrenal axis, is a complex network involving the hypothalamus, pituitary gland, and adrenal glands. This axis controls a number of bodily functions, including stress response, mood, and digestion.
- HPA axis dysfunction occurs when there is an irregularity in this system, such as low cortisol levels or an insufficient response to the hormone ACTH. This condition is commonly found in critically ill individuals, impacting their overall health status and survival.
Objective and Methodology of the Study
- The primary objective of the study was to determine if HPA axis dysfunction occurs in hospitalized neonatal foals, identified by low basal serum cortisol concentration or an inadequate cortisol response to ACTH.
- The study used a group of 72 hospitalized foals and 23 healthy age-matched foals. Basal ACTH and cortisol concentrations were measured, and a paired low/high dose cosyntropin stimulation test was performed on the hospitalized foals upon admission.
- The presence of HPA axis dysfunction in the foals was identified either by an inappropriately low basal cortisol concentration or by an inadequate increase in cortisol concentration after the administration of cosyntropin.
Findings of the Study
- The study found that approximately 46% of the hospitalized foals had an inappropriately low basal cortisol concentration, and 52% had an inadequate delta cortisol concentration after administration of the 100 microg dose of cosyntropin.
- An inadequate delta cortisol response to the high dose of cosyntropin was found to be significantly correlated with shock and multiple organ dysfunction syndrome in the hospitalized foals. This was also correlated with decreased survival in a subgroup of septic foals.
Conclusion
- The research concluded that HPA axis dysfunction is common in hospitalized neonatal foals, significantly impacting the severity of their condition and their survival rates.
Cite This Article
APA
Hart KA, Slovis NM, Barton MH.
(2009).
Hypothalamic-pituitary-adrenal axis dysfunction in hospitalized neonatal foals.
J Vet Intern Med, 23(4), 901-912.
https://doi.org/10.1111/j.1939-1676.2009.0323.x Publication
Researcher Affiliations
- Department of Large Animal Medicine, College of Veterinary Medicine, University of Georgia, and Veterinary Teaching Hospital, Athens, GA 30602, USA. khart4@uga.edu
MeSH Terms
- Adrenocorticotropic Hormone / pharmacology
- Animals
- Animals, Newborn
- Cosyntropin / pharmacology
- Dose-Response Relationship, Drug
- Female
- Horse Diseases / metabolism
- Horses
- Hospitalization
- Hydrocortisone / blood
- Hypothalamo-Hypophyseal System / physiopathology
- Male
- Multiple Organ Failure / veterinary
- Pituitary-Adrenal System / physiopathology
- Sepsis / veterinary
- Shock / veterinary
Citations
This article has been cited 17 times.- Elder E, Wong D, Johnson K, Robertson H, Marner M, Dembek K. Assessment of the hypothalamic-pituitary-adrenocortical axis function using a vasopressin stimulation test in neonatal foals. J Vet Intern Med 2023 Sep-Oct;37(5):1881-1888.
- 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.
- Boakari YL, Legacki E, Alonso MA, Dos Santos ACF, Nichi M, Conley AJ, Fernandes CB. Postnatal Dynamics of Circulating Steroid Hormones in Mule and Equine Neonates. Vet Sci 2022 Oct 28;9(11).
- Lanci A, Mariella J, Ellero N, Faoro A, Peric T, Prandi A, Freccero F, Castagnetti C. Hair Cortisol and DHEA-S in Foals and Mares as a Retrospective Picture of Feto-Maternal Relationship under Physiological and Pathological Conditions. Animals (Basel) 2022 May 14;12(10).
- Lauteri E, Mariella J, Beccati F, Roelfsema E, Castagnetti C, Pepe M, Peric T, Barbato O, Montillo M, Rouge S, Freccero F. Adrenal Gland Ultrasonographic Measurements and Plasma Hormone Concentrations in Clinically Healthy Newborn Thoroughbred and Standardbred Foals. Animals (Basel) 2021 Jun 19;11(6).
- Swink JM, Rings LM, Snyder HA, McAuley RC, Burns TA, Dembek KA, Gilsenan WF, Browne N, Toribio RE. Dynamics of androgens in healthy and hospitalized newborn foals. J Vet Intern Med 2021 Jan;35(1):538-549.
- Anderson MJ, Ibrahim AS, Cooper BR, Woolcock AD, Moore GE, Taylor SD. Effects of administration of ascorbic acid and low-dose hydrocortisone after infusion of sublethal doses of lipopolysaccharide to horses. J Vet Intern Med 2020 Nov;34(6):2710-2718.
- Taylor S. A review of equine sepsis. Equine Vet Educ 2015 Feb;27(2):99-109.
- Rings LM, Swink JM, Dunbar LK, Burns TA, Toribio RE. Enteroinsular axis response to carbohydrates and fasting in healthy newborn foals. J Vet Intern Med 2019 Nov;33(6):2752-2764.
- Stewart AJ, Hackett E, Bertin FR, Towns TJ. Cortisol and adrenocorticotropic hormone concentrations in horses with systemic inflammatory response syndrome. J Vet Intern Med 2019 Sep;33(5):2257-2266.
- Aleman M, McCue PM, Chigerwe M, Madigan JE. Plasma concentrations of steroid precursors, steroids, neuroactive steroids, and neurosteroids in healthy neonatal foals from birth to 7 days of age. J Vet Intern Med 2019 Sep;33(5):2286-2293.
- Dembek KA, Johnson LM, Timko KJ, Minuto JS, Hart KA, Barr BS, Toribio RE. Multiple adrenocortical steroid response to administration of exogenous adrenocorticotropic hormone to hospitalized foals. J Vet Intern Med 2019 Jul;33(4):1766-1774.
- Hoffman CJ, McKenzie HC 3rd, Furr MO, Desrochers A. Glucocorticoid receptor density and binding affinity in healthy horses and horses with systemic inflammatory response syndrome. J Vet Intern Med 2015 Mar-Apr;29(2):626-35.
- Hart KA, Barton MH, Vandenplas ML, Hurley DJ. Effects of low-dose hydrocortisone therapy on immune function in neonatal horses. Pediatr Res 2011 Jul;70(1):72-7.
- Hart KA, Barton MH. Adrenocortical insufficiency in horses and foals. Vet Clin North Am Equine Pract 2011 Apr;27(1):19-34.
- Berghaus LJ, Venner M, Helbig H, Hildebrandt D, Hart K. The potential value of cytokine, cortisol and vitamin D profiles in foals from birth to weaning for respiratory disease prediction on a farm endemic for Rhodococcus equi pneumonia. Equine Vet J 2026 Mar;58(2):359-371.
- Samuels AN, Kamr AM, Reed SM, Slovis NM, Hostnik LD, Burns TA, Toribio RE. Association of the neutrophil-lymphocyte ratio with outcome in sick hospitalized neonatal foals. J Vet Intern Med 2024 Mar-Apr;38(2):1196-1206.
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