Prognostic Indicators for Survival and Athletic Outcome in Critically Ill Neonatal Foals

Managing Reproduction Emergencies in the Field: Part 2: Parturient and Periparturient Conditions

Selected conditions affecting broodmares are discussed, including arterial rupture, dystocia, foal support with ex utero intrapartum treatment, uterine prolapse, postpartum colic, the metritis/sepsis/systemic inflammatory response syndrome complex, and retained fetal membranes. Postpartum colic beyond third-stage labor contractions should prompt comprehensive evaluation for direct injuries to the reproductive tract or indirect injury of the intestinal tract. Mares with perforation or rupture of the uterus are typically recognized 1 to 3 days after foaling, with depression, fever, and leukopenia; laminitis and progression to founder can be fulminant. The same concerns are relevant in mares with retention of fetal membranes.

Investigation of neonatal disorders in New World camelids and factors associated with death during and after hospitalization of affected crias

OBJECTIVE

To assess signalment, clinical findings, and treatments for New World camelids (NWCs) hospitalized for evaluation and treatment of neonatal disorders and investigate associations between these factors and death during and after hospitalization.

ANIMALS

267 NWCs ≤ 30 days of age.

PROCEDURES

Medical records of a veterinary teaching hospital were retrospectively reviewed to identify NWCs admitted for evaluation and treatment of neonatal disorders between 2000 and 2010. Signalment, physical examination data, diagnostic findings, treatments, and outcomes were recorded. Factors were examined for association with death during hospitalization and the overall hazard of death by use of multivariable logistic regression and Cox proportional hazards analysis, respectively.

RESULTS

The sample comprised alpacas (n = 255) and llamas (12). Median age at admission was 3 days, and median hospitalization time was 2 days; 208 of the 267 (77.9%) neonatal NWCs survived to hospital discharge. Factors associated with increased odds of death during hospitalization included prematurity or dysmaturity, hypothermia, sepsis, toxic changes in neutrophils, and undergoing surgery. The odds of death during hospitalization also increased as anion gap increased. After discharge, 151 of 176 (85.8%) animals had follow-up information available (median follow-up time, 2,932 days); 126 (83%) were alive and 25 (17%) had died. Prematurity or dysmaturity, congenital defects, sepsis, oxygen administration, and undergoing surgery as a neonate were associated with an increased hazard of death; the hazard of death also increased as serum chloride concentration at the time of hospitalization increased.

CONCLUSIONS AND CLINICAL RELEVANCE

Results suggested the prognosis for survival during and after hospitalization is good for most NWCs hospitalized because of neonatal disorders.

Plasma iron concentrations and systemic inflammatory response syndrome in neonatal foals

BACKGROUND

Sparse information regarding plasma iron concentration in neonatal foals and its utility as an inflammatory marker in this population has been published.

OBJECTIVES

To determine the physiologic plasma iron concentration in neonatal foals. To assess its utility as an inflammatory marker to predict systemic inflammatory response syndrome (SIRS) and as a prognostic marker.

ANIMALS

Forty-seven ill neonatal foals admitted to a referral equine hospital were divided in 2 groups based on the SIRS criteria (24 SIRS and 23 non-SIRS). Two control groups of 43 hospital and 135 stud farm healthy neonatal foals were also included.

METHODS

Observational prospective study. Data were summarized by mean and its 95% confidence interval and absolute frequency and percentage for quantitative andqualitative variables. One-way ANOVA, ANCOVA (group and age effects) and Dunnett as posthoc analysis were used to compare plasma iron concentration among groups.

RESULTS

Neonatal foals with SIRS did not have had any statistically significant different plasma iron concentrations compared to non-SIRS (P = .56) and stud farm control group (P = .99), 172.8 μg/dL (95% CI; 126.0-219.6), 193.1 μg/dL (139.1-247.2), and 181.8 μg/dL (171.3-192.4), respectively. Plasma iron concentration had a large variability in healthy neonatal foals, and was negatively correlated with age in hospital controls (rho = -0.387) and sick neonatal foals (rho = -0.598) (P < .001).

CONCLUSIONS AND CLINICAL IMPORTANCE

Plasma iron was not a useful marker of SIRS in neonatal foals and was not associated with outcome.

Haematological profile in foals during the first year of life

Foals' haematological values change constantly during their first year of life. The use of updated age-based reference intervals (RIs) is imperative for providing accurate diagnosis and optimum care for sick foals. The authors' objective was to provide updated RIs for 13 haematological values in 2, 7, 14, 30, 90, 180 and 365-day-old foals and to investigate the changes over time in each measured value. Venous blood was collected at those ages from clinically healthy foals. Thirteen haematological values were analysed. The 95% RIs were reported using a bootstrapping method. Differences over time were examined using Friedman test. RIs for each of the measured values were calculated. Results showed noticeable trends in changes over time in several values. Nevertheless, white blood cell counts significantly increased between day 2 and day 90 (P=0.011) while lymphocyte counts increased from day 2 up to day 180 (P=0.033). The mean corpuscular haemoglobin and mean corpuscular volume (P=0.011) significantly decreased between day 2 and day 90. Normal haematological values in foals not only differ from those in adult horses but also change throughout the first year of life; thus, it is critical that clinicians use age-based RIs when treating sick foals.