
Factors Associated with Outcome in Foals with Neonatal Isoerythrolysis (72 Cases, 1988–2003)
Author(s) -
Polkes A.C.,
Giguère S.,
Lester G.D.,
Bain F.T.
Publication year - 2008
Publication title -
journal of veterinary internal medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.356
H-Index - 103
eISSN - 1939-1676
pISSN - 0891-6640
DOI - 10.1111/j.1939-1676.2008.0171.x
Subject(s) - medicine , kernicterus , odds ratio , sepsis , jaundice , population , retrospective cohort study , mortality rate , environmental health
Background: Neonatal foals with isoerythrolysis (NI) often die, but the risk factors for death have not been identified. Objectives: 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. Animals: 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 ≥ 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 ≥ 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 and Clinical Importance: 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.