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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 5 7), kernicterus (n 5 6), and complications related to bacterial sepsis (n 5 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 5 .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 5 .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.

A 22-year-old Appaloosa gelding was examined at the Veterinary Medical Teaching Hospital, University of Florida, with a 2-week history of inappetence, lethargy, and ventral edema. Cutaneous nodules developed on the neck and lateral thoracic region several days before presentation. The horse was quiet, alert, and responsive on initial examination. The horse had tachycardia (80 beats per minute) and mild tachypnea (36 breaths per minute). A grade I of VI holosystolic murmur was noted on the left side on thoracic auscultation. Both conjunctiva had moderate chemosis and the sclera was mildly icteric. Pitting edema was noted in the ventral abdomen and prepuce. Rectal examination revealed firm nodules associated with the left kidney and root of the mesentery. Significant abnormalities on CBC included a normocytic, normochromic anemia with a hematocrit of 21% (reference range, 32-53%), hemoglobin concentration of 8.6 g/dL (reference range, 11-17 g/dL), mean cell hemoglobin concentration of 35 g/dL (reference range, 34-37g/dL), and mean cell volume of 42 g/dL (reference range, 43-54 g/dL). A marked leukocytosis (54.9 ϫ 10 9 /L; reference range, 5.2 ϫ 10 9 -13.9 ϫ 10 9 /L) and lymphocytosis (43.4 ϫ 10 9 /L; reference range, 1.0 ϫ 10 9 -5.0 ϫ 10 9 /L) were also noted. Lymphocytes in the peripheral blood were a pleomorphic population of cells, many of which contained cerebriform nuclei, clumped chromatin, and scant amounts of basophilic cytoplasm (Fig 1). These cells had a distinct resemblance to the Sézary cells sometimes seen in humans and dogs with cutaneous T-cell lymphoma (mycosis fungoides). 1,2 No other leukocyte abnormalities were observed. Serum creatinine concentration was above reference range (2.4 mg/dL; reference range, 1.2-1.9 mg/dL) and serum total protein concentration was 8.6 g/dL (reference range, 5.7-7.9 g/dL) with hyperglobulinemia (6.2 g/dL; reference range, 2.6-4.0 g/dL). Protein electrophoresis revealed a monoclonal gammopathy of gamma 2 region with a protein concentration of 4.4 g/dL (reference range, 0.5-1.9 g/dL). Subsequent immunoelectrophoresis identified this protein to be of immunoglobulin G origin.Abdominal ultrasound revealed irregular nodular structures surrounding the left kidney. The liver appeared enlarged, but was of normal architecture and echodensity. The spleen had a mottled appearance. Cytologic preparations of fine-needle aspirates of the cutaneous lesions were very cel-Medicine 0891-6640/99/1306-0019/$3.00/0 lular and consisted of a population of atypical lymphocytes with nuclei ranging from 10 to 20 m in diameter. The nuclei of many of the cells were indented or cleaved, similar to those seen in the peripheral blood. The chromatin appeared moderately condensed and mitotic figures were occasionally observed. The nucleus to cytoplasm ratio was high and the cells had a thin rim of deeply basophilic cytoplasm. Based on these findings, a cytologic diagnosis of cutaneous lymphoid neoplasm was made. Examination of a bone marrow aspirate revealed mild erythroid hyperplasia with evidence o...

A 22-year-old Appaloosa gelding was examined at the Veterinary Medical Teaching Hospital, University of Florida, with a 2-week history of inappetence, lethargy, and ventral edema. Cutaneous nodules developed on the neck and lateral thoracic region several days before presentation. The horse was quiet, alert, and responsive on initial examination. The horse had tachycardia (80 beats per minute) and mild tachypnea (36 breaths per minute). A grade I of VI holosystolic murmur was noted on the left side on thoracic auscultation. Both conjunctiva had moderate chemosis and the sclera was mildly icteric. Pitting edema was noted in the ventral abdomen and prepuce. Rectal examination revealed firm nodules associated with the left kidney and root of the mesentery. Significant abnormalities on CBC included a normocytic, normochromic anemia with a hematocrit of 21% (reference range, 32-53%), hemoglobin concentration of 8.6 g/dL (reference range, 11-17 g/dL), mean cell hemoglobin concentration of 35 g/dL (reference range, 34-37g/dL), and mean cell volume of 42 g/dL (reference range, 43-54 g/dL). A marked leukocytosis (54.9 ϫ 10 9 /L; reference range, 5.2 ϫ 10 9 -13.9 ϫ 10 9 /L) and lymphocytosis (43.4 ϫ 10 9 /L; reference range, 1.0 ϫ 10 9 -5.0 ϫ 10 9 /L) were also noted. Lymphocytes in the peripheral blood were a pleomorphic population of cells, many of which contained cerebriform nuclei, clumped chromatin, and scant amounts of basophilic cytoplasm (Fig 1). These cells had a distinct resemblance to the Sézary cells sometimes seen in humans and dogs with cutaneous T-cell lymphoma (mycosis fungoides).1,2 No other leukocyte abnormalities were observed. Serum creatinine concentration was above reference range (2.4 mg/dL; reference range, 1.2-1.9 mg/dL) and serum total protein concentration was 8.6 g/dL (reference range, 5.7-7.9 g/dL) with hyperglobulinemia (6.2 g/dL; reference range, 2.6-4.0 g/dL). Protein electrophoresis revealed a monoclonal gammopathy of gamma 2 region with a protein concentration of 4.4 g/dL (reference range, 0.5-1.9 g/dL). Subsequent immunoelectrophoresis identified this protein to be of immunoglobulin G origin.Abdominal ultrasound revealed irregular nodular structures surrounding the left kidney. The liver appeared enlarged, but was of normal architecture and echodensity. The spleen had a mottled appearance. Cytologic preparations of fine-needle aspirates of the cutaneous lesions were very cel- Gainesville, FL 32610-0136; e-mail: polkesa@mail.vetmed.ufl.edu. Submitted May 6, 1999; Accepted August 3, 1999. Copyright ᭧ 1999 lular and consisted of a population of atypical lymphocytes with nuclei ranging from 10 to 20 m in diameter. The nuclei of many of the cells were indented or cleaved, similar to those seen in the peripheral blood. The chromatin appeared moderately condensed and mitotic figures were occasionally observed. The nucleus to cytoplasm ratio was high and the cells had a thin rim of deeply basophilic cytoplasm. Based on these findings, a cytologic diagnosis of cutaneous lymphoid neoplasm was...

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