Metabolic and Endocrine Profiles in Sick Neonatal Foals Are Related to Survival

Abstract

Background: Sick neonatal foals suffer from a variety of endocrine and metabolic derangements that may be related to outcome. There are several hepatic and lipid metabolism blood markers that have never been assessed in neonatal foals.Objectives: Assess panel of endocrine and metabolic variables in group of sick and healthy neonatal foals in order to describe their relationship with diagnosis and survival.Animals: All neonatal foals referred to Unitat Equina-Fundaci o Hospital Cl ınic Veterinari during 3 consecutive foaling seasons and a group of healthy foals.Methods: Observational prospective study. Blood samples were obtained on admission and, when possible, after 24-48 h of hospitalization and immediately before discharge or death. Measured variables were triglycerides, nonsterified fatty acids, glucose, creatinine, urea, c-glutamyltransferase, glutamate dehydrogenase (GLDH), insulin, cortisol, bile acids, and adrenocorticotropic hormone (ACTH). ACTH/cortisol and glucose/insulin ratios were calculated.Results: Urea, creatinine, and cortisol had median concentrations in septic and nonseptic foals 2-to 8-fold higher than in the control group (P < .001). Median ACTH concentration in the septic group was approximately 4 times higher than in nonseptic and control foals (P < .001). ACTH/cortisol ratio was significantly lower in sick foals compared to control foals (P < .001). A score was designed including creatinine, GLDH, and cortisol. When ! 2 of these variables were altered (P < .001), the foal had 32 times more risk of dying (OR, 31.7; 95% CI,.Conclusions and Clinical Importance: Plasma creatinine, GLDH, and cortisol should be determined in sick newborn foals on admission because of their association with survival.

Controversies surrounding critical illness‐related corticosteroid insufficiency in animals

“…Baseline cortisol concentrations and expected ACTH stimulation test results have been published for 0.1 μg/kg, 10 μg/foal, 100 μg/foal, and 250 μg/foal doses of cosyntropin for healthy foals at various ages. Septic foals have been found to have significantly higher concentrations of endogenous ACTH and baseline cortisol than normal foals, as would be expected during physiologic stress of illness. However, Wong et al reported no differences in these endogenous hormone concentrations when comparing septic and nonseptic sick, or when comparing sick and healthy foals .…”

Insulin dysregulation in horses with systemic inflammatory response syndrome

“…Nevertheless, several studies in horses also have reported low serum insulin concentration and improved insulin sensitivity in the early stages of systemic inflammation . For example, in sick foals, relative hypoinsulinemia with appropriate blood glucose concentration response has been described . In addition, septic foals have been reported to have increased insulin sensitivity in the early stages of sepsis .…”

“…20,23,24 For example, in sick foals, relative hypoinsulinemia with appropriate blood glucose concentration response has been described. 25 In addition, septic foals have been reported to have increased insulin sensitivity in the early stages of sepsis. 23 Similar observations have been made in adult horses in which transiently improved insulin sensitivity was documented after LPS infusion.…”

Serum cortisol concentration in the Colombian Creole Horse

“…One study estimated a diff erence of 1.57 μg/dL between ELISA and chemiluminescence, suggesting greater accuracy for the latter. However, this comparison was made in different populations without considering all the variables (Armengou et al, 2013). The present study did not aim to compare techniques; however, validation with commercial controls and the similarity of SC in CCH to other horses from the same region (unpublished data) support the reliability of the technique used.…”

“…Recently, cortisol has gained interest due to its prognostic value in the critical phases of gastrointestinal disease (Mair et al, 2014), respiratory disease (Shaba et al, 2014), and clinical cases of sepsis in equine (Hart et al, 2009;Armengou et al, 2013), and as an indicator of fi tness and athletic performance in sport horses (Kedzierski et al, 2014). Therefore, this substance is considered the hormone of adaptation to physiological, pathological, and environmental stress factors.…”