Prognostic indicators in foals with neonatal encephalopathy

• Main Author: Vilela, Ana Alexandra Vieira
• Publication Date: 2019
• Format: Master thesis
• Language: eng
• Source: Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)
• Download full: http://hdl.handle.net/10348/9094
• topic: Neonatal Encephalopathy; Equine; Neonatology; Foal

Neonatal Encephalopathy is the most common neurological disorder in neonatal foals. It is usually associated with peripartum events that can lead to acute or chronic hypoxia, but neither the etiology nor the pathophysiology are still fully understood. Clinical signs often observed include recumbency, abnormal nursing behavior, loss of awareness of the environment, and seizures. However, a multi-system evolvement can also be found. There is no definitive ante-mortem diagnostic test, so diagnosis is based on history, clinical presentation, elimination of other differentials, and supplementary diagnostic tests. Treatment is mainly supportive, relying on resolution of secondary complications. Prognosis is usually good (60%- 80%) in uncomplicated cases. The purpose of this dissertation is to stablish prognostic indicators in a population of foals with Neonatal Encephalopathy. Medical records from 61 foals with the diagnosis of Neonatal Encephalopathy between 1982 and 2018 were collected from the Equine Hospital of the University of Tennessee, College of Veterinary Medicine, in the United States of America and from the Hospital La Equina, in Málaga, Spain. Variables included in the study were surviving rate, animal identification, predisposing factors of the mare and foal, physical exam and laboratory findings on admission, concurrent diseases, and treatment. In order to determine factors associated with the outcome, these variables were statistically compared between survivors and non-survivors. The overall surviving rate was 57.4%. Neither gender nor breed were associated with the surviving rate. There were no predisposing factors associated with survival as well. This study demonstrated that normal body temperature, normal glycemia levels, normal creatinine concentration, or absence of recumbency were associated with a good surviving rate, while hypothermia, abnormal glycemia levels, creatinine levels >4 mg/dL, pneumonia, anemia, or sepsis were associated with mortality. Foals with hypothermia, hypoglycemia or hyperglycemia had greater odds of non-survival. The use of antibiotics or non-steroidal anti-inflammatory drugs were positively associated with survival. In conclusion, body temperature, glycemia, creatinine concentration, absence of recumbency, presence of pneumonia, anemia, and sepsis are the main prognostic indicators in the population in study. Given its influence in survival, using antibiotics or non-steroidal antiinflammatory drugs are recommended in foals with NE