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Factors Associated with Outcome in Foals with Neonatal Isoerythrolysis (72 Cases, 1988-2003)

Polkes, A.C., Giguère, S., Lester, G.D. and Bain, F.T. (2008) Factors Associated with Outcome in Foals with Neonatal Isoerythrolysis (72 Cases, 1988-2003). Journal of Veterinary Internal Medicine, 22 (5). pp. 1216-1222.

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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 = 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.

Item Type: Journal Article
Murdoch Affiliation: School of Veterinary and Biomedical Sciences
Publisher: American College of Veterinary Internal Medicine
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