Efficacy and Safety of a Commercial Fresh-Frozen Hyperimmune Plasma in Foals With Failure of Passive Transfer of Immunity

In foals more than 12 hours old, the only effective therapy for the treatment of failure of passive transfer (FPT) of immunity is transfusion of equine plasma. Use and efficacy of equine plasma for prophylaxis and treatment of sepsis, a condition primarily associated with FPT, are widely reported. However, plasma- and recipient-related factors associated with extent of IgG transfer and catabolism are not completely defined. Efficacy and safety of transfusion of a commercial fresh-frozen hyperimmune plasma were evaluated in hospitalized foals younger than 7 days of age with total or partial FPT. Sixty-two foals, classified as affected by FPT only, septic (infection plus systemic inflammatory response syndrome [SIRS]), and nonseptic sick, were included, and serum IgG concentration was measured at admission and 24 hours after plasma transfusion. In 25/62 foals, IgG level after 72 hours was also determined. The impact of different classification criteria for septic foals on IgG transfer was evaluated. Serum IgG measured 24 hours and 72 hours after plasma transfusion was significantly greater than at admission, but no significant difference was found in transfer efficacy (TE) between FPT, FPT septic, and FPT nonseptic foals and no significant difference was found in IgG concentration comparing foals with total and partial FPT or survivors and nonsurvivors. No significant difference was found comparing IgG concentration between bacteremic and nonbacteremic foals and foals with or without SIRS. No foal experienced adverse reactions to plasma transfusion. IgG TE and catabolism did not result significantly affected by the presence of sepsis or illness or by the outcome.     

The effect of intravenous fresh frozen plasma administration on fibrinogen and albumin concentrations in sick neonatal foals

This study investigated the immediate (6 h or less) effects of fibrinogen and albumin contained in transfused equine origin fresh frozen plasma on those proteins when measured in sick neonatal foals. Fibrinogen and albumin concentrations were measured in the administered plasma and in 31 sick foals at admission to a referral neonatal intensive care unit. Additional samples were obtained from the foals at 2 and 6 h following transfusion. No changes in albumin concentration were recognised. The main determinant of fibrinogen concentration following transfusion was the concentration of fibrinogen in the foal at admission. Importantly, intravenous transfusion of equine fresh frozen plasma did not result in immediate (6 h or less) increases or decreases in the fibrinogen concentration in the recipient foals. Fibrinogen from the donor contained within transfused plasma will not directly affect fibrinogen concentrations measured at later times.     

Clinical and clinicopathologic variables in adult horses receiving blood transfusions: 31 cases (1999-2005)

OBJECTIVE: To determine clinical and clinicopathologic abnormalities in horses administered a blood transfusion and evaluate effects of blood transfusion on these variables. DESIGN: Retrospective case series. ANIMALS: 31 adult horses that received > or = 1 blood transfusion. Procedures-Medical records of horses receiving a blood transfusion were reviewed to obtain clinical findings, laboratory test results before and after transfusion, adjunctive treatments, transfusion type and volume, response to transfusion, results of donor-recipient compatibility testing, adverse reactions, and outcome. RESULTS: 31 horses received 44 transfusions for hemorrhagic anemia (HG; n = 18 horses), hemolytic anemia (HL; 8), or anemia attributable to erythropoietic failure (EF; 5). Tachycardia and tachypnea were detected in 31 of 31 (100%) and 22 of 31 (71%) horses, respectively, before transfusion. The PCV and hemoglobin concentration were less than the reference range in 11 of 18 horses with HG, 8 of 8 horses with HL, and 5 of 5 horses with EF. Hyperlactatemia was detected in 16 of 17 recorded values before transfusion. Heart rate, respiratory rate, and PCV improved after transfusion, with differences among the types of anemia. Seventeen (54%) horses were discharged, 9 (29%) were euthanized, and 5 (16%) died of natural causes. Adverse reactions were evident during 7 of 44 (16%) transfusions, varying from urticarial reactions to anaphylactic shock. CONCLUSIONS AND CLINICAL RELEVANCE: Abnormalities in clinical and clinicopathologic variables differed depending on the type of anemia. Colic, cold extremities, signs of depression, lethargy, tachycardia, tachypnea, low PCV, low hemoglobin concentration, and hyperlactatemia were commonly detected before transfusion and resolved after transfusion.     

Incidence of Transfusion Reactions and Retention of Procoagulant and Anticoagulant Factor Activities in Equine Plasma

Background: The extent of preservation of clotting factors and incidence of transfusion reactions to noncommercial equine plasma is not documented.
Hypothesis: Equine frozen plasma would retain its coagulation factor activity within the reference range and the incidence of transfusion reactions would be low.
Animals: Ten plasma donor horses. Fifty clinically ill hospitalized horses receiving plasma were reviewed to determine the incidence of reactions.
Methods: In vitro study and retrospective case review. Plasma was prepared by gravity sedimentation from whole blood refrigerated for 48 hours. The activities of factors VII through XII, antithrombin (AT), and Protein C were measured. Factor activities were compared for plasma samples obtained before blood collection (S0), after 48 hours of gravity sedimentation at 5 °C and after plasma separation (S1), and after 90 days of storage at −20 °C (S90). The medical records of 50 consecutive clinically ill horses receiving frozen plasma were reviewed to determine the incidence of transfusion reactions.
Results: The combined effect of plasma harvest, gravity sedimentation, decantation, and freezing caused significant reductions in factors IX, (43% P = .0013), X, (33% P = .0001), XI, (48% P = .0008), AT, (10% P = .02), and Protein C (26% P = .0001). Activities for all factors analyzed, except factor X, remained within the reference ranges. Transfusion reactions were recorded for 5/50 horses.
Conclusions and Clinical Relevance: Clotting factors, AT, and Protein C were well preserved. The incidence of reactions to frozen plasma was 10%.     

Post-Transfusion Survival of 50Cr-Labeled Erythrocytes in Neonatal Foals

Erythrocytes transfused allogeneically into mature horses have a short survival (less than 4 days) compared with an expected erythrocyte life span of 140-150 days. Yet, foals undergo transfusions for neonatal isoerythrolysis successfully. The authors have determined the survival of transfused erythrocytes in neonatal foals, using the stable isotope, 50Cr, to label the erythrocytes. Normal foals underwent transfusions with labeled erythrocytes from three sources: their own erythrocytes (autologous), the erythrocytes of their dam, and the erythrocytes of an unrelated castrated male. After transfusion, samples were taken at 15 minutes and then daily for a week and every 2 or 3 days for 20 days. A stable isotope of iron (57Fe) and 50Cr were determined on diluted-packed erythrocytes by inductively coupled argon-coupled mass spectrometry techniques. 57Fe was used as measure of the sample hemoglobin concentration. The ratio of 50Cr to 57Fe decreased exponentially in all foals. Half-time (T1/2) was 11.7 days (standard error = 2.2) for four foals that underwent autologous transfusions, 5.5 +/- 1.0 days for five foals that underwent transfusions with the erythrocytes of their dams, and 5.2 +/- 1.1 days for five foals that had transfusions with erythrocytes from an unrelated gelding. The authors conclude that erythrocytes that are transfused allogenically into neonatal foals will survive longer than those transfused into mature horses and that 50Cr labeling can be used to measure survival of transfused erythrocytes.     

Retrospective Study: Trends in plasma transfusion at a veterinary teaching hospital: 308 patients (1996–1998 and 2006–2008)

Objectives – To describe changes in fresh frozen plasma (FFP) utilization over a 10‐year period at a veterinary teaching hospital. To evaluate the effect of FFP administration on specific laboratory parameters. Design – Retrospective observational study. Setting – University teaching hospital. Animals– Two hundred and eighty‐three dogs and 25 cats. Interventions – A hospital database search was performed for all animals receiving FFP during the study periods. Measurements and Main Results – Medical records of patients receiving plasma transfusions from 2006 to 2008 and from 1996 to 1998 were reviewed. Data collected included indications for transfusion, transfused volume, concurrent therapies, clinicopathologic data pre‐ and post‐transfusion, transfusion reactions, days of hospitalization, and outcome. FFP was administered to 112 dogs and 23 cats from 2006 to 2008 and to 171 dogs and 2 cats from 1996 to 1998. Significantly fewer patients received FFP for the treatment of hypoalbuminemia (2006–2008: 15% versus 1996–1998: 53%; P<0.001) or pancreatitis (2006–2008: 2% versus 1996–1998: 13%; P=0.001) and significantly more patients received FFP for coagulopathy (2006–2008: 80% versus 1996–1998: 31%; P<0.001) in the 2006–2008 group compared with the 1996–1998 group. For all patients receiving FFP, there was no difference in mean serum albumin concentration pre‐ and post‐transfusion. Median prothrombin time and activated partial thromboplastin time were significantly decreased post FFP administration. No association was found between the volume of plasma administered and outcome. Conclusions – FFP utilization has changed significantly over a 10‐year period. FFP was used most commonly in 2006–2008 for the correction of coagulopathy. FFP administration was associated with significant reduction in prothrombin time and activated partial thromboplastin time but did not significantly alter albumin concentration when administered at median doses of 15–18 mL/kg.     

Prognostic value of clinicopathologic variables obtained at admission and effect of antiendotoxin plasma on survival in septic and critically ill foals

This prospective study compared survival rates of critically ill and septic foals receiving 1 of 2 different types of commercial equine plasma and analyzed admission variables as possible predictors of survival. Standardized clinical, hematologic, biochemical, and hemostatic admission data were collected and foals received either conventional commercially available hyperimmune equine plasma or equine plasma specifically rich in antiendotoxin antibodies in a double-blinded, coded fashion. Sepsis was defined as true bacteremia or sepsis score >11. Overall survival rate to discharge was 72% (49/68). Foals that were nonbacteremic and demonstrated a sepsis score of < or = 11 at admission had a 95% (18/19) survival rate. The survival rate to discharge for septic foals was 28/49 (57%), with truly bacteremic foals having a survival rate of 58% (14/24), whereas that for nonbacteremic, septic foals was 56% (14/25). Sensitivity and specificity for sepsis score >11 as a predictor of bacteremia were 74 and 52%, respectively. For the entire study population, a higher survival rate to discharge was documented for those foals receiving hyperimmune plasma rich in antiendotoxin antibodies (P = .012, odds ratio [OR] 6.763, 95% confidence interval [CI]: 1.311, 34.903). Administration of plasma rich in antiendotoxin antibodies also was associated with greater survival in septic foals (P = .019, OR 6.267, 95% CI: 1.186, 33.109). Statistical analyses demonstrated that, among 53 clinical and clinicopathologic admission variables, high sepsis score (P < .001), low measured IgG concentration (P = .01), high fibrinogen concentration (P = .018), low segmented neutrophil count (P = .028), and low total red blood cell numbers (P = .048) were the most significant predictors of overall mortality.     

Effect of plasma transfusion on neutrophil function in healthy and septic foals

OBJECTIVE: To evaluate the effect of plasma transfusion on phagocytosis and oxidative burst activity of peripheral blood neutrophils from healthy and septic equine neonates with sub-optimal passive transfer of maternal immunity. ANIMALS: Nine healthy and seven septic foals with suboptimal passive transfer of maternal immunity (serum IgG < 8 g/L) presented to participating veterinary hospitals for plasma transfusion, and seven healthy foals less than 7 days of age and with circulating IgG concentrations > or = 8 g/L. PROCEDURE: Foals with serum IgG concentrations < 8 g/L were assessed as healthy or septic. Sepsis was recognised by positive bacterial cultures and/or sepsis scores of > or = 11. All foals received between 1 and 3 L of plasma to boost circulating IgG concentrations to > or = 8 g/L. Serum IgG concentrations were determined before and following transfusion by glutaraldehyde coagulation test and confirmed by single radial immunodiffusion assays. Neutrophil phagocytosis and oxidative burst activity were determined before plasma transfusion and at 0 h, 12 h, 24 h, 48 h and 5 d following treatment. Neutrophil function from seven healthy foals less than 7 d of age and with circulating IgG concentrations of > or = 8 g/L was similarly evaluated on a single occasion. RESULTS: Plasma treatment significantly increased circulating IgG concentrations for healthy and septic foals. Oxidative burst activity of neutrophils from septic foals was significantly increased 5 days following treatment, relative to 0 h post treatment. Other differences were not significant but suggested a transient decrease in phagocytosis by neutrophils from healthy foals and increased phagocytosis by neutrophils from septic foals immediately following transfusion. Oxidative burst activity of neutrophils from septic foals tended to be less than that of healthy foals at all sampling times. Serum IgG concentrations were not correlated with neutrophil phagocytosis, but were correlated with oxidative burst activity. CONCLUSIONS: Plasma transfusion did not improve neutrophil function of healthy foals, suggesting that such treatment may be of equivocal benefit for healthy neonates. Conversely, improved neutrophil function was observed following treatment of septic foals, suggesting that plasma transfusion was beneficial for these foals. Oxidative burst activity of neutrophils from septic foals was lower than that of neutrophils from healthy foals and was significantly improved 5 days post treatment, when compared with values obtained immediately following treatment.     

Association of hyperlactatemia with age,diagnosis, and survival in equine neonates

Objective – To investigate the association between blood lactate concentration, measured at admission and following 12–36 hours of treatment, and age, diagnosis, and survival in neonatal foals. Design – Retrospective, observational study. Setting – Two equine referral hospitals. Animals – One hundred and twelve foals ≤96 hours of age were included. Interventions – Arterial or venous blood samples were obtained from all foals at admission and surviving foals at 12–36 hours. Measurements – The lactate concentration (LAC) was recorded at 2 time points: admission (LAC‐Admission) and 12–36 hours following treatment (LAC‐24 hours). Main Results – LAC decreased by 0.05 mmol/L for each increased hour of age at presentation. Premature/dysmature foals demonstrated increased odds of nonsurvival of 55% for each 1 mmol/L increase in LAC‐Admission while foals with major diagnoses of neonatal encephalopathy (NE), enteritis and ‘Other’ had increased odds of nonsurvival of 52%, 113%, and 247%, respectively, for each 1.0 mmol/L increase in LAC. Blood‐culture positive foals had significantly lower LAC than blood culture negative foals. LAC‐Admission and LAC‐24 hours were significantly larger in nonsurviving foals. LAC‐Admission of >6.9 mmol/L and LAC‐24 hours >3.2 mmol/L, respectively, correctly classified 85.6% and 94.1% of cases as survivors or nonsurvivors. No differences were found when the 24‐hour change in LAC was investigated in terms of outcome, age at admission, or major diagnosis; however, LAC‐24 hours remained significantly associated with survival. Conclusions – Admission or persistent hyperlactatemia is associated with a nonsurvival. Younger foals, premature/dysmature foals, and foals with neonatal encephalopathy had the largest LAC.     

High Seroprevalence Against Lawsonia intracellularis Among Adult Horses in Belgium

Lawsonia intracellularis (LI) is an obligate intracellular gram-negative rod causing equine proliferative enteropathy (EPE). Occasional cases of EPE have been reported in foals living in Belgium, but the seroprevalence of equine LI in this country is unknown. The target population included clinically healthy adult horses, whose blood samples were collected and analyzed for specific IgG antibodies against LI using a blocking enzyme-linked immunosorbent assay test. The results were expressed as percentage of inhibition (PI). Samples that had a PI <20% were judged as negative, those between 20 and 30% as inconclusive, and those >30% were considered positive. A total of 356 blood samples were analyzed with 352 horses (98.8%) testing positive, 2 horses (0.6%) testing negative, and 2 horses (0.6%) showing inconclusive results. The large percentage of seropositive samples obtained in this study confirms a widespread exposure of Belgian horses to LI.     

Pharmacokinetics and Safety of Oral Administration of Meloxicam to Foals

Background

The pharmacokinetics, efficacy, and safety of meloxicam have been evaluated in adult horses, but not foals. Physiologic differences between neonates and adults might alter drug pharmacokinetics and therapeutic index.

Hypotheses

The pharmacokinetics of meloxicam will be different in foals compared with adult horses, and foals could be at increased risk for adverse drug effects.

Animals

Twenty lightbreed foals less than 6 weeks of age at commencement of the study.

Methods

Single and repeated oral dose pharmacokinetics were determined for meloxicam (0.6 mg/kg) in 10 foals. The safety of the drug was further evaluated in a 2nd group of 10 foals in a randomized blinded prospective study.

Results

Plasma concentrations after a single oral dose of meloxicam (0.6 mg/kg) and time to maximum plasma concentration were similar to adult horses. However, drug clearance was much more rapid in foals (elimination half‐life 2.48 ± 0.25 hours). Administration of 0.6 mg/kg every 12 hours was well tolerated by foals for up to 3 weeks, with no evidence of drug accumulation in plasma. Adverse effects observed in adult horses at higher dose rates were not observed in foals given 1.8 mg/kg twice daily for 7 days.

Conclusions and clinical importance

Meloxicam at an oral dose rate of 0.6 mg/kg every 12 hours provided plasma concentrations likely to be therapeutic. In contrast to findings for other NSAIDs, foals appeared more resilient to the adverse effects of this drug than was observed in adult horses.     

Therapy of Suspected Septicemia in Neonatal Foals Using Plasma-containing Antibodies to Core Lipopolysaccharide (LPS)

Equine antiserum to core lipopolysaccharide (LPS) was evaluated in a double-blind prospective study for therapeutic benefit in suspected septicemia in neonatal foals. Forty foals younger than 7 days of age were included in the study by satisfaction of clinical and laboratory criteria, suggestive of gram-negative septicemia. Twenty-two foals were treated with core LPS antiserum (plasma produced from horses which were hyperimmunized with rough gram-negative mutant bacterin) and 18 foals received "nonimmune" plasma (from horses prior to immunization against core LPS). All foals received antimicrobials, fluids, and other supportive care measures, depending on clinical signs and according to accepted current practice. The clinical and laboratory data of each foal were monitored and recorded daily for 14 days after plasma treatment or until death.
The overall survival rate of these 40 foals with septicemia was 52.5%. The most prevalent diagnoses in addition to septicemia were enteritis and pneumonia. Of 30 positive bacterial cultures, 93% were due to gram-negative organisms. There was no statistically significant increase in survival rate in the 22 foals given core LPS antiserum ( P ± 0.05).     

Efficacy of Hyperimmunized Plasma in the Treatment of Horses with Acute Colitis

Colitis in the adult horse is a life-threatening clinical condition that can be caused by any of several enteric pathogens. This study was conducted to determine whether treating horses with plasma obtained from donors that were hyperimmunized against the common equine diarrheal pathogens Clostridium difficile, Clostridium perfringens, and Salmonella sp shortens the duration of diarrhea in acute colitis. To evaluate the efficacy of plasma treatment, 42 horses with acute onset of diarrhea were studied. Horses were enrolled if they were of age >1 year, duration of diarrhea at presentation was <72 hours, and they had not received equine plasma within the last 3 months. In addition, the serum cortisol concentrations of horses with acute diarrhea were studied.Horses were randomized to receive hyperimmunized plasma, control plasma (collected from nonimmunized horses), or no plasma therapy. Clinical parameters and fecal consistency were observed until resolution, discharge, or death, and complete blood counts (CBCs) and biochemical profiles were collected throughout the study. A total of 38 horses completed the study. The mean duration of diarrhea was 40.7 ± 9.8 (mean ± SEM) hours, 119.2 ± 56.1 hours, and 72.0 ± 24.5 hours for the hyperimmunized plasma, normal plasma (NP), and control groups, respectively. Using survival analysis techniques, this difference did not achieve statistical significance (P = .374). Serum cortisol was found to be increased in all horses at presentation and to decrease with time in all treatment groups. There was no difference in cortisol concentrations between the three treatment groups studied (P = .237).     

Lymphocyte stimulation response in horses against phytohaemagglutinin and M protein of Streptococcus equi using whole blood.

Lymphocyte stimulation was observed in whole equine blood in the presence of phytohaemagglutinin and M protein extracted from a typical strain of Streptococcus equi. Blood samples were collected from several healthy horses and horse and pony foals and cultured in vitro with varying concentrations of phytohaemagglutinin and M protein for several days. Phytohaemagglutinin was found to induce lymphocyte stimulation in these animals. Highest mean stimulation indices in horse foals (49.3 +/- 24.4) and pony foals (54.7 +/- 32.0) were observed with 0.625 and 1.25 micrograms/mL phytohaemagglutinin, respectively, at either 72 or 96 hours of incubation. Significantly higher radioactive counts per minute in horse and pony foals were recorded in blood cultures incubated with 0.625 and 1.25 micrograms/mL phytohaemagglutinin. M protein induced a dose related stimulation response in adult horses. Maximum stimulation indices were observed against 125 micrograms/mL M protein at 96 hours. These stimulation indices were higher in adult horses (40.0 +/- 2.2) than observed in pony foals (14.4 +/- 15.7). Higher stimulation levels in adult horses indicated either nonspecific stimulation against M protein or previous exposure of these animals to S. equi.     

A prospective study of the roles of clostridium difficile and enterotoxigenic Clostridium perfringens in equine diarrhoea

Faecal samples from adult horses and from foals with diarrhoea or with normal faeces were evaluated for the presence of Clostridium difficile, C. difficile toxins, C. perfringens enterotoxin (CPE) and C. perfringens spore counts. Clostridium difficile was isolated from 7/55 horses (12.7%) and 11/31 foals (35.5%) with colitis, but from 1/255 normal adults (0.4%) and 0/47 normal foals (P<0.001). Clostridium difficile toxins A and/or B were detected in 12/55 diarrhoeic adults (21.8%) and 5/30 diarrhoeic foals (16.7%) but in only 1/83 adults (1.2%) and 0/21 foals with normal faeces (P<0.001 and P<0.05, respectively). Clostridium perfringens enterotoxin was detected in 9/47 diarrhoeic adults (19%) and 8/28 diarrhoeic foals (28.6%), but was not detected in 47 adult horses (P<0.002) or 4 foals (P = 0.22) with normal faeces. The positive predictive value of isolation of C. perfringens with respect to the presence of CPE was only 60% in adult horses and 64% in foals. There was no association between total C. perfringens spore count and CPE in the faeces. The overall mortality rate from colitis was 22% for adult horses and 18% for foals. Clostridium difficile toxin-positive adult horses with colitis were less likely to survive than C. difficile-negative horses with colitis (P = 0.03). This study provides further evidence that C. difficile and enterotoxigenic C. perfringens are associated with equine enterocolitis.     

Hematological and Blood Biochemical Characteristics of Newborn Heavy Draft Foals After Dystocia

The negative impact of equine dystocia on hematological and serum biochemical profile of neonatal foals remains unknown, particularly in heavy draft horses that show high incidence of dystocia. This study aimed to reveal the hematological and serum biochemical profile of the foals born in normal delivery and examine the effect of dystocia on blood properties in heavy draft newborn foals. In the normal birth group (n = 23), stage II labor was <30 minutes, with spontaneous or assisted delivery with mild traction by one or two people. In the dystocia group (n = 13), stage II labor was ≥30 minutes, with strong traction by more than three people or mechanical tools with or without correcting fetal displacement. Blood samples were collected from the jugular vein at 0, 1, and 12 hours and 1 and 2 days after foaling. Red blood cells, hemoglobin concentration, and packed cell volume remained significantly lower in the dystocia group than in the normal birth group. The white blood cell count was significantly higher in dystocia foals (1 day: P < .05). Dystocia foals had significantly higher cortisol (1 hour: P < .05), urea nitrogen (1 hour: P < .05), and creatine kinase activities (1 hour: P < .01, 12 hours: P < .05). This study revealed that dystocia foals were more likely to be affected by anemia, physical stress, and muscle damage than normal birth foals.     

Behavior of artificially suckled foals

Artificial feeding of foals is rarely practiced other than for raising orphans. This study investigated the effects of an artificial feeding system on the growth and welfare of a group of “Cavallo Agricolo Italiano da Tiro Pesante Rapido” foals (n = 12). A viable artificial rearing method could allow for the commercial supply of mare’s milk for cosmetic or pediatric purposes. Six foals were maintained on an artificial suckling (AS) regimen using a modified bovine milk replacer, and 6 remained with their dams (control group, naturally suckled [NS]).Housing and management was identical for both groups. During the 6-month trial, the foals were weighed every 3 weeks from 4 days of age, and their daily weight gains were calculated. Foals were directly observed for 6 separate 24-hour periods at 4, 10, 47, 114, 142, and 176 days of age, and an ethogram was compiled from the observed behaviors (resting, social, alimentary, and eliminative).All data were analyzed using a repeated measures analysis.At 4 days of age, the behavior of the AS foals was significantly different from that of the control group foals in that they stood up for longer duration (530 vs. 174 minutes, P < 0.01), performed fewer suckling bouts (P < 0.01), and did not play (P < 0.01) or lick (P < 0.05). AS foals were more aggressive and cross-suckled more (P < 0.01) at 10 days of age than at the first observation period.After weaning, AS foals ate more concentrate and less hay than the control group foals (P < 0.01). However, at the end of the trial, there were no significant differences between the groups in terms of weight (AS vs. NS [mean ± standard deviation]: 350 ± 15 vs. 360 ± 20 kg, P = 0.34) and daily weight gains (1630 ± 370 vs. 1600 ± 310 g/d, P = 0.88).Artificial suckling techniques could be applied to Cavallo Agricolo Italiano da Tiro Pesante Rapido foals, without negative effects on growth and welfare during the first 6 months of life. In fact, after an initial adaptation period, the AS foals did not exhibit any abnormal behavior or behavioral differences compared with NS foals. Further studies are required to improve this rearing technique, which could facilitate the efficient raising of orphan foals and/or marketing equine milk. Additional research would enable the effects of this rearing technique on the long-term growth, behavior, and health of the foals.     

Plasma and pulmonary disposition of ceftiofur and its metabolites after intramuscular administration of ceftiofur crystalline free acid in weanling foals

The objectives of this study were to determine the plasma and pulmonary disposition of ceftiofur crystalline free acid (CCFA) in weanling foals and to compare the plasma pharmacokinetic profile of weanling foals to that of adult horses. A single dose of CCFA was administered intramuscularly to six weanling foals and six adult horses at a dose of 6.6 mg/kg of body weight. Concentrations of desfuroylceftiofur acetamide (DCA) were determined in the plasma of all animals, and in pulmonary epithelial lining fluid (PELF) and bronchoalveolar lavage (BAL) cells of foals. After intramuscular (IM) administration to foals, median time to maximum plasma and PELF concentrations was 24 h (12-48 h). Mean (± SD) peak DCA concentration in plasma (1.44 ± 0.46 μg/mL) was significantly higher than that in PELF (0.46 ± 0.03 μg/mL) and BAL cells (0.024 ± 0.011 μg/mL). Time above the therapeutic target of 0.2 μg/mL was significantly longer in plasma (185 ± 20 h) than in PELF (107 ± 31 h). The concentration of DCA in BAL cells did not reach the therapeutic level. Adult horses had significantly lower peak plasma concentrations and area under the curve compared to foals. Based on the results of this study, CCFA administered IM at 6.6 mg/kg in weanling foals provided plasma and PELF concentrations above the therapeutic target of 0.2 μg/mL for at least 4 days and would be expected to be an effective treatment for pneumonia caused by Streptococcus equi subsp. zooepidemicus at doses similar to the adult label.     

Serially determined plasma alpha-tocopherol concentrations and results of the oral vitamin E absorption test in clinically normal horses and in horses with degenerative myeloencephalopathy

Plasma alpha-tocopherol (vitamin E) values were monitored serially in 9 foals sired by a stallion with equine degenerative myeloencephalopathy (EDM) and in 5 age-matched control foals (sired by a clinically normal stallion) raised in the same environment for the first year of life. Clinical evaluation determined that 8 of the 9 foals sired by the stallion with EDM had neurologic deficits consistent with the disease on one or more occasions during the study period, whereas control foals had normal gait. From 6 weeks to 10 months of age, plasma alpha-tocopherol values in foals with signs of EDM were significantly (P less than 0.001) lower than those in control foals. An oral vitamin E absorption test was performed, and results for 8 of the affected horses and the affected stallion were compared with results for 4 of the monitored control horses and 4 additional control horses. Significant differences were not evident in any of the absorption indices. On the basis of data from this study and supported by reported prophylactic and therapeutic benefits of supplemented vitamin E, low plasma concentration of vitamin E is concluded to be a factor in the development of EDM in the first year of life of hereditarily predisposed foals. It was also concluded that the significantly lower alpha-tocopherol values seen in the foals in this study did not reflect a primary gastrointestinal tract absorption problem.     

Preliminary evaluation of hemostasis in neonatal foals using a viscoelastic coagulation and platelet function analyzer

Objectives – To compare coagulation and platelet function parameters measured using a viscoelastic analyzer in 3 groups: foals presenting to a neonatal intensive care unit with presumed sepsis, normal foals, and adult horses. Design – Preliminary prospective trial. Setting – Veterinary teaching hospital. Animals – Ten clinically healthy foals, 13 clinically healthy adult horses, and 17 foals sequentially admitted for suspected sepsis. Intervention – A single citrated (3.8%) blood sample collected at admission was submitted for coagulation evaluation using a viscoelastic analyzer. Measurements and Main Results – Time to initial clot formation (ACT), clot rate (CR), platelet function, and time to peak parameters were collected from the signature generated with the associated software. Peak clot strength was collected manually from signature tracings. Signalment, presenting complaint, blood culture results, clinical progression, and outcome were collected from the medical record. Kruskal‐Wallis testing was used to determine differences in coagulation parameters between groups, as well as to identify any associations between coagulation variables, foal variables, and outcome. Normal foals were more likely to have increased platelet function (P=0.04) compared with normal adult horses. Prolonged ACT (P=0.004) and decreased CR (P=0.03) were associated with foals with positive blood culture. There was a trend toward prolonged ACT and increased likelihood of death (P=0.06). Conclusions – Healthy foals differ in values measured by the viscoelastic coagulation and platelet function analyzer compared with healthy adult horses. ACT and CR abnormalities were more likely to be observed in foals with positive blood cultures. The viscoelastic coagulation and platelet function analyzer may be useful in identifying early hemostasic and platelet dysfunction in critically ill foals, particularly those that are septic.