Intestinal hyperammonaemia in horses

Intestinal hyperammonaemia in horses is a syndrome putatively caused by increased intestinal production and/or absorption of ammonia that clinically manifests as severe neurological abnormalities often in conjunction with signs of gastrointestinal dysfunction but without evidence of hepatic compromise. Ingestion of Black Locust (Robinia pseudoacacia) is a novel primary condition that may predispose to development of the syndrome as described in this issue. Treatment of the condition is symptomatic and aimed at decreasing blood ammonium concentrations by reducing further production and absorption, reducing brain oedema and preventing self‐inflicted trauma. Prognosis for survival is guarded, particularly in cases with severe gastrointestinal lesions, and is influenced by the ability to control clinical signs.