Spurious hypercreatininemia: 28 neonatal foals (2000–2008) |
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Authors: | Kristin P. Chaney DVM DACVIM DACVECC Susan J. Holcombe VMD MS PhD DACVS DACVECC Harold C. Schott II DVM PhD DACVIM Bonnie S. Barr DVM DACVIM |
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Affiliation: | 1. Large Animal Medicine and Surgery Academic Program, St George's University, Grenada, West Indies;2. Department of Large Animal Clinical Sciences, Michigan State University, College of Veterinary Medicine, East Lansing, MI 48824;3. Rood and Riddle Equine Hospital, 2150 Georgetown Road, Lexington, KY 40511 |
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Abstract: | Objectives – To (1) determine the occurrence of spurious hypercreatininemia in a population of hospitalized foals <2 days old, (2) assess the resolution of the hypercreatininemia, and (3) determine its association with survival in these foals. Design – Retrospective case series. Setting – 2 Referral hospitals. Animals – Foals <2 days old with an admission creatinine >442 μmol/L (>5.0 mg/dL) from 2 referral hospitals. Interventions – None. Measurements and Main Results – The medical records of 33 foals were reviewed. Twenty‐eight had spurious hypercreatininemia and 5 had acute renal failure. Admission creatinine was not significantly different between the 2 groups (mean [standard deviation]). The creatinine was 1,202 μmol/L (663 μmol/L) (13.6 mg/dL [7.5 mg/dL]) versus 1,185 μmol/L (787 μmol/L) (13.4 mg/dL [8.9 mg/d]) (P=0.96) in each group, respectively, though BUN at the time of hospital admission was significantly higher for acute renal failure foals (P=0.009). In the spurious group, serum creatinine at admission decreased to 504 μmol/L (380 μmol/L) (5.7 mg/dL [4.3 mg/dL]) by 24 hours, and to 159 μmol/L (80 μmol/L) (1.8 mg/dL [0.9 mg/dL]) at 48 hours, and to 115 μmol/L (44 μmol/L) (1.3 mg/dL [0.5 mg/dL]) at 72 hours. Twenty‐three of 28 foals with spurious hypercreatininemia survived to hospital discharge and there was no difference in mean admission creatinine between survivors (1176 μmol/L [628 μmol/L]) (13.3 mg/dL [7.1 mg/dL]) and nonsurvivors (1308 μmol/L [857 μmol/L]) (14.8 mg/dL [9.7 mg/dL]) (P=0.67). Twenty of 28 foals had clinical signs suggestive of neonatal encephalopathy. Conclusion – Creatinine decreased by >50% within the initial 24 hours of standard neonatal therapy and was within the reference interval in all but 1 foal within 72 hours of hospitalization. The diagnosis of neonatal encephalopathy was common in these foals. |
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Keywords: | azotemia neonatal encephalopathy placentitis |
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