Admission clinicopathological data, length of stay, cost and mortality in an equine neonatal intensive care unit

Abstract

Veterinary internists need to prognosticate patients quickly and accurately in a neonatal intensive care unit (NICU). This may depend on laboratory data collected on admission, the cost of hospitalisation, length of stay (LOS) and mortality rate experienced in the NICU. Therefore, we conducted a retrospective study of 62 equine neonates admitted to a NICU of a private equine referral hospital to determine the prognostic value of venous clinicopathological data collected on admission before therapy, the cost of hospitalisation, LOS and mortality rate. The WBC count, total CO2 (TCO2) and alkaline phosphatase (ALP) were significantly higher (P < 0.05) and anion gap lower in survivors compared with nonsurvivors. A logistic regression model that included WBC count, hematocrit, albumin / globulin ratio, ALP, TCO2, potassium, sodium and lactate, was able to correctly predict mortality in 84 % of cases. Only anion gap proved to be an independent predictor of neonatal mortality in this study. In the study population, the overall mortality rate was 34 % with greatest mortality rates reported in the first 48 hours and again on day 6 of hospitalisation. Amongst the various clinical diagnoses, mortality was highest in foals after forced extraction during correction of dystocia. Median cost per day was higher for nonsurvivors while total cost was higher in survivors

Prognostic indicators associated with early mortality of wild raptors admitted to a wildlife rehabilitation centre in Spain

“…Identifying the best indicators helps in establishing protocols for triage, and the selection of the best complementary diagnostic techniques and treatments. The research of prognostic indicators in veterinary medicine has been mainly focused in domestic species (Nel et al 2004;Saulez et al 2007). The findings from these domestic animal studies have little relevance for wildlife rehabilitation medicine due to the wide variety of species and different presenting conditions.…”

Acid-base balance parameters and a value of anion gap of arterial and venous blood in Małopolski horses

“…The change in the anion gap size is very useful for diagnostics of the colic (Bristol 1982) and metabolic diseases in horses (Gossett et al 1987), and in the case of foals, the AG value is a good prognostic of their survival rate (Bedenice et al 2003, Saulez 2007. When making use of AG in diagnostics, one should always take into account the age of the horses examined, in accordance with the suggestion by Gossett and French's (1983).…”

“…Calculation of AG in mature horses is useful for the diagnosis of metabolic acidosis (Gossett et al 1987, Constable et al 1998); a change in the AG value is also used as a prognostic indicator of colic affections (Bristol 1982). In foals, the anion gap is used as a survival ratio for animals undergoing intensive care (Hoffman et al 1992, Saulez et al 2007) and in the case of pulmonary diseases (Bedenice et al 2003). The anion gap in horses changes with age (Gossett and French 1983) and depends on the physiological condition of the animal e.g.…”

Acid base imbalances in ill neonatal foals and their association with survival

“…Neonatal sepsis is the major cause of morbidity and mortality in foals . Several clinical studies have attempted to identify early markers of outcome in critically ill foals in order to treat aggressively and promptly those at greater risk of death . In human medicine, sepsis may be associated with various acid‐base disorders from primary respiratory alkalosis to various forms of primary metabolic acidosis.…”

“…Initially, an attempt was made to solve this problem by adapting BE (base excess) to the quantitative method (Fencl‐Stewart equation) in order to quantify the metabolic component and Constable simplified the approach reducing calculation of SID to only the main ions (sodium [Na + ], potassium [K + ], chloride [Cl ‐ ] and L‐lactate) and assumed a small difference between real and measured SID (SID m ) that could be quantified by the strong ion gap (SIG) . Normal ranges of parameters used for quantitative acid‐base calculations and interpretation including values of strong ion difference (SID m ) and total nonvolatile weak buffers (A tot ) and the quantitative method has been applied in ill neonatal foals .…”