Disease of the equine neonate pt 3 Flashcards

1
Q

Neonatal Isoerythrolysis
- how many erythrocyte groups in horses:

A
  • Seven erythrocyte groups in horses:
    A C D K P Q U
    <><><><>
    The blood group genes produce surface molecules that contain antigenic sites known as factors. Over 30 different factors have been identified.
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2
Q

Alloantibodies definition

A

immune antibodies that are only produced following exposure to foreign red blood cell antigens
> Produced by exposure to foreign red cell antigens which are non-self antigens but are of the same species. They react only with allogenic cells. Exposure occurs through pregnancy or transfusion.

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3
Q

all standardbreds are which blood type?

A

All Standardbreds are Qa negative

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4
Q

what is neonatal isoerythrolysis? how does it occur?

A
  • Destruction of foal erythrocytes by alloantibodies from the dam absorbed by ingestion of colostrum
  • Alloantibodies only develop after exposure of dam to foreign erythrocyte antigens
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5
Q

Prerequisites for NI

A
  1. Dam must be negative for the offending antigen
  2. Dam must be exposed to the offending antigen
  3. The sire must carry the offending antigen
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6
Q

how does mare sensitization occur for NI?

A
  • Previous blood transfusion
  • Exposure to foal blood in a previous gestation (*parturition)
  • Exposure to foal blood across abnormal placenta
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7
Q

prevalence of NI;
- in throroughbreds, standardbreds, mules

A
  • Thoroughbreds: = 1%
  • Standardbreds: = 2%
  • Mules: = 10%
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8
Q

NI clinical signs

A
  • Normal at birth
  • Progressive depression, weakness and failure to nurse by 24 – 36 hours old
  • Pale or icteric mucous membranes
  • Tachypnea
  • Tachycardia
  • Seizures
  • Death
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9
Q

Neonatal isoerythrolysis Dx

A
  • Anemia:
    > Packed cell volume
    > Red cell count
  • Hemoglobinemia
  • Hemoglobinuria
  • Bilirubinemia
  • Acute renal failure
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10
Q

NI
* Foal erythrocytes bound by alloantibodies are removed by:

A
  • reticuloendothelial system
  • intravascular Compliment-mediated lysis
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11
Q

Treatment of NI foals

A

Clinically affected:
* Withholding colostrum
* Rest (confinement)
* Diuresis > pigments toxic to kidneys
* Whole blood transfusion (PCV<15%)…

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12
Q

what can we do if we give a transfusion for NI foal to make sure it will work

A
  • Crossmatch against mare’s serum
  • Washed mare rbc’s (must remove plasma)
  • Donor rbc’s (Aa and Qa -): Stb gelding preferred
  • Not the sire
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13
Q

Detection of erythrocyte antigens for NI

A
  • Agglutination
  • Complement-mediated lysis by specific
    alloantibodies
  • Foal rbc’s + mare serum
  • Foal rbc’s + mare colostrum
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14
Q

incidence of neonatal isoerythrolysis?
- are most groups strongly antigenic?
- which are particularly antigenicc?

A
  • Most blood groups are not strongly antigenic
  • Incidence is low (1% TB, 2% STB, 10 % Mules)
  • Factors Aa and Qa of A and Q systems are particularly antigenic
  • Mule “donkey factor”
  • Qa not present in STB population.
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15
Q

NI: Treatment
- is transfusion permanent
- how much
- what to do with mare

A
  • Transfusion is temporary
  • 1 – 4 liters
  • Avoid volume overload
  • Also, milk out the mare regularly
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16
Q

NI prevention, and who is at risk?
what stallions should we breed to?
screening?

A
  • Blood type broodmares
  • Aa- and Qa- mares are at risk
  • Breed only to Aa- and Qa- stallions
  • Screen mare’s serum <1 month pre-partum for anti-stallion-erythrocyte antibodies
17
Q

what propotion of NI pregnancies will have alloantibodies against factors other than Aa and Qa

A
  • 1/2000
18
Q

NI
* Aa- TB Mare:
- what proportion are Aa+? what proportion of stallions are compatible?

A
  • 98% of TBs are Aa+
  • 2% of TB stallions are compatible
19
Q

NI
* Qa- TB Mare:
- what proportion are Qa+? what proportion of stallions are compatible?

A
  • 84% of TBs are Qa+
  • 16% of TB stallions are compatible
20
Q

NI
* Qa- Stb Mare:
- what proportion are Qa-? what proportion of stallions are compatible?

A
  • All Stbs are Qa-
  • All Stb stallions are compatible
21
Q

are mules at risk of NI? why?

A
  • All donkeys produce “donkey factor”
  • No horse produces “donkey factor”
  • Thus, all mules are at risk of NI
22
Q

NI prevention
- nursing considerations, screening?

A
  • Prevent foal from nursing until mare’s colostrum is checked for compatibility with foal’s rbcs
23
Q
  • Jaundiced Foal Agglutination Test:
  • how to perform
  • when is it ositive
A
  • Serial saline dilutions of mare serum or
    colostrum
  • Foal rbc’s added to each tube
  • Centrifuged
  • RBC pellet after supernatant removed
  • Positive = 1/16 dilution or greater
24
Q

structures that can be implicated in uroperitoneum

A
  • Rupture Bladder
  • Ureteres
  • Urethra
  • Urachus
25
Q

uroperitoneum clinical signs

A
  • Repeated posturing to urinate
  • Stranguria
  • Distended abdomen
  • Depression
  • Decreased urine production
  • Decreased nursing
26
Q

uroperitoneum Dx

A

*CLINICAL SIGNS
<><>
* CBC :
> Increased PCV / TP
> Stress leukogram
<><>
* X-RAY / US ABDOMEN:
FLUIDS
<><>
* INJECTION OF A DYE
Methylene Blue
Bladder
Peritoneal tap
<><>
* PERITONEAL TAP:
CREATININE RATIO 2/1

27
Q

uroperitoneum lab findings

A
  • Hyponatremia
  • Hypochloremia
  • Hyperkalemia
  • Azotemia
    Electrolytes abnormalities may not always be present
28
Q

uroperitoneum Tx

A
  • Correct electrolytes abnormalities
    <>
  • Abdominal drainage
    <>
  • Surgical repair
    > Laparotomy
    > Laparoscopy
    <>
  • Supportive care
    > Fluid therapy
    > Antibiotics
29
Q

ruptured bladder treatment

A

INITIAL MEDICAL TREATMENT
* Medical emergency !!!
* Abdominal Drainage
<>
* Fluid / Electrolytes imbalances
- 0.9% NaCl solution
- Bicarbonate solution
- Hyper K+ !!!! Cardiotoxicity*
<><><><>
- Abdominal drainage
- Correction of hypovolemia/acidosis
- Dextrose 5% +/- Insulin

30
Q

can uroperitoneum ever be be treated conservatively?

A
  • Only few case reports
  • Small tear at the dorsal aspect of the bladder
  • Urinary Catheter
31
Q

uorperitoneum complications

A
  • anesthesia (hyper k+)
  • recurrence
  • infections