title: Putative intestinal hyperammonaemia in horses: 36 cases.
abstract: BACKGROUND
  Intestinal hyperammonaemia (HA) has been infrequently reported in individual horses; however, there have been no studies describing clinical and laboratory data as well as short- and long-term outcome in a larger number of cases.
  
  
  OBJECTIVE
  To describe clinical and laboratory data and short- and long-term outcome in a large group of horses with intestinal HA.
  
  
  METHODS
  Multi-centred, retrospective study; case records of horses with HA were reviewed and any horse with a clinical or post mortem diagnosis of intestinal HA was included. Hyperammonaemia was defined as a blood ammonium (NH(4) (+)) concentration ≥60 µmol/l and horses with a diagnosis of primary hepatic disease were excluded. Relevant data were recorded and, if appropriate, data from survivors were compared to nonsurvivors to identify potential prognostic indicators.
  
  
  RESULTS
  Thirty-six cases, 26 mature horses and 10 foals with intestinal HA were identified. Case histories included diarrhoea, colic and neurological signs and the most common clinical diagnosis was colitis and/or enteritis. The most common clinical and laboratory abnormalities included tachycardia, increased packed cell volume, hyperlactataemia and hyperglycaemia. Fourteen horses (39%) survived to discharge; NH(4) (+) concentration on admission was the only parameter significantly associated with survival. All surviving horses and foals for which follow-up information was available recovered completely and returned to their intended use without further complications.
  
  
  CONCLUSIONS
  Intestinal HA occurs in mature horses and foals and can be associated with severe clinical and laboratory abnormalities; further studies are required to investigate predisposing factors and delineate possible differences in aetiologies.
authors: Department of Veterinary Clinical Sciences, The Royal Veterinary College, Hertfordshire, UK. bdunkel@rvc.ac.uk
authors: B
authors: B
authors: Dunkel
authors: K P
authors: KP
authors: Chaney
authors: B L
authors: BL
authors: Dallap-Schaer
authors: A
authors: A
authors: Pellegrini-Masini
authors: T S
authors: TS
authors: Mair
authors: R
authors: R
authors: Boston