title: Factors associated with outcome in 94 hospitalised foals diagnosed with neonatal encephalopathy.
abstract: BACKGROUND
  Neonatal encephalopathy is the most common neurological abnormality identified in neonatal foals, but its clinical course has been rarely characterised.
  
  
  OBJECTIVE
  To describe factors associated with nonsurvival in a population of foals diagnosed with neonatal encephalopathy.
  
  
  METHODS
  Retrospective cross-sectional clinical study.
  
  
  METHODS
  Cases were selected from equine neonatal (≤14 days of age) admissions between 1996 and 2007. Multivariable logistic regression was used to identify clinical parameters, laboratory variables and therapeutic interventions associated with nonsurvival.
  
  
  RESULTS
  A total of 94 foals were included in the study. Median age at admission was 12 h (range 0-96 h). The most frequently identified clinical signs included abnormal udder seeking (59%), abnormal suckle (55%), inability to stand (42%), abnormal gastrointestinal motility (37%), abnormal consciousness (34%) and seizure activity (22%). Overall, 75 (79.8%) foals survived to be discharged from the hospital and 19 foals died or were subjected to euthanasia. Variables significantly associated with nonsurvival in the multivariable model were serum total calcium concentration, serum activity of alkaline phosphatase, recumbency, number of concurrent diseases, and use of vasopressors/inotropes. The model correctly classified 92.0% of cases.
  
  
  CONCLUSIONS
  Overall survival was good and similar to previous reports. Vasopressors/inotropes were the only therapeutic intervention associated with nonsurvival, suggesting that persistent hypotension is associated with nonsurvival in the current population. Foals with concurrent disease, high total calcium and low alkaline phosphatase at admission, and that were recumbent or required treatment with vasopressors/inotropes during hospitalisation, were significantly less likely to survive.
authors.affiliation: Hofmann Neonatal Intensive Care Unit, College of Veterinary Medicine, University of Florida, Gainesville, USA.
authors.forename: J
authors.initials: J
authors.lastname: Lyle-Dugas
authors.affiliation: Veterinary Medical Center, University of Georgia, Athens, USA.
authors.forename: S
authors.initials: S
authors.lastname: Giguère
authors.affiliation: Hofmann Neonatal Intensive Care Unit, College of Veterinary Medicine, University of Florida, Gainesville, USA.
authors.forename: M F
authors.initials: MF
authors.lastname: Mallicote
authors.affiliation: Hofmann Neonatal Intensive Care Unit, College of Veterinary Medicine, University of Florida, Gainesville, USA.
authors.forename: R J
authors.initials: RJ
authors.lastname: Mackay
authors.affiliation: Hofmann Neonatal Intensive Care Unit, College of Veterinary Medicine, University of Florida, Gainesville, USA.
authors.forename: L C
authors.initials: LC
authors.lastname: Sanchez
mesh_terms: D000818:Animals; D000831:Animals, Newborn; D001927:Brain Diseases / Q000662:veterinary*; D037901:Euthanasia, Animal; D005260:Female; D006734:Horse Diseases / Q000628:therapy*; D006736:Horses; D006762:Hospitals, Animal; D008297:Male; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: encephalopathy; foal; horse; neonatal maladjustment; neonatology