Hepatoencephalopathy and hypocalcemia in a miniature horse mare

A pregnant, miniature horse mare had clinical signs of hepatoencephalopathy and concurrent hypocalcemia. The signs included dullness, inappetence, blindness, head pressing, weakness, muscle fasiculations, uveitis, and urinary incontinence. Hepatic dysfunction and hypocalcemia were confirmed by serum biochemical analysis. The mare was treated successfully with a continuous infusion of Ringer solution, calcium gluconate, dextrose, B-complex vitamins, sodium ampicillin, and flunixin meglumine; topical administration of ophthalmic ointments; and decompression of the urinary bladder. Histologic examination of a liver biopsy specimen revealed acute hepatic necrosis, which likely was associated with administration of a vaccine of equine origin 2 months earlier.