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Hypothalamic-pituitary-adrenal axis dysfunction in hospitalized neonatal foals
K A Hart1, N M Slovis, M H Barton
1Department of Large Animal Medicine, College of Veterinary Medicine, University of Georgia, and Veterinary Teaching Hospital, Athens, GA 30602, USA. khart4@uga.edu
Journal of Veterinary Internal Medicine
|June 6, 2009
Summary
Hypothalamic-pituitary-adrenal (HPA) axis dysfunction is common in critically ill foals, affecting disease severity and survival. This condition involves low cortisol levels or poor response to ACTH stimulation.
Area of Science:
- Veterinary Medicine
- Endocrinology
- Critical Care
Background:
- Hypothalamic-pituitary-adrenal (HPA) axis dysfunction is prevalent in critically ill humans, impacting survival.
- The occurrence and effects of HPA axis dysfunction in neonatal foals are not well understood.
Purpose of the Study:
- To determine the prevalence of HPA axis dysfunction in hospitalized neonatal foals.
- To characterize HPA axis dysfunction by basal cortisol and response to ACTH stimulation.
- To assess the association between HPA axis dysfunction and disease severity or survival in foals.
Main Methods:
- Studied 72 hospitalized foals and 23 healthy controls.
- Measured basal ACTH and cortisol levels.
- Administered a cosyntropin (ACTH) stimulation test (10 microg/100 microg) at admission.
- Defined HPA axis dysfunction based on basal cortisol and cortisol increase post-ACTH stimulation.
Main Results:
- 46% of foals had low basal cortisol; 52% had inadequate cortisol response to 100 microg cosyntropin.
- Inadequate response to high-dose cosyntropin correlated with shock and multiple organ dysfunction.
- Poor ACTH response was linked to decreased survival in septic foals.
Conclusions:
- HPA axis dysfunction is frequent in hospitalized neonatal foals.
- This dysfunction is associated with increased disease severity.
- HPA axis dysfunction negatively impacts foal survival.
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