Serial plasma vasopressin concentration in healthy and hospitalised neonatal foals.
Authors: Borchers A, Magdesian K G, Schenck P A, Kass P H
Journal: Equine veterinary journal
Summary
# Editorial Summary: Vasopressin Dynamics in Neonatal Foals Vasopressin dysregulation characterises critical illness in both human and equine neonates, yet serial plasma concentrations in sick foals have rarely been documented. Borchers and colleagues prospectively measured arginine vasopressin (AVP) in blood samples from 7 healthy foals and 26 hospitalised neonates at admission (before and after fluid resuscitation) and at 12, 24, 36, 48 and 96 hours post-presentation, stratifying cases by sepsis score (≥11 indicating sepsis). Septic foals demonstrated significantly elevated admission AVP concentrations compared to both healthy controls and sick non-septic foals, though no significant differences persisted between groups on subsequent sampling days; critically, foals that did not survive hospitalisation had higher early AVP concentrations than survivors. These findings suggest that admission plasma vasopressin concentration functions as an early prognostic indicator in hospitalised neonates—elevated levels on presentation may warrant more aggressive therapeutic intervention and closer monitoring, whilst the absence of sustained elevation differences across later timepoints implies that initial AVP dysregulation rather than ongoing imbalance drives poor outcomes. For practitioners managing critically ill foals, measuring AVP at admission could help stratify risk and guide clinical decision-making, particularly regarding intensity of supportive care and client counselling regarding prognosis.
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Practical Takeaways
- •Plasma AVP measurement at admission may help identify septic neonatal foals and stratify mortality risk early in hospitalization
- •Elevated vasopressin on presentation in critically ill foals warrants aggressive intervention and close monitoring, as it correlates with poor outcomes
- •Serial AVP monitoring after initial resuscitation may not provide additional prognostic value compared to admission measurement alone
Key Findings
- •Admission plasma AVP concentrations were significantly elevated in septic foals compared to healthy and sick nonseptic foals
- •No significant differences in AVP concentrations between groups were observed on subsequent measurement days (12-96 hours)
- •Nonsurviving foals had higher AVP concentrations than surviving foals, indicating elevated early AVP is associated with increased mortality