Dynamics of androgens in healthy and hospitalized newborn foals.
Authors: Swink Jacob M, Rings Lindsey M, Snyder Hailey A, McAuley Rachel C, Burns Teresa A, Dembek Katarzyna A, Gilsenan William F, Browne Nimet, Toribio Ramiro E
Journal: Journal of veterinary internal medicine
Summary
# Editorial Summary: Androgen Dynamics in Neonatal Foals Androgens—steroid hormones produced by the adrenal glands and gonads—have remained largely unmeasured in newborn foal populations, despite their potential clinical significance in neonatal disease. This prospective, multicentre study examined 145 hospitalised foals (septic, sick non-septic, or with neonatal maladjustment syndrome) and 80 healthy foals aged ≤3 days, measuring serum concentrations of DHEA, androstenedione, testosterone, and DHT alongside plasma ACTH. Hospitalised foals presented with markedly elevated androgens on admission; whilst healthy foals showed a rapid decline to 4.9–10.8% of initial values within days, septic foals retained 30.8–62.8% of admission concentrations, and non-surviving foals demonstrated persistently elevated or rising androgen levels regardless of disease classification. The ACTH:androgen ratio proved particularly informative in septic and maladjustment cases, and impaired androgen clearance emerged as a strong prognostic indicator, with affected foals carrying an odds ratio >3 for mortality. Beyond their diagnostic value, these findings suggest androgens may actively participate in the pathophysiology of neonatal sepsis and dysfunction rather than merely reflecting systemic stress—a distinction with potential implications for future therapeutic strategies in critically ill foals.
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Practical Takeaways
- •Elevated serum androgens at admission may serve as a prognostic marker for disease severity and survival risk in hospitalized newborn foals
- •Persistent elevation of androgens beyond the first few days of life suggests poor prognosis; normal foals should show rapid androgen clearance
- •Androgen metabolism appears disrupted in sepsis and neonatal maladjustment—monitoring these steroids could help identify foals at highest risk of nonsurvival and guide treatment intensity
Key Findings
- •Serum androgens (DHEA, androstenedione, testosterone, DHT) are significantly elevated in hospitalized foals at admission compared to healthy foals (P < 0.05)
- •Androgens decrease to 4.9-10.8% of admission values in healthy foals but remain elevated in septic (30.8-62.8%) and nonsurviving foals
- •Foals with decreased androgen clearance had >3-fold increased odds of mortality (P < 0.05)
- •ACTH:androgen ratios are significantly higher in septic and NMS foals, suggesting dysregulated androgen metabolism in severe disease