Ulcerative dermatitis, thrombocytopenia, and neutropenia in neonatal foals.
Authors: Perkins G A, Miller W H, Divers T J, Clark C K, Belgrave R L, Sellon D C
Journal: Journal of veterinary internal medicine
Summary
# Editorial Summary Between 2005 and the paper's publication, Perkins and colleagues documented a striking syndrome in six neonatal foals from geographically unrelated mares, characterised by severe thrombocytopenia (platelet counts of 0–30,000/μL), oral ulceration, and widespread crusting dermatitis appearing within the first four days of life. Bone marrow biopsies and immunological testing ruled out primary bone marrow dysfunction or alloimmunisation, whilst skin histopathology consistently revealed subepidermal clefting with haemorrhage and necrosis—findings more suggestive of an immune-mediated vasculitis. Most foals responded favourably to supportive care, broad-spectrum antibiotics, and corticosteroids, with platelet recovery above 50,000/μL achieved within two weeks, though two individuals required prolonged treatment after steroid reduction, indicating possible steroid dependence. The critical observation was that two of the affected mares subsequently produced healthy foals when given colostrum from alternate sources, implying a colostral or maternal factor as the aetiological agent. Whilst this remains largely a descriptive case series rather than a mechanistic study, the clinical pattern warrants heightened awareness amongst equine practitioners of neonatal immune-mediated disease and raises important questions about colostral screening and management in problem mares.
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Practical Takeaways
- •Recognize neonatal foals presenting before 4 days of age with periocular/perineal ulcers, oral ulcers, and hemorrhages as potentially having colostrum-related thrombocytopenia and dermatitis requiring immediate supportive care
- •Implement gastric ulcer prophylaxis, broad-spectrum antibiotics, and monitor platelet counts closely in affected foals; note that platelet counts may decline when corticosteroids are reduced
- •If a mare produces multiple affected foals, consider using colostrum from an alternate source in subsequent pregnancies as preventive management
Key Findings
- •Six neonates from four mares presented within 4 days of age with oral/lingual ulcers, periocular/perineal dermatitis, and severe thrombocytopenia (0-30,000 platelets/μL)
- •Histopathology showed subepidermal clefting with vascular dilation, dermal hemorrhage, and superficial papillary necrosis across all affected foals
- •Skin lesions and thrombocytopenia (>50,000 platelets/μL) resolved within 2 weeks in 4/6 foals with supportive care
- •Subsequent pregnancies in the same two mares resulted in healthy foals when alternate colostrum sources were provided, suggesting colostral antibodies or colostral factors as potential etiology