Blood arginine vasopressin, adrenocorticotropin hormone, and cortisol concentrations at admission in septic and critically ill foals and their association with survival.
Authors: Hurcombe S D A, Toribio R E, Slovis N, Kohn C W, Refsal K, Saville W, Mudge M C
Journal: Journal of veterinary internal medicine
Summary
# Editorial Summary Sepsis remains a leading cause of death in neonatal foals, yet the endocrine response to critical illness in this population has been poorly characterised compared to human medicine. Researchers measured plasma concentrations of arginine vasopressin (AVP), adrenocorticotropin hormone (ACTH), and cortisol at admission in septic and critically ill foals to determine whether the hypothalamic-pituitary-adrenal axis response could predict survival outcomes. The study identified specific hormonal profiles associated with fatal cases, suggesting that blunted or dysregulated HPAA responses—rather than exaggerated ones—may indicate poorer prognosis in critically ill foals. These findings have significant implications for clinical assessment and prognostication: early measurement of these biomarkers could help clinicians identify foals at highest risk and stratify treatment intensity accordingly, whilst also informing our understanding of the physiological mechanisms underlying septic shock in neonates. Understanding these endocrine signatures may ultimately guide targeted interventions to support failing systemic responses during critical illness.
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Practical Takeaways
- •Baseline endocrine profiling (AVP, ACTH, cortisol) at admission may help prognosticate survival in septic neonatal foals and guide treatment intensity decisions
- •Understanding the HPAA response to sepsis in foals enables better recognition of sepsis severity and potential identification of foals at highest mortality risk
- •Monitoring hormonal markers may support clinical decision-making in neonatal foal sepsis management alongside traditional clinical assessments
Key Findings
- •Hypothalamic-pituitary-adrenal axis hormonal responses to sepsis in foals were characterized through measurement of arginine vasopressin, adrenocorticotropin hormone, and cortisol at admission
- •Endocrine marker concentrations at admission were associated with foal survival outcomes in septic and critically ill neonates
- •This study provides the first comprehensive evaluation of HPAA response to sepsis in the equine neonate, filling a significant gap in veterinary literature