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  Discussion on Research Summary: Liver Enzymes and Sick Neonatal Foals
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DrO

Posted on Monday, Jan 2, 2012 - 7:52 am:

Owners are often concerned about elevated liver enzyme levels without understanding the meaning of such changes. While liver enzymes are an important part of the diagnostic picuture, liver enzymes can elevate significantly in relatively minor conditions as well as serious problems. As a result high liver enzyme levels are of little prognostic value in horses. Here is a study that demonstrates this concept in neonatal foals.
DrO

Results suggested that high liver enzyme activities were common in sick neonatal foals, especially foals with sepsis. Foals with high liver enzyme activities were more likely to be septic, and septic foals were less likely to survive than were foals without sepsis. However, high liver enzyme activities alone were not a useful negative prognostic indicator.

J Am Vet Med Assoc. 2011 Sep 1;239(5):661-7.
Clinical implications of high liver enzyme activities in hospitalized neonatal foals.
Haggett EF, Magdesian KG, Kass PH.
Source

Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California-Davis, Davis, CA 95616, USA.
Abstract
OBJECTIVE:

To determine whether high liver enzyme activities were negatively associated with outcome in sick neonatal foals as compared with foals that did not have high liver enzyme activities.
DESIGN:

Retrospective case-control study.
ANIMALS:

147 foals < 30 days old with high ?-glutamyltransferase activity, high sorbitol dehyDrOgenase activity, or both (case foals) and 263 foals < 30 days old with ?-glutamyltransferase and sorbitol dehyDrOgenase activities within reference limits (control foals).
PROCEDURES:

Medical records were reviewed for information on signalment, physical examination findings, and results of hematologic and serum biochemical analyses performed at the time of admission to a veterinary medical teaching hospital.
RESULTS:

Case foals were significantly more likely to die or be euthanized, compared with control foals (odds ratio, 2.22; 95% confidence interval, 1.28 to 3.85). Case foals were significantly more likely than control foals to have sepsis, and septic foals were significantly less likely to survive than were nonseptic foals. For case foals, other factors associated with a greater likelihood of nonsurvival were higher anion gap and higher logarithm of aspartate aminotransferase activity. When sepsis status was controlled for, the presence of high liver enzyme activities was not significantly associated with outcome.
CONCLUSIONS AND CLINICAL RELEVANCE:

Results suggested that high liver enzyme activities were common in sick neonatal foals, especially foals with sepsis. Foals with high liver enzyme activities were more likely to be septic, and septic foals were less likely to survive than were foals without sepsis. However, high liver enzyme activities alone were not a useful negative prognostic indicator.
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