What is Jaundice?
Jaundice, also known as icterus, is typically associated with an elevation in the level of the pigment bilirubin in the blood (called hyperbilirubinemia). In a healthy adult horse, the serum bilirubin is, in most cases, lower than 2 mg/dl. When the serum bilirubin is over 3 mg/dl, jaundice may be apparent. The increased level of bilirubin may be due to liver disease, anorexia or ingesting certain medications.
A condition called neonatal isoerythrolysis, which is commonly known as jaundice, occurs rarely in foals who are born to mares whose immune systems attack their offspring. The mare’s antibodies attack the foal’s red blood cells once the foal drinks the colostrum shortly after birth.
Jaundice, also known as icterus, is often the result of an elevation in the level of the pigment bilirubin in the blood; neonatal isoerythrolysis, also known as jaundice, occurs in foals born to mares whose antibodies attack the red blood cells of their offspring.
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Symptoms of Jaundice in Horses
Other symptoms experienced will depend upon the cause of jaundice in your horse. For example, should your horse be experiencing hepatic insufficiency, in addition to jaundice, he may exhibit the following:
- Weight loss
- Hepatic encephalopathy
- Hepatogenic photosensitization
In neonatal isoerythrolysis, despite a foal appearing healthy at birth, the following symptoms may be seen after the foal has ingested the colostrum:
- Weakness and lethargy that become more significant as time passes
- The eyes of the horse and his mucous membranes may appear pale due to anemia prior to their yellowing.
- The breath of the foal may change and become shallow and then labored.
- The progression of the condition in foals can be quick.
There are two categories of illness that lead to jaundice: hemolytic diseases and hepatobiliary (disease of the liver and biliary system) diseases.
Causes of Jaundice in Horses
Caused by hyperbilirubinemia (an elevated level of bilirubin in the blood), jaundice occurs when a horse has liver disease or there is obstruction to the flow of his bile. Liver disease is not the only cause of jaundice. Jaundice may occur in about 10 percent of healthy horses and horses that are not eating for any reason can develop jaundice. In fact, mild jaundice is a typical finding in horses that are healthy but have fasted for a few hours through a few days.
Particular drugs (like steroids and heparin) can hinder bilirubin uptake and conjugation by hepatocytes, even though there are no problems with the liver. Jaundice can also develop after hemolysis.
In neonatal isoerythrolysis, the antibodies of the mare attack its foal’s red blood cells after the foal ingests the mare’s colostrum. The foal’s red blood cells are destroyed and the foal can become significantly anemic.
Diagnosis of Jaundice in Horses
Should you notice any yellowing of the membranes of your horse’s mouth, the whites of his eyes, or his skin, you should have him examined by your veterinarian. In addition to conducting a physical examination, your veterinarian will ask you what other symptoms you have noticed in him and for how long they have been present.
Should liver disease be suspected, your veterinarian may consider the following diagnostic tests:
- Quantitation of sorbitol dehydrogenase (SDH)
- Gamma-glutamyl transpeptidase or transferase (GGT) activity
- Serum bile acids concentration (SBA)
Usually if there is significant liver disease in your horse, one of these tests will show abnormalities. An increased level on one of the tests will point to liver disease, however will not break down the type of liver disease. A liver biopsy may be conducted to determine the issue.
Should you have a young foal who appears lethargic, weak and depressed and your veterinarian suspects neonatal isoerythrolysis, a packed cell volume (PCV) will be conducted. Should it be determined that your foal is anemic, your veterinarian will look further to find out the cause of the anemia. In order to figure out if your foal has absorbed colostral antibodies, your veterinarian will measure the foal’s IgG concentration. If the foal has neonatal isoerythrolysis he will have a decreased packed cell volume (PCV) and RBC count.
Treatment of Jaundice in Horses
Treatment for jaundice will depend upon the condition that your horse is experiencing. There is limited evidence-based information on how to treat liver disease in horses and treatment will vary based on the particular condition. Often the treatment is supportive in order to alleviate the symptoms that your horse is experiencing.
Should your foal be diagnosed with neonatal isoerythrolysis, your veterinarian will focus on relieving his symptoms. It is important that you limit your foal’s activity as he is weakened from the anemia. Intravenous fluids will likely be administered in order to help the kidneys process the increased amounts of hemoglobin that are due to the condition. In some cases, blood transfusions will be necessary as a result of the anemia.
Recovery of Jaundice in Horses
Once your veterinarian has determined the underlying condition leading to jaundice in your horse, it is important that you follow his recommendations for treatment and attend follow-up appointments as necessary to ensure the best outcome for your horse.
Prevention of neonatal isoerythrolysis is possible; a screening test can be conducted that will show that the mare has produced the antibodies that will cause illness in her foal. Should that be the result, the foal will be kept from the mare and her colostrum stripped. As the foal’s intestinal tract matures and there is no more colostrum being produced, the foal can nurse normally.
Jaundice Questions and Advice from Veterinary Professionals
i have an horse.
he is not drinking water.before 10days he have jaundice also.we have done the treatement.but now he is not drinking water.
he is eating grass also(lusan) properly.
Horses can be temperamental animals which may not drink if the water is too cold, strange smell near the water bucket (or drinker) or due to some medical condition; sometimes sick horses will just refuse to drink when they need fluids the most. Did you discover the underlying cause of the jaundice? Was it clinically significant? Check hydration levels by pinching and twisting a skin fold which should return to normal immediately and check the capillary refill time by pressing the gums until they are white and let go, the blood should return in less than two seconds; if the return to normal is longer call your Veterinarian to check Dilawar and to administer fluids if required. Regards Dr Callum Turner DVM
sir if you don't mind please tell in hindi i can't understand some words or you can tell in simple english language
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My horse has presented with a high temp for 6 days. 40 has come down to 38.5. Won’t eat. Lost a lot of weight. Showing mild colic signs but isnt colicing. Been treated for colic, with flunixin and buscopan. Been treated for biliary with forray 65. Temp was 40 so given penicillin, vit B and cortisone. Then next day his temp is still up so given metacam and exenel which hes had for 2 days, 2 das to go on it. We are waiting for blood results. No appetite. Rapid weight loss. Eyes are slightly jaundice, gums appear normal. What could my DDs be
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I've two horses that have jaundice, one horse, his legs swelled, have since gone down, his eyes and gums are yellow and is very slow to eat, blood tests showed normal except his bilirubin count which is 160,normal range is between 9 and 39, second horse, eyes and gums are yellow, skin is very dry, very slow to eat, bloods showed everything normal except for bilirubin count which is 80, liver cells in both horses are OK, no damage to them, have taken bloods from them over the past 12 wks with no improvement, there is no ragwort around me for them to get poisoned,
I know it's something to do with their environment, 3 vets have looked at them and none of them can tell me what's causing it,
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