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Neonatal Isoerythrolysis

Hemolytic Icterus

Neonatal isoerythrolysis (NI) is a highly fatal haemolytic disease of newborn horse and mule foals. When the blood types of the mare and stallion are different, if the foal inherits the sensitizing red blood cell type from the stallion, they are at risk of NI from nursing from the mare. This is because sometimes the mare produces antibodies against the foal's red blood cells, and transfers these antibodies to the foal when nursing.

Development of liver failure, kernicterus, and complications related to bacterial sepsis are the most common causes of death in foals with NI. Foals administered a large volume of blood products are at greater risk for developing liver failure.

Symptoms

Lethargy

Weakness

Failure to nurse

Jaundice

Increased respiratory rate

Elevated pulse

Diagnosis

History
Clinical signs
Physical exam
Lab Test
Demonstrating anti-red cell antibodies in the colostrum or serum of the mare

Support

Therapies

Therapies	Details
If the foal is less than 24 hours old at time of diagnosis it should be restricted from nursing the mare until it is between 24-48 hours old.
Blood transfusion

Prevention

Testing the mare's serum for antierythrocyte antibodies 1 to 2 weeks prior to giving birth to the foal
Blood typing of the mare and potential stallion

Prognosis

Success depends on rapid identification of sick foals and seperating it from the dam to prevent suckling for 48-72 hours, until the mare no longer produces colostrum and the foal's GI tract is closed.