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  Discussion on Understanding NI
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New Member:
Japs

Posted on Sunday, Mar 16, 2003 - 1:13 pm:

Help quickly please, just had a 4 day old foal dignosised, with neonatal isoerthy,...we have done blood trans. from an unrelated gelding, PCV is up to 25, from 10...filly had just started to feel lethargic, took her right away, no kidney or liver damage thus for, only negative at this point is that the bilirubin is going up from the breakdown of the geldings red blood cells, its at 19.5, they are doing support therapy, ie: fluids and steriods, dipyrone, is there anything else we can do to keep the bilirubin down under 20...Need advice quickly please, my husband is a pharmacist, we are on call so if need be, please phone collect...903-721-0667 or 903-586-8941, we will be more than happy to pay for a phone consult. Thanks, Jill and Charles H. Stanton
Moderator:
DrO

Posted on Monday, Mar 17, 2003 - 6:18 am:

Hello Charles,
Have you found the article on NI associated with this forum? Go to the top of this page and select Neonatal Isoerythrolysis, it will take you to the article on this disease, which has complete information on this disease.

It is not the height of the bilirubin that is a problem for your foal it is the decrease in the PCV that has to be watched. Your success will depend on the severity of the original mismatch, how compatible the gelding is, and the quality of your nursing care. Sometimes repeated transfusions are necessary.
DrO
Member:
Japs

Posted on Monday, Mar 17, 2003 - 11:41 am:

Thanks so much, we have the foal at an equine hospital, we are just trying hard to cover all the bases...We did the transfusion on Sat. at approx. 2pm...by Sunday am., we had a PCV of 25, still no signs reflected in the bloodwork of kidney or liver damage, this morning, the PCV was at 20, so, not much of a DrOp since Sat. afternoon, she is being supported with IV fluids as needed, dextromethosone, gastro-gard as a precaution, and all the other standard treatment options, constant monitoring and bloodwork, filly is nursing well and very active...we know the RBC will continue to DrOp as they are from the unrelated gelding, we were told the bilirubin count, if over 20, was a big problem, and we were trying to ascertain if there was anything we could do to keep that count down, other than the above. Thanks so much for any info., and yes, we've printed out the article, just needed a tad more input.
Member:
Dres

Posted on Monday, Mar 17, 2003 - 1:32 pm:

regarding bilirubin count.. hay who knows.. but in infants coming home from the hospital, the doctors tell us moms to have the child in lots of sunlight or under ultraviolet lamps... that helps for human infants..oh and lots of clear fluids not mothers milk as the fat, in humans, seems to hang on to the ilirubin....

Ann
Moderator:
DrO

Posted on Tuesday, Mar 18, 2003 - 9:10 am:

Hello Charles,
Not recognizing hyperbilirubinemia as a primary disease problem I have gone searching for evidence of this and continue to not be able to find why the bilirubin going over 20 is of primary concern, other than as a general and indirect indication of ongoing hemolysis. The problem with this as a concern is that hemolysis is measured accurately with sequentual PCVs (Hct) and hemoglobin counts.

In cases of hemolysis I don't think billirubin counts are an accurate measurement of liver function. I would be interested in your doctors thoughts on why this is of such great concern.
DrO
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