Changes

==Clinical signs==

==Clinical signs==

===Horses===

===Horses===

Affected foals appear clinically normal at birth, and clinical signs develop from several hours up to a week after ingestion of colostrum. Foals with NI usually become progressively weak, lethargic and depressed develop icterus, tachycardia and tachypnoea. Although the signs are not pathognomonic for NI, a foal displaying haemoglobinuria and icterus born to a multiparous mare should be strongly suspected to have the disease. If the foal becomes severely hypoxic, seizures may occur. Death usually occurs if NI is not diagnosed and treated promptly.

Affected foals appear clinically normal at birth, and clinical signs develop from several hours up to a week after ingestion of colostrum. Foals with NI usually become progressively weak, lethargic and depressed and develop icterus, tachycardia and tachypnoea. Although the signs are not pathognomonic for NI, a foal displaying haemoglobinuria and icterus born to a multiparous mare should be strongly suspected to have the disease. If the foal becomes severely hypoxic, seizures may occur. Death usually occurs if NI is not diagnosed and treated promptly.

===Cats===

===Cats===

Although feline neonatal isoerythrolysis (FNA) is rare, the mortality associated with it is high. In a similar way to affected foals, kittens are born and nurse normally and clinical signs develop within a few hours or days. Purebred cats are more commonly affected than domestic shorthair cats. Signs may be variable and kittens are occasionally found dead within a few hours of the onset of clinical signs. Affected kittens rarely survive the first week of life. Clinical signs may include failure to thrive, weakness, dark red/brown urine, icterus, and anaemia. Affected kittens may separate themselves from the rest of the litter, stop nursing and appear weak. Signs may vary in severity within a single litter; this is thought to be related to differences in colostral intake. Other features of the disease may include necrosis and slouging of the tail tip and disseminated intravascular coagulation.  

Although FNI is rare, the mortality associated with the disease is high. Purebred cats are more commonly affected than domestic shorthair cats. Similarly to affected foals, kittens are born and nurse normally and clinical signs develop within a few hours or days. Signs may be variable and kittens are occasionally found dead within a few hours of the onset of clinical signs. Affected kittens rarely survive the first week of life. Clinical signs may include failure to thrive, weakness, dark red/brown urine, icterus, and anaemia. Affected kittens may separate themselves from the rest of the litter, stop nursing and appear weak. Signs may vary in severity within a single litter; this is thought to be related to differences in colostral intake. Other features of the disease may include necrosis and slouging of the tail tip and disseminated intravascular coagulation.  

==Diagnosis==

==Diagnosis==

==Treatment==

==Treatment==

Treatment in foals depends on rapid identification of sick foals and prevention of suckling the dam for 48-72 hours. If foals are less than 24 hours old at the time of diagnosis, it should be muzzled and fed supplemental milk. As the foal's intestine becomes impermeable to absorption of colostral antibodies by 24 hours of age, prevention of nursing until the foal is 30 hours of age should be sufficient. The mare should be milked every two hours during this period to ensure continued milk production. Separation of the mare and foal is not recommended as this may lead to unnecessary stress of the compromised foal.  

Treatment in foals depends on rapid identification of sick foals and prevention of suckling the dam for 48-72 hours. If the foal is less than 24 hours old at the time of diagnosis, it should be muzzled and fed supplemental milk. As the foal's intestine becomes impermeable to absorption of colostral antibodies by 24 hours of age, prevention of nursing until the foal is 30 hours of age should be sufficient. The mare should be milked every two hours during this period to ensure continued milk production. Separation of the mare and foal is not recommended as this may lead to unnecessary stress of the compromised foal.  

A blood transfusion should be considered if the anaemia is severe (PCV less than 15%) or the foal is weak and shocked. The best donor of blood for transfusion is the dam, but this means that the serum containing the alloantibodies must be removed ('washing' of the red blood cells). This is achieved by mixing the mare's blood with saline and performing repeated centrifugation. If washed red blood cells from the mare are not available, blood from an acceptable blood-typed donor horse may be used.  

A blood transfusion should be considered if the anaemia is severe (PCV less than 15%) or the foal is weak and shocked. The best donor of blood for transfusion is the dam, but this means that the serum containing the alloantibodies must be removed ('washing' of the red blood cells). This is achieved by mixing the mare's blood with saline and performing repeated centrifugation. If washed red blood cells from the mare are not available, blood from an acceptable blood-typed donor horse may be used.