Hemoperfusion as an Adjunctive Therapy for Sepsis or Metabolic Derangements in Calves and Goats

Presentation Description / Summary: Sepsis, hyperammonemia syndrome, and hyperbilirubinemia are increasingly recognized as common and clinically significant conditions in neonatal and juvenile calves and adult goats. These syndromes often present concurrently and are associated with high morbidity, prolonged hospitalization, and substantial financial burden for producers and owners. Despite advances in supportive care, outcomes remain poor in many cases, particularly when metabolic derangements are severe or refractory to conventional therapies. Hemoperfusion, an extracorporeal blood purification technique, has emerged as a promising adjunctive treatment in critically ill veterinary patients. By selectively removing circulating toxins, inflammatory mediators, and protein-bound waste products, hemoperfusion may offer a targeted approach to mitigating the systemic effects of sepsis and metabolic dysfunction. Preliminary data from equine and small animal models suggest potential benefits in reducing hospitalization time, improving survival, and lowering overall treatment costs (hemoperfusion treatment is large animals ranges from $1,000-$1,500). This presentation will explore the pathophysiology of sepsis, hyperammonemia and hyperbilirubinemia in calves and goats, review current treatment limitations, and introduce hemoperfusion as a novel therapeutic strategy. Case examples and early clinical experience will be discussed, highlighting practical considerations for implementation, including vascular access, cartridge selection, and monitoring. The potential for hemoperfusion to improve clinical outcomes while reducing economic impact will be emphasized, with a call for collaborative research to validate efficacy and optimize protocols in ruminant species.