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Equine Medicine > Basics of Foal Diseases > Flashcards

Basics of Foal Diseases Flashcards

1
Q

Critical care for primary or secondary apnea

A 
establish an airway
stimulate the foal
oxygen, ambu bag, coupage
Drugs (doxapram)
Maintain sternal recumbency!!!
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2
Q

Critical care for bradycardia or cardiac arrest

A 
cardiac massage and chest compressions
give a fluid bolus
epinephrine and ADH
Atropine
Get an ECG
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3
Q

Some general observations to make with PE of a foal

A 
eat/sleep/play cycles
bonding to the mare
weight gain
urination and defecation
distension
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4
Q

For hypoglycemia, what do we give?

A

1% dextrose in the fluids, 5-10% will cause neurological disease.

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5
Q

For recumbency of a sick foal, watch for

A

lung collapse from not keeping sternal
decubital (bed sores)
and corneal ulcers

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6
Q

What is a common cause of post-maturity?

A

fescue toxicosis

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7
Q

Prematurity causes

A 
fetal
placental
maternal - disease
iatrogenic - induction
idiopathic
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8
Q

Major systems involved in Prematurity

A

Respiratory - distress, paradoxical breathing, fatigue
MSK - incomplete ossification causing angular limb deformities, crushing joint surfaces. Big deal***
GI - FTPI, poor glycemic control, nec enteritis, drug metabolism

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9
Q

Prematurity “other problems”

A 
CV
Renal
Endocrine -= insulin resistance
neuro - pernatal asphyxia syndrome, seizures
Drug metabolism may be altered.
Predisposed to sepsis
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10
Q

Prematurity treatment options

A

supportive
prevent sepsis
anticipate problems and be realistic about it the animal will live or not.

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11
Q

Causes of Congenital hypothyroidism and dysmaturity

A

prolonged gestation and abortions - the mother and the foal seem to be out of sync

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12
Q

Clinical signs of Congenital hypothyroidism and dysmaturity

A 
mandibular prognathism
forelimb contracture
ruptured common/lateral extensor tendon
delayed ossification
\+/- enlarged thyroid
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13
Q

Congenital hypothyroidism and dysmaturity pathogenesis

A

not much. risk factors like mineral deficiencies (iodine?) and feeding greenfeed (nitrates) causing sporadic occurences

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14
Q

Congenital hypothyroidism and dysmaturity Dx

A

History (gestation length?), clinical signs

Low serum T4/T3 and low response to TSH

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15
Q

Congenital hypothyroidism and dysmaturity Tx

A

Supportive and T4 if needed

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16
Q

Congenital hypothyroidism and dysmaturity prognosis

A

guarded in ICU patients

risks orthopedic problems

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17
Q

What are the benchmarks of post-partum care

A 
look at the placenta
PE of the mare and foal
Make sure there is colostrum in the foal
disinfect the umbilicus
enema to get meconium out
Blood work
Tetanus prophylaxis and AM 
Exercise
Imprint them - differing opinions on this
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18
Q

What are all the parts of the PE?

A

History and general observations (eat/sleep/activity/weight, etc.)
CV for murmurs
Respiratory - lungs sounds, mm/oxygenation, rib fractures
GI - PALATE, feed intake, distention
Genit/Urinary - patent urachus, cryptorch, hernias
Umbilicus - infection/hernia
MSK - lax tendons, swollen joints,
Eye - uveitis, hypopyon, entropion, microphthalmia
Neuro - bonding, maladjustment, eating manure, sleep

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19
Q

COmmon organisms causing sepsis in foals

A 
e coli
actinobacillus
kleb
salmonella
enterbacter
strep
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20
Q

Routes of infection causing sepsis

A

through resp
intra-uterine
GI tract

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21
Q

What are the risk factors in causing sepsis?

A

FTPI *****

management, problems at birth, premature, congnital, etc. etc.

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22
Q

How do you Dx sepsis

A

With the systemic inflammatory response AND infection (localized infection/bacteremia) AND Cultures (Either blood or from the sites - TTW, CSF, etc)

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23
Q

What are the systemic inflammatory response signs in sepsis?

A 
attitude/mentation are off
body temp is messed
HR weird
RR weird
MM are wonky
CBC
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24
Q

Early clinical signs of sepsis

A 
subtle
lethargy, 
decreased suckle reflex
don't gain weight
more recumbent
weird mm
FEVER/HYPOTHERMIA
Tachypnea
Diarrhea
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25
Q

Later signs of sepsis

A

aural petechiation,
uveitis,
hypopyon
specific stuff like - diarrhea, resp signs, swollen joints, umbilicus, neurologic

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26
Q

Treatment of Sepsis

A 
AM - broad - pen/amp + aminoglyc
joint lavage maybe
treat/prevent FTPI and maybe give plasma
nutrition
fluids - looking at DH, elect, acidosis, and glycemic state
O2 if needed
NSAIDs -
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27
Q

Prognosis of Sepsis

A

guarded, 25-50% die still in ICU

worst if joints and neuro signs

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28
Q

When is colostrum production started and when is it no longer

A

starts 2 weeks prior

24 hr after birth, it can’t be absorbed anymore. (but 72 hours is where people feel safe in cases of NI)

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29
Q

How do we make sure the foal gets enough Ig?

A

need adequate intake
good quality
absorption
normal rate of Ig metabolism

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30
Q

how do we evaluate colostrum quality?

A

SG >1.060 or 3000 mg/dL IgG

Do this before suckling

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31
Q

How do we assess FTPI?

A

TP or T globs won’t tell us
It has no clinical signs
TEst IgG in serum at 18-24 hours and possibly repeat.

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32
Q

What are the testing methods for FTPI?

A

SRID - single radial Immunodiffusion
SNAP test (ELISA)
Zinc sulfate turbidity test
Foalcheck (latex agglutination)

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33
Q

Details about the SRID test

A

most accurate for FTPI
quantitative from 0-3000 mg/dL
but takes 24 hours

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34
Q

Details about the SNAP ELISA

A

easy, convenient but only semi-quant

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35
Q

Details about the zinc sulfate turbidity test

A

easy and cheap

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36
Q

Details about the FoalCheck

A

high false positives

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37
Q

If you decide to go with plasma in the fluids for a FTPI, how will you do it?

A

get from commercial (hyperimmune plasma) or healthy horse,
thaw slowly,
slowly infuse through a filter,
watch for a reaction - if there is, slow or stop temporarliy.

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38
Q

How much will 1L of plasma increase IgG?

A

50-200 mg/dL

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39
Q

What is SCID and who gets it?

A

failure to produce T and B lymphocytes
Arabians, mice, dogs and humans
Autosomal recessive

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40
Q

SCID clinical signs

A

normal at birth, but infections of start of unusual organisms at the 3 months mark
Will manifest itself anywhere

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41
Q

Dx of SCID

A 
genetic testing
absolute lymphopenia on CBC
neutrophilia can happen still with infection
No IgM (test the pre-suckle serum)
IgG normal until the 3 week mark too.
42
Q

Treatment of SCID

A

bone marrow transplants?

43
Q

Prognosis of SCID

A

they usually only live 5 months

44
Q

pathology of SCID

A

hypoplasic of spleen, LN, and thymus but still normal architecture

45
Q

What is NI?

A

a reaction on the RBCs of the foal between blood group antigens and plasma antibodies (alloantibodies)

46
Q

Pathogenesis of NI

A

sensitization from transplacental hemorrhage (prev pregnancy) –> foal with antigen from stallion + mare with Ig in colostrum –> Lysis of RBCs

47
Q

How often does NI happen?

A

1% in TB, more commonly in mares with Aa and Qa blood type antibodies or the specific Donkey factor
But it also happens in 100% Stdbred with Qa- bloodtype

48
Q

How do you Dx NI?

A

clinical signs – pallor icterus
Time - 12-72 hour to 1 week old
other weakness and subsequent signs from these
CLinical pathology - anemia

49
Q

What gives us a tentative Dx of Icterus?

A

lethargy, anemia, and icterus

50
Q

DDx for icterus and anemia in foals

A

internal bleeding
piroplasmosis
NI

51
Q

DDx for anemia without icterus

A 
NI
Blood loss (trauma)
52
Q

DDx for icterus without anemia

A

sepsis
meconium impaction (biliary stasis)
Liver failure (Tyzzer’s)
NI

53
Q

Treatment for NI

A

If before they’ve drank, … get other source of colostrum and give them that. Then at 72 hours, give them regular stuff.

If not caught early,…give supportive care and oxygen, decrease stress.
Keep fluids on to keep the kidneys and consider AM for sepsis.

Blood transfusions are only as a life-sparing thing.

54
Q

How do you do blood transfusions for NI?

A

wash RBCs from dam so there is NO serum

Make sure it is Aa/Qa negative and cross-match with the mare’s serum.

55
Q

What about the prognosis of NI

A

better with late onset

neuro signs? poor

56
Q

How should we educate our clients about NI?

A

if the mare had one, she will likely have another so act accordingly, Hold back the colostrum, watch the birth, give colostrum from somewhere else, etc.
Also, tell them to type the stallions and mares
Screen the mare for alloantibodies
DO the Jaundiced Foal Agglutination test

57
Q

Neonatal Maladjustment Syndrome pathophysiologies (3)

A
  1. hypoxia/asphyxia –> causing loss of energy production –> reperfusion injury –> imbalance of NT
  2. Septic ECopathy - because of inflammatory mediators
  3. reversion to the fetal cortical state –> high neurosteroids in the foal
58
Q

What is the most consistent clinical sign (because everything else is so variable)

A

normal at birth foals that show neurological abnormalities within 24-72 hours

59
Q

Prognosis of Neonatal Maladjustment Syndrome

A

good if treated early.

50-80% lead normal lives

60
Q

Conditions that make Neonatal Maladjustment Syndrome worse to treat (prognosis too)

A

sepsis
prematurity
seizures

61
Q

treatment of Neonatal Maladjustment Syndrome

A

Seizure control - increase intracranial pressure with Ketamine/Xylazine, as well as preventing injuries and so on.
Supportive Care - Lohmann just goes with this
Cerebral support with all the wonky stuff - anti-ox, free radical scav(DMSO), edema controllers(Mann, DSMO), perfusion controllers (inotropes, vasopressors), thiamine
Madigan Squeeze***** sounds promising

62
Q

What are the chatacteristics of Respiratory Distress Syndrome in Foals?

A
  1. hypoxemia and hypercapnia from not enough gas exchange
  2. atelectasis from collapse
  3. get paradoxical breathing because of compliance of the lung –> the floppy chest trying to move the stiff wall
63
Q

DDx for seizures in foals

A 
hpoxia/asphyxia
cranial trauma
hypoglyc
hypocalc
hyponatr
infection/sepsis
Hepatoenceph
idiopathic (arabians)
(Lavendar Foal Syndrome)
64
Q

How to Dx seizures

A 
HX, PH, CBC, Chem (first r/os)
arterial BG
CSF
CT, rads
EEG
65
Q

What is the funny name for C. botulism in foals?

A

Shaker foals

66
Q

Dx of botulism in foals

A

clinical signs

toxin in blood/feces

67
Q

Treatment of botulism in foals

A

Penicillin, Anti-toxin?, Vaccinate

68
Q

When we see colic in foals, what should we do?

A

consider congenitals
is it meconium or impactions?
instusseptions
adhesions

Think of colic similar to how you would

69
Q

Treatment of meconium impactions

A 
colostrum acts as a sedative
Enemas (acetylcysteine)
Oral fluids/IV too
mineral oil
restrict milk intake
give pain control
O2 if distension of abdomen much
70
Q

What is Lethal white syndrome?

A

Endothelin receptor gene defect in overo-overo paint breeding
autosomal recessive
hits the ileum, cecum and colon

71
Q

What are the 4 clinical forms of Gastric Ulcer?

A

Silent
Active - bruxism, lying on back, don’t thrive and diarrhea
Perforated
Stricture - gastro-duodenal ulceration and reflux

72
Q

What are the causes of Gastric ulcer syndrome?

A

NSAIDs,
Hypoxic injury - PAS necrotizing enterocolitis
Low-Flow conditions - sepsis, shock, trauma

73
Q

What is PAS?

A

Perinatal asphyxia syndrome

74
Q

How to Dx Gastric ulcer syndrome?

A

endoscopy - squamous ulcers (non-glandular) are the most common but foals have proportionally more glandular than adults.
abdominocentesis
reflux/occult or fecal blood

75
Q

Treatment of Gastric Ulcer syndrome

A

Omep
Ranit
Sucralfate
antacids

76
Q

Prevention of gastric ulcers syndrome

A 
The watch list is to minimize:
prefusion abnormalities
hypoxia
enteral bleeding
NSAIDs
77
Q

On the DDx for diarrhea in foals

A 
foal heat
viral
bacterial 
protozoal
parasitic
dietary diarrhea
78
Q

diarrhea in foals is often a presenting sign of

A

sepsis

79
Q

What on earth is foal heat?

A

when the foal gets diarrhea with the mare in her first heat after parturition.

80
Q

Cause of foal heat diarrhea?

A

not known. maybe strong westeri?

81
Q

When do you see foal heat diarrhea and what does it look liek?

A

mild, self-limiting at 5-14 days of age.

82
Q

When do we dx foal heat diarrhea?

A

when all others are ruled out

83
Q

Where do we see viral diarrheas in foals?

A

in larger groups

84
Q

commmon viral diarrhea etiology

A

rotavirus

85
Q

What does rota do in viral diarrheas?

A

high morb/low mort

denudes the microvilli and dehydrates the foals

86
Q

POssible etiologies for bacterial

A 
clostridia perfringens (C)
C difficile
Salmonella
e coli
a equuili
lawsonia intracell (older)
rhodocuccus equi (older)
87
Q

In neonates with diarrhea, what is indicated?

A

blood culture and sepsis score

88
Q

How to Dx the clost diarrheas?

A

gram stain feces, culture and do toxin assays

89
Q

What are the protozoal etiologies of foal diarrhea/

A

cryptosporidium
eimeria leukarti
trichomonas equi
giardia equi

90
Q

What is important about crypto diarrhea in foals? but…

A

zoonotic.

We will often see in healthy foals and is self-limiting

91
Q

Which are the septic bacterial etiologies in foal diarrhea? and what do we do for them?

A

salmonella, e coli, and a equuili
Fecal culture
fecal PCR

92
Q

parasites causingFoal diarrhea

A 
small strongyles - cyathostomes, 
large strongyles - vulg, edent, and equinus
ascarids
strongyloides westeri
pinworms
botlfy larvae
tapeworms
93
Q

How to treat parasitic Foal diarrhea

A 
avermectins
milbemycins
benzimidazoles
pyrantel salts
praziquantel
94
Q

How to Dx parasitic Foal diarrhea

A

Hx, C/S
FEC - not always reliable because of the prepatent periods
Histopathology

95
Q

Life cycle of Strongylus Vulgaris

A

9 month PPP –> migrates through the arterioles –> cecum, descneding colon –> causes TE Dz often

96
Q

Typical life cycle of the strongyles (large and small)

A

usually eggs passed in feces, developing larvae outside host to infective stage, ingestion, tissue migration, mature adults in GI

97
Q

TRansmission and characteristics of strongyloides westeri infection in foals

A

transmammary transmission
usually infected by 8-12 days
see mild signs

98
Q

WHere does parascaris equorum head to? PPP?

A

hepatopulmonary migration

2-3 month PPP

99
Q

What is the complication of parascaris equorum

A

the worms die and obstruct

100
Q

What are some clinical signs of parascaris equorum?

A

colic, diarrhea, respiratory signs, chronic weight loss

failure to thrive

Equine Medicine (20 decks)

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