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Y4 EQ - Reproduction > Equine Neonatology 1 + 2 Y3 > Flashcards

Equine Neonatology 1 + 2 Y3 Flashcards

1
Q

When is a foal classed as premature?

A

A foal born at a gestational age of < 320 days that displays immature physical characteristics

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2
Q

When is a foal classed as dysmature?

A

A full-term foal that displays immature physical characteristics
- Full term average 340 d

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3
Q

Name 4 characteristics of prematurity/dysmaturity

A

Low birth weight
Short, silky hair coat
Floppy ears
Domed head

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4
Q

Describe the neonate immune system

A

Foals are immunocompetant at birth
Competent specific & non-specific immune system
But immunologically naïve
Autogenous IgG adult levels by 4 months of age

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5
Q

Which cells are responsible for colostrum absorption?

A

Enterocytes

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6
Q

Describe the features of enterocytes

A
  • Specialist enterocytes absorb the immunoglobulins by pinocytosis
  • These cells have a lifespan of a maximum of twenty-four hours
  • Maximum absorption occurs within eight hours of life
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7
Q

When are the IgG levels considered to be normal?

A

Normal transfer > 8 g/l

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8
Q

When are the IgG levels indicating FPT?

A

FPT IgG < 4 g/l
PFPT IgG 4-8 g/l

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9
Q

List the predisposing factors for failure of passive transfer

A
  • Premature lactation: twinning, placentitis
  • Inadequate colostrum production: severe illness, premature foaling
  • Failure to ingest an adequate volume of colostrum: weak foal, foal rejection
  • Failure to absorb colostrum: premature foals and/or foals with concurrent illnesses
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10
Q

When does the greatest absorption of IgG occur?

A

Within the first 6 hours of life

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11
Q

When can IgG levels be read?

A

Peak IgG 18 hours
Best time to test?
- Before 18 hours so the enterocytes haven’t closed and colostrum can still be administered if the levels of IgG are low
- Around 12 hours

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12
Q

How can failure of passive transfer be treated?

A

To treat or not in an otherwise normal foal?
If delay in suck is obvious, give colostrum
Always treat sick foals
> 12-24 hours need plasma from the mare

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13
Q

What is the main risk of treating FPT?

A

Septicaemia

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14
Q

What are the main risk factors for neonatal illnesses?

A
  • Health of the dam during gestation
  • Gestational and foaling environment
  • Ease of delivery
  • Foal’s gestational age at birth
  • Placental abnormalities
  • Adequacy of placental transfer of maternal immunoglobulin
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15
Q

What is the normal time for the suck reflex in a newborn foal?

A

20 minutes

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16
Q

How long should it take for a foal to stand and suck?

A

Stand in 1 hour, suck within 2

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17
Q

What is meconium?

A

Dark brown pellets or paste all passed within 24 hours

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18
Q

How long should it take a foal to urinate?

A

Dilute and large volumes first passed by six hours (colts) or ten hours (fillies)

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19
Q

What is the average weight of a thoroughbred foal?

A

45-55kg

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20
Q

How much weight should a foal gain per day?

A

0.5-1.5kg per day

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21
Q

What is the normal temp of a foal?

A

37.2 - 38.9oC
38.5 is the maximum for an adult horse

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22
Q

What is the heart rate of a foal?

A

Birth: 40 - 80 bpm
First week: 60 - 100 bpm

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23
Q

What is the normal respiratory rate of a foal?

A

45 to 60 brpm
7 days of age - 35 to 50 brpm

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24
Q

Describe the basic intensive medical therapy required for a sick foal?

A
  • Fluids
  • Antibiotics
  • Immunoglobulin (plasma or hyperimmune serum)
  • Anti-inflammatory
  • Circulatory support
  • Antiulcer meds
  • Respiratory stimulants E.g. caffiene
  • Diuretics if persistent oliguria: Furosemide or mannitol (usually reflects CO)
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25
Q

Which anti-inflammatory is given to foals with septicaemia?

A

Flunixin 0.5 - 1 mg/kg bid

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26
Q

Name 2 anti-ulcer medications

A

Sucralfate
Omeprazole

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27
Q

How should a foal be fed?

A

Need 20% BWT in milk/day – 10L minimum split into 2 hourly or more frequent feeds
Care re reflux, air, aspiration

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28
Q

How should a foal undergoing intensive nursing care be monitored?

A
  • Repeat clinical examinations frequently
  • Fluids ins and outs (esp. urine output)
  • Laboratory - Electrolytes, foal profile, urine SpG
  • Radiography
  • Ultrasonography
  • Blood pressure
  • Arterial blood gasses
  • Cardiac output
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29
Q

Which antibiotics can be used in foals?

A
  1. Aminoglycosides
    - Care in very young foals -nephrotoxicity
    - Used in conjunction with gram positive cover
  2. Penicillins and other beta-lactams
  3. Ceftiofur (high, frequent doses e.g. 5 mg/kg, QID compared to adults 2mg/kg S or BID)
  4. Cefquinome 1mg/kg
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30
Q

Describe the respiratory support that can be given to foals

A
  • Postural: Moving the foal from lateral to sternal recumbency is one of the most important things that you can do to improve respiratory function
  • Intranasal oxygen
  • Mechanical ventilation
  • Drugs (bronchodilators, central stimulants)
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31
Q

What is the most important differential in the sick foal?

A

Septicaemia

32
Q

What are the risk factors for septicaemia?

A

FPT
Hygiene
Stress
Poor management
Disease
Pathogen virulence

33
Q

Name some common pathogens involved in septicaemia

A

E coli, Actinobacillus, Salmonella spp., Proteus, Klebsiella, other gram negative spp.
Beta-haemolytic Strepococcus, Staphylococcus, Clostridia
Mixed infections possible

34
Q

How do septicaemic organisms enter the foal?

A

Openings - umbilicus?
Open gut
Inhalation
In utero

35
Q

What are the clinical signs of septicaemia?

A
  • Off suck
  • Lethargic
  • Increase RR and effort
  • Acute severe lameness
  • Discharger or swelling of umbilicus
  • Inconsistent fever
  • Congested, dark mm or petechial haemorrhages
  • Hypopyon: inflammation of the anterior chamber of the eye
  • Diarrhoea
  • Meningitis
36
Q

Describe SIRS (septic shock)

A
  • Vasoactive inflammatory mediators lead to vasodilation
  • Increased metabolic rate and oxygen consumption
  • Cardiac output is increased initially (hyperdynamic phase)
  • Microvascular permeability leads to volume maldistribution
  • Increased cardiac output can no longer be maintained (hypodynamic phase)
37
Q

How is a blood culture used to identify sepsis?

A
  • Obtain blood in sterile manner
  • Prior antibiotic administration reduces likelihood of positive culture
  • Antibiotic sensitivity
  • Delay before results available
  • Provides information on pathogens in your area
38
Q

How can umbilical US help diagnose sepsis?

A

If the umbilical artery is larger than 1cm then it means its infected
Hyperechoic arteries

39
Q

What are the DDx for a foal with respiratory signs?

A
  • Neonatal septicaemia (bacterial pneumonia)
  • Viral pneumonia
  • Meconium aspiration
  • Aspiration pneumonia
  • Haemothorax and pneumothorax
  • Respiratory distress syndrome
  • Pulmonary hypertension
  • Central respiratory depression
40
Q

What does SCID stand for?

A

Severe compromised immunodeficiency

41
Q

Describe the main features of SCID

A
  • Failure to produce functional B and T lymphocytes
  • Autosomal recessive in Arabians and part breds
  • Normal at birth disease begins at 1 to 2 months of age
  • Lethal
42
Q

How is SCID diagnosed?

A
  • Appropriate clinical signs
  • Persistent lymphopaenia < 1x 109/L
  • Confirmation by post mortem - gross and histopathological - hypoplasia in lymph nodes, thymus and spleen
43
Q

Perinatal asphyxia syndrome is also known as?

A

Dummy foal syndrome
Hypoxic-Ischemic Encephalopathy

44
Q

What is perinatal asphyxia syndrome?

A

Ischaemia, oedema and reperfusion injury to foal’s brain, kidneys, intestine and other organs due to lack of oxygen

45
Q

What does PAS present?

A

May not be apparent until the foal is 12-24 hours old

46
Q

What is the main sign of PAS?

A

Hypoxic encephalopathy

47
Q

What are the mild CS of PAS?

A

Unable to attach to mare, poor suck reflex

48
Q

What are the moderate CS of PAS?

A

Aimless wandering
Abnormal phonation (barkers)
Blind

49
Q

What are the severe CS of PAS?

A

Seizures, coma

50
Q

How is PAS managed/treated?

A

Antibiotics (short term), nutrition, care of eyes, stop damage to self
Control of seizures = Diazepam, phenobarbital

51
Q

How does a ruptured bladder occur?

A

Usually excessive pressure during parturition on a distended bladder
Also could be a congenital defect

52
Q

How does a ruptured bladder present?

A
  • Most common in colts and signs are normally present within the first 2-3 days of life
  • Dysuria esp. stranguria
  • Frequent attempts to urinate with only small amounts voided
  • Depression and abdominal distension may be more apparent after 2 days
53
Q

Describe the biochemical changes seen with a ruptured bladder

A

Post-renal azotaemia with hyponatraemia, hypochloraemia and hyperkalaemia
Equilibration of urine in the abdominal cavity with serum electrolytes

54
Q

How else can a ruptured bladder be diagnosed?

A
  • US confirms large amount of fluid in the abdomen
  • Compare creatinine conc of the peritoneal fluid to that of serum and if > 2:1 confirms diagnosis
  • May see calcium carbonate crystals in peritoneal fluid
  • Check if increased inflammation in abdomen - rarely see in uncomplicated cases
55
Q

How is a ruptured bladder treated?

A

Emergency surgery is usually not required - often best to manage medically first
Good out come (>80%) with surgery if performed on a stabilised foal

56
Q

What are the DDx for a foal with colic?

A
  1. Meconium impaction – most common
  2. Ruptured bladder/uroperitoneum
  3. Overfeeding/lactose intolerance
  4. Distension associated with diarrhoea
  5. Gastric ulcers
  6. SI/LI obstruction
  7. Congenital abnormalities
57
Q

What are the DDx for foal anaemia?

A
  1. Blood loss – low protein E.g. umbilical artery or post natal haemorrhage from trauma, injury
  2. Haemolysis – normal protein e.g. esp. neonatal isoerythrolysis
58
Q

How does neonatal isoerythrolysis present?

A

Haemolytic anaemia from 24hr

59
Q

How is neonatal isoerythrolysis diagnosed?

A
  • Confirm by detecting Ab on red cells (Coombs test)
  • Supported by demonstrating red cell antibodies in colostrum using agglutination or haemolytic assays
60
Q

How is neonatal isoerythrolysis treated?

A

PCV > 15% remove source till safe and limit movement and stress (including handling)
<15% blood transfusion - Ensure compatible!
Supportive care for sick foal = antibiotics, anti-ulcer meds, monitor fluids, glucose, nursing

61
Q

What are the DDx for neonatal foal diarrhoea?

A
  • Foal heat diarrhoea at about 7 days old
  • Neonatal septicaemia/infectious diarrhoea (E.coli, Salmonella, other G negs, Clostridia)
62
Q

What are the clinical signs of foal heat diarrhoea?

A

Mild, self-limiting diarrhoea
Foal generally remains bright and sucking

63
Q

How is foal heat diarrhoea treated?

A

Nothing
Intestinal protectants e.g. kaolin, bisthmus subsalicylate
Probiotics
Prognosis = good

64
Q

How does Clostridial D+ present?

A
  • Severe, peracute, frequently fatal
  • Necrotising - foul smelling faeces
  • Seen in individual septicaemic foals and also as outbreaks
  • Severe gas distension and colic
  • Contagious - ISOLATE
65
Q

How is Clostridial D+ diagnosed?

A

Culture – normal flora so interpretation difficult
ELISA or PCR (for toxins: CPE, β2, Toxin A)
Gas in or on the mucosa on ultrasound

66
Q

How is Clostridial D+ treated?

A

Metronidazole or penicillin

67
Q

What are the DDx for diarrhoea in foals 10d +?

A
  • Rota virus
  • Other viruses (coronavirus, adenovirus, parvovirus)
  • Crytosporidium parvum
  • Rhodococcus equi
  • Lawsonia intracellularis
68
Q

How does Rotavirus affect foals?

A

1 - 4 weeks of age
Highly infectious - occurs in outbreaks

69
Q

How is rotavirus diagnosed?

A

Electron microscopy
ELISA - kits available for use in practice labs

70
Q

How does Rhodococcus equi cause D+?

A

Excreted in dams’ faeces, builds up on pasture in warm, dry conditions, ingested, colonizes white blood cells, abscessation
- Enteric infection: persistent diarrhoea, fever
- Intra-abdominal abscess: fever, colic
- Less common that respiratory forms

71
Q

How is rotavirus treated?

A

Passive immunisation
Supportive therapy

72
Q

What is the causative agent of Equine Proliferative Enteropathy?

A

Lawsonia intracellularis

73
Q

What are the clinical signs of equine proliferative enteropathy?

A
  • Weight loss oedema, lethargy depression weakness
  • Diarrhoea, mild colic, episodic pyrexia less common
  • 3 – 11 months of age less commonly older
74
Q

How is equine proliferative enteropathy diagnosed?

A

Dx ultrasonography
Hypoproteinaemia
PCR of faeces and serology (both only moderate sensitivity)

75
Q

How is equine proliferative enteropathy treated?

A

e.g. Erythromycin/rifampin
Oxytetracycline
Should see rapid response

Y4 EQ - Reproduction (7 decks)

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