Exam 1 - Neonatal Equine Colic

Question 1

what are the normal physical parameters for foals?

Answer 1

temp: 99°F-102°F

heart rate: 80-100 bpm for the first 30 days & 60-70 bpm by 2-3 months of age

respiratory rate: 60-80 bpm at birth & quickly fall to 30-40 bpm in the hours following birth

Question 2

what are some differentials for a foal with colic?

Answer 2

<2 weeks - meconium impaction!!!, ruptured bladder!!!!, enterocolitis!!!!, congenital, ulcers (glandular), hernia, atresia coli, & intussusception

older foals - ascarids (4-6 months old)!!!!!!, enterocolitis, gastric outflow obstruction, SI volvulus, intussusception, hernia, small colon obstruction, & ulcers

Question 3

what diagnostic modalities are available to assess a foal with colic?

Answer 3

history & physical exam

bloodwork - CBC, chemistry, IgG

gastric decompression

ultrasound

rads

abdominocentesis

gastroscopy

Question 4

congenital diseases should be considered for foals of what age?

Answer 4

48 hours old or less

Question 5

if you suspect that a foal has a ruptured urinary bladder based off of fluid analysis of your abdominocentesis, what other test can you run to further confirm your suspicion?

Answer 5

peritoneal fluid creatinine

Question 6

what is the number one concern for a foal with a ruptured urinary bladder that could kill it?

Answer 6

uroabdomen = hyperkalemia

can cause bradycardia, arrhythmias

stabilization is critical prior to anesthesia

Question 7

what are some clinical signs associated with colic in foals?

Answer 7

rolling/dead bug, anorexia, abdominal distension, tail flagging, stranguria/tenesmus, & pawing

Question 8

what may be heard upon abdominal auscultation in a foal with colic?

Answer 8

absent sounds - ileus due to inflammation, obstruction, & ischemia

hypermotility - early enterocolitis

gas-filled pings

Question 9

what are the 3 most common causes of colic & lethargy in the neonatal foal?

Answer 9

1. meconium impaction
2. enterocolitis - c. perfringens, salmonella, rotavirus, & coronavirus
3. ruptured bladder

Question 10

what is the most common cause of colic in newborn foals?

Answer 10

meconium impaction

Question 11

what classical electrolyte derangements should clue you in to a ruptured bladder in a neonatal foal with colic?

Answer 11

HYPERkalemia

HYPOnatremia

HYPOchloremia

peritoneal: peripheral creatinine ratio > 2:1

Question 12

what electrolyte derangement causes this on ECG?

Answer 12

hyperkalemia - flattened p waves, prolonged PR interval -> p waves disappear & bradycardia occurs

Question 13

what foals are more at risk for developing a ruptured bladder/uroperitoneum?

Answer 13

1-2 day old large colts & dystocia foals

Question 14

what are the normal parameters for peritoneal fluid in foals?

Answer 14

color - straw
TNCC - < 2,000 to 5,000
protein - < 2.0
lactate - < 2.0
creatinine - < 2:1 ratio

Question 15

what is the scary sequelae that can happen in a foal with enterocolitis?

Answer 15

intussusception

Question 16

what is the importance of an IgG snap test for foals?

Answer 16

helps in determining failure of passive transfer

> 800 = good to go

<400 = fail

Question 17

what clin-path abnormalities do you expect to see in a foal with a ruptured bladder?

Answer 17

HYPERkalemia, HYPOnatremia, HYPOchloremia, AZOTEMIA

Question 18

what is the mechanism of hyperkalemia, hyponatremia, & hypochloremia in a foal with a ruptured bladder?

Answer 18

hyperkalemia because body can’t excrete potassium through the urine

uroperitoneum increases total body water & sodium diffuses from the ECF into the retained urine until equimolar concentrations are achieved

because the total amount of body sodium is unchanged, the ECF and serum sodium concentration decrease causing hyponatremia & chloride follows sodium to maintain electroneutrality resulting in hypochloremia

Question 19

prior to taking a foal to surgery for a ruptured urinary bladder, what is done to stabilize the patient?

Answer 19

do an ECG prior to draining the abdomen

place a urinary catheter

provide IV fluids/diuresis to correct electrolyte imbalances

Question 20

what medications/treatments are used to drive potassium back into the cells in a foal with a ruptured bladder?

Answer 20

glucose

calcium

bicarbonate

Question 21

what is the electrolyte balance in mare’s milk?

Answer 21

high in potassium & low in sodium