Final: Neonatal Flashcards
What are 2 history-related risk factors for a foaling mare?
Past hx of dystocia
Neonatalal isoerythrolysis
What are 3 systemic problems that increase the risk for a foaling mare?
Anemia
Laminitis (stress, pain, meds)
Excessive medication administration
What are some common conditions of neonates that present/occur in utero?
Maternal anemia
CV disease
Placental separation
Placentitis
Hypoxia
Reduced umbilical blood flow
You are called to a farm 30 days before foaling. What treatments will you preform?
Vaccines: Botulism, Rotavirus, Influenza, WNV, EW
Deworm
When does a castlick need to be opened before foaling? When will you re-suture it?
2 weeks prior to foaling
2 weeks post foaling
What blood antibodies destroy foal RBCs? How is isoerythrolysis tested for? What antibodies do not require treatment?
Aa, Qa, or U (=bad)
Cross match mare’s milk with foal’s serum (search for RBC alloantigens in mare’s blood)
Type C= no tx needed (ore if stallion has same antibodies as mare)
What is normal gestation time?
335-340 days
What is the most reliable indicator of impending parturition?
Change in udder size and waxy secretion
What can you exmine on a foal to indicate whether it is ill or healthy?
Check gums
Normal= pink, moist
Problem = dirty, pale, dry
What happens if the chorioallantois does not rupture? How is it treated?
Fetal oxygenation is impaired (Red Bag)
Chorioallantois= thickest part of placenta
Surgery is required to open it ASAP
In the second stage of parturition, how should the foal be oriented?
Forefeet first with soles pointed ventrally
Then head and shoulders (can pull at this point if needed)
What occurs in the third (and final) stage of parturition? What indicates that intervention is required?
Expulsion of fetal membranes
Uterine involution
If the placenta is not expelled within 2 hours (normal is 30min-3 hours) must intervene (don’t pull on placenta, give durgs)
How is uterine torsion diagosed?
Rectal palpation of tense broad ligament
What pre/post-partum complication can present with mild colic signs? What is it associated with?
Invagination of uterine horn
Assocaited with retained placenta
It is abnormal if it takes more than _____ hours for the foal to nurse and more than ____ hours to stand.
2-4
2
When is the suckle reflex present? How often should foals nurse and how much weight should it gain per day?
Within 30 min of birth
5-7 x per hour
1-2 kg per day
How can you check to see if and how much the mare is lactating?
Muzzle the foal and check the udder after 30 minutes
How long does absorption of antibodies from the colostrum through the intestinal epithelium last? How long does passive protection last? When does the foal reach the lowest lebel of IgG?
6-8 hours after birth
Last 3-4 weeks
Lowest by 6-8 weeks
If there is no colostrum available what can you give the foal instead?
Plasma
T/F: It is normal for a foal to be hyperreflexive with a base-mide stance and hypermetric gait for several days post-birth.
True
Is it normal to hear a continuous machinery murmur up to an hour after birth?
No, dysarrhythmias should diappear within 15 min of birth
Why do you palpate each rib when doing your respiratory evaluation of a foal?
To look for fractures
T/F: Septic foals will be febrile.
False, hypothermic
Why is it important to perform a digital rectal exmaination in a foal?
To observe the meconium and rule out atresia ani or atresia coli
How long should the foal’s navel be disinfected?
BID for 3-4 days with 2% betadine (or chlorhex)
What is hypopyon associated with in foals?
Septicemia
What could be the cause of this?
Iron supplementation (Goiter -thyroid gland)
What do you use to treat contracted tendons in a foal? What does laxity or contracted tendons indicate?
Oxytetracyline
Indicate prematurity
Why do cubital ulcers develop in foals?
If unable to stand up to nurse etc.
Need to flip frequently to prevent
Pressure sores
Urine is an important indicator of health in foals. When should they pass their first urine? What is normal USG for subsequent urinations?
12 hours post-parturition
1.001-1.008 (first urination is concentrated)
What is common in foals who are being fed via NG tube?
Reflux
When is the first vaccine given to a foal?
90 days
At least how often should a foal be dewormed within the first year of life?
5-7 times
Otherwise prone to roundworms (small intestines) and tapeworms (colic) as yearlings
What are 2 causes for a foal that is unable to stand? What is the first thing you need to do when presented with these foals? What therapy is indicated?
Gas exchange problem
Glucose problem
or both
FIRST: Place IVC
Administer antimicrobials: Amikacin, K Penicillin, Cetofur (IV)
Administer Polymixin B and/or plasma as anti-endotoxic therapy
Glucose CRI (check glucose often) or enteral nutrition (slowly)
How long do you have to get the foal out if the mare is dystotic before a C-section is indicated?
15 minutes
What do you do first after a C-section?
Intubate foal
What type of foal was carried for the full term but has signs of immaturity, dysmature or premature?
Dysmature
Why are respiratory distress syndrome common in premature foals?
Surfactant is developed in the last 2 weeks of pregnancy and it it reuired for a patent respiratory system
What organism is most commonly responsible for sepsis in newborn foals?
- E.coli*
- Note- doesn’t cause diarrhea in horses*
What lab test abnormalities do you expect in a septic foal?
Leukopenia (neutropenia +/- left shift and toxic changes)
High fibrinogen
High serum amyloid A (indicates bacterial infection)
Low glucose
Azotemia
Hyperbiliirubinemia
Hyperlactemia (prognostic indicator)
Increased ACTH and cortisol (poor prognostic indicator)
Adrenal insufficiency (poor prognostic indicator)
What do you monitor on a septic foal that you are treating?
O2
Lactate
E-lytes
Azotemia
Glucose
What clinicl signs are seen a <7 day old foal with NI?
Icterus
Weakness
Tachycardia
Tachypnea, Dyspnea
ANEMIA (PCV < 20%)
Hyperbilirubinemia
How do you treat a foal with NI?
Supportive therapy
If PCV <10-15% give blood transfusion: Washed RBCs from dam and monitor dor hepatic failure and iron intoxicication; RBCs live for 2-4 days
Antimicrobials
Immunosuppresion
How can you strop a mare of colostrum when NI has occured?
Treat with oxytocin and milk/strip q. 2 hours while foal is muzzles
(while feeding the foal)
Foals are born:
a. beta-gamma globulinemic
b. pangamma globulinemic
c. agamma globulinemic
d. hyperglobulinemic
c. agamma globulinemic
What IgG level indicates complete FPT (failure of passive transfer)? What indicates adequate passive transfer?
<400 mg/dl (FTP)
>800mg/dl (normal PT)
How can you minimize a plasma transfusion reaction in a foal? What indicates that a plasma reaction hs occurred?
Minimize by pre-treating with NSAIDs
CS: Tachycardia, Tremblind, Dyspnea, Hypertension, Pulmonary edema
What does a Dummy Foal have?
Neonatal encephalopathy
Is Hypoxic Ischemic Encephalopathy in foals always fatal?
No, injury to the CNS is reversible (but can progress to irreversible)
How do foals with Hypoxic Ischemic Encephalopathy present? When do signs present?
First get GI signs (diarrhea, ileus)
Mild depression
Loss of suckle reflex
Head tilt
Seizure activity
Can take over 24 hours to show any signs of CNS involvement
How are rib fractures treated?
4 weeks of stall rest preferably in sternal recumbency (then re-evaluate)
May need surgery
What does meconium aspiration indicate? What does it cause and how is it treated?
Fetal stress
Causes aspiration pneumonia
Tx= Antimicrobials, Bronchodilators, O2, +/- steroids
What are causes of aspiration pneumonia in foals?
Aspiration while bottle feeding or improper NG tube use
What does lactose intolerance cause in foals?
Diarrhea for about 1 month without any other clinical signs
What electrolyte must be stabilized in a foal before surgery? What level is life threatening?
Potassium
>5.5 mEq/L
What do you suspect in a lame foal with high fever and extremely high fibrinogen?
Septic physitis
