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Veterinary Nursing > Foal Nursing > Flashcards

Foal Nursing Flashcards

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1
Q

How do we carry out a clinical exam on a recumbent foal?

A 
Every 4-6hrs
Thoracic auscultation, HR, RR
MMs
Palpation - joints, umbilicus
Temperature - 37.5-39 degrees C
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2
Q

What other considerations should we have for nursing recumbent foals?

A 
Sternal - support, bean bag
Intra-nasal oxygen
Keep clean, warm, dry
IV catheter care
Pressor support
Urinary catheter care
Hydration status
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3
Q

How do we feed a foal that is able to suck?

A

Mare is best
No mare - feed milk/milk replacer from bowl
RISK aspiration pneumonia if bottle feed

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4
Q

How do we feed a foal that is unable to suck?

A

Indwelling naso-gastric tube - X-ray to check position, feed by gravity
5% glucose spiked isotonic fluids short-term
Parenteral nutrition long-term
Monitor glucose, may need insulin SC or CRI

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5
Q

What blood tests should we carry out on a foal?

A 
IgG SNAP ELISA
PCV, TP
Glucose
White cells
Creatinine
Blood gas, electrolytes
Lactate
Culture
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6
Q

How do we make sure the foal has the right antibodies before foaling?

A

Vaccinations - influenza, EHV, rotavirus, tetanus
Last tetanus 4-6 weeks before foaling
Move mare to foaling environment 6 weeks before

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7
Q

What is an ideal foaling box setup?

A 
5m x 5m
Good ventilation
Disinfected
Warm, sheltered
Bedding e.g. straw/shavings
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8
Q

On what timeframe do we expect the newborn foal to breathe, stand etc.?

A 
1st breath within 30secs
Attempt to stand - up by 30mins-1hr
Drink colostrum by 1-3hrs
Pass meconium
Urinate
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9
Q

Why does respiratory arrest in equine neonates most commonly occur?

A 
Premature placental separation
Early severance or twisting of the umbilical cord
Dystocia
Airway obstruction by foetal membranes
Failure to spontaneously breathe
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10
Q

What are some causes for cardio-pulmonary arrest in equine neonates not associated with birth?

A 
Primary lung disease
Sepsis
Hypovolaemia
Metabolic acidosis
Hyperkalaemia
Hypoglycaemia
Hypothermia
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11
Q

When would be choose to stimulate a foal rather than begin resuscitation?

A 
HR < 60bpm / irregular
Slow/irregular respiration
In lateral, some muscle tone
On nasal mucosal stimulation, grimace
THEN stimulate and provide intranasal oxygen
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12
Q

When would we attempt neonatal resuscitation?

A

HR/respiration undetectable
Muscle tone limp/absent
Unresponsive to nasal mucosal stimulation

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13
Q

How do we ventilate a foal during resuscitation?

A

Clear airway
Place naso-/ET tube (can do this whilst foal in birth canal)
Ambu-bag to tube if possible (if not, then mouth to tube / ambu-bag to mask / mouth to nose)
Short, infrequent breaths - 10 breaths/min

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14
Q

When do we attempt CPR in a foal?

A

Reassess 30 seconds after starting ventilation

If heart beat absent, less than 40bpm or less than 50bpm and not increasing

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15
Q

How do we do chest compressions in a foal?

A

Knee parallel to spine
Hands on top of each other
Caudal to triceps at highest point of thorax
Shoulders above hands so can use bodyweight
Optimal chest compression - push hard!
Ideally 1 person to compress and 1 to ventilate - no pauses
Compression to ventilation ratio 15:1
Compressions 100-120 per minute

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16
Q

What is failure of passive transfer (FPT)?

A

All antibodies received from colostrum, should suck within 1-2hrs
Gut ‘open’ for 24hrs, in that time allows in not just antibodies but bacteria
Partial FPT 400-800mg/dl
Total FPT < 400mg/dl
Normal > 800mg/dl
FPT massive risk for sepsis

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17
Q

How can we test for failure of passive transfer?

A

SNAP ELISA

Easy, cheap, done in the stable

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18
Q

How do we treat failure of passive transfer?

A 
Hyperimmune plasma transfusion
Defrost slowly
Blood giving set (filter)
Start slow (risk transfusion reaction)
1L over about 1hr
Re-test after each bag
19
Q

What are the clinical signs of sepsis?

A

Pyrexia, depression, recumbency, injected MMs
May have joint effusion +/- lameness
May be totally unresponsive

20
Q

How can we test for sepsis?

A 
Blood culture - white cell count, SAA, SNAP test, creatinine
USG
Glucose
Lactate
Culture from umbilicus?
Joint sample for cytology and culture?
21
Q

How can we treat sepsis?

A 
Broad spectrum antibiotics
Plasma - even if no failure of passive transfer?
Joint lavage
Remove umbilicus?
Intensive care - nursing recumbent foal
22
Q

Describe seizures in foals.

A 
Generalised convulsions / subtle signs
Many causes
Correct primary cause if possible
Maintain airway, admin oxygen
Anticonvulsant therapy - diazepam vs midazolam
23
Q

What is dummy foal syndrome?

A

AKA hypoxic ischaemic encephalopathy / perinatal asphyxia syndrome
Hypoxia at birth/in vivo
Brain and other organ damage

24
Q

What are some clinical signs of dummy foal?

A 
Slow to swallow
Not sucking
Not following mare
Ataxic
Forgetting to breathe
Seizure
25
Q

How can we treat dummy foal?

A

Nursing
Maintain cerebral perfusion - careful IV fluid support
Correct metabolic imbalances
Parenteral nutrition/slow enteral feeding
Squeeze?

26
Q

Define prematurity, dysmaturity and postmaturity.

A

Prematurity < 320 days usually require vet attention, 280 days unlikely to survive
Dysmaturity = look premature despite normal or often longer gestation
Postmaturity = long gestation, normal size but emaciated

26
Q

Define prematurity, dysmaturity and postmaturity.

A

Prematurity < 320 days usually require vet attention, 280 days unlikely to survive
Dysmaturity = look premature despite normal or often longer gestation
Postmaturity = long gestation, normal size but emaciated

26
Q

Define prematurity, dysmaturity and postmaturity.

A

Prematurity < 320 days usually require vet attention, 280 days unlikely to survive
Dysmaturity = look premature despite normal or often longer gestation
Postmaturity = long gestation, normal size but emaciated

27
Q

What are the clinical signs of pre-/dysmaturity?

A 
Smaller than expected
Silky short hair
Floppy ears
Domed head
Weak
Abnormal RR (low or high)
GI/Respiratory organs immature
Musculoskeletal - incomplete ossification of carpal/tarsal bones
28
Q

Describe tendon laxity in foals.

A

Flexor tendons/ligaments
May be premature/dysmature/postmature
Complication from bandage/cast/splint

29
Q

How can we manage tendon laxity?

A

Usually resolve after a few days
Box-rest - limit bedding
Walk on firm ground 5m 3x a day
Bandage heels for protection

30
Q

Describe tendon contracture in foals.

A

Unknown cause - positioning in uterus?
Can be acquired when older
Varying severity, number of limbs
Varying prognosis but usually fair to good

31
Q

How can we manage tendon contracture?

A 
Physiotherapy
Walk on hard ground
Oxytetracycline (1x a day for 3 days)
To extensions
Splint / half limb / full limb cast
Check ligament desmotomy
Tenotomy
32
Q

How can we manage meconium retention in foals?

A 
Soapy water/phosphate enema
Acetylcysteine retention enema (breaks down mucus)
Analgesia - Buscopan
Surgery - rare
IgG SNAP test
33
Q

What are the clinical signs and treatments for a ruptured bladder in foals?

A 
2-3 days old
Colic, distended abdomen
Ultrasound, peritoneal sample
High K - bradycardia
Medical emergency!
Saline 0.9% at 250ml/hr/50kg, drain abdomen, surgery
34
Q

Describe neonatal isoerythrolysis (NIE).

A

Foal erythrocyte antigen not recognised by mare
Mare sensitised to that erythrocyte antigen
Foal drinks colostrum
Antibodies attack foal’s red cells

35
Q

What are the clinical signs of neonatal isoerythrolysis?

A

Anaemia
Icterus
Weakness

36
Q

How do we manage neonatal isoerythrolysis?

A

Transfusion at PCV < 12%
Withdraw colostrum
Prevent future foals from drinking mare’s colostrum
Or blood type dam and sire

37
Q

How can we diagnose pneumonia in foals?

A 
Radiography
Trans-tracheal wash (cytology and culture)
Antibiotics
Oxygen
Sternal
38
Q

How can a foal become infected with Rhodococcus equi?

A

Environment (dust)
Nose-to-nose contact with infected foals
Dam (faeces)

39
Q

What are some clinical signs of Rhodococcus equi?

A 
Clinical signs not usually until at least 6 weeks old
Can vary, difficult to interpret
Pneumonia
Septic/immune-mediated joint effusion
Diarrhoea
40
Q

What diagnostic tests can we run for Rhodococcus equi?

A

Thoracic radiograph - abscesses
Tracheal wash - cytology, culture and sensitivity
Joint fluid sample if effusion
Very high white cell count and fibrinogen

41
Q

How can we treat Rhodococcus equi in foals?

A

Clarithromycin plus rifampicin
Beware fatal diarrhoea in adult i.e. dam!!
Discuss with owner - precautions
Treat until radiographically normal, blood normal (~6 weeks)
Joint lavage if appropriate

42
Q

How can we prevent Rhodococcus equi infection?

A

Environment
Hyperimmune plasma
NOT antibiotics at birth

Veterinary Nursing (65 decks)

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