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Foal Nursing Flashcards

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
How can we treat dummy foal?
Nursing Maintain cerebral perfusion - careful IV fluid support Correct metabolic imbalances Parenteral nutrition/slow enteral feeding Squeeze?
26
Define prematurity, dysmaturity and postmaturity.
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
Define prematurity, dysmaturity and postmaturity.
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
Define prematurity, dysmaturity and postmaturity.
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
What are the clinical signs of pre-/dysmaturity?
``` 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
Describe tendon laxity in foals.
Flexor tendons/ligaments May be premature/dysmature/postmature Complication from bandage/cast/splint
29
How can we manage tendon laxity?
Usually resolve after a few days Box-rest - limit bedding Walk on firm ground 5m 3x a day Bandage heels for protection
30
Describe tendon contracture in foals.
Unknown cause - positioning in uterus? Can be acquired when older Varying severity, number of limbs Varying prognosis but usually fair to good
31
How can we manage tendon contracture?
``` 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
How can we manage meconium retention in foals?
``` Soapy water/phosphate enema Acetylcysteine retention enema (breaks down mucus) Analgesia - Buscopan Surgery - rare IgG SNAP test ```
33
What are the clinical signs and treatments for a ruptured bladder in foals?
``` 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
Describe neonatal isoerythrolysis (NIE).
Foal erythrocyte antigen not recognised by mare Mare sensitised to that erythrocyte antigen Foal drinks colostrum Antibodies attack foal's red cells
35
What are the clinical signs of neonatal isoerythrolysis?
Anaemia Icterus Weakness
36
How do we manage neonatal isoerythrolysis?
Transfusion at PCV < 12% Withdraw colostrum Prevent future foals from drinking mare's colostrum Or blood type dam and sire
37
How can we diagnose pneumonia in foals?
``` Radiography Trans-tracheal wash (cytology and culture) Antibiotics Oxygen Sternal ```
38
How can a foal become infected with Rhodococcus equi?
Environment (dust) Nose-to-nose contact with infected foals Dam (faeces)
39
What are some clinical signs of Rhodococcus equi?
``` Clinical signs not usually until at least 6 weeks old Can vary, difficult to interpret Pneumonia Septic/immune-mediated joint effusion Diarrhoea ```
40
What diagnostic tests can we run for Rhodococcus equi?
Thoracic radiograph - abscesses Tracheal wash - cytology, culture and sensitivity Joint fluid sample if effusion Very high white cell count and fibrinogen
41
How can we treat Rhodococcus equi in foals?
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
How can we prevent Rhodococcus equi infection?
Environment Hyperimmune plasma NOT antibiotics at birth

Veterinary Nursing (65 decks)

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