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CVNT 2 > Foal nursing > Flashcards

Foal nursing Flashcards

1
Q

nursing the recumbent patient

A
  • clinical exam every 4-6hrs:
    • thoracic auscultation, MM, palpation (joints, umbilicus), temp
  • sternal support (beanbag)
  • intra-nasal oxygen
  • keep clean, warm, dry (potential urinary catheter)
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2
Q

temp range for foals

A

37.5-39 degrees C for first 7 days

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3
Q

how to know hydration status

A

urine specific gravity (<1.010)

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4
Q

feeding the sick foal

A
  • milk mare regularly (check for mastitis)
  • replacement milk from bowl if necessary
  • risk of aspiration pneumonia if bottle fed
  • indwelling NO tube- x-ray to check position, feed by gravity
  • glucose spiked isotonic fluid short term if can’t cope with milk
  • PPN long term (parental nutrition)
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5
Q

maternal antibodies

A
  1. make sure mare has right antibodies
    - vaccinations for influenza, EHV, tetanus
    - last tetanus 4-6 weeks before foaling
    - maternal antibodies protect foal for 6 weeks after birth
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6
Q

leaking colostrum

A
  • not normal
  • foal only gets antibodies by drinking colostrum
  • if leaking, colostrum lost
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7
Q

foaling box

A
  • 5m x 5m
  • good ventilation, warm, sheltered
  • disinfected
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8
Q

foaling complications

A
  • have about 1hr to get foal out before death
  • can be slightly longer if ET tube can be placed
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9
Q

newborn foal

A
  • 1st breath within 30 secs
  • attempt to stand within 1hr
  • drink colostrum within 1-3hrs
  • pass meconium and urinate
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10
Q

neonatal resuscitation decision

A
  • physical exam before deciding to
    resuscitation
  • serious physical problems (hydrocephalus) may mean a decision not to resuscitate
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11
Q

respiratory arrest in neonates

A
  • resp arrest precede cardiac arrest
  • resp arrest caused by:
    • premature placental seperation
    • twisting of umbilical cord
    • dystocia
    • airway obstruction by fetal membranes
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12
Q

causes of CPA not associated with birth

A
  • primary lung disease
  • sepsis
  • hypovolaemia
  • metabolic acidosis
  • hypoglycaemia, hyperkalaemia
  • hypothermia
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13
Q

success rates of CPA

A
  • 50% if resuscitation begun before heart stops
  • 10% if delayed start of resuscitation until asystole
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14
Q

when to perform neonatal resuscitation

A
  • HR <60bpm/irregular
  • if slow/irregular respiration
  • some muscle tone in lateral
  • grimace on nasal mucosal stimulation
    stimulate, give intranasal oxygen
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15
Q

resuscitation steps- ventilation

A
  1. clear airway
  2. place naso/ET tube
  3. ventilate (many respond to this alone)
    - mouth to tube
    - ambu-bag to mask
    - mouth to nose (close opposite nostril)
    - short breaths, 10 per min
  4. ensure neck extended to reduce aerophagia (air in stomach)
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16
Q

nasotracheal tube placement

A
  • extend head, pass ventral and medial
  • 2 attempts to place
  • if unsuccessful move onto ET tube
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17
Q

ET tube placement

A
  1. pull tongue forwards and lateral with one hand to stabilise larynx
  2. advance tube in midline over tongue
  3. twist once reached the larynx
  4. check positioning then cuff and secure to head with bandage
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18
Q

resuscitation steps- CPR

A
  • reassess 30 secs after starting ventilation
  • begin CPR if HR absent, less than 40bpm
    1. put back of foal against wall
    2. check for fractured ribs, place them side down
  • if bilaterally fractured, place side with more cranial ribs fractured down
  • compress 100-120 bpm
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19
Q

chest compression position

A
  • knees parallel to spine
  • hands on top of each other
  • caudal to triceps at highest point of thorax
  • shoulders above hands to use body weight
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20
Q

dehydration in foals

A
  • adult signs not consistent in foals
  • diagnose on history, clinical signs, lactate, high index of suspicion and USG
  • may present as flat
  • often hypoglycaemic
  • no nursing for >4hrs= presume dehydrated
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21
Q

treatment of dehydration in foals

A

for 50kg foal:
1. 1L bolus hartmanns then reassess
2. up to 3 additional boluses
3. 5% glucose spiked hartmanns
4. use USG to monitor

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22
Q

transfer of antibodies to foal

A
  • gut ‘open’ for 24hrs letting in antibodies but also bacteria
  • immunologically naive
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23
Q

failure of passive transfer (FPT)

A

partial= 400-800 mg/dl
total= <400 mg/dl
normal- >800 mg/dl
- massive risk factor for sepsis (87.5%)
- measure with blood sample (snap)
- test every foal at 12-24hrs old
- 10-33% foals affected

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24
Q

treatment for FPT

A

hyperimmune plasma transfusion
- defrost slowly (prevents antibody denature)
- 1l over 1hr
- too much/too fast= pulmonary oedema
- retest after each bag

25
Q

sepsis in foals

A
  • most common reason for hospitalisation and death of neonatal foals
  • 30-50% die despite ICU
  • FPT major risk factor
  • systemic bacterial infection (+/- joints, +/- umbilicus)
26
Q

clinical signs of sepsis

A
  • pyrexia
  • depression, recumbency
  • injected mucus membranes
  • +/- joint effusion, lameness
  • collapse, non responsive
27
Q

tests for sepsis

A
  • blood culture
  • WBC count
  • SAA
  • snap test
  • creatinine (risk anuric renal failure)
  • USG
  • glucose
  • lactate
28
Q

treatment for sepsis

A
  • broad spectrum antibiotics
  • plasma
  • joint lavage if have effusion
  • remove umbilicus if infected
  • intensive care
29
Q

seizures in foals

A
  • subtle signs, generalised convulsions
  • many causes
30
Q

treatment for seizures

A
  • correct primary cause
  • maintain airway, give oxygen
  • anticonvulsant therapy:
    • diazepam
31
Q

dummy foal

A
  • also called hypoxic ischaemic encephalopathy, perinatal asphyxia syndrome
  • hypoxia at birth, brain and other organ damage
32
Q

clinical signs of dummy foal

A
  • slow to swallow
  • not sucking
  • not following mare
  • ataxic
  • forgetting to breathe
  • seizure
33
Q

treatment for dummy foal

A
  • nursing
  • maintain cerebral perfusion- careful IV support
  • correct metabolic imbalances
  • PPN/slow enteral feeding
  • squeeze? (removes inhibitory neurotransmitters that usually occurs during birth)
    • don’t do if cause is known to be hypoxic
34
Q

prematurity

A

<320 days

35
Q

dysmaturity

A

look premature despite normal or often longer gestation

36
Q

postmaturity

A

long gestation, normal size but emaciated

37
Q

prematurity, dysmaturity physical signs

A
  • smaller than expected
  • silky, short hair
  • floppy ears
  • domed head
  • weak
  • abnormal RR
38
Q

internal implications of prematurity, dysmaturity

A

immature organs:
- GI tract
- respiratory
- musculoskeletal
- incomplete ossification of carpal + tarsal bones
- flexural deformity (tendon laxity)

39
Q

flexural deformity- tendon laxity causes

A
  • flexure tendons/ligaments
  • may be premature/dysmature/postmature
  • complication from bandage/cast/splint
40
Q

flexural deformity- tendon laxity treatment

A
  • usually resolve after a few days
  • box-rest- limit bedding
  • walk on firm ground
  • bandage heels for protection
41
Q

flexure deformity- tendon contracture causes

A
  • unknown (possible positioning in uterus)
  • can acquire when older
  • varying severity, number of limbs
42
Q

flexural deformity- tendon contracture treatment

A
  • physiotherapy
  • walk on hard ground
  • oxytetracycline (care- nephrotoxic)
  • toe extensions
  • splint
  • half/limb cast
  • check ligament desmotomy
  • tenotomy
43
Q

angular limb deformity

A

valgus (away from midline) or varus (towards midline)
- fetlock, carpus, tarsus
treatment:
- rest, farriery, surgery

44
Q

meconium retention

A
  • colic/restlessness signs
  • often meconium retention and FPT together
  • check rectum is patent
45
Q

treatment of meconium retention

A
  • soapy water enema/phosphate enema
  • acetylcysteine retention enema
    • breaks down mucus
  • analgesia- buscopan
  • surgery (rarely needed)
  • IGG snap test (antibody status)
46
Q

diarrhoea

A
  • infectious cause?
  • check rotavirus
  • check IgG
  • treat dehydration, electrolyte, acid base imbalance
47
Q

gastric ulcers (prevention)

A
  • sucralfate- encourages blood supply to stomach wall
    • give prophylactically (preventative)
48
Q

infected umbilicus

A
  • dip regularly first 2 days (1% chlorhexidine)
  • higher risk infection if FPT
  • ultrasound, culture
  • antibiotics, surgery (rare)
49
Q

ruptured bladder

A
  • occurs 2-3 days old
  • colic, distended abdomen
  • urination?- can still wee
  • ultrasound, peritoneal sample
  • high K- bradycardia
50
Q

ruptured bladder treatment

A
  • medical emergency
  • saline (250ml/hr/50kg)
  • drain abdomen + surgery
51
Q

neonatal isoerythrolysis (NIE)

A
  • foal erythrocyte antigen not recognised by mare
  • mare sensitised to that antigen
  • foal drinks colostrum and antibodies attack foals RBCs
    • no antibodies transferred through umbilical cord
52
Q

NIE clinical signs and treatment

A
  • anaemia (killed RBCs)
  • icterus (yellow)
  • weak
  • require transfusion at PCV <12%
  • withdraw colostrum
  • prevent future foals drinking colostrum or blood type parents
53
Q

pneumonia causes

A
  • aspiration (care when bottle fed)
  • FPT
54
Q

pneumonia clinical signs and diagnosis

A
  • increased RR and effort
  • pyrexia
  • diagnose through radiography
55
Q

treatment of pneumonia

A
  • trans-tracheal wash (cytology and culture)
  • antibiotics
  • oxygen
  • sternal recumbency
56
Q

rhodococcus equi

A

infected at birth
- bacteria lives in environment (dust)
- nose to nose contact with infected foals
- contact with dam’s faeces)
- no clinical signs until 6 weeks old
- foal disease, not seen in adults although they can shed it

57
Q

clinical signs of rhodococcus equi

A
  • can vary
  • pneumonia
  • sepsis, immune mediated joint effusion
  • diarrhoea
58
Q

diagnosing rhodococcus equi

A
  • thoracic radiograph for abscesses
  • tracheal wash, cytology, C + S
  • joint fluid sample if effusion
  • very high WBC count and fibrinogen
59
Q

treatment of rhodococcus equi

A
  • clarithromycin
  • plus rifampicin
    • can cause fatal diarrhoea in adult
  • treat for 6 weeks

CVNT 2 (33 decks)

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