Lecture 20: Equine Neonatology Flashcards
What is the TPR for healthy foal 1 minute post foaling
HR:60
RR: 60
T: 99-101.5
what is HR at 1hr, 1 day, RR after 12hrs post foaling
HR at 1hr- 80-130
HR after 1 day: 80-120
RR after 12hrs: 30-40
what is first concern when foal is born
passive transfer of immunity
what is passive transfer of immunity
immunization through transfer of specific antibody from immunized individual to non-immunized individual
T or f: foals are born immunocompetent- can mount immune response (eventually), but immunologically naive
true
what is primary Ig in colostrum
IgG
mares produce ~__mL/hr for 18hrs of colostrum (~__L)
300mL/hr, 5L
what receptor in foals gut lumen uptakes IgG
FcRN
what mare factors can lead to failure of passive transfer
- Agalactia
- Poor quality colostrum
- Premature lactation/ colostrum leakage
what can you use to measure IgG in colostrum
colostrumeter
what is ideal IgG value on colostrometer
> 1.060: 1,500-5000mg/dL
t or f: can take accurate colostrum values on colostrometer after first suckle from foal
false- must be pre-suckle
how long do maternal antibodies from colostrum circulate in foal
4-5 months
when are autogenous IgG detected in foal
2 weeks
what is the major sequela of failure of passive transfer
sepsis
IgG deficit foals had <__mg/dl whereas normal foals had __mg/dl
400, 800
what stall side test can you use to dx failure of passive transfer and how does it work
SNAP Foal ELISA- quantifies as 400 and 800mg/dl of IgG in 7 minutes
complete failure of passive transfer foals have IgG <___
200mg/dl
partial failure of passive transfer foals have IgG __-___mg/dl
200-400
what is considered safe zone for amount of IgG in foals
> 800mg/dl
what do you do if foal has IgG <800
provide supplemental IgG via colostrum via NG tube, plasma transfusion
how much colostrum should foals get within first 2hrs of age
1-1.5L
how many hours old should you check IgG in foal
12hrs
if a foal is 18hrs old and still has low IgG what is only way to raise IgG
plasma
what is selective IgM deficiency and what are some signs
immunodeficiency of older foals characterized by decreased serum concentrations of IgM
Signs: 2-8 month olds failure to thrive, small size, recurring infections
what breeds is IgM deficiency most common in
Arabians, QH
Define sepsis
clinical illness with suspected or documented infection
what things must foals have to have SIRs (systemic inflammatory response syndrome)
- Abnormal temperature
- Abnormal leukocyte count
One of the following: tachycardia, tachypnea, increased lactate, hypoglycemia
what are some clinical signs of sepsis in neonatal foal
lethargy, depression, anorexia (milk streaming from dam), scleral injection, petechiae ion
Foal presents with the following signs- lethargy, abnormal behavior, scleral injection- what is likely problem and cause
Sepsis likely caused by failure of passive transfer
what is the most common complication in septic foals
diarrhea and pneumonia
what are some other complications in septic foals
septic arthritis, patent urachus, meningitis, uveitis, oral candidiasis
what are some things that compromise a mare and can lead to foal having FPT—> sepsis
- Poor quality colostrum
- Premature lactation
- Mare death/colic/ rejection
what are some examples of how foal can be compromised leading to FPT—> sepsis
- Prematurity
- Neonatal encephalopathy
- Inutero infection
- Deformities that prevent nursing
- Intestinal malabsorption
- Premature shedding of enterocytes
how Do you dx neonatal sepsis
Blood cultures (take days)
Since blood cultures take days to dx neonatal sepsis what should you first do to tx
empiric antibiotics
a sepsis score > or = to 12 means what
predicts sepsis 97% percent of time
sepsis score of < or = 11 means what
predicts Non-sepsis 88% of time
what is the tx of septic foal
- Abx
- Fluids
- Plasma
- Thermoregulation
- Nutrition
- Glucose regulation
- Oxygen
- Ventilation
what bacteria is most common in septic foals
E. Coli, but mixed infections becoming more common
should abx for septic foal be cidal or static
cidal
what is recommended abx tx for septic foals
penicillin/ampicillin + aminoglycosides
+/- 3rd generation cephalosporins
are gram - or + more common in septic foals
gram negatives
what is prognosis for return to athleticism for foals with septic arthritis
poor, 1/3 raced again
what is normal gestation length
320-360 days
foals considered premature if born before __
320 days
what is immaturity/dysmaturity
acceptable gestational age, signs of prematurity
What are some signs of prematurity
small sign, weak, silky coat, domed forehead, floppy ears, hyperextended fetlocks, decreased GI function, hypothermia, incomplete ossification of carpal and tarsal bones
if HR of foal is below 40 what do you do
continue ventilation and thoracic compressions
Give epi if needed
if HR of foal is 40-60 what do you do
HR not increasing: ventilation and thoracic compressions, add epi
HR increasing: continue ventilation
what do you do if foal HR above 60 but was originally gasping
watch for spontaneous respiration then discontinue ventilation
if foal has spontaneous respiration and HR >50 what do you do
evaluate oxygenation
Poor- provide O2
Good- observe and monitor
what are 2 congenital anomalies ion foals that are incompatible with life
- GI atresia
- Major cardiac anomalies
lavender foal syndrome is due to what genetic defect
autosomal recessive mutation in MYO5A
what breeds is lavender foal syndrome common in
Arabians
what are the clinical signs of lavender foal syndrome
dilute coat color, neurologic signs (seizures, hyperesthesia, recumbency)
what is dx and tx for lavender foal syndrome
dx: genetic test
Tx: euthanasia
where is MYO5A normally expressed and what is it involved in
expressed in melanocytes and nerve cells, involved in vesicle transport in cytoplasm
Transfers melanin for pigmentation and formation of nerve synapsids
Arabian foal is recumbent, having seizures, what do you suspect
Lavender foal syndrome
what is cause of overo lethal white syndrome/ ilicolonic aganglionosis
autosomal recessive mutation in endothelia receptor type B
what breeds commonly get overo Lethal white syndrome
paints
what are some signs of overo lethal white syndrome
white hair coat, unrelenting colic
what is dx and tx for overo lethal white syndrome
dx: genetic test
Tx: euthanasia
what is endothelia receptor type B involved in and what does mutation result in
involved in 2nd messenger system activation
Melanocytes fail to migrate to skin, myenteric ganglia fail to develop
what is cause of SCID
autosomal recessive mutation in DNA-PKcs
what breed is SCID common in
Arabians
what are some signs of SCID
recurrent infection
what is dx and tx of SCID
dx: genetic test
Tx: euthanasia
what is DNA-PKcs normally involved in and what does mutation cause
involved in DNA repair and B and T cell development
Mutation leads to no functional B or T cells
what is cause of glycogen branching enzyme deficiency
autosomal recessive mutation in GBE1
what is GBE1 required for and what does mutation lead to
expressed in muscle and liver- required for properly branched glycogen
Mutation leads to poorly branched glycogen and abnormal storage
what breed is glycogen branching enzyme deficiency disease common in
QH
what are some signs of glycogen branching enzyme deficiency
abortion, stillbirth, weak foal, flexural deformities, cardiac and respiratory failure
what is tx and dx for glycogen branching enzyme deficiency
dx: genetic test
Tx: euthanasia
