Neonates Flashcards
DDX of neurologic disorders in foals
- Neonatal encephalopathy (NE) and Hypoxic-Ischemic Encephalopathy (HIE)
- Sepsis-associated encephalopathy (SAE)
- Seizure disorders
- Bacterial meningitis (E. coli, Actinobacillus, Klebsiella, Strepto, Salmonella)
- Trauma
- Botulism (toxin types B and C) → inhibit the release of Ach
- Tetanus (tetanospasmin) → inhibit the release of GABA (inhibitory neurons)
- Metabolic encephalopathy
DDX metabolic encephalopathy in foals
- Hypoglycemia
- Hyponatremia → cerebral edema
- Hypernatremia → osmotic demyelination syndrome
- Hypocalcemia → tetany and seizures. May be due to primary hypoparathyroidism
- Hyperbilirubinemia → kernicterus. May be due to neonatal isoerythrolysis
-
Hyperammonemia. May be due to :
- Hepatic insufficiency
- Portosystemic shunt
- Intestinal production
- Genetic defect in Morgan Foals
DDX congenital neurologic disorders in foals
- Hydrocephalus (Friesian)
- Occipitoatlantoaxial malformation (Arabian)
- Cerebellar abiotrophy (Arabian) → autosomal recessive trait, generally detectable between 4 weeks to 6 months of age.
- Juvenile idiopathic epilepsy (JIE) (Arabian of Egyptian lineage) → self-limiting and resolves by 1 to 2 years of age.
- Narcolepsy and cataplexy (familial component)
DDX of respiratory disorders in foals
- Neonatal Equine Respiratory Distress Syndrome (NERDS) : primary surfactant deficiency
- Acute Lung Injury (ALI) and Acute RDS (ARDS) : syndromes associated with an exagerated inflammatory response → severe tissue damage within the lungs
- Persistent pulmonary hypertension of the newborn : pulmonary disease → hypoxia → sustained increase in the pulmonary vascular resistance → right-to-left shunt
- Congenital upper respiratory tract disorders : wry nose, choanal atresia, cleft palate, subepiglottic cyst
- Meconium aspiration : respiratory distress
- Milk aspiration : secondary to generalized weakness or prematurity, or physical abnormalities of pharynx, larynx, or esophagus
- Transient tachypnea with hyperthermia : idiopathic in hot, humid weather
- Rib fractures : pneumothorax, hemothorax
- Viral infections : EHV-1, EHV-4, EIV, EAV, EAdV
- Fungal diseases : Histoplasma capsulatum, Candida spp, Pneumocystis carinii
- Parasitic pneumonia : Parascaris equorum
- Bacterial infections : Neonatal foal vs older foals
DDX of pulmonary viral infections in foals
- EHV-1 : severe pneumonitis, icterus, marked neutropenia. Necrosis of the lymphoreticular tissues → liver, bone marrox, thymus
- EHV-4 : rare → abortion, stillbirth
- EIV : severe bronchointerstitiel pneumonia
- EAV : severe interstitial pneumonia, enteritis
- Equine Adenovirus (EAdV) : rare → immunocompromised foals (SCID in Arabian foals, Fell pony foals)
Newborn foal with fever, icterus and severe neutropenia +/- respiratory signs. Clinical hypothesis ?
EHV-1 infections
DDX of pulmonary fungal diseases in foals
- Histoplasma capsulatum : in utero infection with placentitis → abortion or foals with granulomatous pneumonia
- Candida spp : superficial or systemic (rare)
- Pneumocystis carinii
DDX of pulmonary parasitic diseases in foals
Parascaris equorum : larvated eggs in the intestinal lumen → migrate through the liver and lungs → coughed up and reingested. Resistance to macrocyclic lactone (ivermectin)
DDX of pulmonary bacterial infections in foals
Neonatal foals : most often associated with hematogenous spread secondary to bacteremia.
Gram - > Gram + like in neonatal sepsis
Older foals : common pneumonia in foals from 1 to 6 months, most common cause of death
- Streptococcus equi zooepidemicus : most common etiologic agent of bacterial pneumonia. Normal URT organism → infection due to decreased maternal Ab, stress of weaning, sales, transport.
- Rhodococcus equi : facultative intracellular gram + coccobacillus with a plasmid encoding a virulence-associated protein VapA. Fever, lethargy, coughing, tachypnea, dyspnea. Extra-pulmonary disorders : diarrhea, ulcerative enterotyphlocolitis, immuno-mediated synovitis, intraabdominal lymphadenitis, or abscessation and uveitis.
What is the most common etiologic agent of bacterial pneumonia in foals of 3 months ?
Streptococcus equi zooepidemicus
What are the definitions of hypoxemia and hypercapnia ?
Hypoxemia : PaO2 < 60 mmHg
Hypercapnia : PaCO2 > 60 mmHg
Is the immunocrit method a reliable method to detect failure of passive immunity in newborn foals ?
The immunocrit test provides a quantitative, quick, inexpensive, reliable and objective method to detect failure of passive transfer of maternal immunity in newborn foals, which is easy to perform directly in horse farms, with minimum laboratory equipment.
Assessment of the immunocrit method to detect failure of passive immunity in newborn foals
Technical notes
evj 2020
Which of the following factors was identified as a significant risk factor for being blood culture positive in neonatal foals in the study?
A) Prematurity
B) Hypoglycemia
C) Maternal uterine infection
D) Hypothermia
Answer:
B) Hypoglycemia
Explanation:
The study found that hypoglycemia was a significant risk factor for bloodstream infection (BSI) in neonatal foals, with an adjusted odds ratio (OR) of 13.51 (P = 0.03). Other significant risk factors included umbilical disease and the combined presence of umbilical disease and low hematocrit.
Factors like prematurity, maternal uterine infection, and failure of passive transfer were not found to be significant risk factors for BSI in this study.
Factors associated with the risk of positive blood culture in neonatal foals presented to a referral center (2000-2014)
jvim 2020
What did the study conclude regarding bacteriological and antimicrobial susceptibility testing in foals with sepsis hospitalized for ≥48 hours?
A) Bacteria isolated after 48 hours of hospitalization showed increased susceptibility to all tested antimicrobial drugs.
B) The isolation frequency of certain bacteria, such as Acinetobacter spp. and Enterococcus spp., increased after ≥48 hours of hospitalization.
C) No changes in bacteriological culture results or antimicrobial susceptibility occurred after 48 hours of hospitalization.
D) Repeat bacteriological cultures are not necessary for foals hospitalized for more than 48 hours.
Answer:
B) The isolation frequency of certain bacteria, such as Acinetobacter spp. and Enterococcus spp., increased after ≥48 hours of hospitalization.
Explanation:
The study found that the relative isolation frequency of certain bacteria, including Acinetobacter, Enterococcus, Klebsiella, Pseudomonas, and Serratia spp., significantly increased after ≥48 hours of hospitalization. Additionally, the bacteria isolated after this period were less susceptible to antimicrobial drugs, highlighting the importance of repeated bacteriological culture and susceptibility testing to adjust treatment strategies in hospitalized foals with sepsis.
Differences in isolation rate and antimicrobial susceptibility of bacteria isolated from foals with sepsis at admission and after ≥48 hours of hospitalization
jvim 2020
What was the key finding of the study comparing critically ill (CI) neonatal crias (llama’s baby) and foals in terms of mortality and disease manifestations?
A) Neonatal crias had a significantly higher survival rate to discharge compared to neonatal foals.
B) Lower respiratory disease was not associated with increased mortality in either species.
C) Euthanasia was more common in neonatal crias than in neonatal foals.
D) The overall survival rate to discharge was comparable between neonatal crias and foals, despite differences in disease prevalence.
Answer:
D) The overall survival rate to discharge was comparable between neonatal crias and foals, despite differences in disease prevalence.
Explanation:
The study found that, despite species-specific differences in disease prevalence (e.g., crias had more congenital defects and failure of transfer immunity, foals had more colic, diarrhea, septic arthritis, patent urachus and omphalitis), the overall survival rate to discharge was similar between neonatal crias (77.8%) and foals (82.1%).
The study also highlighted that lower respiratory disease and glucose or oxygen dysregulation were common factors increasing mortality in both species, while crias (54.2%) were more likely than foals (35%) to die naturally than undergo euthanasia.
Comparative evaluation of clinical findings and prognostic outcome parameters in hospitalized, critically ill neonatal foals and crias
J Vet Emerg Crit Care 2021
What did the study conclude about the diagnostic value of serum amyloid A (SAA) testing in newborn foals?
A) SAA testing is not useful in distinguishing between healthy and nonhealthy foals.
B) SAA testing has a high positive predictive value (PPV) compared to white blood cell (WBC) count and serum immunoglobulin G (IgG) concentration.
C) SAA testing is a reliable tool for detecting early-onset, acute-phase infections or noninfectious morbidities with an inflammatory component in newborn foals.
D) Serum IgG concentration was found to have the highest positive predictive value for detecting nonhealthy foals.
Answer:
C) SAA testing is a reliable tool for detecting early-onset, acute-phase infections or noninfectious morbidities with an inflammatory component in newborn foals.
Explanation:
The study found that SAA testing was effective in distinguishing between healthy and nonhealthy foals, with elevated SAA values being associated with nonhealthy diagnoses. While the SAA test had a positive predictive value (PPV) of 55.6%, IgG and WBC counts had lower PPVs (16.7% and 23.3%, respectively). This indicates that SAA is a useful diagnostic tool for detecting early-onset infections or morbidities with an inflammatory component in newborn foals, particularly in comparison to other tests like IgG and WBC counts.
Comparison of the diagnostic predictability of serum amyloid A, white blood cell count and immunoglobulin G tests as indicators of early-onset, acute-phase morbidities in newborn foals
eve 2022
What was the conclusion of the study regarding the use of serum amyloid A (SAA) testing as a biomarker for sepsis in neonatal foals?
A) SAA testing is not useful for diagnosing sepsis in neonatal foals due to low sensitivity.
B) The SAA test showed high sensitivity, low specificity, and poor predictive values for diagnosing sepsis.
C) SAA testing is a useful diagnostic tool for sepsis in neonatal foals, with high specificity and good predictive values.
D) SAA testing is only useful for detecting sick foals, not for diagnosing sepsis specifically.
Answer:
C) SAA testing is a useful diagnostic tool for sepsis in neonatal foals, with high specificity and good predictive values.
Explanation:
The study found that SAA testing, with a diagnostic threshold of 100 µg/mL, had a sensitivity of 52.9%, specificity of 97.5%, positive predictive value of 75.0%, and negative predictive value of 93.7%.
These results indicate that SAA is a useful biomarker with high specificity for diagnosing sepsis in neonatal foals, aiding in early detection despite its moderate sensitivity. The study concluded that SAA testing is a valuable tool to help diagnose sepsis in neonatal foals, vs healthy and sick-non-septic foals.
Serum amyloid A as an aid in diagnosing sepsis in equine neonates
evj 2022
What was the primary conclusion of the study regarding the use of serum amyloid A (SAA) concentrations in neonatal foals?
A) SAA is a highly sensitive biomarker for detecting sepsis and predicting survival in neonatal foals.
B) SAA concentrations were higher in septic foals and nonsurviving foals, and it can be used to rule out sepsis and nonsurvival due to its good specificity.
C) SAA concentrations were not significantly different between septic and nonseptic foals.
D) The optimal SAA cutoff for predicting survival had high sensitivity and specificity, making it a reliable prognostic marker for foal survival.
Answer:
B) SAA concentrations were higher in septic foals and nonsurviving foals, and it can be used to rule out sepsis and nonsurvival due to its good specificity.
Explanation:
The study found that SAA concentrations were significantly higher in septic foals compared to sick but nonseptic foals, and in nonsurviving foals compared to those that survived.
While the sensitivity of SAA for detecting sepsis and predicting survival was relatively low, the specificity was high, making SAA a useful tool for ruling out sepsis and nonsurvival. The study concluded that SAA could help identify foals at lower risk, although it is not highly sensitive for detecting these conditions.
Serum amyloid A as a marker to detect sepsis and predict outcome in hospitalized neonatal foals
jvim 2022
What did the study conclude about the use of optical (OR) and digital (DR) refractometers for assessing colostrum quality in mares?
A) The refractometers were not reliable for detecting poor-quality colostrum in mares.
B) Both DR and OR refractometers had high sensitivity and specificity for detecting colostral IgG <60 g/L, with DR showing slightly better performance.
C) Only the DR refractometer was reliable for diagnosing poor-quality colostrum, while OR was ineffective.
D) The refractometers showed poor correlation with serum IgG concentrations in foals.
Answer:
B) Both DR and OR refractometers had high sensitivity and specificity for detecting colostral IgG < 60 g/L, with DR showing slightly better performance.
Explanation:
The study found that both the digital (DR) and optical (OR) refractometers were effective tools for diagnosing poor-quality colostrum, with DR having slightly better performance than OR. The DR had a sensitivity of 93.3% and specificity of 87.9%, while the OR had a sensitivity of 93.3% and specificity of 81.8%. Both methods had high negative predictive values, making them reliable for ruling out poor-quality colostrum.
A moderate correlation was observed between IgG concentrations measured by RID in sera and colostrum.
Diagnostic characteristics of refractometry cut- off points for the estimation of immunoglobulin G concentration in mare colostrum
evj 2022
What was the primary conclusion of the study regarding bacterial infections and antimicrobial resistance in equine neonates in the Midwestern United States?
A) Gram-negative bacterial infections were more common than gram-positive infections in neonatal foals.
B) Empirical antimicrobial treatment was not associated with survival outcomes in foals.
C) There was no significant difference in antibiotic susceptibility between the studied pathogens and previous reports.
D) The majority of foals were resistant to common antibiotics, making treatment difficult.
Answer:
B) Empirical antimicrobial treatment was not associated with survival outcomes in foals.
Explanation:
The study found that survival in neonatal foals was associated with a negative fluid culture, not with the choice of empirical antimicrobial treatment. This suggests that the empirical use of antibiotics did not have a significant impact on the survival rates of foals, and that other factors, such as the presence of infection, were more influential.
The study also found that gram-positive organisms were more common than gram-negative ones, and historical antimicrobial choices were supported by local antibiogram data, showing a higher prevalence of resistance in certain bacterial isolates compared to previous studies.
Antibiograms of field and hospital acquired equine neonatal bacterial fluid cultures in the Midwestern United States: 149 samples (2007-2018)
jvim 2023
What is the effect of plasma transfusion in FTPI foals on serum amyloid A concentration ?
Administration of hyperimmune fresh frozen plasma to newborn foals was not associated with changes in SAA concentration.
Effect of plasma transfusion on serum amyloid A concentration in healthy neonatal foals and foals with failure of transfer of passive immunity
jvim 2023
What is the normal variation of SAA in newborn foals ?
SAA increases from foaling to 24h, after colostrum consumption and remains constant between 24h and 72h.
Effect of plasma transfusion on serum amyloid A concentration in healthy neonatal foals and foals with failure of transfer of passive immunity
jvim 2023
Which sentence is correct regarding Red cell distribution width (RDW) values and red cell distribution width-to-platelet ratio (RPR) in foals ?
A) Increased RPR correlated with at-risk foals
B) Decreased RPR correlated with at-risk foals
C) Increased RDW correlated with at-risk foals
D) Decreased RDW correlated with at-risk foals
Answer A
RPR index was higher for at-risk than for healthy foals.
RPR might be a promising early indicator of disease for the field triage of neonatal foal.
Red cell distribution width values and red cell distribution width-to-platelet ratio in Thoroughbred foals in the first 24 hours of life
J Vet Emerg Crit Care. 2023
What was the main finding of the study regarding the use of the red blood cell distribution width to platelet ratio (RPR) in diagnosing sepsis in neonatal foals?
A) RPR was not significantly different between septic and nonseptic foals, making it unsuitable for diagnosing sepsis.
B) RPR was significantly higher in septic foals compared to nonseptic and healthy foals, and it was able to predict sepsis with high accuracy.
C) The study found that RPR was a poor predictor of sepsis, with low sensitivity and specificity.
D) RPR was only useful for estimating the survival outcomes of foals, not for diagnosing sepsis.
Answer:
B) RPR was significantly higher in septic foals compared to nonseptic and healthy foals, and it was able to predict sepsis with high accuracy.
Explanation:
The study found that the red blood cell distribution width to platelet ratio (RPR) was significantly higher in septic foals than in nonseptic and healthy foals.
It was shown to have high accuracy in predicting sepsis.
The optimal cutoff for diagnosing sepsis was determined to be 0.09, making RPR a useful and inexpensive marker for sepsis diagnosis and prognosis in neonatal foals, based on a complete blood count (CBC).
Red blood cell distribution width to platelet ratio in neonatal foals with sepsis
jvim 2023
What was the median Neutrophil-to-Lymphocyte Ratio (NLR) for septic foals?
A) 6.61
B) 3.55
C) 2.00
D) 1.47
Answer: C) 2.00
Association of the neutrophil-lymphocyte ratio with
outcome in sick hospitalized neonatal foals. J Vet Intern Med. 2024
Which of the following statements about Neutrophil-to-Lymphocyte Ratio (NLR) in this study is FALSE?
A) NLR was lower in nonsurviving foals compared to surviving foals
B) Septic foals had a higher NLR than sick nonseptic foals
C) A NLR <3.06 was associated with increased odds of nonsurvival
D) The lowest NLR was observed in nonsurviving septic foals
Answer: B) Septic foals had a higher NLR than sick nonseptic foals.
Septic foals had the lowest NLR vs sick nonseptic and healthy.
The NLR was lower in nonsurviving compared with surviving foals.
Association of the neutrophil-lymphocyte ratio with
outcome in sick hospitalized neonatal foals. J Vet Intern Med. 2024
What was the sensitivity and specificity of NLR <3.9 for predicting nonsurvival in septic foals?
A) 72% sensitivity, 90% specificity
B) 86% sensitivity, 86% specificity
C) 82.8% sensitivity, 74.8% specificity
D) 68% sensitivity, 70% specificity
Answer: B) 86% sensitivity, 86% specificity
Association of the neutrophil-lymphocyte ratio with
outcome in sick hospitalized neonatal foals. J Vet Intern Med. 2024
How does the association between NLR and disease severity in foals differ from that observed in humans, cats, and dogs?
A) In foals, a higher NLR indicates more severe disease
B) In foals, NLR is not associated with disease severity
C) In foals, a lower NLR indicates more severe disease
D) In foals, only the neutrophil count, not the NLR, indicates disease severity
Answer: C) In foals, a lower NLR indicates more severe disease
Association of the neutrophil-lymphocyte ratio with
outcome in sick hospitalized neonatal foals. J Vet Intern Med. 2024
Based on the study results, which of the following is the LEAST likely explanation for the low NLR observed in critically ill foals?
A) Increased lymphocyte count
B) Decreased neutrophil count
C) Altered neutrophil kinetics
D) Impaired bone marrow response
Answer: A) Increased lymphocyte count
Association of the neutrophil-lymphocyte ratio with outcome in sick hospitalized neonatal foals. J Vet Intern Med. 2024
What was the main conclusion of the study regarding Chlamydia psittaci infection in neonatal foals?
A) Chlamydia psittaci is a rare cause of neonatal respiratory disease but has a good prognosis with appropriate treatment.
B) Chlamydia psittaci infection should be considered a differential diagnosis for neonatal foals presenting with acute respiratory distress, and the infection is often fatal.
C) Chlamydia psittaci infection was found to be a common cause of neonatal respiratory distress in foals, with all foals recovering after treatment.
D) Chlamydia psittaci was not detected in any of the foals, and the study suggested a different cause for the respiratory distress.
Answer:
B) Chlamydia psittaci infection should be considered a differential diagnosis for neonatal foals presenting with acute respiratory distress, and the infection is often fatal.
Explanation:
The study found that Chlamydia psittaci infection was associated with severe systemic disease and acute respiratory distress (EqNARDS) in neonatal foals. Of the 15 foals affected, 13 died or were euthanized within 36 hours of hospitalization, while only 2 foals survived.
The study highlights the importance of considering C. psittaci as a potential cause of neonatal respiratory illness, particularly in foals with acute respiratory distress, given its severe and often fatal course. Detection of the pathogen was achieved through PCR testing of nasal secretions, rectal mucosa, and lung tissues, but the study’s findings were based on a small number of confirmed cases.
Chlamydia psittaci infection as a cause of respiratory disease in neonatal foals
evj 2020
What are the risks associated with Chlamydia psittaci infections in horses ?
Late term abortion in mares
Acute respiratory distress syndrome (ARDS) in foals
Rare respiratory disease in adult horses
Caution : zoonotic disease
What is the most common cause of intestinal obstruction in neonatal foals ?
Meconium impaction
What is the risk associated with the repeated use of sodium phosphate enemas in neonatal foals ?
Hyperphosphatemia
What is the most effective type of enema in foals?
Acetylcystein retention enema
Volume of 100 to 200 mL, left within the rectum for 30 à 45 min.
What are the most common congenital defects of the GIT in foals ?
Atresia of the colon, rectum, or anus
What is the congenital aganglionosis ?
Congenital aganglionosis, or overo lethal white syndrome, is a syndrome that affects white American Paint Horse foals born from overo-overo matings (homozygous for mutated endothelin receptor B gene EDNRB).
Affected foals suffered from aganglionosis of the distal small intestine and large intestine, which results in a lack of intestinal motility leading to colic.
Fatal condition
DDX of colic in foals
- Meconium impaction
- Parascaris equorum infestation +/- impaction
- Congenital defects → atresia of the colon, rectum, or anus
- Congenital aganglionosis
DDX of diarrhea in foals
- Foal heat diarrhea → mild, 5-15 days of age
- Perinatal asphyxia-associated GI dysfunction
- Necrotizing enterocolitis (NEC) : intestinal necrosis → diagnosis through RX or US → intramural gas
- Dietary intolerance : with milk replacers
-
Infectious causes of diarrhea :
- Rotavirus
- C. difficile : primary agent of antimicrobial-associated diarrhea (AAD)
- C. perfringens : enterocolitis
- Salmonella, E. coli, Enterococcus spp, Aeromonas spp, Bacteroides fragilis…
- R. equi
- Lawsonia intracellularis (Equine proliferative enteropathy)
- Cryptosporidium
- Strongyloides westeri
- Gastric ulceration
What is the most common cause of infectious diarrhea in foals ?
Rotavirus : Foals 5-35 days
- Multiplication and destruction of the epithelial tips of the villi of small intestine → leads to malabsorption.
- Villous injury → decrease the production of lactase → diarrhea by osmotic mechanisms.
- Large group of foals, acute profuse watery diarrhea, hypoNa, hypoCl, metabolic acidosis.
- Highly contagious, persistent in the environment, resitant to disinfectants → maternal vaccination.
- Diagnosis by ELISA or RT-PCR on feces (or immunochromatography).
What is the most common cause of antimicrobial-associated diarrhea in foals ?
Clostridium difficile-associated diarrhea (CDAD)
Or may be due to stress, hospitalization, starvation, transport…
Diarrhea watery or bloody.
Virulence = toxin A and toxin B +/- CDT (transferase)
ELISA or RT-PCR on feces
What is the dosing regimens of metronidazole in foals ?
Newborn foals : 10 mg/kg PO BID
Foals 10-12 day-old : 15 mg/kg PO BID
Foals > 12 day-old : 15 mg/kg PO TID
DDX of infectious diarrhea in foals
- Rotavirus : Foals 5-35 days, acute profuse watery diarrhea.
- C. difficile : primary agent of antimicrobial-associated diarrhea (AAD). Diarrhea watery or bloody, toxin A and toxin B +/- CDT. ELISA or RT-PCR on feces
- C. perfringens : enterocolitis. Type A and type C → 4 enterotoxins (β-toxin and NetF). Diarrhea +/- bloody with severe enterotoxemia and shock.
- Salmonella, E. coli, Enterococcus spp, Aeromonas spp, Bacteroides fragilis… → associated with sepsis.
- R. equi : older foals. Diarrhea, ulcerative enterotyphlocolitis, and abscessation.
- Lawsonia intracellularis : Equine proliferative enteropathy (EPE). Foals 2-8 months of age. Proliferation of the crypt epithelial cells → protein-losing enteropathy. Fecal PCR testing.
- Cryptosporidium : watery diarrhea, self-limitng. Zoonotic potential. Fecal RT-PCR or immunofluorescence.
- Strongyloides westeri : nematode transmitted to transmammary route. Clinical signs if very high numbers. TT = ivermectin adm° to the mare.
What is the gastroduodenal ulcer syndrome (GDUS) ?
Foals 2 to 6 months, small, unthrifty, pot-bellied appearance foals.
Gastric squamous and glandular ulceration, pyloric ulcer and stricture. Reflux esophagitis secondary to GDUS-induced delayed gastric emptying.
What are the congenital urogenital disorders in foals ?
- Renal dysplasia or hypoplasia
- Ectopic ureters
- Umbilical hernias → < 3 cm, self-resolving
- Inguinal hernias
What is the most common urogenital condition in young foals ?
Uroperitoneum due to bladder wall rupture ++, ureteral tears, urethral tears, or urachal rupture (infection and necrosis of umbilic).
Leads to azotemia, hyperK, hypoNa, hypoCl (dilutional effect) and metabolic acidosis.
What is the clinical effect of AVP administration in neonatal foals ? For what purpose ?
Administration of arginine-vasopressin (AVP) is safe and results in a significant rise in ACTH and cortisol in neonatal foals. A stimulation test with AVP (5 IU) can be considered for HPAA assessment in septic foals.
Assessment of the hypothalamic-pituitary-adrenocortical axis function using a vasopressin stimulation test in neonatal foals
jvim 2023
A 24-hour-old Arabian foal of Egyptian lineage is presented in emergency with convulsive neurological disorders. What is your diagnostic hypothesis?
- Lavender foal syndrome (LFS) is a rare inherited lethal disorder occurring in Arabian horses, particularly those of the Egyptian bloodline but also described in other bloodlines.
- The phenotype of a homozygous recessive foal is marked by silver, pale pink or lavender coat colour, hence the name of the disease, also known as coat colour dilution lethal (CCDL).
- The LFS newborn foal exhibits neurological abnormalities such as tetanic seizures with opisthotonic epilepsy, recumbent posture and reluctance to stand for nursing despite the presence of the suckling reflex.
- Frequency of carriers → 16% ; allele frequency → 0.08
- The observed frequency of heterozygotes suggests foals affected with LFS will be produced among Arabian horses in Egypt. Therefore, screening of the entire population for this mutation should be undertaken in the breeding program.
Evidence for origin of lavender foal syndrome among Egyptian Arabian horses in Egypt
evj 2023
A newborn WB foal presented with ligament hyperlaxity and numerous skin lesions. What is your clinical diagnosis? What other breeds are affected?
Fragile foal syndrome type 1 (FFS), formerly warmblood fragile foal syndrome (WFFS), is an inherited defect of connective tissue characterized by hyperextensible, abnormally thin, fragile skin and mucous membranes that are subject to open lesions.
Affected horses may also have hyperextensible limb joints, floppy ears, accumulation of fluid (hydrops), subcutaneous emphysema, hematomas, and premature birth.
The disease is present at birth and affected newborn foals are euthanized shortly after birth due to the poor prognosis of this untreatable condition.
Fragile foal syndrome type 1 is an autosomal recessive disease, mutation in the PLOD1 gene.
The FFS mutation has been reported in warmblood breeds and is at a low frequency in Thoroughbreds.
