READING: The weak neonatal foal

Question 1

What diseases can result in a weak foal? 6

Answer 1

Sepsis
Neonatal encephalopathy/NE
Prematurity/dysmaturity
Neontal isoeryhtrolysis/NI
Uroperitoneum
MSK abnormalities (e.g. tendon contracture)

Question 2

What may precocious lactation suggest? 2

Answer 2

placentitis or twinning

puts foal at risk of FPT

Question 3

How heavy is an abnormal placenta?

Answer 3

> 11% foal body weight –> suggests placentitis –> may lead to NE or foal sepsis

Question 4

When might crackles be normally heard in foals?

Answer 4

if foal has been laterally recumbent for several hours, crackles may be audible over the dependent lung, associated with inflation of the atelectatic lung

Question 5

When does foal first urinate?

Answer 5

usually within first 12 hours of birth (very dilute, due to diet, should have a USG >1.0.20.

Question 6

When should meconium be passed?

Answer 6

within first few hours, enemas not routine (some foals sometimes strain)

Question 7

Another name for Neontal encephalopathy = ?

Answer 7

hypoxic-ischaemic encephalopathy.
initially hyperreactivity
can progress to depression and possibly seizures (focal or generalised)

Question 8

When might bradycardia occur?

Answer 8

severe septic shock
hypothermia
hypoglycaemia
hyperkalaemia (e.g. ruptured bladder)

Question 9

What heart murmurs are abnormal?

Answer 9

murmurs that are grade 5-6/6, that are bilateral or are accompanied by clinical signs such as cyanosis may suggest a congenital heart anomaly

Question 10

What might poor pulse quality suggest? 2

Answer 10

hypotension as a result of septic or hypovolaemic shock

Question 11

T/F: neonatal foals rarely develop a cough or nasal discharge in conjunction with lower respiratory tract disease

Answer 11

True

Question 12

When should you treat suspected hypovolaemia?

Answer 12

If cool extremities, poor peripheral pulses, prolonged CRT, tachycardia, depression

Question 13

‘On the farm’ treatment - suspected hypovolaemia

Answer 13

polyionic, crystalloid fluids (Hartmann’s, Lactated Ringers or Normosol-R)

Question 14

‘On the farm’ treatment - suspected sepsis

Answer 14

BS parenteral ABs (e.g. cephalosporins, penicillin/ aminoglycoside combination)

Plasma - use in septic foals even if normal IgG at 24 hours. Septic foal will ‘use up’ immunoglobulins (generally each L of plasma with increase the IgG concentration by 2g/L

Question 15

True/false: drug uptake from muscle may be compromised in hypovolaemic/septic foals

Answer 15

True

Question 16

What should be assessed in foals treated with aminoglycosides?

Answer 16

renal function

Question 17

How should you treat hypoglycaemic foals (blood glucose < 3mmol/l)?

Answer 17

5% or 50% glucose solutions
Using 50% glucose, add 10-20ml to each litre of resuscitation fluid. In hospitals, give as continuous infusions (to avoid hyperglycacemia, glucosuria and possible electrolyte derangements associated with rapid infusion)

Question 18

When should you refer a weak neonatal foal? 10

Answer 18

IF:
seizuring
no response to initial fluid boluses
GI dysfunction --> inability to nurse
Ruptured bladder
Suspected septic arthritis
Respiratory distress
Severe diarrhoea
Recumbent foal
Suspect NI
Prematurity

Question 19

How to treat seizuring foal?

Answer 19

Diazepam. (repeated doses can lead to respiratory depression)

Question 20

What is indicated if a foal still shows signs of hypotension/hypovolaemia despite fluid resuscitation?

Answer 20

that the foal is suffering from severe hypovolaemic/ septic shock and will likely need further support (e.g. dobutamine)

Question 21

What is seen on abdominal ultrasound when a foal has a ruptured bladder?

Answer 21

large volumes of anechoic peritoneal fluid

bladder may still be visible, especially if tear is dorsal

Question 22

Initial treatment - ruptured bladder

Answer 22

0.9% NaCL (classically hyponatraemic and hypochloraemic, may be hyperkalaemic if HR is lower than expected)

Question 23

Treatment -severe diarrhoea

Answer 23

IV fluids, plasma and AMs

not difficult to administer but is time intensive so often requires hospital management

Question 24

For a blood transfusion to a foal, when can you use the mare’s serum?

Answer 24

after the mare’s RBCs have been washed