Sick foal Flashcards
Foal diarrhoea
Very common in the first six months
Variable clinical signs
Range of causes
Sometimes colic
Non-infectious causes of foal diarrhoea 0-10 days
Foal heat diarrhoea - 6-10 days
Meconium retention irritation post-resolution
Errors in feeding
Lactose intolerance
PAS
Ulceration?
Infectious causes of foal diarrhoea 0-10 days
Rotavirus
Clostridium difficile and Cloistridium perfringens
Salmonella typhimurium
E. coli
Candida
Cryptosporidium
Rotavirus in foals
2 days - 4/5 months
Most common cause of foal diarrhoea and very contagious so often history of multiples affected
Vaccination reduces morbidity
Maldigestion/malabsorption
ELISA faecal samples
Clostridium difficile and Clostridium perfringens in foal diarrhoea
Enterotoxaemia in foals <1 week
Often colicky
Can be peracute D+ with haemorrhage and sudden death
Toxin testing in faeces - rapid stable side test available
Salmonella typhimurium in foal diarrhoea
Uncommon in the UK but not impossible
Mare usually source of infection - can be periparturient shedding in faeces
Acute D+ and sepsis
Faecal PCR or culture - PCR superior accuracy and speed of testing
Don’t forget Salmonella is a reportable disease - usually reporting laboratory will prompt you
E coli in foal diarrhoea
A less significant pathogen than others mentioned
ETEC = possibly severe disease
Faecal isolation
Non-infectious causes of diarrhoea 10 days-6 weeks
Foal heat (can be up to two weeks)
Errors in feeding
Lactose intolerance (after enterocolitis)
Sand enteritis
Antibiotics
?Gastric ulceration?
Infectious causes of foal diarrhoea 10days - 6 weeks
(Rotavirus
Clostridium difficile and Cloistridium perfringens
Salmonella typhimurium
E. coli
Candida
Cryptosporidium)
PLUS
Rhodococcus equi (usually >6 weeks)
Strongyloides westeri
Strongyloides westeri in foals
Somatic migration to mammary gland at parturition
Rapid pre-patent period in foal as already partly mature larvae
Yellow milky diarrhoea and ill-thrift
Approach to diarrhoea treatment
Supportive care
Biosecurity
Consider bacteraemia risk and justifiable use of antimicrobials
Biosponge- di-tri-octahedral smectite
Analgesics - NSAIDs, paracetamol, opioids
IV fluids and hyperimmune plasma - even if originally had good passive transfer could have sequestered plenty whilst sick
Nutrition
Causes of abdominal pain in foals
Meconium retention
Enteritis
Necrotising enteritis
Obstructive GI lesions (parascaris impaction?)
Peritonitis
Meconium impaction in foals
Common
Colts>fillies
Usually around 18-24 hrs
Risk factors for Meconium impaction in foals
Long gestation
Delay in colostrum ingestion
Prematurity/PAS
Diagnosis of Meconium impaction in foals
Rectal palpation
U/S
Radiography
Partly ruling out other more sinister causes of colic
Treatment of Meconium impaction in foals
Preparatory bottles - Fleet/Microlax
High volume, gravity, soapy water enema
Patience - warm soapy water via foley catheter
Signs of Meconium impaction in foals
Straining to pass faeces
Tail flagging
Colic
Poor appetite
Gastro-duodenal ulceration in foals
Older foals
Bruxism
Generally don’t use preventative anti-acids, as risk of intestinal dysbiosis
But, where clinically justified, can be used
Gastroscopy of foals
Narrow scopes enable endoscopy to be performed safely in foals
Better to know, than to misdiagnose
Can develop duodenal perforations or strictures as sequelae
Omphalophlebitis in foals
Infection in arteries, vein, or urachus
Can be isolated, extra-abdominal
Can be associated with sepsis
External section may be normal
U/S for diagnosis - routine assessment in all septic, pyrexic, or inflammatory bloods in foals
Surgery vs medical therapy
Hotly debated
If leave for medical therapy, risk of septic emboli haematogenous spread
Patent urachus in foals
Might be simple and settle with time
Sometimes a sequelae to straining from meconium impaction/other colic
Some become infected as well as patent, might show signs of sepsis
May be patent from prolonged recumbency
Again, medical vs surgical options often debated
Foal dependent decision making
Pathophysiology of uroperitoneum in foals
Bladder distension and rupture at birth considered the most likely cause
No sex predisposition
Dorsal wall bladder rupture most likely
Then urachus > ventral bladder wall > bladder apex
May be more than one site
Since the urine products are not being removed from the body, significant electrolyte abnormalities are seen:
§ Very low sodium and chloride (hyponatraemia and hypochloraemia)
§ Hyperkalaemia (high potassium)
Urea and creatinine also increase but since creatinine is a much larger molecule, it is not increased at same proportion as urea
Check the peritoneal fluid creatinine to see if the fluid content of the abdomen is urine
Clinical signs of uroperitoneum in foals
Vague and variable
Abdominal distension - may lead to breathing difficulties
Ventral/umbilical oedema
Abdominal pain
CNS signs (rare) if urea very high in circulation
Diagnosis of uroperitoneum in foals
Ultrasound - most valuable test
An elevated peritoneal:serum creatinine is helpful (such a large molecule it does not diffuse out and equal out)
○ 2:1 suggestive (could be higher than this)
High K, low Na and Cl - classic (but this might not be so bad if already on IV fluids, and could also see this with enteritis)
