Flashcards in Basics of Foal Diseases Deck (100):
Critical care for primary or secondary apnea
establish an airway
stimulate the foal
oxygen, ambu bag, coupage
Maintain sternal recumbency!!!
Critical care for bradycardia or cardiac arrest
cardiac massage and chest compressions
give a fluid bolus
epinephrine and ADH
Get an ECG
Some general observations to make with PE of a foal
bonding to the mare
urination and defecation
For hypoglycemia, what do we give?
1% dextrose in the fluids, 5-10% will cause neurological disease.
For recumbency of a sick foal, watch for
lung collapse from not keeping sternal
decubital (bed sores)
and corneal ulcers
What is a common cause of post-maturity?
maternal - disease
iatrogenic - induction
Major systems involved in Prematurity
Respiratory - distress, paradoxical breathing, fatigue
MSK - incomplete ossification causing angular limb deformities, crushing joint surfaces. Big deal***
GI - FTPI, poor glycemic control, nec enteritis, drug metabolism
Prematurity "other problems"
Endocrine -= insulin resistance
neuro - pernatal asphyxia syndrome, seizures
Drug metabolism may be altered.
Predisposed to sepsis
Prematurity treatment options
anticipate problems and be realistic about it the animal will live or not.
Causes of Congenital hypothyroidism and dysmaturity
prolonged gestation and abortions - the mother and the foal seem to be out of sync
Clinical signs of Congenital hypothyroidism and dysmaturity
ruptured common/lateral extensor tendon
+/- enlarged thyroid
Congenital hypothyroidism and dysmaturity pathogenesis
not much. risk factors like mineral deficiencies (iodine?) and feeding greenfeed (nitrates) causing sporadic occurences
Congenital hypothyroidism and dysmaturity Dx
History (gestation length?), clinical signs
Low serum T4/T3 and low response to TSH
Congenital hypothyroidism and dysmaturity Tx
Supportive and T4 if needed
Congenital hypothyroidism and dysmaturity prognosis
guarded in ICU patients
risks orthopedic problems
What are the benchmarks of post-partum care
look at the placenta
PE of the mare and foal
Make sure there is colostrum in the foal
disinfect the umbilicus
enema to get meconium out
Tetanus prophylaxis and AM
Imprint them - differing opinions on this
What are all the parts of the PE?
History and general observations (eat/sleep/activity/weight, etc.)
CV for murmurs
Respiratory - lungs sounds, mm/oxygenation, rib fractures
GI - PALATE, feed intake, distention
Genit/Urinary - patent urachus, cryptorch, hernias
Umbilicus - infection/hernia
MSK - lax tendons, swollen joints,
Eye - uveitis, hypopyon, entropion, microphthalmia
Neuro - bonding, maladjustment, eating manure, sleep
COmmon organisms causing sepsis in foals
Routes of infection causing sepsis
What are the risk factors in causing sepsis?
management, problems at birth, premature, congnital, etc. etc.
How do you Dx sepsis
With the systemic inflammatory response AND infection (localized infection/bacteremia) AND Cultures (Either blood or from the sites - TTW, CSF, etc)
What are the systemic inflammatory response signs in sepsis?
attitude/mentation are off
body temp is messed
MM are wonky
Early clinical signs of sepsis
decreased suckle reflex
don't gain weight
Later signs of sepsis
specific stuff like - diarrhea, resp signs, swollen joints, umbilicus, neurologic
Treatment of Sepsis
AM - broad - pen/amp + aminoglyc
joint lavage maybe
treat/prevent FTPI and maybe give plasma
fluids - looking at DH, elect, acidosis, and glycemic state
O2 if needed
Prognosis of Sepsis
guarded, 25-50% die still in ICU
worst if joints and neuro signs
When is colostrum production started and when is it no longer
starts 2 weeks prior
24 hr after birth, it can't be absorbed anymore. (but 72 hours is where people feel safe in cases of NI)
How do we make sure the foal gets enough Ig?
need adequate intake
normal rate of Ig metabolism
how do we evaluate colostrum quality?
SG >1.060 or 3000 mg/dL IgG
Do this before suckling
How do we assess FTPI?
TP or T globs won't tell us
It has no clinical signs
TEst IgG in serum at 18-24 hours and possibly repeat.
What are the testing methods for FTPI?
SRID - single radial Immunodiffusion
SNAP test (ELISA)
Zinc sulfate turbidity test
Foalcheck (latex agglutination)
Details about the SRID test
most accurate for FTPI
quantitative from 0-3000 mg/dL
but takes 24 hours
Details about the SNAP ELISA
easy, convenient but only semi-quant
Details about the zinc sulfate turbidity test
easy and cheap
Details about the FoalCheck
high false positives
If you decide to go with plasma in the fluids for a FTPI, how will you do it?
get from commercial (hyperimmune plasma) or healthy horse,
slowly infuse through a filter,
watch for a reaction - if there is, slow or stop temporarliy.
How much will 1L of plasma increase IgG?
What is SCID and who gets it?
failure to produce T and B lymphocytes
Arabians, mice, dogs and humans
SCID clinical signs
normal at birth, but infections of start of unusual organisms at the 3 months mark
Will manifest itself anywhere
Dx of SCID
absolute lymphopenia on CBC
neutrophilia can happen still with infection
No IgM (test the pre-suckle serum)
IgG normal until the 3 week mark too.
Treatment of SCID
bone marrow transplants?
Prognosis of SCID
they usually only live 5 months
pathology of SCID
hypoplasic of spleen, LN, and thymus but still normal architecture
What is NI?
a reaction on the RBCs of the foal between blood group antigens and plasma antibodies (alloantibodies)
Pathogenesis of NI
sensitization from transplacental hemorrhage (prev pregnancy) --> foal with antigen from stallion + mare with Ig in colostrum --> Lysis of RBCs
How often does NI happen?
1% in TB, more commonly in mares with Aa and Qa blood type antibodies or the specific Donkey factor
But it also happens in 100% Stdbred with Qa- bloodtype
How do you Dx NI?
clinical signs -- pallor icterus
Time - 12-72 hour to 1 week old
other weakness and subsequent signs from these
CLinical pathology - anemia
What gives us a tentative Dx of Icterus?
lethargy, anemia, and icterus
DDx for icterus and anemia in foals
DDx for anemia without icterus
Blood loss (trauma)
DDx for icterus without anemia
meconium impaction (biliary stasis)
Liver failure (Tyzzer's)
Treatment for NI
If before they've drank, ... get other source of colostrum and give them that. Then at 72 hours, give them regular stuff.
If not caught early,...give supportive care and oxygen, decrease stress.
Keep fluids on to keep the kidneys and consider AM for sepsis.
Blood transfusions are only as a life-sparing thing.
How do you do blood transfusions for NI?
wash RBCs from dam so there is NO serum
Make sure it is Aa/Qa negative and cross-match with the mare's serum.
What about the prognosis of NI
better with late onset
neuro signs? poor
How should we educate our clients about NI?
if the mare had one, she will likely have another so act accordingly, Hold back the colostrum, watch the birth, give colostrum from somewhere else, etc.
Also, tell them to type the stallions and mares
Screen the mare for alloantibodies
DO the Jaundiced Foal Agglutination test
Neonatal Maladjustment Syndrome pathophysiologies (3)
1. hypoxia/asphyxia --> causing loss of energy production --> reperfusion injury --> imbalance of NT
2. Septic ECopathy - because of inflammatory mediators
3. reversion to the fetal cortical state --> high neurosteroids in the foal
What is the most consistent clinical sign (because everything else is so variable)
normal at birth foals that show neurological abnormalities within 24-72 hours
Prognosis of Neonatal Maladjustment Syndrome
good if treated early.
50-80% lead normal lives
Conditions that make Neonatal Maladjustment Syndrome worse to treat (prognosis too)
treatment of Neonatal Maladjustment Syndrome
Seizure control - increase intracranial pressure with Ketamine/Xylazine, as well as preventing injuries and so on.
Supportive Care - Lohmann just goes with this
Cerebral support with all the wonky stuff - anti-ox, free radical scav(DMSO), edema controllers(Mann, DSMO), perfusion controllers (inotropes, vasopressors), thiamine
Madigan Squeeze***** sounds promising
What are the chatacteristics of Respiratory Distress Syndrome in Foals?
1. hypoxemia and hypercapnia from not enough gas exchange
2. atelectasis from collapse
3. get paradoxical breathing because of compliance of the lung --> the floppy chest trying to move the stiff wall
DDx for seizures in foals
(Lavendar Foal Syndrome)
How to Dx seizures
HX, PH, CBC, Chem (first r/os)
What is the funny name for C. botulism in foals?
Dx of botulism in foals
toxin in blood/feces
Treatment of botulism in foals
Penicillin, Anti-toxin?, Vaccinate
When we see colic in foals, what should we do?
is it meconium or impactions?
Think of colic similar to how you would
Treatment of meconium impactions
colostrum acts as a sedative
Oral fluids/IV too
restrict milk intake
give pain control
O2 if distension of abdomen much
What is Lethal white syndrome?
Endothelin receptor gene defect in overo-overo paint breeding
hits the ileum, cecum and colon
What are the 4 clinical forms of Gastric Ulcer?
Active - bruxism, lying on back, don't thrive and diarrhea
Stricture - gastro-duodenal ulceration and reflux
What are the causes of Gastric ulcer syndrome?
Hypoxic injury - PAS necrotizing enterocolitis
Low-Flow conditions - sepsis, shock, trauma
What is PAS?
Perinatal asphyxia syndrome
How to Dx Gastric ulcer syndrome?
endoscopy - squamous ulcers (non-glandular) are the most common but foals have proportionally more glandular than adults.
reflux/occult or fecal blood
Treatment of Gastric Ulcer syndrome
Prevention of gastric ulcers syndrome
The watch list is to minimize:
On the DDx for diarrhea in foals
diarrhea in foals is often a presenting sign of
What on earth is foal heat?
when the foal gets diarrhea with the mare in her first heat after parturition.
Cause of foal heat diarrhea?
not known. maybe strong westeri?
When do you see foal heat diarrhea and what does it look liek?
mild, self-limiting at 5-14 days of age.
When do we dx foal heat diarrhea?
when all others are ruled out
Where do we see viral diarrheas in foals?
in larger groups
commmon viral diarrhea etiology
What does rota do in viral diarrheas?
high morb/low mort
denudes the microvilli and dehydrates the foals
POssible etiologies for bacterial
clostridia perfringens (C)
lawsonia intracell (older)
rhodocuccus equi (older)
In neonates with diarrhea, what is indicated?
blood culture and sepsis score
How to Dx the clost diarrheas?
gram stain feces, culture and do toxin assays
What are the protozoal etiologies of foal diarrhea/
What is important about crypto diarrhea in foals? but...
We will often see in healthy foals and is self-limiting
Which are the septic bacterial etiologies in foal diarrhea? and what do we do for them?
salmonella, e coli, and a equuili
parasites causingFoal diarrhea
small strongyles - cyathostomes,
large strongyles - vulg, edent, and equinus
How to treat parasitic Foal diarrhea
How to Dx parasitic Foal diarrhea
FEC - not always reliable because of the prepatent periods
Life cycle of Strongylus Vulgaris
9 month PPP --> migrates through the arterioles --> cecum, descneding colon --> causes TE Dz often
Typical life cycle of the strongyles (large and small)
usually eggs passed in feces, developing larvae outside host to infective stage, ingestion, tissue migration, mature adults in GI
TRansmission and characteristics of strongyloides westeri infection in foals
usually infected by 8-12 days
see mild signs
WHere does parascaris equorum head to? PPP?
2-3 month PPP
What is the complication of parascaris equorum
the worms die and obstruct