Basics of Foal Diseases Flashcards Preview

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Flashcards in Basics of Foal Diseases Deck (100):
1

Critical care for primary or secondary apnea

establish an airway
stimulate the foal
oxygen, ambu bag, coupage
Drugs (doxapram)
Maintain sternal recumbency!!!

2

Critical care for bradycardia or cardiac arrest

cardiac massage and chest compressions
give a fluid bolus
epinephrine and ADH
Atropine
Get an ECG

3

Some general observations to make with PE of a foal

eat/sleep/play cycles
bonding to the mare
weight gain
urination and defecation
distension

4

For hypoglycemia, what do we give?

1% dextrose in the fluids, 5-10% will cause neurological disease.

5

For recumbency of a sick foal, watch for

lung collapse from not keeping sternal
decubital (bed sores)
and corneal ulcers

6

What is a common cause of post-maturity?

fescue toxicosis

7

Prematurity causes

fetal
placental
maternal - disease
iatrogenic - induction
idiopathic

8

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

9

Prematurity "other problems"

CV
Renal
Endocrine -= insulin resistance
neuro - pernatal asphyxia syndrome, seizures
Drug metabolism may be altered.
Predisposed to sepsis

10

Prematurity treatment options

supportive
prevent sepsis
anticipate problems and be realistic about it the animal will live or not.

11

Causes of Congenital hypothyroidism and dysmaturity

prolonged gestation and abortions - the mother and the foal seem to be out of sync

12

Clinical signs of Congenital hypothyroidism and dysmaturity

mandibular prognathism
forelimb contracture
ruptured common/lateral extensor tendon
delayed ossification
+/- enlarged thyroid

13

Congenital hypothyroidism and dysmaturity pathogenesis

not much. risk factors like mineral deficiencies (iodine?) and feeding greenfeed (nitrates) causing sporadic occurences

14

Congenital hypothyroidism and dysmaturity Dx

History (gestation length?), clinical signs
Low serum T4/T3 and low response to TSH

15

Congenital hypothyroidism and dysmaturity Tx

Supportive and T4 if needed

16

Congenital hypothyroidism and dysmaturity prognosis

guarded in ICU patients
risks orthopedic problems

17

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
Blood work
Tetanus prophylaxis and AM
Exercise
Imprint them - differing opinions on this

18

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

19

COmmon organisms causing sepsis in foals

e coli
actinobacillus
kleb
salmonella
enterbacter
strep

20

Routes of infection causing sepsis

through resp
intra-uterine
GI tract

21

What are the risk factors in causing sepsis?

FTPI *****
management, problems at birth, premature, congnital, etc. etc.

22

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)

23

What are the systemic inflammatory response signs in sepsis?

attitude/mentation are off
body temp is messed
HR weird
RR weird
MM are wonky
CBC

24

Early clinical signs of sepsis

subtle
lethargy,
decreased suckle reflex
don't gain weight
more recumbent
weird mm
FEVER/HYPOTHERMIA
Tachypnea
Diarrhea

25

Later signs of sepsis

aural petechiation,
uveitis,
hypopyon
specific stuff like - diarrhea, resp signs, swollen joints, umbilicus, neurologic

26

Treatment of Sepsis

AM - broad - pen/amp + aminoglyc
joint lavage maybe
treat/prevent FTPI and maybe give plasma
nutrition
fluids - looking at DH, elect, acidosis, and glycemic state
O2 if needed
NSAIDs -

27

Prognosis of Sepsis

guarded, 25-50% die still in ICU
worst if joints and neuro signs

28

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)

29

How do we make sure the foal gets enough Ig?

need adequate intake
good quality
absorption
normal rate of Ig metabolism

30

how do we evaluate colostrum quality?

SG >1.060 or 3000 mg/dL IgG
Do this before suckling

31

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.

32

What are the testing methods for FTPI?

SRID - single radial Immunodiffusion
SNAP test (ELISA)
Zinc sulfate turbidity test
Foalcheck (latex agglutination)

33

Details about the SRID test

most accurate for FTPI
quantitative from 0-3000 mg/dL
but takes 24 hours

34

Details about the SNAP ELISA

easy, convenient but only semi-quant

35

Details about the zinc sulfate turbidity test

easy and cheap

36

Details about the FoalCheck

high false positives

37

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,
thaw slowly,
slowly infuse through a filter,
watch for a reaction - if there is, slow or stop temporarliy.

38

How much will 1L of plasma increase IgG?

50-200 mg/dL

39

What is SCID and who gets it?

failure to produce T and B lymphocytes
Arabians, mice, dogs and humans
Autosomal recessive

40

SCID clinical signs

normal at birth, but infections of start of unusual organisms at the 3 months mark
Will manifest itself anywhere

41

Dx of SCID

genetic testing
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.

42

Treatment of SCID

bone marrow transplants?

43

Prognosis of SCID

they usually only live 5 months

44

pathology of SCID

hypoplasic of spleen, LN, and thymus but still normal architecture

45

What is NI?

a reaction on the RBCs of the foal between blood group antigens and plasma antibodies (alloantibodies)

46

Pathogenesis of NI

sensitization from transplacental hemorrhage (prev pregnancy) --> foal with antigen from stallion + mare with Ig in colostrum --> Lysis of RBCs

47

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

48

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

49

What gives us a tentative Dx of Icterus?

lethargy, anemia, and icterus

50

DDx for icterus and anemia in foals

internal bleeding
piroplasmosis
NI

51

DDx for anemia without icterus

NI
Blood loss (trauma)

52

DDx for icterus without anemia

sepsis
meconium impaction (biliary stasis)
Liver failure (Tyzzer's)
NI

53

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.

54

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.

55

What about the prognosis of NI

better with late onset
neuro signs? poor

56

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

57

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

58

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

59

Prognosis of Neonatal Maladjustment Syndrome

good if treated early.
50-80% lead normal lives

60

Conditions that make Neonatal Maladjustment Syndrome worse to treat (prognosis too)

sepsis
prematurity
seizures

61

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

62

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

63

DDx for seizures in foals

hpoxia/asphyxia
cranial trauma
hypoglyc
hypocalc
hyponatr
infection/sepsis
Hepatoenceph
idiopathic (arabians)
(Lavendar Foal Syndrome)

64

How to Dx seizures

HX, PH, CBC, Chem (first r/os)
arterial BG
CSF
CT, rads
EEG

65

What is the funny name for C. botulism in foals?

Shaker foals

66

Dx of botulism in foals

clinical signs
toxin in blood/feces

67

Treatment of botulism in foals

Penicillin, Anti-toxin?, Vaccinate

68

When we see colic in foals, what should we do?

consider congenitals
is it meconium or impactions?
instusseptions
adhesions

Think of colic similar to how you would

69

Treatment of meconium impactions

colostrum acts as a sedative
Enemas (acetylcysteine)
Oral fluids/IV too
mineral oil
restrict milk intake
give pain control
O2 if distension of abdomen much

70

What is Lethal white syndrome?

Endothelin receptor gene defect in overo-overo paint breeding
autosomal recessive
hits the ileum, cecum and colon

71

What are the 4 clinical forms of Gastric Ulcer?

Silent
Active - bruxism, lying on back, don't thrive and diarrhea
Perforated
Stricture - gastro-duodenal ulceration and reflux

72

What are the causes of Gastric ulcer syndrome?

NSAIDs,
Hypoxic injury - PAS necrotizing enterocolitis
Low-Flow conditions - sepsis, shock, trauma

73

What is PAS?

Perinatal asphyxia syndrome

74

How to Dx Gastric ulcer syndrome?

endoscopy - squamous ulcers (non-glandular) are the most common but foals have proportionally more glandular than adults.
abdominocentesis
reflux/occult or fecal blood

75

Treatment of Gastric Ulcer syndrome

Omep
Ranit
Sucralfate
antacids

76

Prevention of gastric ulcers syndrome

The watch list is to minimize:
prefusion abnormalities
hypoxia
enteral bleeding
NSAIDs

77

On the DDx for diarrhea in foals

foal heat
viral
bacterial
protozoal
parasitic
dietary diarrhea

78

diarrhea in foals is often a presenting sign of

sepsis

79

What on earth is foal heat?

when the foal gets diarrhea with the mare in her first heat after parturition.

80

Cause of foal heat diarrhea?

not known. maybe strong westeri?

81

When do you see foal heat diarrhea and what does it look liek?

mild, self-limiting at 5-14 days of age.

82

When do we dx foal heat diarrhea?

when all others are ruled out

83

Where do we see viral diarrheas in foals?

in larger groups

84

commmon viral diarrhea etiology

rotavirus

85

What does rota do in viral diarrheas?

high morb/low mort
denudes the microvilli and dehydrates the foals

86

POssible etiologies for bacterial

clostridia perfringens (C)
C difficile
Salmonella
e coli
a equuili
lawsonia intracell (older)
rhodocuccus equi (older)

87

In neonates with diarrhea, what is indicated?

blood culture and sepsis score

88

How to Dx the clost diarrheas?

gram stain feces, culture and do toxin assays

89

What are the protozoal etiologies of foal diarrhea/

cryptosporidium
eimeria leukarti
trichomonas equi
giardia equi

90

What is important about crypto diarrhea in foals? but...

zoonotic.
We will often see in healthy foals and is self-limiting

91

Which are the septic bacterial etiologies in foal diarrhea? and what do we do for them?

salmonella, e coli, and a equuili
Fecal culture
fecal PCR

92

parasites causingFoal diarrhea

small strongyles - cyathostomes,
large strongyles - vulg, edent, and equinus
ascarids
strongyloides westeri
pinworms
botlfy larvae
tapeworms

93

How to treat parasitic Foal diarrhea

avermectins
milbemycins
benzimidazoles
pyrantel salts
praziquantel

94

How to Dx parasitic Foal diarrhea

Hx, C/S
FEC - not always reliable because of the prepatent periods
Histopathology

95

Life cycle of Strongylus Vulgaris

9 month PPP --> migrates through the arterioles --> cecum, descneding colon --> causes TE Dz often

96

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

97

TRansmission and characteristics of strongyloides westeri infection in foals

transmammary transmission
usually infected by 8-12 days
see mild signs

98

WHere does parascaris equorum head to? PPP?

hepatopulmonary migration
2-3 month PPP

99

What is the complication of parascaris equorum

the worms die and obstruct

100

What are some clinical signs of parascaris equorum?

colic, diarrhea, respiratory signs, chronic weight loss
failure to thrive