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X Clinical Veterinary Nursing Theory > Foal Nursing > Flashcards

Foal Nursing Flashcards

1
Q

what is key when nursing foals?

A

be prepared as often an emergancy

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2
Q

how can foal nursing equipment be managed?

A

equipment only used part of the year (january to june)
have a stock list and check stock before season
ICU/foal trolley or foal packs for cars
familiarise new staff with equipment, where it is and how to use it

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3
Q

what level of nursing is needed for the recumbent foal?

A

almost continuous

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4
Q

how often should a clinical exam be performed in a recumbent foal?

A

every 4-6 hours

could be fewer depending on stability

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5
Q

what is involved in the clinical exam of the recumbent foal?

A 
thoracic auscultation 
HR
RR
MM
palpation of joints and umbilicus
temperature
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6
Q

what are joints assessed for in the recumbent foal?

A

swollen - presence of infection

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7
Q

what are you looking at when assessing the umbilicus of a recumbent foal?

A

infection

urine leaking

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8
Q

what is the temperature of a foal in the first 7 days after birth?

A

37.5 - 39 degrees

goes down to 37.2 - 38.3 after that

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9
Q

when does the foal temperature range match that of the adult horse?

A

7 days after birth

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10
Q

what position should foals be placed in when recumbent?

A

sternal

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11
Q

why is lateral recumbancy in a recumbent foal unsafe?

A

affects perfusion and breathing

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12
Q

how should recumbent foals be placed in sternal?

A

chests are pointed so will not stay on their own
support
bean bag
nurse to reposition especially as they start to improve and fight!

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13
Q

what respiratory support may recumbent foals need?

A 
intra-nasal oxygen (common)
mechanical ventilation (rare)
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14
Q

what should you ensure the recumbent foal is at all times?

A

clean
warm
dry

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15
Q

how can foals be helped to stay dry and not urine soaked?

A

urinary catheter

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16
Q

what is used to place IV catheters in the foal?

A

over the wire prefurrable for small, collapsed veins

use stylet if that is your preferred method

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17
Q

under what conditions must an IV catheter be placed in foals?

A

sterile (use drape and may need sedation)

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18
Q

why must the recumbent foals IV catheter be wrapped?

A

to prevent mum from chewing it

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19
Q

how often should foal IV catheters be checked?

A

every 4-6 hors

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20
Q

what are foal IV catheters checked for?

A

thromboplebitis

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21
Q

what is the only flush that can be used in foal IV catheters?

A

saline only (no heparin)

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22
Q

what are separate ports needed for on a foal IV catheter?

A

TPN

medication

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23
Q

why does TPN need a separate port on an IV?

A

reduce port handling due to the high risk of infection associated with TPN

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24
Q

what parameter may need additional support in recumbent foals?

A

BP

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25
Q

how is BP supported in recumbent foals?

A

pressor support

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26
Q

why do foals need pressor support?

A

severely ill
usually septic
get low BP which leads to multiple organ failure and death

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27
Q

what drugs are used for pressor support?

A

dobutamine infusion

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28
Q

how is BP in foals monitored?

A

tail cuff

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29
Q

what is a common complication of urinary catheters in foals?

A

cystitis

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30
Q

what can be monitored through a urinary catheter?

A

urine output
hydration
anuric renal failure secondary to sepsis
ruptured bladder

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31
Q

what is the only way to be sure of a foals hydration status?

A

urine specific gravity

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32
Q

what is the correct urine specific gravity for foals?

A

<1.010 (dilute)

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33
Q

what should be done with the mare (if present) when she has a sick foal?

A

milk regularly to maintain supply

check for mastitis

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34
Q

how should the foal be fed if able to suck?

A

from the mare is best even if the foal has to be held there
if no mare or too weak to stand then feed milk/milk replacement from a bowl
NG tube

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35
Q

why should bottle feeding not be performed in foals?

A

risk aspiration pneumonia

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36
Q

how should the NG tube position be checked in a foal?

A

x ray

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37
Q

should foals be fed via a pump on an NG tube?

A

no - olny fed via gravity

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38
Q

what sort of nutrition should be used in horses if they have no suck reflex?

A

parenteral nutrition

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39
Q

how should foals who are unable to cope with milk be fed in the short term?

A

5% glucose spiked isotonic fluids

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40
Q

how should foals who are unable to cope with milk be fed in the long term?

A

parenteral nutrition

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41
Q

what is found in parenteral nutrition?

A

amino acids
glucose
fat

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42
Q

what needs to be monitored in foals receiving TPN?

A

glucose - may need insulin SC or CRI

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43
Q

what are the 2 main diagnostic tests performed on recumbent foals?

A

blood

urine

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44
Q

what is the test performed on urine in recumbent foals?

A

USG

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45
Q

what are the blood tests performed in recumbent foals?

A 
IgG SNAP ELISA
PCV
TP
glucose
white cells
creatinine
blood gas
electrolytes
lactate 
culture
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46
Q

what is the IgG SNAP ELISA test for?

A

antibodies

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47
Q

what will PCV and TP tell us in sick foals?

A

less about hydration but indication of how sick they are

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48
Q

what information is gained from monitoring glucose in recumbent foals?

A

whether foal is self regulating

if they require more glucose

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49
Q

what information is gained from monitoring WBC in recumbent foals?

A

presence of infection

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50
Q

what information is gained from monitoring creatinine in recumbent foals?

A

kidney function

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51
Q

what information is gained from monitoring lactate in recumbent foals?

A

perfusion

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52
Q

what information is gained from performing blood culture in recumbent foals?

A

look for bacteraemia

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53
Q

what protects the foal from infection after birth?

A

mare antibodies

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54
Q

how long do mare antibodies protect the foal after birth?

A

about 6 weeks

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55
Q

how can you ensure that the mare has the correct antibodies to pass on to the foal?

A

ensure vaccinations are up to date (flu, EHV, rotavirus, tetenus)

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56
Q

when should a mare’s last tetanus vaccine be given before foaling?

A

4-6 weeks before

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57
Q

when should the mare be moved into her foaling environment?

A

6 weeks before due date

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58
Q

how does the foal get antibodies from it’s mother?

A

only by drinking colostrum

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59
Q

how can you ensure that the foal will be able to receive colostrum?

A

check if there have been any problems in the pregnancy

ensure that the mare has not leaked milk

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60
Q

what should happen if the mare has leaked milk during her pregnancy?

A

colostrum is lost and will not be available for the foal so need to plan to give colostrum from another mare or hyperimmune plasma

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61
Q

what is hyperimmune plasma?

A

plasma from a highly vaccinated horse

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62
Q

what size should a foaling box be?

A

5m x 5m

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63
Q

describe the foaling box

A 
large
good ventilation
disinfected
warm
sheltered 
thick bedding
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64
Q

what is the length of gestation for horses?

A

320-360 days - wide

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65
Q

what are the signs that a mare is ready to foal?

A

best indicator is when they have foaled before
some show no signs
waxing up
milk electrolyte changes

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66
Q

what is shown by milk electrolyte changes?

A

gives 48 hour warning of foaling

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67
Q

how long does stage 1 of foaling last for?

A

variable length

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68
Q

what happens during stage 1 of foaling?

A

foal moves into birth canal

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69
Q

what is the correct position of the foal in the birth canal?

A

nose pointing caudally
resting on forelimbs
one forelimb slightly in front of the other

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70
Q

what are the signs that a mare is in stage 1?

A 
restless
agitated
sweaty
lies down and gets up
colic signs
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71
Q

what happens in stage 2 of foaling?

A

birth

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72
Q

how long should stage 2 of foaling take?

A

<30 mins - dangerous if any longer

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73
Q

what happens during stage 3 of foaling?

A

expulsion of the placenta

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74
Q

what should you do when the placenta is delivered?

A

check it is whole

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75
Q

how long after birth should the placenta be expelled?

A

1-2 hours

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76
Q

what should you do if the placenta has not been expelled after 3 hours?

A

walk

give oxytocin to contract uterus

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77
Q

what should happen if the placenta has not been expelled 6 hours after birth?

A

aggressive treatment including oxytocin, lavage, walking, antibiotics, anti-endotoxins, weights

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78
Q

what is the risk associated with retained placenta?

A

laminitis
infection
can be fatal

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79
Q

what is the main complication of foaling?

A

dystocia

red bag delivery - placenta delivered around foal incorrectly

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80
Q

what are the possible issues with dystocia?

A

death of foal
hypoxia (short term)
broken ribs
injury to mare

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81
Q

how long do you have once dystocia occurs to deliver the foal?

A

~1 hour

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82
Q

what can be done to buy you more time to deliver the foal if there is dystocia?

A

ET tube if possible to ventilate

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83
Q

how can foals be delivered if there is dystocia?

A

epidural and ropes, manipulation and lubrication

GA - manipulation, C - section or fetotomy if deceased

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84
Q

what type of C-section can be performed in horses?

A

emergency only - will not survive planned

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85
Q

when should the foal take it’s first breath?

A

within 30 seconds of birth

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86
Q

when should the foal be able to stand?

A

within 30 mons to 1 hr of birth

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87
Q

when should a foal drink colostrum?

A

within 1-3 hours of birth

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88
Q

what should the foal do within hours of being born?

A

pass meconium

urinate

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89
Q

what should you do before deciding to resuscitate foals?

A

cursory physical exam

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90
Q

what conditions may mean a decision not to resuscitate?

A

hydocephalus

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91
Q

what almost always precedes cardiac arrest in foals?

A

respiratory arrest

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92
Q

what are the most common causes of respiratory arrest in foals?

A

premature placental separation
early severance or twisting of umbilical cord
dystocia
airway obstruction by fetal membranes
failure to spontaneously breathe due to unknown cause

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93
Q

what are the causes of CPA in equine neonates that are not associated with birth?

A 
primary lung disease
sepsis
hypovolaemia
metabolic acidosis
hyperkalaemia
hypoglycaemia
hypothermia
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94
Q

what must be provided to all foals who require CPR?

A

ventilation

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95
Q

hy must ventilation be provided to all foals as a part of CPR?

A

as respiratory arrest underlies cardiac arrest

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96
Q

what is the success rate of CPCR in foals?

A

if resuscitation begins before non-perfusing rhythm develops the likelihood of revival is good
if delayed until after asystole survival is less than 10%

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97
Q 
what should you do if any of:
HR <60 bpm/regular
slow / irregular respiration
foal in lateral
some muscle tone
grimace on nasal mucosal stimulation occurs?
A 
stimulate foal (rub with towel etc)
intranasal O2
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98
Q

what should you do if any of:
HR / respiration undetectable
muscle tone limp or absent
unresponsive on nasal mucosal stimulation occurs?

A

neonatal resuscitation

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99
Q

how should the ventilation portion of resuscitation be performed?

A

clear the airway
place naso or endotracheal tube if possible (even with foal in birth canal)
ventilate (may respond)

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100
Q

how should a nasotracheal tube be placed?

A

extend head

pass tube through nose ventral to medial

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101
Q

how many attempts to place nasotracheal tubes are before you should progress to ET tubes?

A

2 attempts

102
Q

how should an ET tube be placed in an foal?

A

pull tongue forwards and lateral with one hand to stabilise larynx
advance tube in midline over the tongue
twist once you reach the larynx
check position, cuff and secure to head

103
Q

how should the patient be ventilated?

A

abubag to tube if possible

104
Q

how should the foal be ventilated if ET tube to bag is not possible?

A

mouth to tube
ambu bag to mask
mouth to nose and close opposite nostril

105
Q

what must you do if a cuffed tube is not in place during ventilation?

A

ensure head is extended to reduce aerophagia

106
Q

what is aerophagia?

A

stomach filling with air

107
Q

what is the issue with aerophagia during CPR?

A

stomach distended with air can reduce thoracic capacity

108
Q

how can you ensure tidal volume in the ventilated foal is sufficient?

A

look at chest

109
Q

how may breaths are needed when ventilating a foal?

A

10 short breaths per min

110
Q

when should the foal be reassessed after starting ventilation?

A

30 seconds

111
Q

what is being assessed 30 seconds after ventilation commences?

A

HR presence

112
Q

when should compressions be performed in foals?

A

after 30 secs of ventilation:
if no HR
HR less than 40 bpm
HR less than 50 bpm and not increasing

113
Q

where should ribs fractures be placed if present?

A

fractured rib side down

114
Q

what should you do if rib fractures are seen bilaterally?

A

place the side with more cranial rib fractures down

115
Q

what position should chest compressions be performed in in foals?

A

kneel parallel to spine
foals back against wall
hands on top of each other
shoulders above hands to use body weight

116
Q

where should hands be placed for compressions in foals?

A

caudal to triceps at highest point of thorax

117
Q

what is the correct compression to ventilation ratio in foals?

A

15:1

118
Q

what is the compression rate in foals?

A

100-120 per minute

119
Q

what is the optimal compression depth in foals?

A

push hard

120
Q

what should you do if the foal remains bradycardic following CPR?

A

give epinephrine every 3 mins until HR >60

121
Q

how can epinephrine be administered?

A

IV

intra-tracheal

122
Q

what should you do with your patient following successful resuscitation?

A

keep warm with bandages and blankets

keep off floor

123
Q

what can be given IV to foals following resuscitation?

A

5% glucose at maintainance

124
Q

what is maintenance rate for foals?

A

250 ml/hr for 50kg foal

125
Q

what must you do before warming foals if hypoglycaemic?

A

give glucose to counteract protective response

126
Q

how should hypothermic foals be warmed?

A 
slowly
hot hands
bandage legs
rugs
care using heat lamps
127
Q

how is dehydration diagnosed in foals?

A 
history
clinical signs
lactate
high index of suspicion
USG**
128
Q

when should dehydration in foals be presumed?

A

if no nursing for more than 4 hours

129
Q

can adult signs of dehydration be used in foals?

A

no - not consistant

130
Q

hwo can dehydration in foals be corrected?

A

1L hartmann’s

up to 3 additional boluses

131
Q

what should be used to monitor hydration in foals?

A

USG

132
Q

what imbalance is often seen alongside dehydration?

A

hypoglycaemia

133
Q

how is glucose level measured?

A

glucometer

134
Q

where are all foal antibodies received from?

A

colostrum

135
Q

how long is a foals gut ‘open’ to antibodies for?

A

~24 hours (less if antibodies recived)

136
Q

what is the issue with the gut being ‘open’ to antibodies?

A

also open to bacteria which is also gained from the mother which can enter the blood stream

137
Q

what is the value of partial failure of passive transfer?

A

400-800 mg/dl

138
Q

what is total FPT measured as?

A

<400 mg/dl

139
Q

what is normal blood antibody concentration in foals if passive transfer has occurred?

A

> 800 mg/dl

140
Q

what is FPT a risk factor for?

A

spsis

141
Q

when should foals be tested to see if passive transfer has occurred?

A

12-24 hours old

142
Q

what foals should be tested for FPT?

A

all at risk

but ideall all foals

143
Q

how can FPT be tested for?

A

blood test or SNAP elisa

144
Q

what is the benefit of a SNAP ELISA for FPT?

A

easy
cheap
done in the stable
saves lives by early detection of FPT

145
Q

how is FPT treated?

A

hyperimmune plasma transfusion

146
Q

why must antibodies be given IV if FPT has occurred?

A

gut is ineffective or has closed

147
Q

why should hyperimmune plasma be defrosted slowly?

A

avoid denaturing antibodies

148
Q

what should hyperimmune plasma be given via?

A

blood giving set with a filter

149
Q

why should hyperimmune plasma transfusion be started slowly?

A

to check for transfusion reaction

150
Q

what must be observed for to ensure volume overload doesn’t occur during hyperimmune plasma transfusion?

A

adjust volume for size

look for pulmonary oedema and protein reaction

151
Q

when should foals plasma levels be reassessed following hyperimmune plasma transfusion?

A

after each bag of plasma

152
Q

what is the most common reason for hospitalisation and death of neonatal foals?

A

sepsis

153
Q

why may foals be born septic?

A

placentitis

154
Q

what is a major risk factor for sepsis?

A

FPT

155
Q

what is sepsis?

A

systemic bacterial infection (bacteraemia)

156
Q

what is seen along side sepsis in foals?

A

infected joints

infected umbilicus

157
Q

what are the signs of sepsis in foals?

A 
pyrexia
depression
recumbancy
injected mucous membranes
joint effusion +/- lameness
totally unresponsive
158
Q

what tests are used to diagnose sepsis?

A 
sterile blood culture
WBC count
SAA
SNAP test for antibodies
creatinine
USG - hydration
glucose level
lactate
culture from umbilicus and arthrocentesis sample if involvement
159
Q

what will the WBC count be like in a septic patient?

A

low

160
Q

why should creatinine be checked in septic patients?

A

sepsis attacks kidneys so they are at risk of anuric renal failure

161
Q

what is the benefit of checking lactate levels in septic patients?

A

shows perfusion

indication of prognosis

162
Q

how is sepsis treated?

A 
broad spectrum antibiotics
hyperimmune plasma (even if no FPT)
joint lavage - if joint involvement
removal of umbilicus (rare)
ICU
163
Q

what disease makes foals more prone to seizures?

A

sepsis

164
Q

what causes seizures in foals?

A

many causes

165
Q

what are the signs of seizures in foals?

A

subtle - repetitive movement that you cannot interrupt

generalised convulsions

166
Q

how should seizures in foals be treated?

A

correct primary cause if possible
maintain airway if appropriate
administer oxygen
anticonvulsant therapy (diazepam)

167
Q

what are the main causes of dummy foal?

A

range - unknown

hypoxia at birth / in utero

168
Q

what does dummy foal lead to?

A

brain and other organ damage

169
Q

what is dummy foal also known as?

A

hypoxic ischaemic encephalopathy (HIE)

perinatal asphyxia syndrome (PAS)

170
Q

what are the signs of dummy foal?

A 
may be born normal and decline
slow to swallow
not sucking
not following mare
ataxic
forget to breathe
seizure
171
Q

how is dummy foal treated?

A 
nursing is crucial
maintain cerebral perfusion
IVFT
correct metabolic imbalances
PPN or slow entral feeding
172
Q

when may squeezing a dummy foal help?

A

if no brain damage present may stimulate the inhibitory neurotransmitters to be removed - can have profound effect

173
Q

why can squeezing a dummy foal if there is no brain damage present help?

A

help loss of inhibitory neurotransmitters that are needed in utero and should be halted during birth

174
Q

when is a foal classed as premature?

A

<320 days gestation

175
Q

is a foal younger than 280 days likely to survive?

A

no

176
Q

what is foal dysmaturity?

A

foal looks premature despite normal or often longer gestation

177
Q

what is postmaturity?

A

long gestation and normal size foal but emaciated as dam is unable to meet nutritional demands

178
Q

what are the signs of a premature / dysmature foal?

A 
smaller than expected
silky short hair
floppy ears
domed head
weak
abnormal RR - either low or high
179
Q

what organs are immature in prematurity or dysmaturity?

A

GI
respiratory
MSK

180
Q

what is the most significant issue with premature / dysmature foals?

A

incomplete ossification of carpal and tarsal bones so bones are soft and compressed if weightbearing occurs

181
Q

what effect can incomplete ossification of carpal and tarsal bones have on a horses future career?

A

unlikely to be athletes and even may struggle as pleasure horses

182
Q

when is tendon laxity more likely?

A

if premature

183
Q

what structures are affected by tendon laxity?

A

flexor tendons or ligements

184
Q

what can tendon laxity be caused by?

A

premature / dysmature / postmature

complication from bandage, cast or splint

185
Q

how is tendon laxity treated?

A

resolves after a few days
box rest on limited bedding
walk on firm ground for 5m 3 times a day

186
Q

what precautions must be taken when walking a foal with tendon laxity?

A

bandage heels for protection

187
Q

how far should foals with tendon laxity be walked each day?

A

5m

3 times a day

188
Q

what is the cause of tendon contracture?

A

unknown
may be due to positioning in uterus
can be acquired when older

189
Q

when is tendon contracture often acquired?

A

secondary to orthopedic pain

190
Q

what is the prognosis of tendon contracture?

A

varies in severity and number of affected limbs so prognosis is varible but usually fair to good

191
Q

how is tendon contracture treated?

A 
physio to stretch toes
walk on hard ground
oxytetracycline (for 3 days)
toe extensions
splint
half or full limb cast
surgery
192
Q

what is the purpose of oxytetracycline in treatment of tendon contracture?

A

binds calcium so aids tendon stretch

193
Q

what is of significant concern when giving oxytetracycline?

A

is nephrotoxic

194
Q

what surgeries may be performed on tendon contracture patients if they have not responded to medical management?

A

check ligament desmotomy

tentotmy

195
Q

what are the main types of angular limb deformity?

A

valgus or varus of fetlock, carpus or tarsus

windswept

196
Q

how are angular limb deformities treated?

A

rest
farriery
surgery

197
Q

when must surgery to correct angular limb deformity be completed?

A

before growth plate fused

198
Q

what are the signs of meconium retention?

A

colic
restlessness
may have passed some meconium or none

199
Q

what is often seen alongside meconium retention?

A

failure of passive transfer

200
Q

what must be checked if foal has meconium retention?

A

patent rectum (atresia ani)

201
Q

how can atresia ani be diagnosed?

A

rectal exam

contrast study if glove clean on rectal

202
Q

how is meconium retention treated initially?

A

soapy water / phosphate enema

203
Q

what is given if a soapy water enema doesn’t resolve meconium retention

A

acetylcysteine retention enema

204
Q

how is a acetylcysteine retention enema performed?

A

foley catheter used to keep fluid in rectum and allow breakdown of mucus and meconium

205
Q

what analgesia is often used for meconium retention?

A

buscopan

206
Q

is surgery used to treat meconium retention?

A

rare

207
Q

what tests must be performed on every foal with meconium retention?

A

IgG SNAP ELISA for FPT

208
Q

what can cause diarrhoea in foals?

A

infection

209
Q

what should be checked for if a foal has diarrhoea?

A

rotavirus

IgG - FPT

210
Q

how should dehydration in foals be treated if symptomatic?

A

dehydration resolved
electrolyte balance restored
acid base imbalance managed

211
Q

what is foal heat diarrhoea?

A

seen 1-2 weeks post birth
caused by bacteria populating colon
not linked to dam’s heat cycle

212
Q

what must be prevented in hospitalised foals as it is so common?

A

gastric ulcers

213
Q

do gastric ulcers form for the same reasons in foals as for in adults?

A

no - different pathophysiology

214
Q

what can be given prophylactically in foals to prevent gastric ulcers?

A

sucralfate

215
Q

what does sucralfate do?

A

encourgaes blood supply to stomach

216
Q

how can an infected umbilicus be prevented?

A

dip regularly in 1% chlorhexidine for the first 2 days

217
Q

when is an infected umbilicus more likely?

A

if FPT

218
Q

what are the signs of infected umbilicus?

A

swelling and pus at site

219
Q

how is infected umbilicus diagnosed?

A

ultrasound

cutlure

220
Q

how is infected umbilicus treated?

A

antibiotics

surgery

221
Q

what can cause a ruptured bladder in foals?

A

birth

sepsis / other insult leading to damage

222
Q

when is a ruptured bladder most often first noticed?

A

2-3 days ol

223
Q

what are the signs of a ruptured bladder?

A

colic
distended abdomen
may still be able to urinate

224
Q

how is ruptured bladder diagnosed?

A

ultrasound for excess fluid

peritoneal sample for uroabdomen

225
Q

what electrolyte imbalance can be caused by a ruptured bladder?

A

hyperkalaemia

226
Q

what arrhythmia is common with hyperkalaemia?

A

bradycardia

227
Q

how should bladder rupture be treated?

A

emergancy
0.9% NaCl at 250ml/kr/50kg
drain abdomen
surgery to repair

228
Q

what rate should fluids be given for treatment of ruptured bladder?

A

0.9% NaCl at 250ml/kr/50kg

229
Q

what is neonatal isoerythrolysis?

A

foal RBC antigen not recognised by the mare so antibodies are produced in response and mare becomes sensitised
when foal drinks mares colostrum the antibodies are passed over and foals RBC are attacked

230
Q

when does neonatal isoerythrolyisis occur?

A

with the second foal as mare has produced antibodies from first?

231
Q

what are the signs of neonatal isoerythrolyisis?

A

anaemia (as RBC are destroyed)
icterus
weakness

232
Q

when is a blood transfusion needed for foals with neonatal isoerythrolyisis?

A

PCV <12%

233
Q

how is neonatal isoerythrolyisis treated?

A

withdraw colostrum
prevent future foals from drinking colostrum from dam
blood typing of dam and sire

234
Q

how is neonatal isoerythrolyisis prevented once it is known the mare carries the antibodies?

A

prevent future foals from drinking colostrum from dam

blood typing of dam and sire

235
Q

what puts foals at risk of pneumonia?

A

aspiration during bottle feeding (owners)

FPT

236
Q

what are the signs of aspiration pneumonia?

A

increased RR and effort

pyrexia

237
Q

how is pneumonia diagnosed?

A

radiography

trans-tracheal wash for cytology and culture

238
Q

how is pneumonia treated?

A

antibiotics
O2
foal in sternal

239
Q

what bacteria often causes pneumonia in foals?

A

Rhodococcus equi

240
Q

when should you suspect a foal can be infected with Rhodococcus equi?

A

from birth

241
Q

what can cause infection with Rhodococcus equi?

A

environment (dust)
nose to nose contact with infected foals
faeces of dam

242
Q

when do clinical signs of Rhodococcus equi appear?

A

until around 6 weeks old

243
Q

why is Rhodococcus equi only a disease of foals?

A

change in T helper immunity in adulthood leading to immunity in adulthood

244
Q

what are the clinical signs of Rhodococcus equi?

A

variable and difficult to interpret
one, all or some of: pneumonia, septic or immune mediated joint effusion
diarrhoea

245
Q

how is Rhodococcus equi diagnosed?

A

thoracic radiograph for abscesses
tracheal wash for cytology, culture and sensitivity
joint fluid sample if effusion
blood smaple

246
Q

what is seen on the blood sample of a foal with Rhodococcus equi?

A

very high WBC and fibrinogen

247
Q

how is Rhodococcus equi treated?

A

clarithromycin and rifampicin

joint lavage if appropriate

248
Q

what must you be careful of when treating foals for Rhodococcus equi with Clarithromycin?

A

fatal diarrhoea can be caused in adult if ingested

should be administered outside stable and ensure foals mouth is clean

249
Q

how long should foal be treated for Rhodococcus equi?

A

until radiographically normal (~6 weeks)

250
Q

how is Rhodococcus equi prevented?

A

clean environment
Rhodococcus hyperimmune plasma transfusion
routine ultrasound to check for any signs
antibiotics should not be given until clear infection and culture and sensitivity performed

X Clinical Veterinary Nursing Theory (70 decks)

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