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Equine michaelmas 23 > Sick foal > Flashcards

Sick foal Flashcards

1
Q

Foal diarrhoea

A

Very common in the first six months

Variable clinical signs

Range of causes

Sometimes colic

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2
Q

Non-infectious causes of foal diarrhoea 0-10 days

A

Foal heat diarrhoea - 6-10 days

Meconium retention irritation post-resolution

Errors in feeding

Lactose intolerance

PAS

Ulceration?

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3
Q

Infectious causes of foal diarrhoea 0-10 days

A

Rotavirus

Clostridium difficile and Cloistridium perfringens

Salmonella typhimurium

E. coli

Candida

Cryptosporidium

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4
Q

Rotavirus in foals

A

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

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5
Q

Clostridium difficile and Clostridium perfringens in foal diarrhoea

A

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

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6
Q

Salmonella typhimurium in foal diarrhoea

A

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

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7
Q

E coli in foal diarrhoea

A

A less significant pathogen than others mentioned

ETEC = possibly severe disease

Faecal isolation

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8
Q

Non-infectious causes of diarrhoea 10 days-6 weeks

A

Foal heat (can be up to two weeks)

Errors in feeding

Lactose intolerance (after enterocolitis)

Sand enteritis

Antibiotics

?Gastric ulceration?

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9
Q

Infectious causes of foal diarrhoea 10days - 6 weeks

A

(Rotavirus

Clostridium difficile and Cloistridium perfringens

Salmonella typhimurium

E. coli

Candida

Cryptosporidium)

PLUS

Rhodococcus equi (usually >6 weeks)

Strongyloides westeri

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10
Q

Strongyloides westeri in foals

A

Somatic migration to mammary gland at parturition

Rapid pre-patent period in foal as already partly mature larvae

Yellow milky diarrhoea and ill-thrift

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11
Q

Approach to diarrhoea treatment

A

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

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12
Q

Causes of abdominal pain in foals

A

Meconium retention

Enteritis

Necrotising enteritis

Obstructive GI lesions (parascaris impaction?)

Peritonitis

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13
Q

Meconium impaction in foals

A

Common

Colts>fillies

Usually around 18-24 hrs

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14
Q

Risk factors for Meconium impaction in foals

A

Long gestation

Delay in colostrum ingestion

Prematurity/PAS

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15
Q

Diagnosis of Meconium impaction in foals

A

Rectal palpation

U/S

Radiography

Partly ruling out other more sinister causes of colic

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16
Q

Treatment of Meconium impaction in foals

A

Preparatory bottles - Fleet/Microlax

High volume, gravity, soapy water enema

Patience - warm soapy water via foley catheter

17
Q

Signs of Meconium impaction in foals

A

Straining to pass faeces

Tail flagging

Colic

Poor appetite

18
Q

Gastro-duodenal ulceration in foals

A

Older foals

Bruxism

Generally don’t use preventative anti-acids, as risk of intestinal dysbiosis

But, where clinically justified, can be used

19
Q

Gastroscopy of foals

A

Narrow scopes enable endoscopy to be performed safely in foals

Better to know, than to misdiagnose

Can develop duodenal perforations or strictures as sequelae

20
Q

Omphalophlebitis in foals

A

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

21
Q

Patent urachus in foals

A

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

22
Q

Pathophysiology of uroperitoneum in foals

A

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

23
Q

Clinical signs of uroperitoneum in foals

A

Vague and variable

Abdominal distension - may lead to breathing difficulties

Ventral/umbilical oedema

Abdominal pain

CNS signs (rare) if urea very high in circulation

24
Q

Diagnosis of uroperitoneum in foals

A

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)

25
Q

Management of uroperitoneum in foals

A

Not a surgical emergency

Stabilise medically first

If hyperkalaemia is present, the foal may be at risk of bradycardia (or asystole) under GA -> WAIT

Saline not Hartman’s is preferable (Hartmans has a small amount of K+)

Drain peritoneal cavity of the urine may help lower K+ pre-operatively

Surgical correction has an excellent prognosis

26
Q

Uroabdomen in foals

A

Due to periparturient trauma

Also, infectious, or ischaemic injury in hospitalised foals

U/S - hypoechoic effusion

Compare peritoneal to blood creatinine concentrations

Medical emergency to reverse electrolyte abnormalities, and decompress abdominal distension with catheter, prior to surgical repair of bladder rupture

Not a surgical emergency

27
Q

Neonatal isoerythrolysis (NI) in foals

A

Immunologic disease

RBC destruction

Immune-mediated anaemia

The offending antibody is produced by the mare and transferred to the foal when suckling colostrum

Only occurs in multiparous mares

28
Q

Causes of Neonatal isoerythrolysis (NI) in foals

A

At term, or during pregnancy with placental leakage, some foal RBC are exposed to the mares immune system
○ This is considered foreign material
○ An immune response is produced
○ These antibodies remain in the circulation (B cells, memory T cells) and are activated again during next pregnancy/term
○ There are more than 30 blood types in horses
○ The red cell factors most associated with NI are Qa and Aa
○ More likely in TBs but not uncommon in many breeds

Equine michaelmas 23 (17 decks)

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