Equine Med- Neonatal Foal 1

kelseyfmeyer's version from 2016-10-03 18:55

bb neigh

Question Answer
**when you are examining a neonate you should always....wear gloves, asshole
**3 most common illnesses of newborn foals?(1) Failure of passive transfer (2) septicemia (3) Hypoxic ischemic encephalopathy (dummy foal) [and they can all occur together! yay! >:( ]
dummy foals fancy doctor namehypoxic ischemic encephalopathy
what is normal gestational age? what is considered premature?normal gestation is 11mo (330-333) so premature is <320d
health of mare can really affect this aspect of pregplurcenturrr
whats that magic 1,2,3 rule again?in 1 hour should stand, in 2 hours should nurse, and in 3 hours that placenta should be bye bye
(said in class) if they don't get colostrum they can have problems up to what age?up to 3wk age
Normal Behavior/Mentation: how long before bb should be sternal after birth?should be sternal w/in minutes, being alert and cautious and responding to noxious stimuli. Should have tropism to the mare
should be standing how soon?within an hour! (1,2,3 rule)
how much weight should a fola be gaining?2-3lbs a DAY
best way to track progress of growth of foal?WEIGH THEM should be gaining 2-3lbs a day
what is a normal amount of nursing for a foal, why?a whole lot- like 4-6 times an hour. need to take a lot throughout the day bc mare milk is watery and not high in nutrients
what is the proper way to restrain a foal, and why?one arm behind hind leg-- one arm in front of front legs. YOU DO NOT WANT TO HAVE ARMS AROUND THEIR CHEST OR ABD- you can break their ribs or rupture their bladder. (And dont have your head near their head or theyll getcha good)
#1 sign of abnormal mentation?they dont know how the hell to feed themselves-- suckling on wall and such, basically anywhere but the udder.
what are some signs of abnormal mentation in a foal?suckling on wall/anywhere that isnt the udder, tongue hanging out, chewing, dull, Period of somnolence followed by hyperactivity (basically duhhhh -OMG)
what are some signs of Prematurity/Dysmaturity? (5)Soft silky coat (we named we silky! uh...that's nice), small and weak, laxity in limbs, FLOPPY EARS, Incomplete ossification of bones
what's the diff between prematurity and dysmaturity?PREMATURITY is when they have not been in the oven long enough (<320d), but DYSmaturity is when they ARE full gestation age (330-333 days) but have signs like they ARE premature.
owner be like "bruh i wanna c-section on my horse!" and you all likebabies do not do will with Csection- go from completely not ready to ready in like 48 hour period-- if there isnt appropriate cortisol release at the right time, dysmature. might see resp difficulties, limbs not very right
what is the most fatal/bad complication of pre/dysmaturity?Incomplete ossification of bones. do a VD of carpus and lateral of hock. if not normal boes there, prog is almost zero.
neuro exam: when can you do menace?no menace till like ~1.5wk (10d) of age
why might little baby neighs be predisposed to corneal ulcers and such?Until 10d of age they don't have a menace, AND they have incomplete eyelid closure a lot of the time AND they have dec corneal sensitivity
how common are seizures in horses?in adults, very rare (usually narcolepsy or cataplexy <--collapse but are unconcious). but fairly common in foals (more on this on other card)
what are 5 reasons foals might have seizures?(1) HIE (hypoxic ischemia encephalopathy) (asphyxia) (2) septic meningitis (3) electrolyte derangements (4) congenital malformations (5) prematurity
if a foal has entropion, what can you do?correct with PPG (procain penicillin G-- as in just inject that in there and let it swell to normal location) or sutures
why might foals have entropion?might be dehydrated so eye is sunken and eyelid rolls in- some are just born with it but grow out of it
what is usually the cause of uveitis in foals?complication of sepsis (all foals septic till proven otherwise)
what is this called? what happened? what is prog dependant on?This is "Wry nose". They arent sure why it happens but it is congenital (doesnt seem to be heritable). Prognosis depends on if the deformity is bad enough to prevent them from eating and breathing. (main issue is how well they can air exchange- being obligate nasal breathers and all)
white stuff is coming out of my foals nose doc- what is your #1 R/O?This is most likely milk! which means #1 RO is cleft palate. (might be mucopurulent stuff but think cleft palate first)
if you see brown stuff coming out of a foals nose, what do you think is is, what do you think happened?meconium aspiration (foal stressed in utero--> releases meconium--> breathes it in--> severe pneumonia can result)
(said in class) when will foals first incisors start to come in?3d
you look in bb neighs mouth and you see these injected mm--> what do you think? injected like this is normal for a foal (abnormal for adult)
what do you think is going on here? Ecchymotic petechiosis (inflammation can lead to probs with coag.)
what do you think is going on here? This is a TOXIC LINE (endotoxemia)
If you see a one day old neigh with yellow mm and eyes, what do you think is happening?Neonatal Isoerythrolysis is most likely RO- and RO this first before other stuff bc NI can kill them
what is happening in Neonatal Isoerythrolysis? (describe some situations where this can happen)Mare makes antibodies against foal’s RBCs-- could be placental compromise and RBCs exposed, could be from previous parturition.
which 2 blood groups (in who) are typically implicated with neonatal isoerythrolysis? Aa and Qa (in broodmare)
explain pathogenesis of neonatal isoerythrolysis and how fast does this all occur?happens super fast: 12-24 hours from ingestion to colostrum--> CSs. Basically foal drinks colostrum which has Abs against its blood type in moms milk. This leads to large amount of immune mediated intravascular hemolysis. Can totes be fatal.
what age is it most common to see neonatal isoerythrolysis and which breeds tend to get it more?1-2 days of age, esp Thoroughbreds, Standardbreds and Mules
how do you dx neonatal isoerythrolysis?Coobms test!
how do you treat neonatal isoerythrolysis?Remove from mare (limited utility at 48 hours…). Transfusion: (washed mare RBCs the best) (washed= spin down whole blood and get clump of RBCs (Abs in serum,) so take only RBCS and then rinse them down.) Crossmatch RBCs in mare is not used for washed RBCs. But if not in a fancy lab, cant wash RBCs, then if there is a gelding that has never had blood transfusion before, take blood from him. Also provide Supportive (fluids to protect kidneys, strict stall rest)
how do you help prevent neonatal isoerythrolysis?Test broodmares for Aa or Qa, and If + or has had an NI foal already= no colostrum!!
3 good ways to check for hydration in a foal?Pinch eyelids to test for hydration status, look for sunken eyes, look at urine (should be very dilute normally)
what is normal pulse in foal- what factors should you consider?normal 50-70, but depends on size and excitement level too.
when are arrhythmias common in foals?<1hr old (not uncommon for them to be arrhythmic in first hour of life. Past an hour, arrhythmia is abnormal.)
foal murmur on R probably?VSD (not TI- that is old horses)
murmur in foal that's continuous on L?PDA (normal till >7d)
low grade murmur on left in foal prolly?long grade on left- physcological flow murmur (calm them down and listen again)
how can you take BP in foal?can actually take indirect with decent accuracy, but only in foals (tail cuff)
normal RR in foal?20-40 (lol like HR in adult but its resp in a foal)
So you ascult a foal and you hear crackles! Is this abnormal or normal, why?depends on how old foal is- if <1 hour old, normal, because they suck fluid in utero all the time. If >1hr old, time to worry. Give lasics.
what is meconium like? when should it be passed?brown super sticky stuff. They should pass it after their first nursing (should be nursing by 2 hours) bc gastrocolic reflex should trigger to expel it.
owner calls you up worried about the foal eating poop. you tell them?coprophagia normal in foals
abd distension-- you should suspect what 2 systems being awry?GI or urogenital (good thing abd palp easier in foals)
2 most common causes of colic in foals?meconium impaction and ulcers
if you are worried about meconium impaction in foals, what can you do to tx, how do you do it, when should you be very careful?USE ENEMA! Can be safe and effective. Use warm soapy water and let gravity help you. CAUTION WITH COMMERCIAL PRODUCTS.
what are the major clinical signs of a foal with colic?rolle, LIE ON THEIR BACK, SWISH THEIR TAIL, BACK INTO THINGS (not normal for them trying to be rubbing their butt on stuff)
Lethal white foal syndrome-- who gets this? what is actually the problem they have? what should you know when trying to diagnose this?This happens when you cross overo x overo. they get Intestinal agaglionosis which leads to severe colic. You need to remember that not all white foals have white foal syndrome. but if both parents are overo, all white, and colicing as soon as eat, there are no neural signals in GI-- thats prolly LWS
how long before foal does first urination?can take up to 10 hrs
how much does a foal urinate in a day/ how does this compare to an adult, and why is it this way?150ml/kg/day which is like 5-10xs more than an adult. This is bc their diet is all liquids (mares milk is dilute), and their body is composed of more water, and their urine is more dilute than an adults (concentrating ability not matured)
what should the USG (she said USPG, same diff) of a foal be after 24 hr?<1.010
how can you assess if a foal is drinking enough?look at their USG! (should be like <1.010)
you look at this one day old foals urine and it looks like water. what do?just smile- this is normal. If it didn't look watery theyre prolly not getting enough fluids.
normal temp for foal?99-102ºF (adult is 99-102.5 so we good)
hyperthermia in a foal might mean?infxn (possibly septicemia)
hypothermia in a foal might mean? hypovolemia, shock or broken thermometer
in every foal exam what should you be palpating which you usually dont palpate in adults?RIBS (thoax), and ABDOMEN, and umbilicus
what thoracic prob is pretty common in foals?fx ribs
CSs of fx ribs?None (incidental finding on PE), Painful, don’t want to lie down, Tachypnea, cyanosis
you see some knobby looking things along a foals ribs- what do you think?could just be the costochondral junctions. Feel for instability or crepitus (SQ air/emphysema) and bruising to differentiate from broken ribs
dx of fx ribs?palpation, US, radiographs
which is better to dx fx ribs- US or rads, and why?US- bc ribs often inward or outward displacement, not lateral. So US more sensitive for this. Rads good to detect pneumothorax or if they are displaced tho.
how/should you tx fx ribs?if foal seems fine and its incidental, leave in stall and put on pain meds. if rib poking into lungs need to deal with it. wires and plates can fix it. usually resolve on own with conservative stall rest and pain meds but depends on how bad it is
most common foal hernia?umbilical
umbilical hernias are common and should always be checked for-- how do you know if you need to tx or not?If 1-2 fingers’ width, it'll close in a week, don't worry about it. If bigger than that, monitor, might need to correct.
if the foal has an inguinal or scrotal hernia, what do?more problematic than umbilical - reduce and wrap- might require sx
bb neigh plops out of mom and umbilicus dangling there... cut? (y/n)N: should tear not cut! tearing will allow natural coag
is it normal for umbilicus which has torn to bleed? what do?depends. some dripping is fine. should not be consistent bleeding though. If so, clamp
what should you do with that baby's umbilicus, and how often, and why?Umbilicus is like one of the major ways they get sepsis so you should clamp if bleeding too much, and then dip every 4-6 hours for the first day with a 1:4 chlorhex: sterile water solution. OR IN DILUTE~ BETADINE. super dilute. deeeelute.
what adjectives should the umbilicus never be?wet, swollen, hot, painful to palp
why should that umbilicus betadine solution be super dilute?bc not dilute enough will slough off all their skin (yay). So dilute that bottle for them or just knock it over
first sign of septic arthritis might be?dont wanna walk
you should palpate all of babies joints. if they come back with 4-5 grade lamness, what are you thinking?Septic joint until proven otherwise- joint will prolly be effusive and hot
what are the chances your bb has laminitis?pretty darn rare- and you wont be able to find those digital pulses anyway
prog for contractural deformities? tx?Most resolve- try some splints, oxytetracycline, and banamine. Check creatinine first! (<--uh...maybe bc NSAIDs and kidney? idk)
which is easier to deal with - contractural deformity or laxity?laxity
what can you do to help with joint laxity in foals, how long till improvement?Improve over 3-4 days, exercise helps! can wrap if needed