Texas Equine Veterinary Association

73 GASTROINTESTINAL MANAGEMENT • Preventing Ileus: o Early enteral feeding (even small amounts). o Prokinetics (e.g., Metoclopramide - use with caution). o Minimize stress. • Managing Diarrhea: o Identify cause (infectious, dietary). o Fluid therapy to correct dehydration and electrolyte imbalances. o Intestinal protectants (e.g., Biosponge). • Preventing Gastric Ulcers: o Stress reduction. o Prophylactic use of H2 blockers (Ranitidine) or proton pump inhibitors (Omeprazole). INFECTION CONTROL & ANTIMICROBIAL THERAPY • High risk of infection due to immature immune system, open umbilicus, and invasive procedures. • Strict Hygiene: Aseptic technique for catheters, wounds, feeding tubes. • Antimicrobial Therapy: o Broad-spectrum antibiotics initially (e.g., Penicillin + Amikacin or Ceftiofur). o Culture and sensitivity testing to guide specific therapy. o Monitor for side effects (e.g., nephrotoxicity with aminoglycosides). NURSING CARE & ENVIRONMENT • Clean, dry, bedded environment prevents decubitus ulcers and hypothermia. • Regular Turning: Every 2-4 hours for recumbent foals to prevent lung atelectasis and pressure sores. • Umbilical Care: Disinfect with chlorhexidine or dilute iodine solution. • Eye Care: Keep clean, lubricate if needed. • Bladder Management: Monitor urination, catheterize if needed to prevent bladder rupture or urine scalding. • Gentle Handling: Minimize stress. POSITIONING OF RECUMBENT FOAL • Padding and blankets. • Padding on stall. • Diapers. • Corn starch or baby powder. • Rotate foal every 2-3 hours. • Keep foal next to mare. SUPPORTIVE CARE OF THE CRITICALLY ILL FOAL • Technicians play an important role. • Physical Exam. • Bloodwork and lab tests. • Placing catheters. • Placing feeding tubes/oxygen cannulas. • Restraint. • Supportive care. TECHNICIAN ROLES IN FOAL CARE • Help veterinarian get detailed history. • Provide sedation for mare and foal. • Very thorough physical exam. • Obtain blood for testing. • Place catheter. • Provide adequate padding for foal. • Treat umbilicus as needed. • Provide supportive care. • Assist in mare/foal bonding. PHYSICAL EXAM • TPR. • Mucous membranes. • Icteric membranes and sclera. • Coronary bands. • Petechiation. • Uveitis and entropion. • Rib Fractures. • Assess limb temperature and perfusion. • Joints. • Umbilicus. • Suckle Reflex. • Gut sounds. • Foal's stance or recumbency (constipated or lateral). • Obtain weight. • Non-invasive blood pressure. • Radiographs of chest if depressed breathing and carpus/tarsus for prematurity/dysmaturity. BLOOD GLUCOSE • Can be measured with a glucometer or lab test. • An indicator of recent nursing. • Low blood glucose indicates sepsis. IGG TESTING • Stallside snap test. • Failure of Passive Transfer (FPT): <400 mg/dl. • Partial Failure of Passive Transfer (PFPT): 400-800 mg/dl. • Complete Passive Transfer: >800 mg/dl. • If a foal is less than 24 hours old and has FPT or PFPT, more colostrum can be given orally. • If a foal is older than 24 hours and has FPT or PFPT, plasma should be given IV. CATHETER PLACEMENT • Prefer to use over-the-wire catheters made by Mila or Arrow. • Requires sterile placement. • Provides long-term, secure placement. • Does not kink in a foal's short neck as an over-the-needle catheter would. BLOOD CULTURES • Blood can be pulled from the catheter as it is being placed sterilely. • If the foal has already been on antibiotics, the culture broth will differ. • Results are available in a minimum of 48 hours. • A 20 ml bottle of culture broth needs 2-4 ml of blood. • A 70 ml bottle of culture broth needs 7 ml of blood. Blood Gas Analysis - Normal Values • pH: 7.35-7.45. • PCO2: 35-45 mmHg. • PO2: 80-100 mmHg on room air. • SaO2: 95-100%. Assess Hydration Status • Physical assessment: o Skin tent. o Sunken eye-uveitis. o Dry mucous membranes. • PCV/Total Solids. UMBILICUS CARE • Ensure the foal is not bleeding. • Monitor for drainage. • Ultrasound to check for patent urachus. • Dip in dilute Nolvasan solution every 2-4 hours. SUPPORTIVE CARE (ADDITIONAL NOTES) • Nutritional Support: 20% of body weight/ day, 5% of body weight/day. • Total Parenteral Nutrition (TPN). • Supporting lax tendons (do not bandage legs!). • Provide Oxygen. • Eye lube/triple antibiotic ointment. MARE/FOAL BONDING • Let the mare give birth as naturally as possible. • Bonding process begins when the mare can aggressively clean the foal. • Foal should stand and nurse within 1 hour and will explore the mare's body looking for teats. • If the mare rejects the foal trying to nurse, aid should be given, such as holding the mare or giving her Acepromazine. • Take precaution with overprotective mares. • Let the mare teach socialization skills and "manners" to the foal. CONCLUSION • Supportive care is the cornerstone of successful management for critically ill foals. • Requires a dedicated team, vigilant monitoring, and proactive intervention. • Early recognition and aggressive treatment of complications improve outcomes. • Every critically ill foal is a unique challenge requiring individualized care.

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