Disorders of Foals

Diagnosis and treatment of non-infectious and infectious foal diarrhoea

“…The underlying pathophysiology is part of the perinatal asphyxia syndrome (PAS), a syndrome which occurs as a result of in utero compromise, intra or post partum complications or failure to adapt rapidly to the extra uterine environment after parturition. One or more organ systems may be affected, such as the central nervous system (hypoxic-ischaemic encephalopathy; HIE), kidneys or the gastrointestinal tract (Wilkins 2004). Organ dysfunction is associated with tissue hypoxia during periods of hypoperfusion and/or hypoxaemia with subsequent reperfusion injury often contributing to organ damage.…”

“…Organ dysfunction is associated with tissue hypoxia during periods of hypoperfusion and/or hypoxaemia with subsequent reperfusion injury often contributing to organ damage. Clinical signs may be evident shortly after birth or manifest within the first 48h of life: signs associated with compromise of the gastrointestinal system include intolerance of enteral feeding, meconium retention, abdominal distension, ileus, mild to moderate colic, nasogastric reflux and passage of watery to bloody faeces (Slovis 2003, Wilkins 2004. Affected foals frequently suffer from multi-systemic problems with weakness, inability to stand and nurse, obtundency or seizures associated with HIE often being the predominating clinical signs.…”

“…This suggestion is supported by the fact that post mortem examination of neonatal foals treated with and without anti-ulcer medications revealed no differences in the occurrence, the subjectively judged severity and location of ulcers between the two groups. As the acidic environment also serves as a protective barrier against colonialisation of the gastrointestinal tract by potentially harmful bacteria, the indiscriminate use of anti-ulcer medications in foals with diarrhoea can not be recommended, but requires careful consideration of the age of the patient, the underlying disease process and expected benefits from the treatment (Wilkins 2004). …”

“…Diagnosis is established by the combination of mild, self-limiting diarrhoea and the typical age. Signs of systemic disease such as loss of appetite, fever, depression or dehydration indicate a more serious underlying pathophysiology and warrant immediate investigation (Wilkins 2004). …”

Supportive care for the critically ill neonatal foal

“…Underlying pathologies may include pulmonary immaturity and associated surfactant dysfunction, a disease for which the term neonatal equine respiratory distress syndrome (NERDS) has been recently suggested (PA Wilkins et al 2007), bacterial pneumonia, often associated with sepsis or aspiration, viral pneumonia, meconium aspiration and acute lung injury/acute respiratory distress, recently termed equine neonatal acute lung injury/acute respiratory distress (EqNALI/EqNARDS) (Peek et al 2004, Wilkins 2004, Wilkins et al 2007). Other causes associated with hypoxaemia/hypoxia include persistent pulmonary hypertension (PPH), primary cardiac abnormalities, particularly if right-toleft shunting is present, anaemia, for example due to neonatal isoerythrolysis, and centrally mediated hypoventilation, often in connection with PAS (Wilkins 2004). …”