OK, so what's the short list?

Having made up your mind something is amiss with the foal, where do you start?  A quick checklist of the most common problems follows (the executive summary if you like)...

Differential diagnosis of the depressed neonate:
Intrauterine growth retardation (IUGR)
  • Compromised placental function on either the maternal or fetal side.  Nutrients and oxygen supplied to, and wastes removed from, both the fetus and the placenta are diminished.
  • Intrauterine growth retardation (IUGR) results from the accumulation of cellular damage and derangements of endocrine, metabolic, and cardiovascular processes.
  • Outcome is dependent on the severity and duration of changes, as well as the concurrent fetal developmental events.

Hypoxic ischemic encephalopathy (HIE)/Perinatal asphyxia syndrome (PAS)
  • Risk factors to the neonate as above.
  • Oxygen and blood deprivation of the foal as a result of a difficult birth.
  • Signs may take 1 to 2 days to become apparent.  Watch closely, they can be subtle.
  • Initially, behavior changes such as loss of affinity for mare, depression, and wandering may be all that is apparent.  Loss of suckle reflex may develop.
  • Later, seizure activity beginning as focal muscle tremors progressing to generalized seizures may occur.  If seizures are not observed, the presence of unexplained physical trauma may be noted.
  • Concurrent vital organ dysfunction may be detected on routine examination.
  • Treatment is supportive.

Sepsis
  • Initial clinical signs are vague and non-specific.
  • Severe complications can occur: septic arthritis, multiple organ dysfunction, death.
  • Infections rapidly become overwhelming.
  • Treatment must be early and aggressive.

Neonatal isoerythrolysis (NI)
  • Clinical signs of NI may be subclinical or clinical. Foals appear healthy at birth and the onset of clinical signs occurs from several hours to as late as seven days after ingestion of colostrum.
  • Clinical signs may vary depending upon the blood group antigen involved, the concentration of antibodies in the colostrum, and the timing of colostrum administration.  The major clinical signs also depend upon the degree of hemolysis.
  • Foals with NI usually become progressively lethargic, weak, and depressed. Mucous membranes may become pale and later icteric (jaundiced, yellow).
  • Breathing may become shallow, rapid, and labored. A rapid heart rate also may develop.
  • Oxygen carrying ability of the blood is diminished.  Foals may convulse or become comatose and die. Foals that are severely affected may develop shock and die quickly (within 6-8 hours postpartum).
  • Treatment includes restoring an adequate ability for the blood to carry oxygen.  This usually involves a blood transfusion.  Supportive care is sometimes extensive if syndrome has been allowed to progress until the foal is compromised.

Mother was right (wasn't she always?).  An ounce of prevention is worth a pound of cure.  I'll start going through these conditions one by one in more detail soon.  Be warned, some of what comes next will be intense, so you need to hang in there.

Until then, keep your eyes on those mares and foals.

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