Plus-Hex CLINICAL
Urine production
If an indwelling urinary catheter and collection bag are in place , the urine will need to be drained and measured at least every 2 hours . Note the volume and colour , and measure the specific gravity using a refractometer . The neonate ' s first urination is normally concentrated . Foals receiving IV fluids and / or on a milk diet will normally have dilute urine with a specific gravity range of 1.003 – 1.010 .
Fluid accumulation
Closely check the foal ' s body for signs of fluid accumulation . In neonates on continuous infusions of IV fluids , axillary and ventral oedema can indicate fluid overload due to sodium retention , and may coincide with harsh lung sounds . Some clinicians recommend fluid balance assessments , documenting the ‘ ins and outs ’ – the total volumes of infused IV fluids and ingested milk are compared with the total urine output over a 2-hour period . TPN volumes are excluded from this calculation as TPN is calorie dense , with its components being used as food .
Gastrointestinal system
Auscultate the abdomen dorsally , ventrally and bilaterally to assess gut motility , and note any distension . Distension can be evident ventrally and around the paralumbar fossa . Document the presence , absence or reduction of normal , hypermotile , intermittent , fluid or gassy borborygmi sounds . Also note whether these findings are associated with pain .
Umbilicus / urachus
Conclusions
Nursing the recumbent neonatal foal presents many challenges for the veterinary team . The equine veterinary nurse is at the heart of the care team and can provide specialist support to meet the needs of the neonates in their care .
Neonates can have complex and extensive medical needs . It is important to know the normal parameters for the age of the foal in order to recognise anything abnormal – and there can still be individual variations from one sick foal to another .
Systematically assessing each body system at every check will help to ensure that nothing is overlooked , giving the foal the best chance of survival without complications .
REFERENCES
1 Millar B , Hay-Kraus B , Wong D , Kopper J . Critical care techniques in the neonatal foal . In : Wong DM , Wilkins PA . ( eds .) Equine Neonatal Medicine . Hoboken : John Wiley & Sons ; 2024 . p . 1268 – 1319 .
2 Gelatt KN , Gelatt JP , Plummer CE . Equine ophthalmic surgery . In : Veterinary Ophthalmic Surgery . 2nd ed . Philadelphia : Elsevier ; 2022 . p . 360 – 441 .
3 Carr EA . Field triage of the neonatal foal . Veterinary Clinics of North America : Equine Practice . 2014 ; 30 ( 2 ): 283 – 300 . Available from : https :// doi . org / 10.1016 / j . cveq . 2014.05.001 .
4 Magdesian KG . Neonatology . In : Orsini JA , Divers TJ . ( eds .) Equine Emergencies : Treatment and Procedures . 4th ed . St . Louis : Elsevier ; 2014 . p . 528 – 564 .
It is not uncommon to notice foals dribbling urine through a patent urachus during the neonatal phase . Localised treatment is routinely recommended . Observe the umbilicus for pain , heat , swelling , purulent discharge or the presence of wet hair on the ventral abdomen .
Joints
With all newborns , septic arthritis is of particular concern , especially if the foal has not received adequate maternal antibodies from colostrum . The aetiology in neonates is often associated with generalised bacteraemia , physeal and perisynovial infections , and it can affect any joint . At every assessment , it is important to palpate all joints , feeling for areas of heat , joint distension and discomfort . Septic arthritis is usually associated with lameness , but this will not be evident in recumbent foals .
Volume 39 ( 2 ) • April 2024
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