Nutritional management of the foal with diarrhoea

Diarrhoea is a common problem in the neonatal and suckling foal. In certain circumstances supplemental nutrition is necessary depending on the age of foal, severity of diarrhoea and presence of other systemic manifestations. Nutritional supplementation can be provided either enterally or parenterally. Enteral nutrition is superior to parenteral nutrition because it is the most natural and physiologically sound means to provide nutritional support. Parenteral nutrition may be warranted if the foal is unable to receive or tolerate enteral nutrition. Dextrose alone or with amino acids and lipids can provide appropriate nutrition when enteral feeding is not tolerated. As soon as the foal stabilises enteral feeding can be reintroduced.     

Nutritional support in critical care patients.

Malnutrition in the form of insufficient nutrient intake to support tissue metabolism undermines appropriate medical or surgical therapeutic management of a case. The major consequences of malnutrition in all patients are decreased immunocompetence, decreased tissue synthesis and repair, and altered intermediary drug metabolism. A practical goal is to begin nutritional support within 24 hours of the injury, illness, or presentation. There are only two methods by which nutrients can be supplied to the body: enteral and parenteral. General guidelines are presented to help establish a foundation.     

Intensive care of the neonatal foal

The basic concepts of diagnosis and treatment in the abnormal neonatal foal are presented. Methods of restraint, sedation, and general nursing care are discussed, as well as more specific techniques of respiratory and circulatory system support.     

Nutritional management and practical feeding of the orphan foal

Foals are dependent on a milk‐based diet for the first 3–4 months of life. If they are orphaned during this period they require appropriate nutritional and behavioural management to allow them to develop into sound, well‐grown horses and ponies with well established normal behavioural patterns. In order to meet these needs it is necessary to understand the metabolic requirements of the foal and the composition of mares' milk. Usually managing these foals requires short‐term, emergency feeding of the foal while a long‐term option is sought. Long‐term options include use of a foster mare, induction of lactation in a parous, barren mare or hand rearing with suitable equine company. It is important to monitor growth and development of these foals to ensure that over the long term their nutritional needs are being met to allow normal growth and development.     

Ventilatory support of the critically ill foal.

Critically ill foals often have respiratory failure and benefit from respiratory support. Conventional mechanical ventilation using modem mechanical ventilators is easily adapted to foals. Establish-ing ventilator settings is a dynamic process aided by constant monitoring of blood gas values, end-tidal carbon dioxide, airway pressures, respiratory volumes, airway resistance, and respiratory compliance. Early weaning is as important as timely initiation of ventilation.     

Nutritional muscular dystrophy in a four-day-old Connemara foal

This report describes a four-day-old, full-term Connemara colt, presented for the evaluation of a progressive inability to rise unassisted. A diagnosis of nutritional muscular dystrophy was made based on muscular weakness, elevated muscle enzymes and low vitamin E, selenium and glutathione peroxidase activity. The foal was treated with intramuscular vitamin E-selenium and made a full recovery.     

Nutritional support for patients

A good intake of fluids and essential nutrients in the first fourteen days is of vital importance to recuperating animals. Moreover, it is important to encourage cats and dogs to eat after illness or surgery, in order to promote optimal functioning of the gut and the immune system. Enteral nutrition is to be preferred to nasogastric feeding or parenteral nutrition. In the first stage of recovery, during the first 24 to 48 hours, it is important to feed the gut' with nutrients, and thereafter, in the second stage of recovery (after day 3), the calorie intake can be increased. Timely nutritional support with nutraceuticals, such as arginine, glutamine, taurine, long-chain polyunsaturated omega-3 fatty acids, and prebiotic fibres, can considerably shorten the recovery period of cats and dogs after illness or surgery     

Nutritional support of hospitalized patients

Effective nutritional support requires sound knowledge of both basic and clinical nutrition of dogs and cats as well as familiarity with products and delivery systems. Case management includes assessment of nutritional status and estimation of fuel sources. Most starved or stressed patients use fatty acids for over 70 per cent kcalME and protein for over 20 per cent kcalME. Approximate kcal needs are calculated from maintenance energy equations. Most patients respond best to enteral nutrition. Meat-based pet foods, liquid enteral products, and nutrient modules are offered in slurries or are tube-fed. Management includes careful monitoring of patients and gradual transitions to diets with more complex nutrient sources.     

Nutritional support of hospitalised animals

Effective nutritional support requires a sound knowledge of both basic and clinical nutrition of dogs and cats as well as familiarity with products and their administration. Management includes the assessment of a patient's nutritional status and estimation of fuel sources. Most starved or stressed patients utilise fatty acids at over 70 per cent kcalME (metabolisable energy) and protein at over 20 per cent kcalME; appropriate diets contain at least 30 per cent kcalME from protein as well as fat. Approximate calorie needs are based on maintenance energy requirements. Enteral nutritional support is superior to parenteral support in most patients as gastrointestinal integrity and enterocyte viability are maintained. Meat-based pet foods, liquid enteral products and nutrient supplements are offered in slurries and via tubes. Management includes careful monitoring of patients and the gradual transition to diets with more complex nutrient sources.     

Nutritional support of hospitalized animals.

Nutritional support of hospitalized animals is new and encouraging, although it is in need of rigorous evaluation. Principles and procedures of established value in human patients appear to be readily applied to other species, with due regard to comparative physiologic properties and medicine.     

Veterinary intensive care

The term ‘intensive care’ is becoming increasingly popular in veterinary medicine to describe those techniques employed in caring for the critically ill animal. Application of the techniques required for intensive care is not difficult and can be employed in any veterinary practice. The purpose of intensive care is the uncomplicated conversion of a dramatic disease process into an uneventful one, not the performance of life-saving heroics. Critically ill patients share several common features, particularly the need for diligent monitoring and nursing. Regardless of the primary disease, the function of many organs is frequently impaired in these patients and they require total body care. Critically ill animals may have fluid, acid-base and electrolyte imbalances, increased caloric requirements and an increased susceptibility to infection. This paper describes the equipping and staffing of an intensive care unit and the various techniques for monitoring critically ill animals. It also reviews aspects of fluid and electrolyte disturbances and therapy, and the unusual respiratory problems and nutritional requirements of these patients.     

Nutritional support for neonatal foals.

In recent years, equine neonatal medicine has made significant advances. The importance of nutritional support for the sick neonatal foal has been recognized, and methods of providing that sup-port have been developed. Today, the clinician has many options when designing a nutritional plan for the neonatal foal. When the foal's gut permits, enteral diets are an inexpensive source of nutrients. Under conditions where the gut requires rest, methods for delivering nutrients by the parenteral route have also been developed. In this article, the nutrition of the normal and sick foal is described. Guidelines for designing a nutritional plan are also reviewed.     

Nutritional support of hospitalised dogs and cats

SUMMARY Nutritional support of hospitalised dogs and cats improves recovery from illness, reduces mortality, and improves responses to trauma and stress. The primary goal of nutritional support is to prevent use of tissue protein. This is accomplished by the provision of sufficient calories and dietary protein in optimal proportions. For nutritional support, calorie intake is adjusted according to the patient's metabolic rate so that the animal may be fed above or below its usual intake. Nutritional support should always be started gradually, no matter what the final calorie goal may be. For many sick dogs fed enterally, diets provide about 30% of calories from fat and at least 27% of calories from protein. Carbohydrates in nutritional support diets should not include maize, wheat or, especially, soy. Sick cats fed enterally should receive at least 30% of calories from both fat and protein.     

Raising the orphan foal

Orphan foals are best reared by fostering them onto a brood mare of appropriate size. If no foster mother is available, they can be reared on 2 per cent fat skimmed cow's milk fortified with dextrose at the rate of 20 gm per L. This should be slowly increased from 10 per cent of body weight at 1 day of age to 25 per cent of body weight at 10 days of age. The amount should then be held constant until weaning. Alternatively, foals can be reared on milk replacers. Manufacturers' feeding instructions rarely mimic the milk intake obtained by a foal nursing her dam, and problems have been observed in milk replacer fed foals. It may be better to feed milk replacers at 1- to 2-hour intervals as a 12.5 per cent solution. The volume fed can be slowly increased from 5 per cent of body weight at day 1 to 20 per cent of body weight at day 10. Fresh water, hay, and good-quality creep feed with at least an 18 per cent crude protein should be offered from 2 weeks of age. Foals can be weaned at 8 to 12 weeks of age.     

Hypothyroidism in the foal

Hypothyroidism in the foal occurs as two entities because of the separate actions of thyroid hormones in regulation of metabolic rate and in cell differentiation. The hypometabolic state which results in inadequate thermogenesis and lethargy, occurs concurrently with a period when thyroid hormone secretion is inadequate. Also the severity of the concurrent symptoms is related to the degree of hormone inadequacy as measured by plasma concentrations of free T4 and T3. By contrast, the developmental lesions caused by hypothyroidism are often observed during periods when plasma thyroid hormone concentrations are normal. This is because during the development of most tissues there is a period during which deprivation of thyroid hormones leads to developmental defects which may first appear weeks or months later, by which time thyroid hormone levels may have returned to normal. In the foal the critical period for some developmental processes, eg, myelination, is before birth so it is difficult to confirm a pre-natal hypothyroid state as the cause of neonatal neuromuscular incompetence. Post natal developmental lesions of the epiphyses or ossification centres, for example, may also manifest themselves some weeks subsequent to the period during which hypothyroidism existed. Because confirmation of diagnosis using plasma hormone measurements is very difficult in the foal, and because the symptoms of hypothyroidism are not specific, the incidence of confirmed hypothyroidism in foals is low. However there is suggestive evidence that where awareness of the condition exists it is diagnosed frequently. The aetiology is obscure although diet has been implicated.(ABSTRACT TRUNCATED AT 250 WORDS)