Bilateral Polydactyly in a foal

The following case report describes the diagnosis and surgery of bilateral polydactyly of unknown origin in a colt. A 7-month-old Berber colt was referred for cosmetic and curative excision of supernumerary digits. Radiographic examination revealed bilateral polydactyly and well-developed first carpal bones. Surgery consisted of an osteotomy of both second metacarpal bones combined with an amputation of the supernumerary digits. The follow-up at 18 months after surgery revealed a sound horse with an excellent cosmetic outcome.     

Paratracheal air cyst in a foal

A 1-day-old American Paint Horse was presented for a large air-filled mass along the ventral aspect of the neck. Bronchoscopy and oesophagoscopy revealed no sign of communication with the trachea or oesophagus. Radiographs and a computed tomography scan of the neck identified a communicating tract between the lumen of the cystic mass and mid-trachea. The foal was systemically healthy at this initial presentation, and delayed removal of the cyst was recommended to allow further maturation of the foal prior to undergoing general anaesthesia. Upon discharge, the cyst continued to grow in size and became more fluid than air-filled requiring repeat centesis and draining. The foal was then re-presented at 3 weeks of age for surgical removal. In surgery, direct communication with the trachea was identified and ligated. Histopathology demonstrated that the cyst lining was composed of squamous epithelium with goblet cells and occasional ciliated cells. The location, morphological features and congenital presentation of the mass were consistent with a paratracheal air cyst (PAC). Surgical resection resulted in excellent functional and cosmetic outcome. Although not previously reported in horses, PAC should be included in the differential diagnosis of an air-filled ventral neck mass in equine neonates. Complete surgical excision may result in a successful outcome.     

An unusual cause of colic in a neonatal foal

A case of a neonatal foal with acute colic and respiratory distress is described. The foal presented with signs of acute colic and was treated medically. The foal did not respond to treatment and 2 h after admission the foal began to demonstrate signs of respiratory distress. Thoracic and abdominal radiographs were obtained and a diagnosis of a diaphragmatic hernia was made. Surgical repair of the hernia was recommended but the owner declined and the foal was subjected to euthanasia. Post mortem findings confirmed the diagnosis and revealed that the defect was of congenital origin. Congenital diaphragmatic hernia is an unusual cause of colic in a neonatal foal.     

Oesophageal ectasia as a cause of dysphagia and milk regurgitation in a neonatal foal

Dysphagia and milk regurgitation are relatively infrequently observed clinical signs in neonatal foals but, when present, can commonly arise from anatomic or functional disorders of the upper airway. Less commonly, milk regurgitation can be caused by anatomic or neuromuscular disorders of the oesophagus. In the report presented here, a neonatal foal was examined for milk regurgitation at 4 days of age and was diagnosed with transient oesophageal ectasia via oesophagoscopy and contrast radiography. Aspiration pneumonia was treated with broad-spectrum antimicrobials and the owner was instructed to intermittently elevate the forelimbs to facilitate passage of milk out of the dilated oesophagus. The milk regurgitation resolved and reassessment of the foal at 6 weeks of age documented the absence of oesophageal ectasia and resolution of aspiration pneumonia. The foal was reported to be healthy and consuming food normally 6 months after initial examination and was in good body condition. This case is unique in that the oesophageal ectasia improved with time; furthermore, other potential causes of dysphagia and milk regurgitation of oesophageal origin in neonatal foals are discussed.     

Surgical repair of a congenital lateral abdominal wall hernia in a neonatal foal

A 16‐hour‐old Quarter Horse filly presented for evaluation of a soft mass in the right caudoventral lateral abdominal wall. Radiography and ultrasonography confirmed the presence of a nonreducible lateral abdominal wall hernia with small intestine located between the skin and body wall. The size of the defect itself could not be imaged and the filly was taken to surgery. A 4 cm vertical defect that appeared congenital was found in the transverse abdominal muscle and was repaired by primary apposition. This case report describes the repair and outcome of this unusual type of congenital hernia.     

Congenital bilateral aplasia of the metacarpophalangeal joints in a foal

A 2‐day‐old Warmblood filly was presented for examination of an angular limb deformity of the left front limb and an upright conformation of both metacarpophalangeal joints. Radiological examination revealed bilateral absence of the metacarpophalangeal joint space with fusion of the third metacarpal bone and first phalanx (synostosis). No treatment was undertaken. The filly was readmitted to the clinic 10 weeks later for bilateral front limb lameness. On radiological examination, the synostosis of the front metacarpophalangeal joints was still present. Physitis of the distal growth plate of the right third metacarpal bone and proximal growth plate of the right proximal phalanx, and an avulsion fracture of the palmaromedial and proximal aspect of the left middle phalanx, with a cystic like lesion on the medial aspect of distal first phalanx and proximal middle phalanx were diagnosed. Given the poor prognosis, the foal was subjected to euthanasia. Post mortem examination confirmed the absence of the metacarpophalangeal joint space with a trabecular bony union between the third metacarpal bone and the first phalanx. A rudimentary joint capsule was present at the level of the absent joints as well as a small zone of articular cartilage, which invaginated over a short distance into the dorsal trabecular bone on the right front limb. On the medial aspect of the left proximal interphalangeal joint, a focal defect of articular cartilage with exposure of subchondral bone was observed. This is the first case report of a foal born with congenital aplasia of both metacarpophalangeal joints. Congenital malformations should be considered as differential diagnosis in lame foals or foals born with angular or flexural limb deformities.     

Megavesica in a neonatal foal

A newborn male foal was diagnosed with a greatly enlarged urinary bladder (megavesica), a urinary bladder diverticulum, and a herniated and abnormal umbilical remnant. Approximately 50% of the cranial bladder including the abnormal structures was surgically resected; the foal recovered and was still asymptomatic 15 months after surgery. The aetiology of megavesica in foals is unknown but successful outcome may be achieved with surgical intervention and adequate medical support.     

Laparoscopic assisted surgical removal of a congenital rectal hamartoma in a foal

In this report we describe a 3‐week‐old Paint horse filly that presented with rectal bleeding associated with a protruding mass. Rectal bleeding in neonates can be caused by infectious agents, trauma, congenital defects, rectal tears or tumours. Histopathology was performed on an avulsed piece of tissue. A second mass was identified endoscopically and was removed using a stapling instrument per rectum under endoscopic guidance and laparoscopic assistance. The mass was diagnosed as a rectal hamartoma. Recovery was uneventful.     

Volvulus of the large colon in a neonatal foal

A one‐day‐old Thoroughbred colt foal was presented for assessment of abdominal pain and reduced urine output. Physical examination of the foal revealed marked abdominal distension, mild tachycardia, tachypnoea and congested mucous membranes. A marked anechoic peritoneal effusion, intestinal hypomotility and mural thickening of the large colon were detected sonographically. Serosanguinous fluid was obtained by abdominocentesis. After haemodynamic stabilisation, the foal underwent general anaesthesia and exploratory laparotomy and a 720° volvulus of the large colon at the sternal and diaphragmatic flexures was identified. After correction of the volvulus, the intraoperative findings were consistent with nonviability of the affected portion of the colon. The owner declined partial colon resection and elected for euthanasia of the foal. Although rare in neonatal foals, large colon volvulus should be considered in foals with signs of abdominal pain, abdominal distension and ultrasonographic findings of colonic mural thickening and luminal distension.     

Multiple rib fracture in a neonatal foal using a nylon strand suture repair technique

OBJECTIVES: To report rib fracture repair using the Securos Cranial Cruciate Ligament Repair System (SCCLRS; Securos Veterinary Orthopedics, Charlton, MA) in a neonatal foal. STUDY DESIGN: Case report. ANIMALS: A 1-day-old Standardbred foal with fracture of left ribs 2-9. METHODS: Four days after admission the foal was anesthetized and rib fractures were repaired using open reduction and the SCCLRS. RESULTS: Rib fractures were successfully stabilized and the foal was discharged 7 days postoperatively without further complications. CONCLUSIONS: The SCCLRS provided a straightforward, effective method of rib fracture repair in neonatal foals. CLINICAL RELEVANCE: Effective rib fracture repair in neonatal foals can be achieved with the SCCLRS.     

Oxytetracycline associated acute kidney injury in a neonatal foal

A 3-day-old Australian Stock Horse filly presented with fulminant acute kidney injury after receiving 4 g of intravenous oxytetracycline at 24 and 48 h of age for medical management of flexural deformities. The filly’s clinical status initially improved, but worsening azotaemia prompted euthanasia after 55 h of supportive care. Necropsy confirmed proximal tubular necrosis. Nephropathy in association with oxytetracycline administration has been rarely reported. This case describes severe nephropathy in an apparently normal foal and highlights the need for thorough case evaluation prior to use of high-dose oxytetracycline therapy for correction of flexural deformities in foals.     

Congenital limb abnormality in a Thoroughbred foal in Trinidad

A congenital defect of the right hindlimb of a 36‐h‐old Thoroughbred foal as reported for the first time in Trinidad, West Indies. The foal was subjected to euthanasia and radiographs of both hindlimbs revealed that the bones distal to P1 of the right hindlimb only, were missing. Insertion of both the superficial and deep digital flexor tendons were found to be on the most proximal aspect of P1. Necropsy revealed no other congential defects.     

Thoracic trauma and post operative lung injury in a neonatal foal

A 24‐hour‐old Standardbred filly was referred with an acute history of weakness, respiratory distress and subcutaneous emphysema. Radiographic evaluation revealed left sided rib fractures, unilateral pneumothorax and pneumomediastinum. Serial arterial blood gas measurements pre‐ and post rib repair showed pulmonary dysfunction. Post operative radiographs revealed the presence of air bronchograms and a bronchointerstitial pattern, suggestive of alveolar parenchymal pathology consistent with pulmonary contusion, pulmonary oedema or ALI/ARDS. The filly was treated with intranasal oxygen and an active chest draining unit and recovered uneventfully.     

Imaging diagnosis and clinical presentation of a Chiari malformation in a Thoroughbred foal

A newborn Thoroughbred foal was presented to the clinic with ambiguous neurological deficits, spinal anomalies and a soft tissue swelling dorsal to the lumbar vertebral column. The foal was alert but unable to rise and stand. With radiography, ultrasonography, computed tomography (CT) and magnetic resonance imaging (MRI) a lumbar dysraphic anomaly, cerebellar herniation and coincidental skeletal abnormalities were documented. Finally, a meningomyelocele was defined and, in context with the cerebellar herniation through the foramen magnum, the foal was diagnosed to have a Chiari malformation. The MRI examination corresponded best with the post mortem findings. Although 3‐dimensional imaging methods have been considered superior regarding full and detailed assessment of the congenital malformation, radiography and ultrasonography also provide essential information to diagnose dysraphic lesions at reduced costs and efforts. A Chiari malformation should be considered as a differential diagnosis in foals with neurological deficits.     

Successful outcome after surgical correction of large colon atresia in a colt foal

This report describes successful surgical correction and long-term survival of a case of large colon atresia in a 24-h-old Warmblood colt, referred with signs of unrelenting abdominal pain and a suspicion of meconium impaction. Radiographic and ultrasonographic examination was indicative of large colon meconium impaction with secondary ileus. Due to deterioration of the foal, surgery was recommended. An atretic segment was found between the left ventral and dorsal large (ascending) colon. A band of fibrous tissue with no identifiable lumen connected the segments. Surgical correction was done by performing a stapled side-to-side anastomosis. Twelve days after surgery, the foal was discharged. Twenty-two months after discharge, the owner reported the foal developing as expected compared with its peers, but had a mild, self-limiting episode of colic at 20 months of age.     

Cervical vertebral anomaly and ventricular septal defect in an Arabian foal

A male Arabian foal born with a cervical mass and no apparent clinical signs presented with a cervical vertebral anomaly and ventricular septal defect. Both congenital anomalies were diagnosed at age 3 weeks and rechecked at age 6 months with radiographs and ultrasonographic studies respectively. At 11 months, in addition to radiographs and Doppler ultrasonographic studies, a contrast ultrasonographic study and post mortem myelographic and computed tomographic studies of the cervical vertebral column revealed the appearance of this rare cervical vertebral anomaly and the severity of the ventricular septal defect. To the authors' knowledge, in the Arabian foal, both conditions have not been reported simultaneously in the same patient.     

Neonatal respiratory distress and sepsis in the premature foal: Challenges with diagnosis and management

The presentation of a premature, neonatal foal affected with respiratory distress and seizures represents a difficult diagnostic and therapeutic challenge often best addressed by the provision of appropriate emergency care followed by prompt referral to a well‐equipped critical care facility. Veterinary management of the premature foal described in the accompanying report was complicated by the development of sepsis and pulmonary failure. The development of pulmonary emphysematous bullae was identified during the course of the foal's treatment and probably contributed to its clinical deterioration. Diagnostic imaging modalities that may be used for the diagnosis of respiratory distress in neonatal foals include thoracic radiography, ultrasonography, computed tomography (CT) and magnetic resonance imaging (MRI). Both CT and MRI require general anaesthesia. The likelihood of a successful outcome for the foal in this report might have been improved by the provision of urgent veterinary care and referral to the critical care facility earlier in the course of its management. Important early indicators of the need for urgent veterinary care in this case included the foal's prematurity, inability to stand, and the need to provide manual support to facilitate nursing from the mare's udder. Foals affected in this manner should warrant treatment with broad‐spectrum antimicrobials, circulating volume maintenance, immunoglobulin support, and the use of a nasogastric tube to facilitate nutritional support.     

Complete AV block in a neonatal foal suffering from nutritional myodegeneration

This case report concerns a 1-day-old, full-term Quarter Horse colt presented due to a progressive inability to rise and nurse. Besides the general weakness, a marked bradycardia was evident, which was caused by a third-degree atrioventricular (AV) block. Subsequently, the diagnosis of acute nutritional myodegeneration (NMD) was made based on clinical signs, elevated muscle enzymes, ECG findings, as well as low serum selenium and vitamin E values. Despite intensive care and supportive therapy, the foal´s condition deteriorated, and euthanasia was elected. Necropsy confirmed the diagnosis of NMD and revealed diffuse necrosis and inflammatory infiltration of the skeletal and myocardial musculature, as well as the cardiac conduction system which might have resulted in complete AV block.