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.     

Congenital hypothyroidism and dysmaturity syndrome in foals: First reported cases in Europe

Congenital hypothyroidism and dysmaturity syndrome (CHD) in neonatal foals was first described in western Canada in 1981 and remains an important problem for the western Canadian horse industry. This syndrome is characterised by hyperplasia of the thyroid gland, increased gestational length and multiple congenital musculoskeletal abnormalities. This case series describes the first confirmed cases of CHD in Europe and challenges contemporary opinion which suggests that this syndrome is distinct from congenital hypothyroidism associated with visible goitre.     

Active tension‐extension splints: A novel technique for management of congenital flexural deformities affecting the distal limb in the foal

A variety of methods are described for managing distal limb flexural deformities in the foal, including intravenous oxytetracycline and splint or cast use. This case series describes a novel technique that creates an ‘active tension‐extension splint’ by wiring the toe into a custom‐made fibreglass splint and therefore into active extension. A dorsal fibreglass splint is made by halving a cast that is set around the affected leg with padding underneath it, so that it is sculpted to a more appropriate anatomical shape. Cerclage wire is placed through the toe and the dorsal aspect of the splint, then tightened to pull the limb into active extension. Foals with distal limb flexural deformities that were treated in this way were followed up by examination of hospital records and telephone questionnaire. Records were examined for 13 foals treated between 2004 and 2010. One foal developed septic osteitis of the distal phalanx due to suspected laminar penetration; other post operative complications seen were bandage sores and minor cosmetic scarring. Out of 10 foals where follow‐up by questionnaire was available, 8 had complete resolution of their deformity following active tension‐extension splinting, one required inferior check ligament desmotomy for complete correction and one had carpal flexural deformities that did not resolve. All that survived to adulthood are sound and have achieved their intended purpose. This previously unpublished technique using a wire through the toe to create an active tension‐extension splint has a high success rate for correction of congenital flexural deformities affecting the distal interphalangeal and metacarpo‐/metatarsophalangeal joints in the foal. The majority of post operative complications are minor and easily managed. This is a simple technique that can improve the management of neonatal distal limb deformities both in a hospital situation and for equine practitioners in the field.     

Congenital oesophageal stricture in an Arabian filly treated by balloon dilation

Congenital oesophageal stricture was diagnosed via endoscopy in a 3‐day‐old Arabian filly suffering from nasal milk regurgitation. Vascular ring anomaly or other extramural, intramural or intraluminal causes were not identified on radiographs or on a computed tomography scan; thus a functional abnormality was suspected. The filly was treated with antibiotics for aspiration pneumonia and was fed milk through an indwelling nasoesophageal tube. Two sessions of balloon bougienage at the stenotic site, under sedation, resulted in marked clinical improvement and thereafter the filly was gradually reintroduced to suckling from the mare. The filly was discharged from the hospital after 17 days and on follow‐up there were no reports of food regurgitation even after the introduction of solid food. The filly was still doing well in the latest follow‐up at age 11 months.     

Tetralogy of Fallot in a Young Ferret (Mustela putorius furo)

A 17-month-old albino, castrated male domestic ferret (Mustela putorius furo) was presented for evaluation of a heart murmur. The murmur was first auscultated when the ferret was 12 weeks of age, coinciding with its first known evaluation by a veterinarian. At the time of diagnosis, the ferret was reported to have mild exercise intolerance. The clinical findings on the ferret were within normal limits other than a right parasternal systolic murmur (grade 4/6) that radiated to the left parasternal region. The ferret was not receiving any medications. All 4 features of tetralogy of Fallot (TOF) were identified with echocardiography. Thoracic radiographs were suggestive of TOF with mild right-sided enlargement of the cardiac silhouette and small pulmonary vasculature. A serum biochemistry profile and complete blood count were within the reference ranges for domestic ferrets. At that time atenolol (3.25 mg, every 24 hours, orally) was prescribed to treat the clinical condition of the animal. At a 1-week follow-up examination, the patient's heart rate had decreased from 240-300 beats per minute to 180-260 beats per minute. The owner reported that the ferret was sleeping more frequently during the first week of therapy but had normal activity when awake. At a 5-month recheck examination, the patient was reported to be completely normal at home. This is the first case report of TOF in a ferret.     

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.     

Assessment of the equine neonate in ambulatory practice

The ambulatory practitioner is usually the first to evaluate the equine neonate and must assess the foal and determine its health status. If there is suspicion of one or more abnormalities, then the ambulatory veterinarian must initiate appropriate treatment and determine if the foal can be successfully treated in the field or should be referred to a specialty hospital. This article will describe the examination procedure including an accurate history, a comprehensive physical examination, laboratory evaluation and application of point‐of‐care diagnostics. The initial examination is the basis for the correct determination of health or illness and informing the owner of the correct course of action for the neonatal foal.     

A review of equine sepsis

Sepsis is defined as an exaggerated, systemic inflammatory response to infection and is a common condition in horses. Systemic inflammatory response syndrome (SIRS) associated with bacterial infection is a hallmark of sepsis. Sepsis in neonatal foals is a common sequela of failure of passive transfer and, in addition to development of SIRS, may be characterised by bacteraemia, pneumonia, enterocolitis, omphalophlebitis, meningoencephalitis or arthritis. Sepsis in mature horses is most commonly observed secondary to gastrointestinal lesions that result in disrupted mucosa and bacterial translocation into circulation (endotoxaemia). Pleuropneumonia and metritis may also cause sepsis in mature horses. Diagnosis of sepsis is based on SIRS criteria as well as suspected or confirmed infection. Due to the relatively low sensitivity of microbial culture and the subjectivity of sepsis scoring, many sepsis biomarkers are being studied for their usefulness in diagnosis and prognostication of sepsis in horses. Treatment of sepsis requires an intensive care approach that includes antimicrobial drug administration, fluid resuscitation and pressure support, and treatment for inflammation, endotoxaemia and coagulopathy. Early recognition of sepsis and prompt antimicrobial drug treatment are critical for a successful outcome. Multiple organ dysfunction syndrome may occur in severe cases of sepsis, with common manifestations including laminitis and coagulopathies. Although prognosis for septic mature horses depends highly on the primary disease process, the overall survival rate in septic neonatal foals ranges from 26 to 86%, with most studies indicating a survival rate of 45–60%.