Texas Equine Veterinary Association

www.texasequineva.com • 10 gestational length, parturition, time to stand and nurse, meconium and urination, as well as placental appearance. The foal should stand within 2 hours of being born and should nurse within 3 hours. A thickened abnormal placental appearance consistent with placentitis should strike the veterinarian to further investigate the health of the foal due to the potential risk of sepsis. Ideally, the placenta should weigh less than 11% of the foal's body weight. It is important to establish maturity of the foal on initial exam. A normal gestational period doesn't necessarily mean that the foal is mature. Foals that are born small in size, weak, with a domed forehead, fine silky hair, and droopy ears, as well as incomplete cuboidal bones are either premature or dysmature. These foals could be at a disadvantage to perform appropriate tasks within the usual time frame; therefore, they may not stand, nurse, or urinate appropriately. These foals as well as mature foals can develop "dummy foal" syndrome or Perinatal Asphyxia Syndrome (PAS) due to a hypoxemic event or inability to decrease neurosteroids in placenta when born. (Aleman. M, et al. 2019) These foals may have an abnormal respiratory pattern; they may be hyper-reactive and may not be able to nurse well or find the udder. A baseline physical exam can give you limited information about the health of the foal. Important aspects to focus on a neonatal physical exam include heart auscultation, mucous membranes, ribs, joints, umbilicus, and mentation. When auscultating the heart, foal neonates can have physiologic heart murmurs that are holosystolic ejection type (innocent murmurs) and these can persist for a few days after being born. A continuous murmur consistent with a patent ductus arteriosus, loud murmurs (greater than grade 4/6), or any murmurs in addition to signs of cardiac disease such as cyanosis, lethargy, and exercise intolerance should be investigated with echocardiography. The cardiovascular system should be closely monitored or evaluated if the heart murmur worsens or persists. The color of the mucous membranes can give you a subjective of the degree of oxygenation and a hyperemic color can be an indicator of sepsis. Palpating the ribs of foals that were assisted during delivery is important to rule out any rib fractures. These can be life threatening depending of the displacement and position. Some possible risks include hemothorax, diaphragmatic laceration, and pericardial puncture. Evaluating the umbilicus by palpation and sonographically is important if any abnormalities are noticed (thickened, discharge, patent urachus). To ultrasound the umbilicus, it is easiest to sedate the foal and lay them down in lateral recumbency. Good sedatives for neonates are diazepam, midazolam, or butorphanol. See table 1 for sedative doses. Neonatal foal management: To refer or not to refer? Spring time can be a chaotic season for most equine veterinarians, especially for veterinarians working with large breeding facilities. Developing a strategic plan for newborn foals is important and allows the veterinarian to make the decision if a referral to a specialized equine hospital is needed or not. Foal management has multiple variables, including the value of the foal, type of farm, economic constraints, and location. Depending on those factors, discussing with the owners what is best for the foal's outcome will determine your management plan. To the eyes of many owners, many newborn foals appear healthy but they can rapidly deteriorate. Therefore, performing a physical exam at 12 to 24 hours of birth is advised. Talking to the owners to get a thorough history is also important. The veterinarian should ask about ABOUT THE AUTHOR Natalia Rodriguez was born and raised in Bogota, Colombia. She completed her undergraduate studies and veterinary school at the University of Georgia, followed by an equine internship at private practice in Scottsdale, Arizona, and a large animal surgery and medicine internship at Texas A&M. She then completed an internal medicine fellowship at Hagyard Equine Medical Institute. Currently at Texas A&M as a second-year large animal internal medicine resident. Natalie Rodriguez, DVM Foals

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