Page 1370 - Equine Clinical Medicine, Surgery and Reproduction, 2nd Edition

The foal 1345

VetBooks.ir after birth and these foals tend to have more severe output and other foals become completely intolerant
of enteral feeding. Renal signs range from mild oli-
disease and a poorer prognosis.
Neurological signs are often the most common.
in foals following significant hypoxia. This is very
These can range from a foal that appears slightly guria to complete anuria. Complete anuria can occur
‘slow’ to a foal with marked obtundation or uncon- difficult to manage and often associated with high
trollable seizures. Common signs include loss of mortality. Endocrine and metabolic dysfunction is
suck reflex and poor teat searching, persistent chew- also common.
ing movements, tongue protrusion (Fig. 14.11),
aimless wandering, altered mentation, abnormal Differential diagnosis
head carriage, reduced interaction with the mare or Numerous differential diagnoses may be considered.
the environment, hyperaesthesia, weakness or rapid These include neonatal sepsis, septic meningitis,
exhaustion and inability to stand or stay standing. severe metabolic disturbances leading to electrolyte
More severe signs include central blindness with imbalances and renal failure, cranial trauma and
anisocoria, opisthotonus or hypotonia, seizures hydrocephalus.
(Fig. 14.12) and coma.
Other body systems are commonly affected. Diagnosis
Respiratory signs can include periods of apnoea, Diagnosis relies on history and clinical signs and
abnormal breathing patterns or barking vocalisation ruling out other conditions. Clinicopathological
(rare), shallow tachypnoea and/or dyspnoea. Some abnormalities reflect the presence and severity of
of these signs relate to abnormal central control of complications such as sepsis and organ dysfunction.
breathing rather than primary respiratory disease. Progestagen concentrations can also be measured;
In foals that become recumbent or develop second- however, this is not used routinely at this time.
ary sepsis, primary respiratory disease with atelecta-
sis can occur. This leads to respiratory dysfunction Management
from a mismatch in ventilation and perfusion. The majority of foals with NMS will survive if given
Gastrointestinal signs are also common and range early and appropriate supportive care. Once foals
from mild colic to severe ileus. Some foals sim- have developed secondary complications, such as
ply have reduced intestinal transit time and faecal sepsis, the survival rate decreases. Early supportive

14.11 14.12

Fig. 14.11 A foal showing classic early signs of NMS Fig. 14.12 A foal showing seizure activity.
with no affinity for the mare and a protruding tongue.