Page 1386 - Equine Clinical Medicine, Surgery and Reproduction, 2nd Edition

The foal 1361

VetBooks.ir and early use can have a positive effect on outcome. soiled areas and applications of barrier ointments. It
is also important to advise handlers of potential zoo-
Young foals with salmonellosis should be given anti-
biotics, because they usually have, or will develop,
contagious nature of some of the infectious causes of
sepsis. Antibiotic choice should be based on culture noses (Salmonella, Campylobacter) and also the highly
and sensitivity results where possible, but in many diarrhoea.
cases, owing to the delay in obtaining these results,
empirical broad-spectrum treatment is started on the Other drugs
basis of clinical judgement. It is important to under- Recent studies have suggested that the use of antico-
stand the pharmacokinetics of the antibiotics that agulants such as low molecular weight heparin may
are used, because any that are excreted or secreted be beneficial in cases of sepsis. Polymixin B can also
into the bowel after systemic administration, along be used as an antiendotoxic drug although its poten-
with those given orally, will be more likely to affect tial for nephrotoxicity should be considered (see
the intestinal flora. The toxic side-effects of antibi- Neonatal sepsis, p. 1340)
otics (e.g. nephrotoxicity with aminoglycosides) are
potentiated in the hypovolaemic foal. Control and prevention
The use of protective clothing, gloves and foot dips
Exogenous lactase enzyme will help reduce the spread of infection. Keeping
This should be given to foals with rotavirus, coro- each mare and foal in a designated stable through-
navirus or Cryptosporidium, and those with primary out treatment has been shown to reduce the build-
lactose intolerance or osmotic diarrhoea, to aid up of infectious disease. Stabling or using dedicated
in digestion. Exogenous lactase is administered at contaminated ‘dirty’ paddocks for scouring foals will
6,000–9,000 U/50 kg foal q3–8 h. help contain environmental build-up of infection.
A rotavirus vaccine is available for vaccination of
Feeding mares in the 8th, 9th and 10th months of pregnancy.
Milk is typically not withheld if the foal wishes to This vaccine increases antibody levels in the colos-
nurse but in severe cases of diarrhoea or in those trum and IgA in the milk during lactation but is not
with ileus or colic, 24 hours of dietary rest may be fully protective against disease.
required. During this time, intravenous glucose
should be administered, and blood glucose con- SEPTIC ARTHRITIS/OSTEOMYELITIS
centrations monitored. In severe cases, parenteral
nutrition may be necessary, because malnutrition Definition/overview
can significantly delay recovery, but this requires Septic arthritis/osteomyelitis is a common, poten-
a hospital setting. When the foal is off suck, bolus tially career- or life-threatening condition seen in
stomach tubing or, ideally, the use of an indwell- young foals. Up to 1% of foals were affected in a
ing feeding tube will allow the nutritional require- survey of Thoroughbreds, but the incidence today
ments to be met via the enteral route. It is important is likely to be somewhat lower, owing to a better
to evaluate whether the enteral route is appropriate understanding of joint disease and improved man-
in foals that are off suck with GI disease. In addi- agement practices. It may be part of other multifocal
tion, as the foal’s stomach is small, it must not be infections in some foals. The most critical period is
overloaded. A starting volume of 300–400 ml is the first 30 days of age, when the likelihood of devel-
appropriate for a Thoroughbred foal under 2 weeks oping septic arthritis is reported to be greatest. Early
of age. diagnosis and appropriate aggressive treatment are
the keys to a successful outcome.
Nursing
High standards of nursing and hygiene are impor- Aetiology/pathophysiology
tant with sick diarrhoeic foals. They should be kept Infection via the haematogenous route is most com-
clean, dry and comfortable, with regular cleaning of mon in foals. Infection can occur as a secondary