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Protective mums a challenge in caring for ill foals

April 7, 2011

Around 3 to 7 per cent of newborn foals will have significant health issues in the first month of life, an expert says.

Pamela Wilkins with a patient. © L. Brian Stauffer
Pamela Wilkins, a professor of equine internal medicine and emergency/critical care at the University of Illinois, is the author of a new paper on equine neonatal intensive care.

Like any other newborn, the neonatal horse can be a challenging patient, she says.

Its immune system is still under construction, its blood chemistry can vary wildly, and - like most infants - it wants to stay close its mother.

These factors are magnified in the critically ill foal, explains Wilkins, whose paper, published in Clinical Laboratory Medicine, offers guidance to large-animal veterinarians and shows the very real challenges of the job.

Sickness can play havoc with a foal's blood chemistry, Wilkins said.

Teasing out the causes of these changes requires that the veterinarian first understand what is normal in a newborn horse, and then how it can go wrong.

To help address current gaps in knowledge, Wilkins regularly conducts blood tests or other tests, such as X-rays and CT scans, on healthy foals to determine how their body chemistry or physiology differ from that of an adult horse - or from that of a sick foal.

"Roughly 3 to 7 per cent of newborn foals are going to have some kind of significant health issue in the first month of life," Wilkins says. "And because our patients can't talk to us, we have to figure out what's wrong with them based on physical examination and testing and histories given by their owners."

The paper also offers guidance in the use of portable "point of care" devices to measure and monitor a sick foal's changing health status. Such tools can offer immediate results in the field and cut costs associated with care. But the practitioner needs to know how use each device and interpret the results, she says.

"For example, foals with severe infections can have a very, very low or a very high glucose level," she says. Low blood glucose could be the result of the foal not taking in enough nutrients from its mother. Or the animal may not be able to make use of the glucose that is already stored as glycogen in its body.

It is the veterinarian's job to find out what's going on, she says.

To do that, they must understand the normal fluctuations in levels of glucose and other biomarkers of health or disease, Wilkins says.

"Blood glucose levels are going to be different between the normal, healthy adult horse and the healthy foal," she explains. "And they're going to be different at different stages of the foal's life."

Hormones, immune cells, red blood cells, protein levels, enzymes and electrolytes all vary between the adult and the infant horse, she says, and many of these markers change as the foal matures and grows.

The challenges of treating sick foals do not end there, she says. A horse, even a foal, is a big, precocious animal.

"Horses are a prey species, so they have to be able to get on their feet and run pretty quickly after birth," she said. "The older and slower I get, the harder it is to approach them.

"You spend a lot of time on your knees dealing with them, and they can kick. I get bruises all over my body during foaling season and I have no idea where they're from because I'm focused on what I'm doing."

Add a protective mother to the equation, and the task gets even trickier.

"The mum needs to be there," Wilkins explains. "She gets really upset if she's not."

So when a foal comes into the hospital for critical care, the mother comes, too. And like any mother with a sick baby, she hovers.

"Figuring out a way to keep mum from pulling the intravenous (IV) lines out and getting upset when you're between her and the baby, that takes some doing.

"The mothers don't sleep; they don't lie down; they don't rest. They're on their feet with their heads hanging over their babies most of the time. So it's tough for them."

If a foal needs surgery, the medical staff will sedate the mother until the foal is back at her side.

Wilkins' patients may be the progeny of racehorses or performance horses, but many are also just people's pets, she says.

The cost of care can be high, so owners with a strong economic or emotional incentive are most likely to bring a critically ill foal to the hospital.

Despite the many challenges, Wilkins loves the work.

"Foals are just wonderful, wonderful creatures," she says. "I can't imagine working with anything else in my life."



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