Equine Connection-Spring 2011 - University of Minnesota College ...

CARE & TREATMENTPremature and dysmature foals require round-the-clock careAfull-term equine pregnancy lasts340 to 360 days–nearly a year.Foals born prior to the 340-daymark can be premature. Prematurity oftenoccurs in twins, foals that developedinfections in the womb, and mares withabnormal placenta.It is important for breeders to recognizesigns of prematurity immediately, becausepremature foals are at high risk of rapidlydeveloping severe medical complications.Signs of prematurity include small size,low birth weight, domed forehead, floppyears, silky coat, lax tendons, and poormuscle development.Sometimes, these signs are also seen infoals born after 340 days. In this case,the foal is considered “dysmature.”Dysmaturity may be due to a lack ofnutrients reaching the foal, placentalinsufficiency, hormonal alterations, orother unknown factors.Many times, premature and dysmaturefoals seem bright and active for afew hours after birth, but this can bedeceptive, because they can rapidlydevelop complications. One complicationis a drop in energy level and a rapidincrease in breathing. This is often due toa lack of lung maturity in premature foals,which limits oxygen delivery to theirtissues and puts them at risk for suddenrespiratory distress. These foals are incritical need of oxygen and treatment inan intensive care facility.Another early sign of prematurity in foalsis laxity in their limbs upon standing.The foal’s front knees often seem to flexbackwards, and their fetlocks may extendfar enough to touch the ground. Standingand walking can put premature foals atrisk for crushing immature bones in theirknee and fetlock joints. These bones areoften poorly calcified, and damagingthem can lead to limb deformity, chronicarthritis, and limited potential for futureathletic performance.Lax tendons and poor muscledevelopment in premature foals oftenmeans that the foals may not be able tostand on their own and suckle adequately.Without assistance, they will not getcolostrum, the antibody-rich milk a mareproduces immediately after birth thatenables the foal to fight infection. A weaksuckle reflex may also impair their abilityto get colostrum and result in aspiration ofmilk into the lungs and pneumonia. Evenif foals suckle to obtain enough colostrum,it may not be well-absorbed by the foal’simmature gut, predisposing them toinfection, including pneumonia and septicjoints.Recognizing signs of prematurity andgetting a full examination by a veterinarianas soon as possible are important stepstoward minimizing future complications.Most often, premature and dysmaturefoals require hospitalization and 24-hourneonatal critical care. The round-the-clockmonitoring and continual veterinary carethat these foals need is beyond what mostbreeders or owners can provide.Veterinarians at the University ofMinnesota Veterinary Medical Center’sneonatal intensive care unit immediatelyand continually assess foals for signs ofrespiratory distress, infection, dehydration,malnutrition, and intestinal dysfunction.Oxygen therapy, broad-spectrumantibiotics, intravenous fluids, andassistance to nurse hourly or placementof a feeding tube are common therapiesprovided for premature and dysmaturefoals. A “foal team” in the intensive careunit provides support and monitoringfor the foals at all times, and veterinarytechnicians and doctors monitor vitalsigns and hydration status every hour.Radiographs are taken upon arrival todetect the extent of ossification of hockand carpal bones. Support for the legs,such as the casts pictured on the twin foalsbelow, and restricted time standing can beimplemented to try to prevent permanentdamage to the foal’s small cuboidal bones.Constant attention and familiarity withthe foals in the intensive care unit are keyto making the continual adjustments totherapy necessary to save these precariouslives. Owning a premature foal can bean emotional roller coaster, as the foal’sstatus can fluctuate for several weeks untilits condition stabilizes.Recognizing the premature or dysmaturefoal at birth and knowing where 24-hour intensive care can be obtainedare important to survival for thesefoals. Despite the risk associated withprematurity and dysmaturity, these foalscan survive and thrive as future athletes.Twin foals receiveintensive care at U of MIn May 2010, the University ofMinnesota’s Large Animal Hospitaladmitted twin foals to their neonatalintensive care unit. The twins hadclear signs of prematurity. The ownerrecognized the problem soon after theywere born and immediately broughtthem to the U of M for care. In theneonatal ICU, they received constantnursing care and therapy, includingintravenous nutrition, antibiotictherapy, oxygen, fluid therapy, bloodtransfusion from Hercules, splinting ofthe legs, and restricted exercise. Dueto the early recognition of the clinicalsigns by the owner and the intensivecare provided by the University ofMinnesota, William and Henry weredischarged after 20 days and continueto do well at home.7