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How I Ultrasound the Foal with the Acute Abdomen in the Field: What to Look for
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The approach to the ultrasound examination of the foal with signs of acute abdominal pain is similar to that used for the adult equine patient. There are some special circumstances and lesions that may be unique to the younger foal that need to be evaluated. The use of a high-frequency (5 to 7.5 mHz) probe – whether linear or microconvex – is sufficient for imaging most of the abdominal cavity in the young foal with good resolution of structures. This can be performed with the foal standing or in a recumbent position.
The ultrasound examination should proceed as with the adult patient by evaluating the ventral thorax and abdomen by passing the ultrasound probe dorsal to ventral along each intercostal space beginning just caudal to the triceps muscle on each side and progressing in a cranial to caudal fashion to the thigh. The exam is completed by then sweeping the ventral aspect of the abdomen to evaluate the umbilical structures and the urinary bladder.
Foals with abdominal pain and abdominal distension can have a variety of conditions:
- gas distension of the large colon in the foal with conditions such as meconium impaction or occasionally colonic tympany associated with early rotavirus infection,
- small intestinal fluid distension with small intestinal volvulus, or occasionally enteritis, ‐ peritoneal fluid accumulation with either uroperitoneum, hemoperitoneum, or peritonitis.
Gastric distension (Fig. 1) can be evaluated in the foal in a similar manner to that seen in the adult. Causes of gastric distension may include ileus with or without enteritis or small intestinal strangulation obstruction. Occasionally and usually in older foals, duodenal stricture (Fig. 2) associated with the gastroduodenal ulcer syndrome can be identified along the right side of the abdomen, and is helpful in confirming the need for surgical correction. In these patients, the amount of gastric distension may be profound (Fig. 2) – possibly leading to gastric atony later in the course of the disease. Ultrasound can be useful in confirming the proper location of the nasogastric tube when attempting placement for enteral feeding of a weak neonate or refluxing a foal with colic (Fig. 3).
Small intestinal obstructive disorders such as volvulus or entrapment in scrotal hernias will appear similar to that seen in the adult patient – with profoundly fluid-distended segments of small intestine occasionally with sedimentation of particulate material to the ventral aspect (Fig. 4). With the hernia, small intestinal segments may also be evident within the vaginal tunic.
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