Neonatal Intensive Care: What It Involves and Is It Worth It?

What is involved?
Intensive care for neonatal foals requires several inescapable ingredients: 1) the philosophical commitment of the entire practice to provide ICU services; 2) trained technicians to provide round-the-clock nursing care and patient monitoring; 3) climate controlled environment equipped with ‘foal-friendly’ fluid and oxygen delivery systems; 4) laboratory services capable of providing same day haematology and biochemistry results; 5) continuing education for mare/foal owners. Common conditions afflicting newborn foals include neonatal encephalopathy, septicaemia, dysmaturity, limb deformities, enteritis and colic. Sick newborn foals are like slowly burning fuses. Regardless of what disorder ignites the process, once a neonate stops nursing the downhill spiral escalates due to metabolic instability, multi-organ system failure and disruption of normal post partum adaptive processes. Successful outcomes depend on rapid diagnosis and treatment of specific diseases while managing secondary hypothermia, hypoglycaemia, hypoxia, hypotension, septicaemia, seizures and complications associated with recumbency.

The level of foal care varies from basic supportive nursing care including short-term O2 support and i.v. fluid and antimicrobial therapy provided on the farm to 24/7 nursing care in a clinic ICU capable of providing continuous fluid, nutritional and respiratory support and patient monitoring. In the latter environment, the most critical component is skilled nursing staff capable of obtaining venous and arterial samples, placing i.v. catheters and oxygen cannulas and intubation. Since NICUs are seasonal, a popular strategy for many practices is to support a critical core of skilled nurses year-round and hire a reliable team of seasonal ‘nursing assistants’ and volunteers during the foaling season. [...]