Clinical Approach to the Neonatal Ill Foal

Introduction
Neonatal foals are in an adaptive stage where they are maturing and stabilising homeostatic mecha- nism. Disease can destabilise or reverse these processes. Early signs of disease tend to be vague and non-specific, and early diagnosis requires familiarity with normal behaviour (table 1). The clinician must be cognisant of normal parameters in the neonatal foal in order to diagnose and treat alterations. Close monitoring is essential as changes can occur very rapidly.
Mare’s general health, past pregnancies, current pregnancy and details of foaling should be checked.

History and clinical examination
Full term: 320-360 days, 341 for the TB, 333 for the pony. Abortion: <300 days.
Stillbirth: >300 days.
Premature: <320 days.
Dysmature: >320 days but with signs of prematurity. Normal foal behaviour may be indicated by: running away behind the mare when humans enter the stable, nursing frequently 5-7 times/h, although this may decrease when sleeping, being inquisitive and interacting with the mare when awake.

Physical examination
General maturity: signs of prematurity or dysmaturity: small bodyweight, silky coat, domed forehead, weakness and limb deformities.
Head: milk on forehead; off-suck/weak or excessive milk production. Milk from nostrils; cleft palate, dysphagia or generalised weakness. Jaw alignment.
Mucous membranes: icteric; haemolytic or septicaemia. Congested or petechiae: septicaemia. Cyanotic; low paO2-cardiopulmonary system.
Eyes: Hyaloid artery remnant often visible and of no significance. Scleral congestion, retinal haemorrhage; traumatic birth. Entropion ± corneal ulceration. Uveitis; bacteraemia. Congenital deformities, e.g. micropthalmia, cataracts. [...]