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Physical Exam of the Equine Neonate
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For normal post-foaling parameters see Normal Equine Labor, Delivery and Newborn Foal Vital Signs.
I. History
- Mare current and past pregnancy complications.
- Parturition - Duration - Complications.
- Post foaling times for standing, nursing, etc.
- Medication or procedures performed post-birth.
- Umbilical care.
- Meconium passage.
- Urination observed.
- Environmental factors - Infectious disease present, previous farm problems.
- Short form for neonatal post birth evaluation.
II. Examination of Foal - Record all Findings
- Observe from a distance initially.
- Note degree of alertness and maternal interaction.
- Assess general conformation. Watch movement and gait and look for evidence of pain or lameness.
- Observe respiratory rate and character.
- Normal is 30-40 breaths/min if environmental temperatures are moderate.
- May be 60-80 with high environmental temperature.
- Small abdominal component of breathing cycle at end expiration is normal.
- Marked abdominal component with flared nostrils and exaggerated rib retractions or grunting is abnormal.
- Premature foals can exhibit abnormal paradoxical breathing pattern consisting of inward motion of the rib cage during inspiration out of phase with outward motion of abdomen.
- Recall metabolic acidosis and response to pain causes increased respiratory rate.
- Evaluate size and maturity with regard to stated gestational age.
- Observe for "milk face"
- Milk from full, non-nursed upon mammary gland may run onto foal's forehead.
- Obtain temperature, pulse and respiration of the restrained foal.
- Pulse normal 80-120 beats/min.
- Temperature 99-101.8°F (37.2-38.8°C).
- High environmental temperatures can alter the foal's afternoon temperature
- A.M. temperatures are best used for daily comparisons using a temperature chart.
- Immediate post-birth rectal temperature can fall to 98.6°F.
- Shivering in cold environments is normal for 3-4 hours to generate heat.
- Systems exam: Start at the head.
- Cardiovascular
- Mucous membranes - Normally pink and moist.
- Not a good indication of degree of oxygenation of blood.
- Scleral injection seen with toxemia or conjunctivitis.
- Petechial hemorrhage - Normal to have episcleral hemorrhages from pressure of birth canal. Abnormal on gums, tongue, palate, vulva or pinnae of the ears.
- Icterus, if severe suspect neonatal isoerythrolysis or liver problem.
- Capillary refill time 1-2 seconds.
- Arterial pulse quality.
- Normal is just detectable - Use fingertips, check at facial, brachial and great metatarsal.
- Jugular pulses are abnormal.
- Assess jugular distensibility, should fill up briskly if not hypovolemic.
- Murmurs.
- Common to hear a holosytolic grade I-IV murmur at left heart base over third intercostal space for up to one week, believed associated with ductus arteriosus.
- Louder murmurs with palpable thrills associated with congenital defects. (See Congenital Cardiac Anomalies)
- Blood pressure [1].
- Doppler tail method in lateral recumbency day 1 systolic 81 ± 10 mmHg, diastolic 35 ± 7 mmHg, day 7 systolic 104 ± 21 mmHg, diastolic 40 ± 14 mmHg.
- Distal extremities and ears should be warm with adequate circulation in a neutral thermal environment.
- Respiratory system
- Ausculted sounds are louder than in adult.
- Increased rates may produce abnormally loud and harsh sounds.
- Inspiratory sounds louder than expiratory normally.
- May hear air moving over entire lung field with no wheezes or dullness and find significant abnormalities in a thoracic radiograph from interstitial disease or edema.
- Down lung in premature foals can become quieter and congested just from body position.
- Changes in respiratory rate over time may indicate increased compromise of respiratory function as well as pain, environmental temperature response, metabolic responses or transient tachypnea syndrome.
- Best pulmonary function test in veterinary medicine is an arterial blood gas.
- Oxygen levels reflect respiratory component.
- CO2 levels reflect ventilation component
- Coughing as a symptom is not a common component of severe pulmonary problems in neonatal foals.
- Always evaluate patency of airway in a respiratory distress situation.
- Gastrointestinal System
- Examine oral cavity for bite, cleft palate, and pharyngeal paralysis.
- Observe nursing behavior and swallowing.
- Check medial canthus of eye and skin for meconium staining which may indicate in utero stress.
- Gut sounds - Normal to hear gurgling in four quadrants.
- Right and left ventral and right and left dorsal abdominal areas.
- Observe any abdominal distension - Can be associated with:
- Impending enteritis or ileus.
- Colonic torsion or volvulus if painful.
- Gastric distension associated with over feeding in premature foals.
- Obstruction from high meconium impaction or GI congenital defect.
- Uroperitoneum associated with ruptured bladder or urachus.
- Fulminating peritonitis.
- Check for passage of meconium (dark brown to black) and patency of GI tract.
- Ileocolic aganglionosis, overo-overo breeding (white foals).
- Atresia ani or coli in any breed.
- Genitourinary System
- Urination usually occurs by 8.5 hours.
- Specific gravity low 1.001-1.01
- Urethral mucous plug in some males. Attempt to urinate - Improves following catheterization
- Persistent preputial ring in males. Inability to extend penis.
- Vulva and clitoris, abnormalities are enlargements possibly reflecting chromosomal problems.
- Check scrotum for both testicles and for scrotal hernia.
- Umbilical Region
- Size, heat, tenderness, moisture, edema.
- Should learn normal appearance for age.
- Consider ultrasound (See Ultrasonography of the Fetus and the Neonate).
- Patent urachus
- Moist hairs around navel or urine scald on inside of legs.
- Palpate for hernia.
- Eye - Use Penlight and Ophthalmoscope
- Check for ulcers or uveitis.
- Congenital lesions - Cataracts, etc. (See Congenital Anomalies and Genetic Disorders)
- Pupils should be equal, large and circular in one day old foal and become small and more oval by one week of age.
- Pupillary light response can be sluggish if foal is excited and has sympathetic override.
- Menace response is lacking in normal foals until two weeks of age.
- Entropion is common in ill and premature foals.
- Musculoskeletal System
- Conformation - Avoid being over critical in first 12 hours of life.
- Observe motion and gait.
- Contracted tendons and weak flexor tendons often improve within a few days.
- Angular limb deformities if not severe are best reevaluated in a few days.
- Check joints and physes for heat, swelling or pain.
- Fractured ribs at birth - Check closely.
- Passive range of motion is increased along with greater fetlock drop in premature foals. May correct remarkably well if left alone and foal can nurse.
- Wry neck and face. May correct somewhat if left alone and foal can nurse.
- Scoliosis and kyphosis often associated with contracted limbs.
- Neurologic System [2,3].
- General attitude and behavior - Foals are normally "hyper", swift and "jumpy".
- Stands within 2 hours.
- Recognizes mother and mammary glands.
- Usually easily aroused by individuals; however, can deeply sleep and require stimulation to rise, especially after 2 weeks of age.
- Cranial nerves.
- Optic nerve II.
- Pupils - Normal unless excited.
- Trigeminal nerve (V) foals are hypersensitive and overreact compared to adult to tactile stimuli.
- Palpate temporal, masseter and digastricus for symmetry.
- Facial nerve (VII).
- The ear, eyelid, lip and nostril reflexes (V sensory - VII motor).
- Same as adult but jerky.
- Vestibulococlear (VIII)
- Can hear at birth but exaggerated jerky response.
- Vestibular nystagmus (normal) with head movement seen at birth.
- Glossopharyngeal (IX), vagus (X), spinal accessory (XI).
- Ability to swallow - Check with tub
- Milk in nostrils may be weakness, cleft palate or temporary pharyngeal paralysis syndrome.
- Feeding requires [2]: swallow (IX, X, XI), reflex lip movement (VII), jaw (V), and tongue (XII), and recognition -sight (II), and awareness of dam (cerebrum).
- Hypoglossal nerve (XII)
- Many foals hang tongue out of mouth, normal (behavioral) if the tongue is retracted when stimulated by touch.
- Unique reflexes of the neonatal foal [2].
- Flexor or withdrawal reflex causes crossed extension of the contralateral limb up to 3 weeks of age.
- Patellar reflex is brisker and more exaggerated and can be followed by clonus in neonatal foals.
Neonatal Post Birth Evaluation Form
Mare: ___________________________________ Date Last Bred: _________________________________
Sire: ____________________________________ Expected Foaling Date: ___________________________
Date Foaled:________________________ Time Foaled:_________________________________________
Sex:________________ Color:______________________________________________________________
MARE:
History of Previous Foal Problems: __________________________________________________________
History of Problems During Pregnancy: ______________________________________________________
Assistance Required: ____________________________________________________________________
FOAL:
Time to Stand: _______________________________________ Chlorhexidine: ____________________
Time to Nurse: ________________________________ Enema: ________________________________
Meconium Passage: ___________________________________________________________________
Colostrum Absorption __________________________________________________________________
Urination Normal: ________________________ PCV: _______________________
Colostrum Harvested: ____________________ CSG: ______________________
MARE:
Placenta Passed: ________________________ Temporary Vulvar Closure:____________________
Placenta Condition: ______________________ Milk Let Down: _____________________________
Premature Separation?: ____________________________________________________________
Foal Examination Concerns:
Laboratory Data Requested:
Level of Observation Requested: ___________________________________________________
Recheck In: _____________________________________________________________________
DATE _______________________________ TIME ________________________
COMMENTS _______________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
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How to reference this publication (Harvard system)?
Affiliation of the authors at the time of publication
School of Veterinary Medicine, University of California-Davis, CA, USA.
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