Transport of the Critically Ill Equine Neonate

Proper care during transport is required for the successful outcome of the ill or premature foal that needs to be moved to a facility for constant nursing or intensive care.

I. Problems That Must Be Dealt With During Transport [1]

1. Restraint and protection from trauma.

1. Leave the mare initially if the recumbent or weak foal cannot have a protected area in the trailer to avoid being knocked down or stepped on by the mare.
2. Have a person ride with the foal to prevent trauma to the head, eyes, and limbs and to give medication, if necessary.
   Editor's Comment - Put a very weak foal in the cab of the truck and turn on the heater. Have someone else drive!
3. Wrap distal limb extremities.
4. Place on protective bedding (not sawdust unless covered).

2. Hypoglycemia in recumbent or weak foals.

1. Check a dextrose strip for whole blood glucose determination.

1. If less than 40 mg/dl (2.2 mmol/l) and the trip is long, place an IV jugular catheter and run warmed Lactated Ringers with 1% dextrose (add 20 ml of 50% dextrose into 1 liter of LR) and administer at 200 ml/hr/50 Kg.
2. IV bolus of dextrose may produce hyperglycemia and subsequent rebound hypoglycemia.

2. Administer 8 oz. (240 ml) mare's milk (colostrum) if no gastric reflux is present.
3. Send colostrum, if available at the farm, if the foal is less than 16 hrs of age.

3. Hypoxia

1. Administer oxygen if -

1. Respiratory rate <30 (respiratory depression) or >80 respiratory rate and obvious respiratory distress is present.
2. Mucous membranes pale or cyanotic.
3. History of conditions which could have produced some degree of asphyxia.

2. Methods

1. E tank O2 will supply approximately 1 hour of oxygen at 5 liters/minute.
2. Face mask such as 1/2 gallon jug cut in half, can be used. Allow room for exhaled air to escape.
3. Nasopharyngeal catheter - A Harris edema flush tube or plastic IV line cut to length can be used. Tape to the nose or suture to nostril with the end of the tube positioned in nasopharynx.
4. Rate 5-10 liter/min of 100% O2.
5. Provide humidification of the oxygen if used longer than 2-3 hours.

3. Attempt to maintain sternal recumbency for most efficient respiration. If the foal cannot be kept sternal, rotate sides every hour.
   Editor's Comment - Sternal position can generally help blood oxygenation.

4. Hypothermia - Check temperature: if <99°F (37.2°C)

1. Place in warm draft free vehicle if possible.
2. Insulate area below recumbent foal.
3. Wrap in warm blankets.
4. Place down vest or sweater on the foal with front legs through the armholes or sleeves.
5. Place hot water bottles or gallon jugs adjacent to foal (insulate bottles/jugs to prevent burns).

5. Seizures

1. Administer Valium® (diazepam)(0.1-0.2 mg/kg (5-20 mg/50 kg foal) IV slowly or Midazolam 0.1-0.2 mg/kg (start with 5 mg/50 kg) to effect.
2. Recurrent seizures -place IV catheter and instruct on the administration of diazepam during transport if attendant is capable. Record medication use in log.
3. Always check blood sugar.
4. Do not use acepromazine or xylazine because they cause hypotension and depression, and acepromazine lowers threshold for seizures.

6. Consider antimicrobial therapy if delay is going to be more than a few hours to clinic.
7. Record vital parameters (TPR) on paper and send foals and mares pertinent history.
8. Place placenta in plastic bag and send with foal along with blood from dam in red (plain) and purple (EDTA) top tubes.

Arrange to bring the mare to supply milk if the foal was shipped separately.