Neonatal Case Discussions

A 13 day old filly was admitted with a history of suspected trauma. On admission the foal was recumbent and blood was noted to be coming from the right ear with a marked turning of whole head to neck to the right and a head tilt to the right. Nystagmus and abnormal positioning of both eyes was present. The filly was quite bright and aware of her surroundings and would make unsuccessful attempts to stand. Hematology was normal.
Radiographs of the head revealed differences between the petrous temporal bones and although a distinct fracture line could not be identified a fracture or multiple fractures was suspected. Initial treatment consisted of broad spectrum antibiotics, NSAID’s, corticosteroids, fluid therapy and supportive care. The filly deteriorated neurologically over the following two days and on the third day an ultrasound examination of the atlanto-occipital space was performed which revealed a large blood clot.
The filly at this point was unaware of her surroundings, had bilateral dilated pupils and was unable to stand. Given the deterioration in her condition, the uncertain and likely poor prognosis and costs of ongoing indefinite therapy, it was decided to euthanize the filly. Necropsy examination demonstrated multiple fractures of the right petrous temporal bone, blood clots with the cranium and proximal spinal canal. […]