Date post: | 22-Jan-2018 |
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Science |
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Prematurity in foals
Rajeev Kumar MishraL2015M38M
COVS, GADVASU, Ludhiana
• A foal is considered premature if delivered before Day 320 of gestation.
• He has not been able to complete developing inside his mother's uterus.
Dysmature foals?????
• Low birth weight
• Small frame; thin
• Poor muscle development
• Flexor laxity
• Peri-articular laxity
• Hypotonia
• Short, silky hair coat
• Domed forhead
• Floppy ear
• Weak suck reflex
• Poor thermoregulation
• Gastrointestinal dysfunction
• delayed maturation of renal function
• Entropion with 2° corneal ulcer
• Poor glucose regulation
• Poor ACTH response
• Neutrophil : lymphocyte <1.0
• Poor cortisol level
Clinical characteristic of prematurity
Placental problems: twins, placentitis, premature placental separation.
Fetal problems: fetal sepsis (Herpes virus, EVA, ehrlichiosis, other bacteria), fetal malformation, hydroallantois, fetal placentitis (FIRS), etc.
Maternal problems: severe systemic disease, chronic debilitation, maternal placentitis.
Iatrogenic:
Early induction based on: inaccurate breeding dates, misinterpreting late term colic as ineffective labor.
Early C-section because of catastrophic medical problem in mare: fatal colic, fracture of major bone, progressive neurologic disease.
Idiopathic.
What’s the cause ????????
Condition with improved survival rate..
• -ve systemic disease in mare and +ve of suckle reflex.
• TLC > 500/µl
2
Treatment
• Mechanical ventilation
• Nasotracheal intubation
• Intratracheal surfactant administration
Respiratory system:
Abnormal behaviour…
• Inability to stand = Assist to stand and change
the side every 2 hrs
• Weak suck reflex = Nasogastric tube,
perentral nutrition
Abnormal homeostiasis
• Hypothermia = Raise ambient temperature
(Temp ≤ 37.2°c)
• Metabolic acidosis = hypovolemia isotonicHCO3-(PH ≤ 7.5) Adequate ventilation ensured
Haem concentration = maintenance fluid@80-120ml/kg
Hypoglycaemia (≤50mg/dl) = I/V dextrose
GIT dysmotility…
• Gastric reflux/ ileus = decrease feed load
oral/iv Perinorm
• Constipation = enema, oral mineral oil
psyllium husk P.O
• Diarrhoea = Oral proctants,
Active cultures
• Ulceration = aciloc@ 6.6mg/kg qid
sucralfate, avoid NSAID
Flexor laxity & Peri-articular laxity
• Inability to stand.
• Physical therapy
• Glue on Shoes with heel extension
• Restricted exercise on soft surface.
Hypogammaglobinaemia
• IgG ≤ 400-800 mg/dl.
• Oral colstrum, minimum of 1lt if < 18 hrs age.
• i/v plasma @20-40ml/kg
• Broad spectrum antibiotics
Cardiovascular support
• Premature foals often have poor or marginal cardiovascular function. This is primarily due to a lack of responsiveness of vessels to pressors. Careful use of fluid support and inotropes and pressors such as dopamine, dobutamine, epinephrine and vasopressin may achieve improvement of cardiovascular function.
Renal function
• The abnormal renal function is not a reflection of “premature kidneys.
• It is important not to fluid load these foals and then rely on diuretic therapy to rid the body of the iatrogenic fluid overload.
Prevention of self-trauma
• Protection can be afforded by deeply bedding the neonate or placing him on blankets, a mattress, etc.
• Keeping the foal dry is the key to avoiding development of decubitus ulcers.