Chest and abdomen radiographs can be obtained with portable machines and
used to aid in diagnoses and treatment plans- i.e. nasogastric tube placement.
Lung pathology, for example interstitial pattern, consolidation, atelectasis, fluid
accumulation, fractured ribs, can be determined. Abdominal radiographs can
reveal ileus, gas distension and meconium impactions.
Orthopaedic radiography can help screen for prematurity, joint sepsis,
physitis, physeal abscesses and fractures. If suspicious of bone sepsis and it
is not seen on initial radiographs, do not be shy in repeating radiographs 48
hours later.
Ultrasonography is great for neonatology and no neonatal exam is complete
without the ultrasound probe! Ultrasonographic evaluation of the chest can
reveal pleural fluid, abscesses and peripheral consolidation.
Chest
radiography may be more beneficial for deeper seated lesions. Abdominal
ultrasound can reveal ileus, increased free fluid, thickened mucosal walls,
adhesions, intussusceptions, bladder abnormalities and information about the
umbilical remnants.
Treatment
A definitive diagnosis does not always have to be reached and many disease
processes can occur together i.e. sepsis and HIE. It is important to determine
the need for therapy.
• Fluid therapy (covered in more depth by Dr Karin Kruger)
This is an essential part of treatment, aiming to:
improve perfusion and treat hypovolaemia (most commonly from septic
shock)
increase oxygen delivery to tissues
provide fluid therapy for maintenance requirements
replace on going losses (reflux, diarrheoa, blood loss)
correct acid base disturbances
meet sodium requirements
provide glucose
correct anaemia (blood transfusions)
improve oncotic pressure (use of colloids)
provide immunotherapy and normalize coagulation (plasma therapy)
Out in the field, fluid boluses are more commonly used as maintenance of
intravenous lines can be challenging, particularly if the foal remains in a stable
with the mare and owners/lay staff are left to monitor. This approach can be
used safely. The amount of fluid needed over the day, needs to be carefully
considered, particularly in foals with diarrhea where losses may be larger than
anticipated. The total amount of fluids needed should be calculated for the day
and then divided into bolus administrations depending on the condition of the
foal, logistics of the attending vet and capabilities of the owners/laystaff.
Ideally bolus administration should be limited to 1-2 liters per bolus. Fluid
choices should be dictated by the needs of the foal, but generally the sodium
15-‐18
February
2016
East
London
Convention
Centre,
East
London,
South
Africa
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