SAEVA Proceedings 2016 | Page 205

  Fresh grass, cocoa powder or the use of domperidone (1.1mg/kg po SID) may increase dam lactation. If fresh mare’s milk is not available then the next best thing is frozen mares milk, followed by goat’s milk, followed by commercial replacers. If commercial replacers are used, ensure consistency in mixing up. It may be prudent to start at 50% strength when initiating enteral feeding. Ensure excellent hygiene; boil water, sterilise equipment (baby ‘Milton’ is excellent for this), and store premade milk in the fridge for up to 48 hours only. The method of administration depends on many clinical factors including mental status and gastrointestinal function. Options include bottle feeding, bowl feeding, stomach tubing and indwelling feeding tubes. Beware the dummy foal that has an overzealous but un- coordinated suck reflex. These foals are at a high risk of aspiration pneumonia if bottle fed by inexperienced hands. Indwelling feeding tubes are tolerated well and can easily be placed under diazepam sedation with the use of endoscopy or radiography to ensure correct positioning. These are then sutured in place to the nostrils and forehead with tape around the muzzle to help secure. Bowl feeding is much safer than bottle feeding but it can be frustrating and time consuming at first with the dummy foals, especially the colt foals. The most common problem with providing enteral nutrition is over feeding. Aim to initially provide 5% body weight over the first twenty four hours, divided into 12 2 hourly feeds (200ml q. 2 hrs) then increase up to 10% of body weight throughout the second day, then increase this to 25% body weight/24hrs over the next couple of days. The normal healthy TB foal should gain approx. 1-2kg per day. Ideally the neonatal foal should not go for longer than 3 hours without feeding. Glutamine, a non essential amino acid in the healthy foal, becomes important in disease states. Enterocytes can extract glutamine directly from the GI tract and require it for healthy enterocyte regeneration. There is a large body of evidence demonstrating improved long term outcomes when humans in critical care are supplemented with glutamine. Glutamine is relatively cheap and easily available from health stores. The author recommends 10-20g over 24 hours, added to enteral feeds. • • • • • 0-1 week of age feed every 2-3 hours 1-2 week of age feed every 3-6 hours. SICK foals need more frequent feeding 2-4 weeks of age feed 3-6 feedings per day. Begin offering creep feed and small quantities hay 4-6 weeks 2-3 feedings per day. Increase solid food intake >6 weeks stop feeding milk/ milk substitute if solid intake adequate There is conflicting evidence for the use of gastric acid modifiers in the neonate. If enteral feeding cannot be tolerated, parenteral nutrition should be considered. This will require infusion pumps or controlled IV giving sets, 15-­‐18  February  2016      East  London  Convention  Centre,  East  London,  South  Africa     204