An important part of the recovery phase is physiotherapy and stimulation.
Time should be taken manipulating and stimulating foals. It is important to
assist the foal to stand and encourage them to move as soon as possible.
They should be taken out into the sun and fresh air on a regular basis.
Sick neonates are often long, complex cases and good record keeping is
essential. Changes in parameters are often insidious and trends are just as
important as absolute changes. Special record sheets should be maintained
and all lab data filed accordingly.
• Control of seizures
Diazepam is the author’s drug of choice to control seizures (5-10mg/kg i.v.).
This can be repeated upto 4 times.
Midazolam is preferred for CRI: add 45 mls 0.9% saline to 5 ml midazolam (5
mg/ml) administer at 2 – 6 ml/hour for a 50 kg foal.
Phenytoin is a useful drug in practice and may be used orally for long term
therapy. It alters membrane potentials and amino acid and neurotransmitter
concentrations. It inhibits the generation of repetitive action potentials
(10mg/kg po).
Gabapentin and allopurinol have also been used with some success.
•
Anti-inflammatories and antioxidants:
Magnesium sulphate - 50 mg/kg/hr for first hour then 25 mg/kg/hr for next 35 –
47 hours
Vitamin E – 10 iu/kg, SID, po
DMSO - 1 gm/kg in 10% solution over several hours for three days
Low dose hydrocortisone therapy (1.3mg/kg/day then 0.65 then 0.3, divided
into 4 hourly doses)
Mannitol - 0.25 - 1 gm/kg q4 hrs iv, 20% solution slowly. Mannitol can be
given if cerebral oedema is suspected although oedema is usually intracellular
so mannitol may not be very effective.
•
Analgesia and sedation
Foals do not tolerate pain well, and a multimodal drug approach will often be
required. There is a wide selection of NSAID’S available and discussion of
them is beyond the scope of these notes.
Benzodiazepines, as previously discussed will provide short term relief of
seizures and provide short term sedation.
Alpha 2 agonists may also be used in foals. Although the cardiopulmonary
effects of a benzodiazepine versus an α-2 agonist administered alone has not
been directly compared in the foal, in adult horses the benzodiazepines have
15-‐18
February
2016
East
London
Convention
Centre,
East
London,
South
Africa
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