Referral To A Specialist Centre
Many diseases can be treated on the farm or in a first opinion clinic, but this depends
upon:
Facilities and manpower available for treatment and nursing
Ability and enthusiasm of personnel available
Ability and enthusiasm of the clinician
Condition of the mare and foal
Tolerance/availability of transportation
Financial implications of specialist referral
An early decision to refer is clearly better than undue delay.
There is little rational in referring a dying foal, with little or no hope of surviving the
journey. The referral centre will appreciate contact during the early stages of the
problem and are always willing to provide phone advice.
Referral should be considered seriously in many incidences. Ask yourself the
following questions:
• Do I have access to the correct drugs, fluids and catheters?
• Do I have access to suitable stomach tubes/feeding tubes/ replacement
feeds?
• Can I deliver humidified oxygen 24 hours a day?
• Can I provide 24 hour nursing care?
• Can I maintain body temperature and good standards of hygiene?
• Do I have the correct equipment and expertise to use them?
• Is there suitable experience to hand/ on the end of a phone?
• Is there another clinician to share the workload with?
• (Is the owner aware of the cost implications and risk factors?)
• Don’t refer on owners not willing to accept these risks and responsibilities!
If the answer is no to any of the above then referral should be the primary option.
Neonatal intensive units are a far cry from first opinion practice, however with the
inclination and facilities, good intensive care can be given to foals outside of referral
centres.
Thorough clinical examinations, the understanding of multi organ
involvement, continuous monitoring, treatment of presenting signs and excellent
nursing care can lead to positive, rewarding treatment of the equine neonate.
References
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Corley, K.T.T., (2002) Monitoring and treating haemodynamic disturbances in critically ill neonatal foals, Part 1 and 2:
assessment and treatment Equine Vet Ed 14 (6)328-336.
Corley, K.T.T., Donaldson, L.L., Furr, M.O. (2005) Arterial lactate concentrations, hospital survival, sepsis and SIRS
in critically ill neonatal foals Equine Vet J Jan;37(1): 53-59.
Dunkel B. and Corley K.T.T. Pathophysiology, diagnosis and
treatment of neonatal sepsis Equine vet. Educ.
(2015) 27 (2) 92-98 doi: 10.1111/eve.12234
Gardner, R.B., Nydam, D.V., Luna, J.A., Bicalto, M.L., Matychak, M.B., Flaminio, M.J. (2007) Serum opsonization
capacity, phagocytosis and oxidative burst activity in neonatal foals in the intensive care unit J Vet Intern Med. JulAug 2194) 797-805.
Proceedings
of
the
South
African
Equine
Veterinary
Association
Congress
2016
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