MSU CVM Weeks 3 and 4

The last few weeks have been busy at the MSU Large Animal Hospital. We have had many outpatient appointments for lameness exams and joint injections. My primary role is to help the technician who is working with inpatients do hourly treatments. This includes cleaning stalls, feeding and watering, monitoring vitals, hanging IV fluids, refluxing colic horses via nastogastric intubation and administering fluids, walking and grazing patients, etc. I have learned a lot the last month. Starting next week I will be moving from the day shift to the night shift, where I expect to see more emergencies.

An interesting case that has come in early Wednesday morning is a newborn foal that had experienced substantial blood loss from his umbilicus, and was also exhibiting signs of being a dummy foal. At presentation, he was in hypovolemic shock from the blood loss and had a packed cell volume of 12%. IV fluids were administered, while blood work was submitted and a feeding tube was placed. He then received a 1 L blood transfusion using his dam as a donor. He was placed in a stall adjacent to his dam, with a window between the stalls so that she could see him. We began feeding the foal every two hours via the tube with milk from the dam, while the foal continued on IV fluids. After a few times milking the mare, she became very averse to the process and nearly kicked me, so we discontinued milking her for the time being and supplemented the foal with goat's milk. Wednesday afternoon we planned to perform another blood transfusion from the dam. We sedated her for the procedure, but found that the foal's packed cell volume had increased to 24%, meaning he did not need another transfusion at this time! However, we took advantage of the dam's sedated state and were able to milk 1100 ml from her. Wednesday evening the foal was able to stand with assistance, however he continued to attempt to nurse inappropriately. Dummy foal syndrome, also known as neonatal maladjustment syndrome,  is seen in foals less than 72 hours old and involves neurological signs ranging from severe such as seizures to mild such as inappropriate behavior (Diesch and Mellor 2013). This foal was suckling very inappropriately, including attempting to nurse from the blankets in his stall, the wall of the stall, etc. Today, he is able to stand with assistance for longer periods of time. If he continues to do well throughout the day, the plan is to attempt to reintroduce him to his dam this afternoon and assist him with appropriate nursing.

Additionally, many colics have been in and out of the hospital the last two weeks. I have been able to get quite a bit of practice refluxing horses and administering fluids via a nasogastric tube. After today's shift is over, I am off work until Tuesday evening, when I begin my month on the night shift.

Diesch, T.J. and D.J. Mellor. "Birth Transitions: pathophysiology, the onset of consciousness and possible implications for neonatal maladjustment syndrome in the foal." Equine Vet J 2013 Nov; 45(6): 650-60.