Patient Profile
Premature Foal Needs Special Care
 Anne Wooldridge, DVM
Equine Medicine Resident
The Allens never expected that their Quarter Horse mare, Juana Kai, would foal early because everything had been going fine.  When they found their new foal at 2:30 a.m. on February 9, 1999, he was tiny (60 pounds) and very weak.  The mare was pregnant for only 311 days before she foaled (normal is 330 days).  A foal born less than 320 days gestation is considered premature.  The foal was not nursing very well, and since he was so early, the mare had not made any colostrum (first milk) which is the only way that newborn foals get immunity against germs that cause infections.  His ears and lips were soft and droopy and his haircoat was very fine and silky indicating that he was not fully developed yet.  All four of his legs were crooked indicating that the bones in his legs were also not fully developed and ready to bear weight.  The foal traveled all the way to Baton Rouge from Arkansas.  When he arrived at LSU, Dr. Lais Costa, an internal medicine clinician, evaluated him.  “He was very weak and small and was already exhibiting signs of infection,” said Dr. Costa.  Infection is one of the biggest problems facing internal medicine specialists who care for foals like Juana Kai’s.  According to Dr. Costa, “When foals don’t receive colostrum, and when they’re weak and stressed, they become especially susceptible to bacterial infections.  These infections usually enter the bloodstream from enteritis, pneumonia, or a navel infection, or they can be born infected if the mare’s placenta is not healthy.”  The foal’s weakness and probable infection were the first problems that were addressed.  A group of faculty clinicians, residents, veterinary technicians, fourth-year students, and foal team members worked on the foal.  The foal was administered intravenous fluids and antibiotics through an IV catheter to restore his hydration and treat the infection.  He was also given a plasma transfusion.  Plasma transfusion is a major source of immunity for foals that do not receive colostrum.

 

The foal responded very well to initial treatment and became stronger and began nursing well.  The next problem that had to be addressed was the crooked legs.  Dr. Rustin Moore, an equine surgeon; Dr. Jorge de la Calle, first-year surgery resident; and Dr. Jeremy Hubert, second-year surgery resident, were called in to consult on correcting the orthopedic problem.  X-rays were taken of the legs and were evaluated by the orthopedic specialists.  “The bones in the foal’s knees and hocks were still mostly soft cartilage instead of bone because the foal was premature,” said Dr. Moore.  “When the foal places weight on his legs, the legs bow out to the side because of the soft bones and weak ligaments.  If this is not corrected, the foal’s legs will not grow properly, the soft bones will become deformed, and he will be crooked as an adult, if not lame.  To correct this problem, the legs need to be held consistently in a straight, supported position.”  Juana Kai’s foal was sedated and casts were placed on all four limbs from above the ankles to the elbows and stifles.  It was initially awkward for the foal to walk, but he soon learned how to run and then how to buck and kick.  He became so feisty, in fact, that he soon earned his barn name, “Damion!”  “Most of the newborn foals that come in don’t have names yet, so we get to know them for a few days and give them a barn name,” said veterinary technician Leslie Talley.  Ms. Talley is usually responsible for naming most of the foals because she spends so much time caring for them and holding them while doctors do unpleasant (in the foal’s opinion) tasks.  The other problem that Damion faced with his casts was that he was unable to stand to nurse on his own.  Everyone assisted Damion to stand up and lay back down every 30 minutes during the day, and at night a foal team member was on hand to help.

 

Everything was going well, but then Dr. Costa and the fourth-year student noticed that the foal’s navel was swollen and painful.  They evaluated the navel with ultrasound, and noticed that the structures on the inside were also enlarged.  The foal’s white blood cell count was also quite elevated.  An infection in the navel was suspected.  “Navel infections are serious because the bacteria in the navel can spread through the bloodstream to other areas, especially joints.  Joint infections can be life- threatening and career-ending for foals.  Antibiotics can be sufficient to treat navel infections, but surgery to remove the infected area is quicker and safer, especially when the foals have already been receiving antibiotics,” said Dr. Costa.  The surgeons were called in once again, and the foal was placed under general anesthesia and the navel structures were removed.  The foal did well after the surgery and did not develop any complications.

 

“Damion” went home on March 17, 1999, with leg bandages instead of casts and has grown up very well, with straight legs.  The Allens named him “CD Cajun Magic,” aka “Louie.”  They say he still sometimes acts like he’s possessed by “Damion.”  They were pleased enough that they want to bring Juana Kai to LSU this year so she can foal here and be closely monitored.