Neonatal Intensive Care Unit
Intensive Care for Neonatal Foals
The Royal Veterinary College opened its first dedicated neonatal intensive care unit (NICU) for foals in 2004. Following the opening of the new equine surgery complex, two new intensive care units, one for foals and a separate intensive care unit for adult horses, have been opened in 2010. Building of the old and new units has been funded through the generosity of donors to the Royal Veterinary College Animal Care Trust. The units are dedicated to providing state of the art medical and nursing care for all critically ill patients in our hospital.
Transporting a Foal to the Royal Veterinary College
General rules for transporting foals for intensive care: Time really is of the essence for getting foals to a critical care facility so the fastest mode of transport available should be chosen. This is often the back of a car.
Even if a horse box is immediately available, a car may be preferable for severely compromised neonates, as it can travel more quickly.
The mare can follow within the next 24h without endangering the bonding between mare and foal. If available, the foal should receive oxygen during transport. Broad spectrum antimicrobials (for example cefquinome) should be given by the veterinarian intravenously or intramuscularly prior to referral as early antimicrobial treatment could enhance the chances of survival in septic foals. If transport time is greater than 60 minutes, and a veterinarian is present, the foal should be given one to two litres of fluid intravenously prior to transport if it can be accomplished quickly without delaying transport, for example using a short-stay catheter or needle.
Have your veterinarian call the hospital as soon as the decision has been made to transfer the foal, so that the full team is immediately available to attend to the foal. The phone number is 01707-666297.
A map giving the location of the Royal Veterinary College is available on the Hawkshead Travel Directions page.
Differential Diagnoses for Neonatal Foals:
Symptoms |
Differential Diagnosis |
Lethargy/ listlessness, increased time sleeping Slow to stand/nurse Difficulties standing/nursing No interest in mare/failure to follow mare |
PAS (Peri-partum Asphyxia Syndrome) Sepsis PAS + Sepsis |
Colic Abdominal distension Straining to defaecate |
PAS → Meconium retention/impaction → Enteritis/enterocolitis → Intussusception Sepsis → Enteritis/enterocolitis → Bladder rupture Small intestinal volvulus Other strangulating/non-strangulating lesions |
Diarrhoea |
PAS → Necrotising enterocolitis Sepsis → Infectious enteritis/enterocolitis Infectious enterocolitis → Sepsis → Lactose intolerance |
Changes in respiratory rate or pattern |
PAS → Aspiration pneumonia → Central hypoventilation → Persistent fetal circulation Sepsis → Disseminated pneumonia → Acute respiratory distress syndrome (ARDS) Rib fracture Aspiration pneumonia → PAS/Sepsis Neonatal isoerythrolysis → PAS Anaemia Prematurity → PAS Persistent fetal circulation → PAS Choanal atresia → PAS |
Neurological signs Head tilt Blindness Abnormal vocalisation Collapse Seizure Coma |
PAS → Hypoxic ischaemic encephalopathy → Severe electrolyte abnormalities Sepsis → Bacterial meningitis → Severe electrolyte abnormalities Hepatic disease Congenital malformation |
Abrasions on limbs/over joints Lameness Joint distension |
PAS → Trauma Sepsis → infectious arthritis/osteomyelitis/physitis Prematurity Trauma Tendon laxity/contracture Rupture of gastrocnemius muscle Congenital malformation |