What to Do with the Septic Foal

PHYSICAL EXAMINATION FINDINGS When examining a sick neonatal foal, think sepsis until proven otherwise! It is the leading cause of morbidity and mortality in this population, thus should never be far from your mind. Initial clinical signs can be vague and vary widely but frequently include depression, decreased or absent suckling, and lethargy, which may progress to recumbency. Dehydration becomes a more significant problem as time progresses; tachycardia and tachypnea are common. The mucous membranes often develop a bright or injected appearance and the capillary refill time may be rapid. Rectal temperature may be normal or mildly increased. Hypothermia can be associated with advanced sepsis or moderate to severe prematurity. Diarrhea is common in foals with sepsis (and no other evidence of enteric pathogens) and can be the primary presenting complaint. Other localizing signs include uveitis, seizures, joint effusion, lameness, respiratory disease or distress, subcutaneous abscesses, patent urachus, and omphalitis. It is important to note that many foals with umbilical remnant infection and/or abscessation often have normal external umbilical structures. Thus, ultrasonographic examination is recommended in any presumed septic foal.