Sv: Dummy föl
Håll hoppet uppe, jag hittade detta skrivet av en amerikansk veterinär. Jag översätter sista raderna:
75% av fölen återhämtar sig och växer upp till normala vuxna. Generellt sett ser man förbättring varje dag. De mer påverkade fölen kan behöva 5-7 dagar innan de kan hitta sin mamma och dia. Mindre påverkade föl är okej inom 48 tim.
Prognosis for HIE is fair to good if uncomplicated by sepsis; ~75% of HIE foals recover and grow to be normal adults. Generally, improvement is seen each day. The more severely affected foals may take 5-7 days before they are able to recognize their dam and suckle. Less severely affected foals may recover in 48 hr.
Hela texten:
Hypoxic ischemic encephalopathy (HIE) is a term used to describe a variety of behavioral disturbances in the newborn foal.
Pathogenesis:
HIE is noninfectious and thought to result from some degree of asphyxia (decreased oxygen delivery to tissues) during birth. The resulting hypoxia causes varying degrees of CNS tissue damage, depending on the age of the fetus and the severity and duration of the hypoxia. Partial prolonged asphyxia may be associated with the development of cerebral edema, focal hemorrhage, and necrosis. It has been proposed that fetal asphyxia may result in accumulation of toxic concentrations of excitatory neurotransmitters (eg, glutamate, aspartate), which allows intracellular influx of sodium and chloride and passive flow of water, leading to neuronal swelling. The production of oxygen free radicals as well as reperfusion injury may also play a role in the pathogenesis of HIE. Perinatal asphyxia may be strongly suspected in cases of dystocia or generalized placental pathology, but could remain unidentified if in utero placental separation occurs.
Clinical Findings:
Many different abnormal behaviors may be grouped under the diagnosis of HIE. Signs range from a slow suckle response at birth to hyperexcitability, aimless wandering, depression, recumbency, generalized hypotonia, and seizures. This may reflect different degrees of asphyxia and CNS pathology. In the classic syndrome, the foal appears normal at birth and progressively loses interest in its dam, loses its suckle reflex, becomes recumbent, develops clonic seizures, and may start vocalizing. The vocalization has been described as that of a barking dog, hence the term “barker” foal.
Diagnosis:
Because the signs of HIE are seen soon after birth, it is often associated with failure of passive transfer of antibodies, which can lead to septicemia. There are no definitive blood chemistry or WBC abnormalities that aid in diagnosis, but these tests are helpful in eliminating other causes of the clinical signs. Other clinical syndromes that can present with similar signs and must be differentiated from HIE include hypoglycemia, electrolyte and acid-base derangements, septic meningitis, head trauma, cerebral bleeding, and congenital CNS defects.
Treatment:
The management of HIE is supportive. Providing warmth and nutrition is essential. If the foal does not have a suckle response, an indwelling nasogastric tube should be placed and the foal fed mare’s milk or a mare milk substitute at 15-25% of its body weight over each 24-hr period. Lactated Ringer’s solution plus 5% dextrose IV will ensure hydration and adequate glucose levels. If the foal did not receive adequate colostrum, a plasma transfusion is indicated. Although HIE is not infectious, foals should receive antibiotics to prevent secondary infections.
Seizure control is imperative. Diazepam (0.11-0.44 mg/kg) is usually effective. This dosage can be repeated as needed, but if longterm control is required, phenobarbital (2-10 mg/kg, IV, bid-tid) can be given. Dimethyl sulfoxide (1 g/kg in a 10% solution, IV) may be used as an adjunct to decrease cerebral edema. Mannitol (1 g/kg as a 20% solution, IV) has been proposed for similar reasons, but it should be used with caution due to the common presence of subdural hemorrhage in these foals.
Self-trauma can be a problem during seizures and can be prevented by providing a protected or padded environment and a human holder to cradle the animal. These foals are especially susceptible to eye trauma and corneal ulceration during their seizures; fluorescein staining and subsequent ocular treatment are often important.
Prognosis for HIE is fair to good if uncomplicated by sepsis; ~75% of HIE foals recover and grow to be normal adults. Generally, improvement is seen each day. The more severely affected foals may take 5-7 days before they are able to recognize their dam and suckle. Less severely affected foals may recover in 48 hr.