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Equine Neonatal Medicine
Equine Neonatal Medicine
University of Illinois Urbana–Champaign

Iowa State University
Pamela A. Wilkins
David M. Wong
Urbana, Illinois
Ames, Iowa
Edited by
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Library of Congress Cataloging-in-Publication Data applied for:
Hardback: 9781119617259
Cover Design: Wiley

Cover Image: © Steven Tian
Set in 9.5/12.5pt STIXTwoText by Straive, Pondicherry, India

Book Dedication
This book is dedicated to my wife, Kristine, and daughters, Olivia, Pip, and Estelle, and their steadfast support of me over the
years as an equine veterinarian; to Pam Wilkins, my emergency and critical care mentor and friend; to all my colleagues at
the Lloyd Veterinary Medical Center (Iowa State University), Marion duPont Scott Equine Medical Center (Virginia Tech),
and New Bolton Center (University of Pennsylvania) – it has been a pleasure to work together through so many foaling
seasons with you; and to all the mares and foals that we have had the honor to provide veterinary care to.
David M. Wong
I would like to dedicate this book to those who came before us, the editors of the original Equine Clinical Neonatology book,
Anne Koterba, Willa Drummond, and Philip Kosch, and to all our patients and dedicated veterinarians caring for them over
the generations since.
Pam A. Wilkins
vii
Contents
List of Contributors xiv

Foreword xix
Preface xx
Part I The Newborn Foal 1
Chapter 1 Postpartum Adaptation of the Newborn Foal 3
Section I Fetal Heart Rate and Fetal ECG 3
Section II Fetal Circulation and Cardiorespiratory Transition 8
Section III Maturation of the Lung and the Surfactant System 12
Section IV Onset of Breathing 26
Section V Control of Breathing 32
Section VI Renal Transition from Fetus to Newborn 37
Section VII Newborn Physical Examination 42
Chapter 2 Principles and Theory of Cardiopulmonary Resuscitation (CPR) 51
Chapter 3 The Premature and Dysmature Neonatal Foal 64
Part II Disorders of the Neonatal Foal 79
Neonatal Respiratory System 81
Chapter 4 Embryology and Anatomy of the Respiratory System 81
Chapter 5 Clinical Neonatal Respiratory Physiology 84
Chapter 6 Examination, Therapeutics, and Monitoring of the Respiratory System 90
Section I Physical Examination 90
Section II Thoracic Radiography of the Neonatal Foal 94
Section III Thoracic Ultrasonography of the Neonatal Foal 101
Section IV Advanced Imaging (CT, MRI) of the Neonatal Respiratory System 109
Section V Inhalation Therapy 117
Section VI Ventilator Therapy 126

viii Contents
Chapter 7 Congenital Disorders of the Respiratory System 140
Chapter 8 Respiratory Disorders 153
Section I Disorders of Breathing Pattern in the Neonatal Foal 153
Section II Lower Respiratory Tract Disorders 156
Section III Meconium Aspiration Syndrome 183
Section IV Persistent Pulmonary Hypertension of the Newborn 189
Section V Pneumothorax and Pneumomediastinum 196
Section VI Diaphragmatic Hernias 201
Section VII Miscellaneous Disorders of the Respiratory System 206
Section VIII Nonpulmonary Disease Processes Manifesting as Respiratory Disease 216
Neonatal Cardiovascular System 224
Chapter 9 Embryology and Anatomy of the Heart 224
Chapter 10 Clinical Neonatal Cardiac Physiology 232
Chapter 11 Examination, Therapeutics, and Monitoring of the Cardiovascular System 238
Section I Examination of the Cardiovascular System 238
Section II Echocardiography 244
Section III Advanced Cardiac Monitoring in Foals 259
Section IV Central Venous Pressure 268
Section V Cardiovascular Medications for the Neonatal Foal 273
Chapter 12 Congenital Heart Defects 284
Chapter 13 Cardiovascular Disorders of the Neonatal Foal 315
Section I Arrhythmias 315
Section II Pathophysiology of Shock Syndromes in the Neonatal Foal 323
Section III Catheter-Associated Thrombophlebitis 337
Neonatal Digestive System 343
Chapter 14 Embryology and Anatomy of the Digestive Tract 343
Chapter 15 Examination of the Digestive Tract 351
Section I Physical Examination of the Digestive System 351
Section II Abdominocentesis and Cytologic Evaluation of Peritoneal Fluid 354
Section III Ultrasonographic Examination of the Neonatal Foal Abdomen 357
Section IV Endoscopy of the Digestive Tract 369

Contents ix
Section V Radiography of the Alimentary Tract 374
Section VI Oral Lactose Tolerance Test and Oral Glucose Absorption Test 387
Section VII Liver Biopsy 389
Section VIII Diagnostic Tests and Fecal Analysis in the Neonatal Foal with Diarrhea 391
Section IX Nutritional Support 396
Section X Prokinetic Therapy in Foals 402
Section XI Endotoxemia in the Neonatal Foal 407
Chapter 16 Congenital Disorders of the Equine Gastrointestinal Tract 421
Chapter 17 Gastrointestinal Disorders 436
Section I Causes of Dysphagia in the Neonatal Foal 436
Section II Gastroduodenal Ulcer Syndrome and Ileus in the Foal 442
Section III Enteritis, Colitis, and Diarrhea 451
Section IV Peritonitis 471
Section V Meconium Impaction 482
Section VI Hernias 487
Section VII Intestinal Hyperammonemia 491
Chapter 18 The Acute Abdomen in the Neonatal Foal 495
Chapter 19 Hepatobiliary Diseases 525
Neonatal Endocrine System 543
Chapter 20 Endocrine Physiology in the Neonatal Foal 543
Section I The Hypothalamic-Pituitary-Adrenal Axis and Steroid Hormones 545
Section II Energy and Growth Hormones 556
Section III Thyroid Hormones 563
Section IV Hormones Involved in Blood Pressure and Blood Volume Regulation 567
Section V Hormones Involved in Calcium, Phosphorus, and Magnesium Regulation 573
Chapter 21 Endocrine Disorders in Foals 580
Section I Disorders of the Hypothalamic Pituitary Adrenal Axis and Neurosteroids 582
Section II Disorders of Energy and Growth Hormones 589
Section III Disorders of Thyroid Hormones 594
Section IV Disorders of Hormones Involved in Blood Pressure and Volume Regulation 599
Section V Disorders of Calcium, Phosphorus, and Magnesium Homeostasis 603
Section VI Diagnosis and Treatment of Endocrine Disorders 611

x Contents
Neonatal Urinary System 629
Chapter 22 Embryology and Anatomy of the Urogenital System 629
Chapter 23 Clinical Neonatal Renal Physiology 638
Chapter 24 Examination, Therapeutics, and Monitoring of the Urinary System 644
Section I Examination of the Urinary System 644
Section II Medications Acting on the Urinary System 654
Section III Renal Replacement Therapies 662
Chapter 25 Congenital Urogenital Disorders 670
Chapter 26 Renal Disorders in Neonatal Foals 676
Chapter 27 Urinary Tract Disorders 684
Neonatal Nervous System 705
Chapter 28 Embryology and Anatomy of the Neonatal Nervous System 705
Chapter 29 Physiology of the Neonatal Nervous System 712
Chapter 30 Examination, Therapeutics, and Monitoring of the Nervous System 724
Section I Neurologic Examination of the Neonatal Foal 724
Section II Cerebrospinal Fluid Collection and Analysis 730
Section III Electrodiagnostics in the Neonatal Foal 734
Section IV Intracranial Pressure Monitoring 739
Section V Medications Acting on the Neonatal Nervous System 741
Chapter 31 Congenital Nervous System Disorders 759
Section I Juvenile Idiopathic Epilepsy 759
Section II Lavender Foal Syndrome 763
Section III Cerebellar Abiotrophy 765
Section IV Deafness in Foals 768
Section V Occipitoatlantoaxial Malformation (OAAM) in Foals 770
Section VI Miscellaneous Congenital Disorders of the Nervous System 773
Chapter 32 Nervous System Disorders 784
Section I Infectious and Inflammatory – Bacterial Meningoencephalomyelitis 784
Section II Infectious and Inflammatory – Sarcocystis and Neospora in the Mare and Foal 787
Section III Infectious and Inflammatory – Tetanus in the Neonatal Foal 795
Section IV Toxicities – Neurotoxicities 806
Section V Pathophysiology and Treatment of Central Nervous System Trauma in the Foal 831
Contents xi
Section VI Traumatic Brain and Spinal Cord Injury in the Foal 858
Section VII Metabolic Causes of Neurologic Dysfunction 886
Section VIII Idiopathic – Neonatal Encephalopathy 895
Section IX Idiopathic – Neonatal Epileptic Seizures 915
Section X Idiopathic – Narcolepsy in Foals 919
Section XI Autoimmune – Kernicterus 921
Section XII Nervous System Neoplasia 925
Section XIII Peripheral Nerve Disorders – Nerve Injury Secondary to Dystocia 927
Section XIV Peripheral Nerve Disorders – Botulism 931
Neonatal Musculoskeletal System 940
Chapter 33 Embryology and Anatomy of the Neonatal Musculoskeletal System 940
Chapter 34 Clinical Neonatal Musculoskeletal Physiology 950
Chapter 35 Examination, Therapeutics, and Monitoring of the Neonatal Musculoskeletal System 953
Section I Diagnostic Tests 953
Section II Medications for Intra-articular and Musculoskeletal Use in the Neonatal Foal 961
Chapter 36 Congenital and Acquired Musculoskeletal Disorders in the Neonatal Foal 976
Chapter 37 Musculoskeletal Disorders 992
Section I Infectious Neonatal Musculoskeletal Disorders 992
Section II Noninfectious Neonatal Musculoskeletal Disorders 1007
Neonatal Integumentary System 1024
Chapter 38 Embryology and Anatomy of the Integument 1024
Chapter 39 Diagnostics, Therapeutics, and Monitoring of Skin Diseases in the Foal 1026
Chapter 40 Congenital and Inherited Skin Disorders 1031
Chapter 41 Skin Disorders in the Neonatal Foal 1043
Neonatal Hematology and Clinical Chemistry 1049
Chapter 42 Development of Hemopoiesis in the Foal 1049
Chapter 43 Evaluation of the Hematopoietic System – Flow Cytometry 1055
Chapter 44 Clinical Chemistry in the Foal 1060
Chapter 45 Hematologic Disorders 1073

xii Contents
Neonatal Immunology & Infection 1089
Chapter 46 Innate Immunity in the Foal 1089
Chapter 47 Humoral Immunity & Transfer of Maternal Immunity 1099
Chapter 48 Cellular Immunity in the Neonatal Foal 1109
Chapter 49 Congenital Disorders of Immunity 1113
Chapter 50 Neonatal Infection 1126
Section I Bacterial Sepsis 1126
Section II Viral Infections 1156
Neonatal Ophthalmology 1178
Chapter 51 Embryology and Anatomy of the Equine Eye 1178
Chapter 52 Ocular Physiology and Vision in the Equine Neonate 1185
Chapter 53 Examination, Diagnostics and Therapeutics of the Neonatal Equine Eye 1197
Chapter 54 Congenital Ocular Abnormalities in the Foal 1214
Chapter 55 Inherited Ocular Disorders 1222
Chapter 56 Acquired Ocular Diseases in Neonatal Foals 1234
General Treatment Principles for the Equine Neonate 1245
Chapter 57 Neonatal Care at the Farm 1245
Chapter 58 Feeding the Neonatal Foal 1259
Chapter 59 Critical Care Techniques in the Neonatal Foal 1268
Section I Foal Restraint and Handling 1268
Section II Sedation of the Neonatal Foal 1272
Section III Nasotracheal and Orotracheal Intubation 1273
Section IV Placement of Nasal Insufflation Tube 1275
Section V Nasogastric Tube Placement 1277
Section VI Intravenous Catheter Selection, Placement, Maintenance, and Monitoring 1280
Section VII Intraosseous Infusion Technique 1287
Section VIII Treatment of Hypothermia 1290
Section IX Direct and Indirect Blood Pressure Measurement 1294
Section X Urinary Catheter Placement 1296

Contents xiii
Section XI Arterial and Venous Blood Gas Collection 1300
Section XII Capnography 1302
Section XIII Neonatal Transfusion Therapy 1305
Section XIV Umbilical Care 1312
Section XV Point-of-Care Monitors in Neonatal Medicine 1314
Chapter 60 Special Considerations in Pharmacology of the Neonatal Foal 1320
Chapter 61 Antimicrobial Therapy in the Neonatal Foal 1328
Chapter 62 Fluid Therapy in the Neonatal Foal 1344
Chapter 63 Nonsteroidal Anti-inflammatory Drugs and Analgesics in the Neonatal Foal 1358
Chapter 64 Anesthesia of the Neonatal Foal 1366
Chapter 65 Necropsy Examination and Sample Submission of the Fetus, Fetal Membranes, and Foal 1395
Chapter 66 Special Considerations for the Neonatal Donkey and Mule Foal 1399
Part III The Periparturient Mare 1419
Chapter 67 Colic in the Periparturient Mare 1421
Chapter 68 Cesarean Section 1436
Chapter 69 The High-Risk Pregnancy 1439
Chapter 70 Poor Maternal Behavior, Induction of Lactation, and Foal Grafting 1448
Chapter 71 Maternal Complications Associated with Parturition 1453
Chapter 72 Anesthesia of the Late-Term Mare 1467
Appendix Formulary for Equine Neonatal Medications 1478
Index 1505
xiv
List of Contributors
Michelle Abraham, BSc, BVMS, DACVIM Darren Berger, DVM, DACVD

Assistant Professor Associate Professor
University of Pennsylvania Iowa State University
Kennett Square, PA Ames, IA
Emma Adam, BVetMed, PhD, MRCVS, DACVS, DACVIM Rebecca Bishop, DVM
Equine Veterinary Research & Outreach Equine Surgery Resident
Gluck Equine Research Center University of Illinois
Lexington, KY Urbana, IL
Cody Alcott, DVM, DACVIM (LAIM, Neurology) Anthony Blikslager, DVM, PhD, DACVS
Owner Professor
Tucson Veterinary Specialists North Carolina State University
Tucson, AZ Raleigh, NC
Monica Aleman, MVZ, PhD, DACVIM (LAIM, Neurology) Charles Brockus, DVM, PhD, DACVIM, DACVP
Professor Owner
University of California CBCP Consulting
Davis, CA Sparks, NV
Rafael Alzola-Domingo, BVM&S, MSc, Cert AVP,

Teresa A. Burns, DVM, MS, PhD, DACVIM
DECVSMR, MRCVS
Associate Professor
Equine Surgeon, Veterinary Associate
The Ohio State University
Troytown Equine Hospital
Columbus, OH
Kildare, Ireland
Scott Austin, DVM, MS, DACVIM Christopher Byron, DVM, MS, DACVS
Clinical Associate Professor Associate Professor
University of Illinois Virginia Maryland College of Veterinary Medicine
Urbana, IL Blacksburg, VA
Theresa Beachler, DVM, PhD, DACT Undine Christmann, DVM, MPH, PhD, MS, DACVIM
Assistant Professor Associate Professor
Iowa State University Lincoln Memorial University
Ames, IA Harrogate, TN
Daniela Bedenice, Dr. med. vet., DACVIM, DACVECC Sarah Colmer, VMD, DACVIM
Associate Professor Neurology Fellow
Tufts University University of Pennsylvania
Medford, ME Kennett Square, PA
List of Contributors xv
Jennifer Davis, DVM, PhD, DACVIM, DACVCP Darien Feary, BVSc, MS, DACVIM, DACVECC
Associate Professor Associate Veterinarian
Virginia Maryland College of Veterinary Medicine Randwick Equine Centre
Blacksburg, VA Horsley Park, NSW, Australia
Emma Deane, DVM, DACVECC M. Julia B. Felippe, MedVet, MS, PhD, DACVIM
Associate Veterinarian Professor
Loomis Basin Equine Medical Center Cornell University
Penryn, CA Ithaca, NY
Julie Dechant, DVM, MS, DACVS, DACVECC Gustavo Ferlini Agne, MV, MS, DACVIM
Professor Lecturer
University of California University of Adelaide
Davis, CA Roseworthy, SA
Katarzyna A. Dembek, DVM, PhD, DACVIM Langdon Fielding, DVM, MBA, DACVECC, DACVSMR
Assistant Professor Owner
North Carolina State University Loomis Basin Equine Medical Center
Raleigh, NC Penryn, CA
Graeme M. Doodnaught, BSc, BVM&S, DES, MRCVS, DACVAA

Constanze Fintl, DVM, EBVS
Staff Anesthesiologist
Associate Professor
Centre Veterinaire Rive-Sud
Norwegian School of Veterinary Science
University of Montreal
Oslo, Norway
Bettina Dunkel, DVM, PhD, DACVIM, DECEIM,

DACVECC, MRCVS Alastair Foote, MA, VetMB, PhD, FRCPath, MRCVS
Professor Clinical Director Rossdales Laboratories
Royal Veterinary College Rossdales Veterinary Surgeons
London, UK Newmarket, Suffolk, UK
Adam Eatroff, DVM, DACVIM Ryan Fries, DVM, DACVIM (Cardiology)

Associate Veterinarian Assistant Professor
ACCESS Specialty Animal Hospitals University of Illinois
Culver City, CA Urbana, IL
Kira Epstein, DVM, DACVS, DACVECC Paula Galera, DVM, MSc, PhD
Professor Associate Professor
University of Georgia College of Veterinary Medicine
Athens, GA University of Brasilia, Brazil
Sara Erwin, DVM Brian C. Gilger, DVM, MS, DACVO, DABT

Graduate Student Professor
North Carolina State University North Carolina State University
Raleigh, NC Raleigh, NC
Krista Estell, DVM, DACVIM Alexandra Gillen, MA, MS, VetMB, DACVS, DECVS,
Clinical Associate Professor FHEA, MRCVS
Marion duPont Scott Equine Medical Center Senior Lecturer
Virginia Maryland College of Veterinary Medicine University of Liverpool
Leesburg, VA Wirral, UK
xvi List of Contributors
Elizabeth A. Giuliano, DVM, MS, DACVO Kiho Lee, PhD

University of Missouri University of Missouri
Columbia, MO Columbia, MO
Jenifer Gold, DVM, DACVIM, DACVECC Rudy Madrigal, DVM, DACVIM

Associate Veterinarian Associate Professor
Wisconsin Equine Hospital Equine Sports Medicine & Surgery
Oconomowoc, WI Weatherford, TX
K. Gary Magdesian, DVM, DACVIM, DACVECC, DACVCP

Ralph Hamor, DVM, MS, DACVO
Professor
Clinical Professor
University of California
University of Florida
Davis, CA
Gainesville, FL
Dustin Major, DVM, DACVS
Kelsey A. Hart, DVM, PhD, DACVIM
Clinical Assistant Professor
Associate Professor
Texas A&M University
University of Georgia
College Station, TX
Athens, GA
Celia Marr, BVMS, MVM, PhD, DEIM, DECEIM, FRCVS
Bonnie Hay-Kraus, DVM, DACVS, DACVAA Associate Veterinary Specialist
Associate Professor Rossdales Veterinary Surgeons
Iowa State University Newmarket, Suffolk UK
Ames, IA
Bianca Martins, DVM, MS, PhD, DACVO
Kate L. Hepworth-Warren, DVM, DACVIM Associate Professor
Assistant Professor University of California
North Carolina State University Davis, CA
Raleigh, NC
Annette M. McCoy, DVM, MS, PhD, DACVS
Laura D. Hostnik, DVM, MS, DACVIM Assistant Professor
Clinical Associate Professor University of Illinois
The Ohio State University Urbana, IL
Columbus, OH
Harold McKenzie, DVM, MS, MSc, DACVIM
Amy L. Johnson, DVM, DACVIM (LAIM, Neurology) Professor
Associate Professor Virginia Maryland College of Veterinary Medicine
University of Pennsylvania Blacksburg, VA
Kennett Square, PA
Francisco Mendoza, DVM, PhD, MSc, DECIM
Jamie Kopper, DVM, PhD, DACVIM, DACVECC Professor
Assistant Professor Department of Animal Medicine and Surgery
Iowa State University University of Cordoba
Ames, IA Cordoba, Spain
Gabriele Landolt, DVM, MS, PhD, DACVIM Bonny Millar, VT, REVN, RVN
Professor Equine Veterinary Nurse
Colorado State University Consultant and VNJ Equine Editor
Fort Collins, CO Gwynedd, UK
Kara M. Lascola, DVM, MS, DACVIM James Moore, DVM, PhD, DACVS
Associate Professor Professor
Auburn University University of Georgia
Auburn, AL Athens, GA
List of Contributors xvii
Cristobal Navas de Solis, LV, MS, PHD, DACVIM Diane Rhodes, DVM, DACVIM
Assistant Professor Associate Veterinarian
University of Pennsylvania Loomis Basin Equine Medical Center
Kennett Square, PA Penryn, CA
Rose Nolen-Walston, DVM, DACVIM

Eric Rowe, DVM, PhD
Associate Professor
Associate Professor
University of Pennsylvania
Iowa State University
Kennett Square, PA
Ames, IA
Yvette Nout-Lomas, DVM, MS, PhD, DACVIM, DACVECC
Associate Professor Rebecca Ruby, MSc, BVSc, DACVIM, DACVP
Colorado State University Assistant Professor
Fort Collins, CO University of Kentucky
Lexington, KY
Andrea Oliver, DVM
Resident, Internal Medicine
Emily Schaefer, VMD, DACVIM
Clinical Assistant Professor
Kennett Square, PA
Marion duPont Scott Equine Medical Center
Virginia Maryland College of Veterinary Medicine
Emil Olsen, DVM, PhD, DACVIM (LAIM, Neurology)
Leesburg, VA
Clinician, Neurology & Equine Internal Medicine
Swedish University of Agricultural Sciences
Uppsala, Sweden Andre Shih, DVM, DACVAA, DACVECC
Associate Veterinarian
Jon Palmer, DVM, DACVIM Capital Veterinary Specialists
Associate Professor Jacksonville, FL
Kennett Square, PA Nathan M. Slovis, DVM, DACVIM, CHT
Practice Member
Lindsay M.W. Piel, DVM, PhD Hagyard Equine Medical Institute
USDA-ARS Veterinary Medical Officer Lexington, KY
Washington State University
Pullman, WA
Sara M. Smith, DVM, MS, DACVO
Giorgia Podico, DVM, MSc Veterinary Associate
Clinical Instructor Eye Specialists for Animals
University of Illinois Denver, Colorado
Urbana, IL
Brett Sponseller, DVM, PhD, DACVIM
Steve Reed, DVM, DACVIM Professor
Shareholder Iowa State University
Rood & Riddle Equine Hospital Ames, IA
Lexington, KY
Kim A. Sprayberry, DVM, DACVIM, DACVECC

Heidi Reesink, VMD, PhD, DACVS
Professor
Associate Professor
Cal Poly University
Cornell University
San Luis Obispo, CA
Ithaca, NY
Roxanne M. Rodriguez Galarza, DVM, MS, DACVO Danielle Strahl-Heldreth, DVM, MSEd, MSVMS, DACVAA
Associate Veterinarian Clinical Assistant Professor
Animal Eye Care Associates University of Illinois
Cary, North Carolina Urbana, IL
xviii List of Contributors
Ben Sykes, BSc BVMS MSc MBA DipACVIM PhD FHEA Edwina Wilkes, BVSc, MPHarm, FANZCVS, DVStud
Veterinary Curriculum Development Lecturer in Equine Medicine
Southern Cross University Charles Sturt University
Lismore, NSW, Australia New South Wales, Australia
Ramiro E. Toribio, DVM, MS, PhD, DACVIM Jarred Williams, DVM, PhD, DACVS, DACVECC
The Ohio State University University of Georgia
Columbus, OH Athens, GA
Gaby van Galen, DVM, MSc, DES, PhD, DECEIM, DECVECC Sharon Witonsky, DVM, PhD, DACVIM
Senior Clinician Associate Professor
Goulburn Valley Equine Hospital Virginia Maryland College of Veterinary Medicine
Congupna, Victoria, Australia Blacksburg, VA
Ashlee Watts, DVM, PhD, DACVS David Wong, DVM, MS, DACVIM, DACVECC
Associate Professor Professor
Texas A&M University Iowa State University
College Station, TX Ames, IA
Robin White, DVM, DACVR Kate Wulster Bills, VMD, DACVR

Clinical Assistant Professor Clinical Assistant Professor
Iowa State University University of Pennsylvania
Ames, IA Kennett Square, PA
David Whitley, DVM, MS DACVO Amanda Ziegler, DVM, PhD

Professor Emeritus Research Assistant Professor
University of Florida North Carolina State University
Gainesville, FL Raleigh, NC
Pamela A. Wilkins, DVM, MS, PhD, DACVIM, DACVECC

Professor
University of Illinois
Urbana, IL
Reference 11
Table 1.II.2 Noninvasive blood pressure values in growing foals.
Age (days) Systolic (mmHg) Diastolic (mmHg) Mean (mmHg)
1 81 ± 10 35 ± 7 50 ± 8
7 104 ± 21 40 ± 14 61 ± 15
14 100 ± 16 41 ± 7 61 ± 6
21 107 ± 28 48 ± 17 68 ± 16
30 114 ± 21 54 ± 13 74 ± 11
60 103 ± 12 53 ± 20 70 ± 6
90 111 ± 15 57 ± 19 75 ± 16
Source: Adapted from Lombard et al. [18].
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University of Pennsylvania http://nicuvet.com/nicuvet/ systematic review and meta-analysis. JAMA 319:
Learn/Perinatology%20Handout.pdf. 1221–1238.
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117. Ad Att. vii. 3.
118. Horace, Sat. II. 3, 239.
119. Ad Att. xi. 25.
120. Ad fam. iv. 5.
121. Ad Att. iv. 6.
122. Ad Att. x. 8.
123. Plin. Hist. nat. xiv. 22.
124. Ad fam. xvi. 21.
125. Brut. ad Cic. ii. 3.
126. De offic. ii. 7.
127. Ad Att. i. 12.
128. Ad fam. xiii. 77.
129. Ad fam. xvi. 22.
130. A. Gell. vii. 3.
131. Ad fam. xvi. 10.
132. Ibid. xvi. 21.
133. Ad fam. xvi. 18.
134. Ad fam. xvi. 3, 4.
135. A. Gell. xiii. 20.
136. Plin. Epist. viii. 16.
137. Virgil, however, always faithful to ancient traditions, places, in Tartarus,
the patron who had deceived his client beside the son who had struck his father.
138. De petit. cons. 9.
140. Ad Quint. i. 1.
142. Ibid. vii. 31.
143. Ad Att. vi. 1.
144. I have endeavoured to prove this with more detail in a memoir published
by the Revue archéologique, entitled, Atticus, éditeur de Cicéron.
145. Ad Att. iv. 4, 8.
146. Ad Att. i. 13.
147. Ibid. i. 19.
148. De Leg. i. 7. He is still faithful to this part of an amateur in philosophy,
when he says further on (i. 21), that Antiochus had made him take a few steps in
the Academy, deduxit in Academiam perpauculis passibus. He never penetrated
further.
149. T. Pomp. Att. 13. All the preceding details are taken from the life of
Atticus by Cornelius Nepos.
150. Ad Att. vi. 1.
151. Ad Att. iv. 9.
152. Ibid. vi. 1.
153. Ad Att. vii. 8: soles conglutinare amicitias.
154. It is the saying of Tacitus: pessimum veri affectus venenum sua cuique
utilitas.
155. Ad Att. xiii. 33.
156. It must be remarked, however, that the last letter that we have from
Cicero to Atticus (xvi. 16) contains a proof of the very active steps that Cicero took
to save a part of the fortune of Atticus which was endangered after the death of
Caesar.
157. Ad Att. iv. 8.
158. Ad Att. ii. 1.
159. Ad Att. i. 14.
160. Ibid. xvi. 3.
161. Ibid. xii. 3.
162. Ad Att. xii. 51.
163. Ibid. i. 18.
164. Ibid. xii. 14.
165. Cui potest esse vita vitalis, ut ait Ennius, qui non in amici mutua
benevolentia conquiescat? (Cicero, De Amicit. 6.)
166. T. Liv. xxi. 63: Quaestus omnibus patribus indecorus visus
167. Scipio says so in the Republic (i. 22): Quum mihi sit unum opus hoc a
parentibus majoribusque meis relictum, atque administrate rei publicae, etc.
168. Corn. Nep. Attic. 7: Usus es aetatis vacatione.
169. Nep. Attic. 6.
170. Ad Att. xiv. 10.
171. Ibid. viii. 2.
172. Ibid. x. 15.
173. Ad Att. x. 16.
174. Ad Att. i. 17. See also de Offic. i. 21, and especially i. 26. This last passage
evidently contains an allusion to Atticus.
175. Epist. Brut. i. 17.
176. De Rep. i. 2.
178. Attic. 10.
179. De Orat. 34.
180. In the time of the Gracchi, the Censor Metellus thus expressed himself in
a speech in which he vigorously attacked bachelors: “Citizens, if we could live
without wives we should all dispense with that encumbrance (omnes ea molestia
careremus); but, as nature has willed it to be as impossible to do without them as it
is disagreeable to live with them, let us sacrifice the charms of so short a life to the
interests of the republic, which must always endure.” This way of encouraging men
to marry seemed apparently very efficacious, since, at the time when men married
less than ever, Augustus thought he ought to have the speech of old Metellus read
to the people.
181. Liv. xxxiv. 3.
182. Pro Muraen. 12.
183. Schol. Bob. p. Sext. ed. Or. p. 304.
184. Schwab. Quaest. Catull. p. 77.
185. All these details, and those that follow, are taken from the Pro Caelio of
Cicero.
186. Macr. Sat. ii. 10.
187. Ovid, Trist. ii. 427.
188. Apul. de Mag. 10. A learned German, M. Schwab, in a book that he has
just published on Catullus (Quaest. Catull. 1862), seems to me to have put the
truth of this assertion of Apuleius beyond doubt.
189. Catull. Carm. 26.
190. Catull. Carm. 86.
191. Cat. Carm. 5.
192. Cat. Carm. 12.
193. Cat. Carm. 70.
194. Ibid. 85.
195. Probably with some woman that Caelius loved. Cicero, in replying to this
letter, tells him that the rumour of his exploits has reached Mount Taurus. Many
suppose he means amorous exploits.
196. Ad fam. viii. 7.
197. Quint. Inst. or, iv. 2.
198. De Ira. iii. 8.
199. Ad fam. ii. 8.
201. Ibid. viii. 4.
202. Ibid. viii. 5. The sense of this phrase is altered in Orelli.
203. Ibid. viii. 14.
206. Ad fam. ii. 8.
207. See the excellent memoir of M. Th. Mommsen, entitled Die Rechtsfrage
zwischen Caesar und dem Senat. Breslau, 1857.
209. We see at the end of the eighth book De Bello Gallico, that Caesar had
eight legions in Gaul, one in Cisalpine Gaul, and two that he gave to Pompey. At
the first threat of war he ordered those that were in Gaul to approach the frontier.
After the capture of Corfinium he had three of his old legions with him.
214. Ad Att. viii. 11.
215. Ibid. ix. 6.
216. Ad Att. ix. 12.
217. Ad Att. ix. 10.
218. Ad fam. ii. 16.
219. Ibid. vi. 6.
221. De amic. 15.
222. It would be wrong to pass over the name of Matius in silence. A very fine
letter of his on the death of Caesar remains (Ad fam. xi. 28). He was a true friend
of Caesar; but it is to be remarked that he was not one of those whom he made
praetors and consuls, and whose debts he had often paid. Matius never filled any
important political office, and his name would not have come down to us if it had
not been for Cicero’s correspondence.
223. De bell. civ. iii. 53.
224. Ibid. iii. 91.
225. De amic. 15.
226. Ad Att. ix. 19.
227. Ibid. ix. 18.
228. Suet. Caes. 54.
229. Ad Att. x. 4.
231. Pro Flacco, 38.
233. A very curious detail preserved by Quintilian, shows us that Caelius
retained his levity of character and bantering humour in the midst of these grave
affairs in which he staked his life. After his curule chair had been broken he had
another made entirely of leather thongs, and took it to the consul. All the
spectators burst out laughing. The story ran that Servilius had had a strapping in
his youth.
234. Inst. orat. x. 1.
235. Pro Marcello, 9.
236. In Pis. 22.
237. Pro Dom. 28.
238. Ad Quint. ii. 1.
239. Ibid. ii. 3.
240. Pro Sext. 35.
241. Ad pop. pro red. 7.
242. Ad Att. iv. 3. Ego diaeta curari incipio, chirurgiae taedet.
243. Ad Att. iv. 2.
244. Ad Att. iv. 5.
245. Ad Att. iv. 5.
246. Ibid. iv. 6.
247. Ad fam. i. 9.
248. Ad fam. i. 9.
249. In Pis. 32.
251. Ibid. ii. 15.
252. This at least was the opinion of all the historians of antiquity. We read in
a fragment of a letter from Cicero to Q. Axius quoted by Suetonius (Caes. 9):
Caesar in consulatu confirmavit regnum de quo aedilis cogitaret.
254. Or only forty-two, if we place his birth in 654. See, on this point, an
interesting note in the Life of Caesar, by Napoleon III., Bk. II. ch. i.
255. Ad fam. vii. 5.
258. Ad fam. vii. 6: nisi te extrusissemus.
259. Ad fam. vii. 17.
260. Ibid. vii. 13.
261. Ad fam. vii. 18.
262. Ibid. vii. 10.
263. De orat. ii. 3.
265. Caes. 47.
267. Suet. Caes. 67.
268. Suet. Caes. 46, 48.
269. Ad Quint. iii. 1.
272. Ibid. ii. 16.
273. Cic. Brut. 72, and Pliny, Hist. nat. vii. 30.
274. Caesar wrote to Cicero twice from Britain. The first letter took twenty-six
days to reach Rome, and the second twenty-eight. This was quick travelling for that
time, and we see that Caesar must have organized his mail-service well.
Furthermore, we know his stay in Britain was very short.
276. De prov Cons. 13, 14.
277. M. Mommsen completely settles this in his Roman History.
278. De Arusp. resp. 25.
280. Ad Att. xi. 20. I read cognitionem instead of notionem, which does not
seem to me to have any sense.
281. Ad fam. ix. 1.
282. Ad Att. xvi. 31.
283. Ad fam. ix. 5.
284. Ad Att. ix. 20.
285. Ad Att. x. 4.
286. Bell. Afric. 88.
287. Ad Att. ix. 7.
288. The general amnesty that Suetonius speaks of did not take place till much
later.
290. It is unnecessary to say that I believe in the authenticity of this speech: it
has been disputed for reasons that seem to me futile. Further on I shall reply to
those drawn from the character of the speech, by showing that it is less base and
servile than has been asserted.
291. Pro Marc. 4.
292. Ad fam. iv. 4.
293. Pro Marc. 7.
294. Ibid. 8.
295. Philipp. iii. 11.
296. Ad fam. xv. 5.
299. Pro Mur. 36.
300. Ad Att. ii. 1.
301. Ad Att. xii. 4.
302. Ann. iv. 34.
303. Ad Att. xiii. 46.
304. Caes. Bell. civ. i. 4.
305. Philipp. ii. 32.
306. It is not easy to say what Caesar’s projects were, as his work was
interrupted by his death. Some insist that he only desired a sort of dictatorship for
life; the greater number suppose that he thought of permanently establishing
monarchical rule. The question is too grave to be entered upon incidentally, and
settled in a few words. I will simply say that perhaps he only thought at first of the
dictatorship; but in proportion as he became more powerful, the idea of founding a
monarchy seemed to take more consistency in his mind. Yet it may be inferred
from a passage in Plutarch (Brut. 7), that he was not decided on the question of an
hereditary succession when he died.
307. Ad fam. xii. 17.
308. Brut. 51.
309. Pro Rabir. 7.
310. Pro Rosc. Am. 12.
311. Ad fam. iv. 5.
312. Ibid. xiii. 68.
313. Ibid. xii. 18.
314. Ibid. vi. 9.
315. Pro Marc. 10.
316. Ad Att. xii. 45.
317. Pro Dejot. 12.
318. “All the honest men,” said Cicero (Phil. ii. 12), “in so far as they could,
have killed Caesar. Some wanted the means, others the resolution, several the
opportunity; no one wanted the will.”
319. Ann. i. 3.
320. The authenticity of these letters has been often called in question since
the last century, and has been debated in Germany quite recently with much
warmth, and a distinguished critic, F. Hermann of Göttingen, has published some
remarkable essays, to which it seems to me difficult to reply, in order to prove that
they are really letters of Brutus and Cicero. I have summed up his principal
arguments in Recherches sur la manière dont furent recueillies les lettres de
Cicéron, ch. v.
321. Ad Att. vi. 1.
322. Ad fam. iii. 11.
323. Ad Att. vi. 1.
324. Orat. 10.
325. Ad Att. xiv. 1.—A very curious statue of Brutus is to be seen at the
Campana Museum. The artist has not tried to idealize his model, and seems to
have aimed at nothing but a vulgar exactness; but we can very well recognize in it
the real Brutus. We can trace in that low forehead and the heavy bones of the face a
narrow mind and an obstinate will. The face has a feverish and sickly look; it is at
once young and old, as is the case with those who have never really been young.
Above all we perceive in it a strange sadness, that of a man overwhelmed by the
weight of a great and fateful destiny. In the fine bust of Brutus preserved in the
Museum of the Capitol, the face is fuller and handsomer. The sweetness and
sadness remain; the sickly look has disappeared. The features exactly resemble
those on the famous medal struck during Brutus’ last years, and which bears on the
reverse a Phrygian cap between two daggers, with the threatening legend, Idus
Martiae. Michael Angelo commenced a bust of Brutus, of which the admirable
rough model may be seen at the Uffizi in Florence. It was not a fancy study, and we
see that he had made use of ancient portraits while idealizing them.
326. Ad Att. xv. 1, B.
327. Ad Att. xii. 21.
328. Liv. xlv. 18.
329. Cic. Ad Quint. i. 1.
330. Ad Att. vi. 1.
332. Ad Att. vi. 1.
333. Ibid. v. 21.
334. Ad Att. xi. 4.
335. Ad fam. xv. 15.
336. Ad fam. iv. 9.
337. Cic. Brut. 96.
338. Tusc. ii. 2.
339. See on this question the very interesting work of M. Martha, Les
Moralistes sous l’Empire Romain.
340. Ad Att. xv. 2.
341. Quint. x. 1.
342. Sen. Cons. ad Helv. 9.
344. App. De bell. civ. iv. 133.
345. Plut. Brut. 12.
346. Those who employed these manœuvres well knew that they were taking
Brutus on his weak side. His descent from him who expelled the kings was much
contested. The more it was regarded as doubtful the more anxious he was to prove
it. To say to him: “No, you are not Brutus,” was to put on him the necessity or the
temptation of proving his origin by his actions.
347. Ad fam. xv. 18.
348. De Offic. ii. 7.
349. De Divin. ii. 2.
350. Brut. 97.
351. Epis. Brut. i. 17.
352. Ibid. x. 16.
353. Ibid. i. 17.
354. Quint. ix. 3.
355. It must, however, be noticed that there are several of Cassius’ letters in
Cicero’s correspondence, and that some of them are witty and very lively. There are
even puns in them.—(Ad fam. xv. 19.)
356. De Bell. civ. ii. 113. Plutarch relates the same thing, and almost in the
same words.
357. Ad Att. xv. 4.
358. De Bell. civ. ii. 120.
359. Ad Att. xiv. 10, and xv. 11.
360. De Bell. civ. iii. 42.
361. Ad Att. xv. 11.
362. Ad fam. xi. 3.
363. Philipp. x. 4.
364. Ad fam. x. 1.
365. Ad fam. xi. 7.
366. Ibid. x. 16.
367. Ad Brut. ii. 7.
368. Ad fam. xi. 23.
369. Philipp. xiii. 19.
370. Philipp. xi. 8.
371. Ad fam. xii. 2.
372. Ad Att. xiv. 20.
373. Ad Brut. i. 10.
375. Ad fam. ix. 16.
376. Ad Att. xvi. 11.
377. Ibid. xiv. 12.
378. Ad fam. xii. 25: Quem ructantem et nauseantem conjeci in Caesaris
Octaviani plagas.
379. Orelli, Fragm. Cic. p. 465.
380. Suet. Aug. 101.
381. Exploration archéologique de la Galatie, etc., par MM. Perrot, Guillaume
et Delbet. Paris, 1863. Didot. As the Galatians spoke Greek and understood Latin
ill, the official text was put in the place of honour, in the temple itself, and the
translation was placed outside where every one might read it, in order to bring the
narrative of Augustus within their reach. But the exterior of the temple has not
been any more respected than the interior. The Turks have fixed their houses
against the walls, carelessly driving their beams into the marble, and using the
solid masonry as a support for their brick and mud party-walls. All the skill of M.
Perrot and his companion M. Guillaume was required to penetrate into these
inhospitable houses. When they had entered they met with still greater difficulties.
It was necessary to demolish the walls, take away the beams and support the roofs
in order to reach the ancient wall. This was but little. The wall was hammered and
cracked, blackened by dirt and smoke. How could the inscription that covered it be
deciphered? It was necessary to remain for weeks in dark and foul rooms, or on the
straw of a loft, working by candlelight, throwing the light in every direction on the
surface of the marble, and thus gradually winning each letter by extraordinary
efforts of courage and perseverance. This painful labour was rewarded by complete
success. Of nineteen columns of Greek text, the English traveller Hamilton had
copied five completely and fragments of another; M. Perrot brings back twelve
entirely new ones. One only, the ninth, could not be read; it was behind a thick
party-wall that it was found impossible to pull down. These twelve columns,
although they have suffered much from the ravages of time, fill up in great part the
lacunae of the Latin text. They make us acquainted with entire paragraphs of which
no traces remain in the original; and even in passages where the Latin was better
preserved they rectify at almost every step mistakes that had been made in the
interpretation of the text. M. Egger, in his Examen des historiens d’Auguste, p. 412
et seq., has carefully and critically studied the inscription of Ancyra. M. Mommsen,
with the help of M. Perrot’s copy, is preparing a learned work on this inscription,
after which, no doubt, nothing will remain to be done. (M. Mommsen’s work, that
was announced in the first edition of this book, has since appeared under the title:
Res gestae divi Augusti ex monumentis Ancurano et Apolloniensi.)
382. Dio, lii. 14–40. See what M. Egger says of Dio in his Examen des hist.
d’Aug. ch. viii.
383. The figure cannot be read either in the Latin or Greek.
384. The figure cannot be read. The great number of gladiators who fought,
and no doubt perished in these bloody fêtes will be noticed. Seneca, to show how
far men can become indifferent to death, relates that, under Tiberius, a gladiator
complained of the rarity of these grand massacres; and alluding to the time of
Augustus said: “That was a good time! Quam bella aetas periit!”
385. There is some probability, according to a passage of Suetonius (Aug. 52),
that what the Greek text of the inscription calls absolute authority αὐτεξουσιὸς
ἀρχὴ was the dictatorship.
386. I have only summed up here a very curious chapter of Dio Cassius (Hist.
Rom. liii. 17). We see there clearly how the Roman constitution, in which the
separation of powers was a guarantee for liberty, became, by the sole fact of their
concentration, a formidable engine of despotism.
387. The Ancyra inscription gives most precise information on the subject of
this increase. In 725 Augustus took the census for the first time after an
interruption of forty-one years: 4,063,000 citizens were counted in this return.
Twenty-one years later, in 746, the numbers returned amounted to 4,233,000. In
767, the year of Augustus’ death, there were 4,937,000. If, to the figures that
Augustus gives, we add the number of women and children who were not
comprised in the Roman census, we shall see that in the last twenty years of his
reign the increase had reached an average of very nearly 16 per cent. This is exactly
the figure to which the increase of population in France rose, after the Revolution,
from 1800 to 1825; that is, like political circumstances produced like results. It
might be thought, indeed, that this increase of population under Augustus was due
to the introduction of foreigners into the city. But we know, from Suetonius, that
Augustus, contrary to the example and principles of Caesar, was very chary of the
title of Roman citizen.
388. Suet. Aug. 31.
389. De Clem. 9; Divus Augustus mitis fuit princeps. It is true that elsewhere
he calls his clemency a wearied-out cruelty.
390. Suet. Aug. 84.
391. See especially Velleius Pat. ii. 66.
392. Sen. Suas. 6.
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Equine Neonatal Medicine 1st Edition

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University of Illinois Urbana–Champaign

Published by John Wiley & Sons, Inc., Hoboken, New Jersey.

Library of Congress Cataloging-in-Publication Data applied for:

Cover Design: Wiley

Set in 9.5/12.5pt STIXTwoText by Straive, Pondicherry, India

List of Contributors xiv

Part I The Newborn Foal 1

Chapter 1 Postpartum Adaptation of the Newborn Foal 3

Section I Fetal Heart Rate and Fetal ECG 3

Section II Fetal Circulation and Cardiorespiratory Transition 8

Section III Maturation of the Lung and the Surfactant System 12

Section IV Onset of Breathing 26

Section V Control of Breathing 32

Section VI Renal Transition from Fetus to Newborn 37

Section VII Newborn Physical Examination 42

Chapter 2 Principles and Theory of Cardiopulmonary Resuscitation (CPR) 51

Chapter 3 The Premature and Dysmature Neonatal Foal 64

Part II Disorders of the Neonatal Foal 79

Neonatal Respiratory System 81

Chapter 4 Embryology and Anatomy of the Respiratory System 81

Chapter 5 Clinical Neonatal Respiratory Physiology 84

Chapter 6 Examination, Therapeutics, and Monitoring of the Respiratory System 90

Section I Physical Examination 90

Section II Thoracic Radiography of the Neonatal Foal 94

Section III Thoracic Ultrasonography of the Neonatal Foal 101

Section V Inhalation Therapy 117

Section VI Ventilator Therapy 126

Chapter 7 Congenital Disorders of the Respiratory System 140

Chapter 8 Respiratory Disorders 153

Section I Disorders of Breathing Pattern in the Neonatal Foal 153

Section II Lower Respiratory Tract Disorders 156

Section III Meconium Aspiration Syndrome 183

Section IV Persistent Pulmonary Hypertension of the Newborn 189

Section V Pneumothorax and Pneumomediastinum 196

Section VI Diaphragmatic Hernias 201

Section VII Miscellaneous Disorders of the Respiratory System 206

Section VIII Nonpulmonary Disease Processes Manifesting as Respiratory Disease 216

Neonatal Cardiovascular System 224

Chapter 9 Embryology and Anatomy of the Heart 224

Chapter 10 Clinical Neonatal Cardiac Physiology 232

Chapter 11 Examination, Therapeutics, and Monitoring of the Cardiovascular System 238

Section I Examination of the Cardiovascular System 238

Section II Echocardiography 244

Section III Advanced Cardiac Monitoring in Foals 259

Section IV Central Venous Pressure 268

Section V Cardiovascular Medications for the Neonatal Foal 273

Chapter 12 Congenital Heart Defects 284

Chapter 13 Cardiovascular Disorders of the Neonatal Foal 315

Section I Arrhythmias 315

Section II Pathophysiology of Shock Syndromes in the Neonatal Foal 323

Section III Catheter-­Associated Thrombophlebitis 337

Neonatal Digestive System 343

Chapter 14 Embryology and Anatomy of the Digestive Tract 343

Chapter 15 Examination of the Digestive Tract 351

Section III Catheter-Associated Thrombophlebitis 337

Section I The Hypothalamic-Pituitary-Adrenal Axis and Steroid Hormones 545