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Discussion on Question about protocol for sick foal.
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Member:
Oscarvv
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Posted on Monday, Mar 7, 2005 - 11:06 pm:
Dr O,
I had a colt born 2/16/05, foaling was normal, Igg was normal, umbilicas was treated right after birth and multiple times in the next few days. On 2/23 he was on three legs. And lame on his lh. It was his stifle which had a small amount of swelling. Foal was depressed, temp was 101.9. Blood work came back slightly elevated wbc (14,000) and fibrinogen. We started him on pen bid and gen sid along with Probiotics. he bounced back quickly and was sound within 12 hours.
On 2/24 vet came out to tap the stifle joint to be sure there was no infection. He pulled no fluid out of the joint.
We continued antibiotics, per vet, for 5 days when his bloodwork came back normal.
On 3/3 he didn't seem right. A bit depressed and seemed a little bit painful...picking up one foot and then another. Temp was 101.8. Vet came out and pulled blood and we started him on gastroguard. Bloodwork was normal and the vet listened to lung sounds and said all was fine.
On 3/4 he was depressed and his rh ankle had swelling and he was lame. I had the vet out (again) and he pulled blood. he said the ankle seemed more like trauma as it had pitting edema. Temp varied from 101.4-102.1 today. I told him that I had heard the colt cough 5 times and that he is depressed, not nursing well and started with diarrhea that evening.
his bloodwork came back with elevated wbc's and fibrinogen again. Our vet offered to come out that evening with different antibiotics. I opted to take him to the University.
The colt is found to have from x-rays, moderate pneumonia, he is dehydrated and the swollen ankle joint is tapped. The tap shows inflammation and no infection. The colt was immediately started on IV fluids and antibiotics. he is doing well and will come home tommorrow.
So after all of that, my question is should he have been on antibiotics longer than 5 days when he came up with the initial swelling in his stifle?
Thank you,
Barbara
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Moderator:
DrO
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Posted on Tuesday, Mar 8, 2005 - 6:30 am:
Hmmmm, the stifle did not become reinfected so apparently was taken care of by the initial series of antibiotics and the pneumonia may or may not be related to this earlier problem.
If you have read our article on joint infections you see a longer recommended treatment period. This is mainly because of the poor penetration of many or our antibiotics into bone and cartilage. To look at this from the other side Barbara, if the foal had developed a serious reaction to the antibiotic you would be wondering why you did not stop earlier: it really is a clinical call.
DrO
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Member:
Oscarvv
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Posted on Tuesday, Mar 8, 2005 - 7:30 am:
DrO,
Thank you once again for your insight.
You are right, I dreaded every morning and evening giving him the antibiotics and was relieved when we were told to stop.
I was thinking that because the swelling was very minimal and the vet could not get any fluid when he tapped the stifle that maybe there was something else going on. I forgot too mention that on the last day of the drugs I saw a bit of snot in the baby's nostril and told the vet. he said that was impossible with the drugs the baby was on. Also, because another joint became inflammed could that indicate that it was a systemic infection that just ended up in a different joint.
I am starting to feel this vet relies too much on the bloodwork and the drugs should have been continued longer. And finally, the evening (7 PM) he went to the U (Friday) I told this vet that AM about the coughing and he did not listen to his lungs.
I know this is the busiest time of the year for vets but I felt like he was on a pit stop and would zoom in and out.....I just don't feel confident with this vet and feel he doesn't listen to me. It's been very frustrating and expensive.
On a good note, the colt should come home today on Baytril and gastroguard if he maintains his current status.
Thanks again,
Barbara
(sorry, my capital 'g' and 'h' are not working)
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