Echocardiography in foals from birth to three months old

M-Mode Echocardiographic Measurements of Interventricular Septum, Left Ventricular Internal Diameter, and Left Ventricular Free-Wall Thickness in Normal Horses-A Meta-Analytical Study

The purpose of this study was to provide a systematic meta-analysis on echocardiographic measurements in normal Thoroughbred and Standardbred horses. The current systematic meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). All the available published papers on the reference values of echocardiographic assessment via M-mode echocardiography were searched, and fifteen studies were finally selected for analysis. In both fixed and random effect, the confidence interval (CI) for the interventricular septum (IVS) was 2.8-3.1 and 4.7-7.5; for the left ventricular free-wall (LVFW) thickness, it was 2.9-3.2 and 4.2-6.7; and for the left ventricular internal diameter (LVID), it was -5.0-4.6 and -10.0--6.7, respectively. For IVS, the Q statistic, I-squared, and tau-squared were 925.3, 98.1, and 7.9, respectively. Similarly, for LVFW, all the effects were on the positive side of zero, with a range of 1.3-68.1. The CI indicated a significant variation among the studies (fixed, 2.9-3.2; random, 4.2-6.7). The z-values of LVFW for fixed and random effects were, respectively, 41.1 (p < 0.001) and 8.5 (p < 0.001). However, the Q statistic was 886.6 (p < 0.001). Moreover, the I-squared was 98.08, and the tau-squared was 6.6. By contrast, the effects of LVID fell on the negative side of zero, (2.8-83.9). The present meta-analysis provides an overview of the echocardiographic measurements of cardiac diameters in healthy Thoroughbred and Standardbred horses. The meta-analysis indicates variations in results among different studies. This result should be considered when evaluating a horse for heart disease and each case should be evaluated independently.

Impact of sedation, body position change and continuous positive airway pressure on distribution of ventilation in healthy foals

Background

This study aimed to compare the distribution of ventilation measured by electrical impedance tomography (EIT), in foals under varying clinical conditions of sedation, postural changes, and continuous positive airway pressure (CPAP). To support the interpretation of EIT variables, specific spirometry data and F-shunt calculation were also assessed.

Materials and methods

Six healthy Thoroughbred foals were recruited for this sequential experimental study. EIT and spirometry data was recorded: (1) before and after diazepam-sedation, (2) after moving from standing to right lateral recumbency, (3) in dorsal recumbency during no CPAP (CPAP₀) and increasing levels of CPAP of 4, 7, and 10 cmH₂O (CPAP₄, ₇, ₁₀, respectively). Ventral to dorsal (COV_VD) and right to left (COV_RL) center of ventilation, silent spaces, tidal impedance variation, regional ventilation distribution variables and right to left lung ventilation ratio (R:L) were extracted. Minute ventilation was calculated from tidal volume (V_T) and respiratory rate. F-Shunt was calculated from results of arterial blood gas analysis. Statistical analysis was performed using linear mixed effects models (significance determined at p < 0.05).

Results

(1) Respiratory rate was lower after sedation (p = 0.0004). (2) In right lateral recumbency (compared to standing), the COV_VD (p = 0.0012), COV_RL (p = 0.0057), left centro-dorsal (p = 0.0071) and dorsal (p < 0.0001) regional ventilation were higher, while the right ventral (p = 0.0016) and dorsal (p = 0.0145) regional ventilation, and R:L (p = 0.0017) were lower. (3) Data of two foals for CPAP₁₀ was excluded from statistical analysis due to prolonged apnea. Stepwise increase of CPAP led to increases of COV_VD (p = 0.0028) and V_T (p = 0.0011). A reduction of respiratory rate was detected with increasing CPAP levels (p < 0.0001).

Conclusions

(1) In healthy foals, diazepam administration did not alter distribution of ventilation or minute ventilation, (2) lateral recumbency results in collapse of dependent areas of the lung, and (3) the use of CPAP in dorsal recumbency at increasing pressures improves ventilation in dependent regions, suggesting improvement of ventilation-perfusion mismatch.

Feasibility of the echocardiographic subcostal view in newborn foals: two-dimensional and Doppler aortic findings

BACKGROUND

In dogs, due to better alignment with the aortic outflow, the subcostal (SC) transducer site provides greater Doppler-derived velocities than those obtained from the left parasternal view. The feasibility of this imaging approach has never been described in equine echocardiography.

OBJECTIVES

The objective of this study was to evaluate the feasibility of the SC view in newborn foals and compare aortic two-dimensional and Doppler-derived velocity measurements with those of standard parasternal long-axis (LAX) views.

STUDY DESIGN

A prospective observational study.

METHODS

Twenty-three newborn healthy Standardbred and Warmblood foals, aged from 7 h to 6 days, underwent transthoracic two-dimensional (2DE), M-mode and Doppler echocardiography that was performed in lateral recumbency. Right and left parasternal long-axis (R-LAX, L-LAX) and SC views were obtained to perform 2DE and Doppler assessments of the aortic valve (AoV). Aortic diameter at the sinus of Valsalva (AoS D) was measured from R-LAX and SC images. Aortic maximal velocity (AoV Vel_max ), velocity time integral (AoV VTI) and pressure gradient (AoV PG) were obtained by pulsed wave Doppler spectra from SC and L-LAX views.

RESULTS

The SC view was feasible in all foals. No significant difference was found in AoS D between different views (P = 0.06), and no significant correlation was detected for bodyweight (BW). AoV Vel_max , VTI and PG obtained from the SC view were greater than from the L-LAX view (P<0.0001, P = 0.0001 and P<0.0001 respectively), especially in foals with lower BW.

MAIN LIMITATIONS

The order of the transducer site was not randomised among foals, and the observer was not blinded during offline measurement.

CONCLUSIONS

The SC view can be easily obtained in recumbent newborn foals and provides optimal alignment with aortic outflow, leading to more reliable Doppler flow velocity than the conventional L-LAX view. Further investigations of the potential use of this view in Doppler estimation of aortic outflow and cardiac assessment of sick foals are recommended.

Relationships between body dimensions, body weight, age, gender, breed and echocardiographic dimensions in young endurance horses

BACKGROUND

The heart's physiological adaptation to aerobic training leads to an increase in heart chamber size, and is referred to as the Athlete's heart. However, heart dimensions are also related to body weight (BWT), body size, growth and (in some species) breed. There are few published data on the relationships between heart dimensions and growth or aerobic training in Arabian and Arabian-related endurance horses. Therefore the objective of the present study was to describe the influence of body dimensions (body length (BL), thoracic circumference (TC), withers height (WH)), BWT, age, gender, breed (purebred Arabians, part-bred Arabians, Anglo-Arabians, and Others) and the initiation of endurance training on echocardiographic measurements in competition-fit endurance horses aged 4 to 6 years.

RESULTS

Most left atrial (LA) and left ventricular (LV) dimensions increased with age, whereas LA and LV functional indices did not. Although there was no gender difference for LV dimensions, females had larger LA dimensions. In terms of breed, Anglo-Arabians had the largest LV dimensions. Regression models indicated that the included explanatory factors had a weak influence on heart dimensions. Age, body dimensions, breed and gender showed the most consistent influence on LA dimensions, whereas BWT, breed and kilometres covered in competition showed the most consistent influence on LV dimensions.

CONCLUSION

The increase in echocardiographic dimensions with age indicates on-going growth in our population of 4 to 6 year-old horses. We also observed small changes associated with the initiation of endurance training. Morphometric dimensions had a greater influence on LA dimensions, whereas LV dimensions were also influenced (albeit weakly) by parameters associated with exercise intensity. These results may therefore reflect early adaptations linked to the initiation of endurance training.

The Equine Neonatal Cardiovascular System in Health and Disease

The neonatal foal is in a transitional state from prenatal to postnatal circulation. Healthy newborn foals often have cardiac murmurs and dysrhythmias, which are usually transient and of little clinical significance. The neonatal foal is prone to infection and cardiac trauma. Echocardiography is the main tool used for valuation of the cardiovascular system. With prompt identification and appropriate action, dysrhythmias and other sequel to cardiac trauma can be corrected. With infection, the management and prognosis are driven by concurrent sepsis. Congenital disease represents an interesting diagnostic challenge for the neonatologist, but surgical correction is not appropriate for most equids.

Ultrasonographic anatomy and biometric analysis of the thoracic and abdominal organs in healthy foals from birth to age 6 months

Knowledge of normal renal parameters, as documented in mature horses, is essential for the accurate evaluation of abnormal kidneys. Although the ultrasonographic appearance and location of the abdominal organs in foals and the renal dimensions in neonates have been reported, there is currently no information available for the assessment of normal organ growth in foals. The objectives of the study were to describe the ultrasonographic characteristics, location and variations of the thoracic and abdominal organs with relation to age, height and weight; and provide a growth table for comparison with diseased foals. The thoracic and abdominal cavities of 10 healthy foals were evaluated at ages 1, 7, 14 and 21 days and 1, 2, 3, 4, 5 and 6 months. The equipment used was an Ausonics Opus Plus ultrasound. For every evaluation, weight and height were obtained, the foals were sedated and the area of study was clipped and cleaned. The ultrasonographic location, appearance and measurements of the different organs were recorded for each examination. The study revealed that foals age >1 month resemble the mature ultrasonographic pattern. Continual growth of the organs was observed from Day 1 to age 6 months, being faster in the first month. Organ growth was closely correlated with age, but not with sex, height or weight in healthy foals up to age 6 months. Our study has provided measurements of longitudinal organ growth in healthy foals, presented in a simple form for easy comparison with diseased individuals.

Two-dimensional and M-mode echocardiographic measurements of cardiac dimensions in healthy standardbred trotters

The aim of the study was to establish normal echocardiographic values of healthy Standardbred trotters not published previously. Twenty-three clinically normal horses weighing between 350 and 490 kg were examined in the same manner: first a thorough physical and then detailed echocardiographic examination were performed. Standardised two-dimensional (2D) and guided M-mode echocardiographic imaging techniques were used to measure interventricular septal thickness (IVS), left ventricular internal diameter (LVID), left ventricular wall thickness (LVW), left atrial internal diameter (LAID) in end-systole (s) and end-diastole (d) and aortic diameter (AOD) in end-diastole. Mean, range and standard deviation of the different parameters were calculated. The mean values (in centimetres) were as follow (2D/M-mode): IVSs: 4.6/4.7; IVSd: 3.1/3.0; LVIDs: 7.0/7.0; LVIDd: 10.7/10.7; LVWs: 3.9/3.9; LVWd: 2.7/2.7; LAIDs: 10.4/-; LAIDd: 11.3/-; AODd: 7.2/-. Results of two-dimensional and M-mode measurements were compared to each other and to normal values obtained from other breeds.

M-mode echocardiographic reference values in cats in the first three months of life

Thirty-five young cats were studied by echocardiography from the 2nd to 12th weeks of life to analyze correlation between body weight, body surface area, age and heart rate with fourteen echocardiographic parameters. There was a positive linear correlation (r = 0.49-0.78) between the independent variables (body weight, body surface area, age) and left ventricular wall thickness and diameter, aortic diameter and left atrial diameter, whereas there was a negative correlation (r = -0.39 and r = -0.43) between the heart rate and left ventricular diameter during systole and diastole. No linear dependence of the fractional shortening, ejection fraction, percentage thickening of the interventricular septum and left ventricular posterior wall, LA/AO ratio, and the ratio IVSED/LVWED to the independent variables was observed.

Severe mitral regurgitation in horses: clinical, echocardiographic and pathological findings

Forty-three horses with mitral regurgitation (MR) and congestive heart failure were examined, using M-mode, 2-dimensional real-time and Doppler echocardiography. There was no breed or sex predisposition when compared to the general hospital population. The mean +/- s.d. age of affected horses was 7.6 +/- 8.1 years. Horses with MR and congestive heart failure had significant increases in mean values for left ventricular chamber size, left atrial size and heart rate and significant decreases in interventricular septal and left ventricular free wall thickness. Significant increases in pulmonary artery diameter were detected compared to aortic diameter. Mean values for fractional shortening were not significantly different from normal. All horses had a Grade 3-6/6 holosystolic or pansystolic murmur with its point of maximal intensity in the mitral to aortic valve area. Atrial fibrillation was found at presentation in 24 horses with MR and congestive heart failure. One horse presented with atrial tachycardia and subsequently developed atrial fibrillation. Seven horses had ventricular premature contractions. Exercise intolerance (n = 34), respiratory signs (n = 31), and fever (n = 21) were the most common presenting signs. Thickening of the left atrioventricular valve leaflets, endocarditis, flail valve leaflets, rupture of a chorda tendineae, and mitral valve prolapse were detected echocardiographically. Doppler echocardiography confirmed the presence of a large systolic regurgitant jet in the left atrium in all horses in which it was used, and in many horses, concurrent tricuspid and pulmonary regurgitation was detected. All horses died or were subjected to euthanasia due to the severity of their MR and/or lack of response to therapy. Post mortem examinations were performed in 35 horses and confirmed the echocardiographic findings. The echocardiographic detection of a flail mitral valve leaflet was significantly associated with the detection of a ruptured chorda tendineae at post mortem examination. There was a significant association between echocardiographic detection of a dilated pulmonary artery and its presence at post mortem examination. M-mode, 2-dimensional real-time, and Doppler echocardiography should be used to accurately characterise the valvular abnormalities and assess the severity of mitral regurgitation. Pulmonary artery dilatation, an echocardiographic indication of severe pulmonary hypertension, should be considered a grave prognostic indicator and may indicate impending pulmonary artery rupture.

Echocardiographic measurements of cardiac dimensions and indices of cardiac function in normal adult thoroughbred horses

Cardiac dimensions and indices of cardiac function were measured in 29 clinically normal adult Thoroughbreds (TB) which performed minimal exercise using guided M-mode and two-dimensional (2-D) echocardiography, from a variety of image planes and measurement methods, and standardised imaging planes based on intracardiac anatomical landmarks. The different methods of measuring these variables were compared. The variables which were considered to be most valuable for quantitative echocardiography were measured in a further 9 horses. Comparable measurements of cardiac dimensions can be obtained from a variety of different imaging planes, using either 2-D or guided M-mode echocardiography from the left or right side of the chest, although differences in measurement methods must be taken into account. The results of this study give a useful range of dimensions and indices of cardiac function in normal adult TBs for comparison with those recorded from horses with suspected cardiac disease. Comparisons are only valid if there is meticulous attention to correct orientation of imaging planes with regard to internal landmarks and that comparable measurement locations and timing are used.

Echocardiographic measurements of cardiac dimensions in normal ponies and horses

Echocardiographic examinations were performed on 41 clinically normal small ponies, large ponies and horses. Using standardised two-dimensional (2-D) echocardiographic images to guide M-mode studies, the interventricular septal thickness, left ventricular internal dimension and left ventricular wall in systole and diastole, and aortic diameter in diastole were measured. Normal values for these echocardiographic dimensions were obtained across a wide range of bodyweights. Although there was a trend for echocardiographic dimensions to increase with bodyweight across the whole range of animals examined, little or no linear correlation was found between dimensions and bodyweight within the small pony, large pony and horse groups.

Equine echocardiography--sound advice at the heart of the matter

Echocardiography is an extremely versatile tool for both the equine clinician and physiologist. There are three useful forms of echocardiography, B mode, M mode and Doppler. Together they provide complementary information on cardiac disease and haemodynamic status. B mode is used to image the cardiac chambers, valves, myocardium and pericardium. M mode allows determination of motion of cardiac structures; it is superior to B mode for timing of events and it is used to make precise measurements of the heart. Doppler echocardiography can assess intracardiac blood flow and its velocity. Echocardiography has applications in all forms of equine cardiac disease. In this article the principles of, and imaging techniques used in, B mode, M mode and Doppler echocardiography in the horse are reviewed. Normal findings and abnormalities seen in association with valvular lesions, congenital cardiac disease, myocardial and pericardial diseases are discussed. Recent developments in echocardiographic techniques for assessment of ventricular function are described.

Normal electro- and vectorcardiographic data in the growing Friesian calf using a semi-orthogonal lead system

This study derives normal values for electro- and vectorcardiographic parameters, as generated by the Holmes semi-orthogonal lead system, in healthy growing calves. Sixty-four electrocardiograms were recorded from healthy Friesian calves aged from one week to one year. Waveform and duration were analysed and compared in the X-, Y- and Z-leads. The modal P, QRS and T tridimensional vectors were graphically constructed and their magnitude and orientation were calculated. The duration of waves and intervals were similar to data previously reported in the bovine species. Differences from data reported in other species were attributed to heart rate. The duration of waves and QT and ST intervals significantly lengthened with the decrease in heart rate which occurred during growth. PR interval significantly lengthened with physical maturation, and this change was independent of the decrease in heart rate. The magnitude and the orientation of the spatial modal vectors were approximately similar to the few data previously reported in cattle and in other ungulates and were not affected by somatic growth.

Standardised imaging technique for guided M-mode and Doppler echocardiography in the horse

Eighteen echocardiographic images useful for diagnostic imaging, M-mode echocardiography, and Doppler echocardiography of the equine heart were standardised by relating the position of the axial beam to various intracardiac landmarks. The transducer orientation required for each image was recorded in 14 adult horses by describing the degree of sector rotation and the orientation of the axial beam relative to the thorax. Repeatable images could be obtained within narrow limits of angulation and rotation for 14 of the 18 standardised images evaluated. Twenty-seven National Hunt horses were subsequently examined using this standardised technique. Selected cardiac dimensions were measured from two-dimensional and guided M-mode studies. Satisfactory results were achieved in 26 of the 27 horses. There was no linear correlation between any of the measured cardiac values and bodyweight. There was no significant difference between measurements taken from the left and the right hemithorax. Six horses were imaged on three consecutive days to assess the repeatability of the measurements. No significant difference was found between measurements obtained on different days. This study demonstrates a method for standardised echocardiographic evaluation of the equine heart that is repeatable, valuable for teaching techniques of equine echocardiography, applicable for diagnostic imaging and quantification of cardiac size, and useful for the evaluation of blood-flow patterns by Doppler ultrasound.

Measurement of cardiac dimensions with two-dimensional echocardiography in the living horse

Two-dimensional echocardiography (2DE) was performed on 22 unsedated Thoroughbred and part Thoroughbred horses weighing between 411 and 650 kg to establish normal reference values for 2DE measurements. Animals stood during examinations performed with a 3.5 MHz mechanical sector transducer using various transducer positions and tomographic planes. Right ventricular diameter (RVD), ventricular septal thickness (VSTh), aortic diameter (AoD), area of the chordal lumen of the left ventricle (CTA), left ventricular diameter (LVD) and left atrial diameter (LAD) were determined at ventricular end-diastole (Ed) and/or end-systole (Es). Fractional shortening (FS) of the left ventricle and end-systolic left atrial to aortic ratio (LAD-Es:AoD-Es) also were calculated. Echocardiographic data were related to body weight by linear regression analysis. Intra-observer variability was checked in five horses by measuring each parameter during each of 10 consecutive cardiac cycles. The 2DE data were compared with M-mode values in published reports. In the 18 horses whose weight did not exceed 551 kg, repeatable recordings of good quality were obtained, and 2DE measurements could be made using intra-cardiac reference points. Increasing body weight proved to impose substantial limitations on measurements taken with the available machine and transducer. This problem might be overcome by using probes of lower frequency or equipment with higher quality image display at greater depth. The following parameters correlated significantly to body weight: VSTh-Es (r = 0.69; P less than 0.01). AoD-Es (r = 0.64; P less than 0.01) and CTA-Es (r = 0.84; P less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Advances in echocardiography

Before the development of echocardiography, cardiac disease in the horse was diagnosed if a loud heart murmur (grade III-IV/VI or louder) and clinical signs of congestive heart failure (coughing, edema, venous distention, jugular pulsations) were detected on physical examination. Arrhythmias that persisted during and after exercise also indicated cardiac disease, which could be characterized electrocardiographically. Electrocardiography, thoracic radiography, angiography, cardiac catheterization, and oximetry could add only small pieces of information about the heart. M-mode echocardiography provided the first "window" with which to evaluate the heart and its intracardiac structures, albeit an ice-pick one-dimensional view. With M-mode echocardiography, the diameter of the aorta at the valves, the left ventricle, right ventricle, and left atrial appendage, as well as the thickness of the interventricular septum and left ventricular free wall, could be measured. Motion and thickness of the tricuspid, mitral, and aortic valves could be assessed, but only in a one-dimensional plane. Two-dimensional echocardiography provided an added dimension, resulting in visualization of all the intracardiac structures, aorta, and pulmonary artery. Two-dimensional echocardiography became the diagnostic technique of choice for the evaluation and characterization of congenital cardiac disease in critically ill neonates, as well as in adult horses. Two-dimensional echocardiography also improved the ability to diagnose valvular regurgitations, characterize valvular lesions (bacterial endocarditis, ruptured chorda tendineae), myocardial function (segmental wall motion abnormalities), atrial size, mass lesions (endocarditis, neoplasia, and thrombi), and pericardial effusion. Information about blood flow was obtained using contrast echocardiography but was limited to certain cardiac abnormalities (congenital cardiac defects and tricuspid regurgitation). This information about blood flow was limited to the detection of positive or negative contrast jets. Comprehensive information about blood flow was lacking until the application of Doppler echocardiography to equine cardiology. Pulsed-wave and color flow Doppler echocardiography resulted in precise localization of the abnormal blood flow and semiquantitation of the shunt flow or regurgitant jet. Color flow Doppler echocardiography sped up the localization and semiquantitation of the jet in many instances and provided some information about blood flow velocity in the enhanced and variance modes. The peak velocity of jets can be determined using continuous-wave Doppler echocardiography. This value then can be used to estimate pressure difference between cardiac chambers or to calculate cardiac output noninvasively if angles parallel to flow can be obtained. Thus, information about cardiac size, function, and blood flow can be combined to diagnose cardiac disease in horses and to formulate a prognosis for life and performance.

Cardiovascular adaptations to exercise and training

The cardiovascular system provides the link between pulmonary ventilation and oxygen usage at the cellular level. During exercise, efficient delivery of oxygen to working skeletal and cardiac muscles is vital for maintenance of ATP production by aerobic mechanisms. The equine cardiovascular response to increased demand for oxygen delivery during exercise contributes largely to the over 35-fold increases in oxygen uptake that occur during submaximal exercise. Cardiac output during exercise increases greatly owing to the relatively high heart rates that are achieved during exercise. Heart rate increases proportionately with workload until heart rates close to maximal are attained. It is remarkable that exercise heart rates six to seven times resting values are not associated with a fall in stroke volume, which is maintained by splenic contraction, increased venous return, and increased myocardial contractibility. Despite the great changes in cardiac output, increases in blood pressure during exercise are maintained within relatively smaller limits, as both pulmonary and systemic vascular resistance to blood flow is reduced. Redistribution of blood flow to the working muscles during exercise also contributes greatly to the efficient delivery of oxygen to sites of greatest need. Higher work rates and oxygen uptake at submaximal heart rates after training imply an adaptation due to training that enables more efficient oxygen delivery to working muscle. Such an adaptation could be in either blood flow or arteriovenous oxygen content difference. Cardiac output during submaximal exercise does not increase after training, but studies using high-speed treadmills and measurement of cardiac output at maximal heart rates may reveal improvements in maximal oxygen uptake due to increased stroke volumes, as occurs in humans. Improvements in hemoglobin concentrations in blood during exercise after training are recognized, but at maximal exercise, hypoxemia may reduce arterial oxygen content. More effective redistribution of cardiac output to muscles by increased capillarization and more efficient oxygen diffusion to cells may also be an important means of increasing oxygen uptake after training.

Echocardiography

Diagnostic ultrasound permits the clinician to image the beating heart, quantitate cardiac dimensions, identify specific congenital and acquired cardiac lesions, and estimate the degree of cardiac compensation and muscle failure that accompanies a specific lesion. The M-mode (motion) echocardiogram and two-dimensional echocardiogram are complementary studies that have proved useful for identification of cardiac septal defects, endocarditis, pericardial effusion, intracardiac shunting, cardiomegaly, and heart muscle failure. Appreciation of the technique and basic knowledge of the types of information that can be obtained from echocardiography are necessary to appropriately refer horses for these studies.

Anesthesia for neonatal foals

A brief discussion of those aspects of neonatal physiology that pertain to anesthetic risk and selection of anesthetic techniques is followed by discussion of suggested techniques for anesthetic management in healthy foals. Preoperative preparation and management of foals with selected serious surgical conditions are also considered.

Cardiovascular disease in the equine neonate

Cardiac disease in the equine neonate occurs infrequently. Murmurs are often heard in foals and are not considered significant unless they persist beyond 4 days of age. Congenital cardiac defects are the most common form of primary cardiac disease in the foal, with ventricular septal defects occurring most frequently. Other neonatal foal diseases such as ruptured bladders, white muscle disease, neonatal respiratory distress syndrome, and septicemia have secondary cardiac involvement.

Respiratory studies in foals from birth to seven days old

Respiratory measurements and blood-gas and acid-base values are reported in nine term induced foals. Measurements were performed at 2, 15, 30 and 60 mins, 4, 12, 24 and 48 h, and four and seven days after birth. Minute respiratory volume was significantly lower at birth than values from 12 h old. Tidal volume peaked at 60 mins old, while respiration rate decreased significantly at 15 mins after birth. Oxygen consumption was high at birth and decreased to its lowest values at 24 and 48 h. The respiratory exchange ratio and ventilatory equivalent showed few significant changes to seven days, as did the minute alveolar ventilation and physiological deadspace. The blood-gas and acid-base values indicated that the foals rapidly establish adequate pulmonary ventilation within minutes of birth, and that those values changed little from 12 h to seven days after birth. Body position had a significant effect on arterial oxygen tension with Pao2 values in lateral recumbency being, on average, 14 mmHg lower than when the foals were standing.

Response to oxygen administration in foals: effect of age, duration and method of administration on arterial blood gas values

The effect of oxygen administration on blood gas values was examined in six newborn foals from birth to seven days old. Three variables were studied: the effect of increasing age on the ability to elevate arterial oxygen tension (Pao2), the effect of duration of oxygen delivery on Pao2 and the effect of method of administration. The results demonstrated a significant effect of age on the ability to increase Pao2 values, with the highest Pao2 values being found at seven days old. The duration of oxygen administration caused little change in Pao2 values; peak values were reached after 2 mins of oxygen inhalation and changed little throughout the 20 min administration. No significant differences were found in Pao2 when oxygen was administered via a face mask, compared to administration at 10 litres/min via an intranasal tube. The clinical importance of these findings is discussed, along with the factors which may be involved in the inability to elevate Pao2 in the early post natal period.