Diarrhea of the Neonatal Foal
Basic Information 
Clinical Presentation
Physical Exam Findings
• Temperature: Hyperthermic or hypothermic
• Heart rate: Often tachycardic
• Mentation: Depressed, lethargic, decreased affinity for the dam
• Mucous membranes: Injected, tacky, bright, muddy; prolonged capillary refill time
• Perineum: Wet with diarrhea unless very projectile; inspect walls of the horse’s stall for evidence of diarrhea.
• Hydration: Severely dehydrated foals have sunken eyes, sluggish jugular refill, and cool extremities.
Etiology and Pathophysiology
• Foal heat diarrhea: Unknown; believed to be related to maturational changes of the gastrointestinal (GI) tract; occurs between approximately 5 and 15 days of age.
• Asphyxia-associated gastroenteropathies: Hypoxic insult to the GI tract and hypoperfusion; possibly reperfusion injury sustained during hypoxic event (umbilical cord compression, dystocia, red bag delivery).
• Necrotizing enterocolitis: Unknown; necrotizing insult to the GI tract; suspected to be associated with prematurity or hypoxia.
• Mechanical enterocolitis: Ingestion of sand, dirt, bedding, or the dam’s tail hair may result in mechanical irritation of the GI mucosa.
• Dietary intolerances: Feeding a milk replacer often results in diarrhea; lactase deficiency occurs with the loss of the mucosal brush border of the small intestine. (Clostridium difficile and rotavirus infections are especially associated with lactase deficiency.)
• Clostridial enteritis: C. difficile and Clostridium perfringens are most commonly involved; both can be primary pathogens to foals without preceding risk factors.
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