Gastrointestinal disease is one of the most common problems neonatal foals face during the first weeks of life. The most frequently encountered problem in this age group is contagious gastroenteritis which has been well described. Less well understoodand less common is the gastrointestinal (GI) dysfunction which often accompanies neonatal encephalopathy (also referred to as hlypoxic ischemic encephalopathy, asphyxia syndrome) and neonatal nephropathy during the first days of a foal's life. This triad of neurologic, renal and GI syndromes often with signs of sepsis is the most common complaint of foals less than 48 hours old admitted to our Neonatal Intensive Care Unit. The GI component has a wide range of clinical signs and severity form very milddysmotility to severe necrotizing disease. The necrotizing disease we see has some similarities (and some differences) to the disease well recognized in human infants called Necrotizing Enterocolitis (NEC). This talk will describe our experience with two recent studies which have brought attention to the occurrence of necrotizing gastrointestinal (GI) disease and asymptomatic intussusceptions in neonatal foals. The relevance and association of clinical and sonographic findings in neonates with gastrointestinal disease will be discussed from the perspective of a sonographist and a neonatologist. During this session we will not attempt to review the technique, normal or abnormal findings in abdominal sonograms in foals. However, we want to point out 2technical notes. The sonographic examination ofthe neonate with abdominal disease can be done with the foal standing, in lateral or sternal recumbency. It is important to realize that lesions tend to localize in the most dependent part of the abdomen and that these lesions can be mobile. Therefore itis important to scan carefully the gravity dependent area. This implies to place the probe under the foal to scan the ventral abdomen if the foal is sternal, to scan the left side if the foal is in left lateral recumbency and the right side if the foalis in right lateral recumbency. The author finds microconvex probes to be the most useful probes. These probes typically have a frequency of 5-11MHz. The frequency varies depending on the equipment used. To assess carefully the echogenicity of the wall,the wall layering or to be precise when measuring the thickness high frequency linear probes (usually 8-15 MHz) are required. Soaking the hair with alcohol is, in most foals, enough to obtain adequate images for 'fluid checks' or to detect severe abnormalities. To obtain detailed images clipping may be necessary. Clipping and using gel reduces the scanning time although it increases the preparation time.Abdominal ultrasonography has been used for years as a valuable diagnostic aid and has become routine in the assessment of foals with critical gastrointestinal disease, however information about its usefulness, accuracy and limitations is not available.Abdominal ultrasound examinations are performed commonly by non-radiologists in human and veterinary intensive care units. In human critical care units, the time from presentation to operative care, length of hospitalization, complications and cost decrease when emergency abdominal sonograms are performed, potentially due to a more rapid diagnosis'
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