A Fresh Look at the Process of Arriving at a Clinical Prognosis. Part 3: Neonatal Illness

Determining the prognosis in a sick newborn foal is complicated by the following three factors: the normal transition from maternal/placental dependence to independence, intrauterine conditions before birth, and the birth process itself. In addition, there are several vulnerabilities and unique characteristics of the neonatal foal that are not shared by older foals or adult horses. However, the same principles of assessing homeostasis apply to establishing a prognosis in a sick neonate, as previously described for the adult. Overall, survival rates for septic critically ill foals generally vary between 60% and 80%. In noncritical yet seriously ill foals—a diverse group sometimes referred to as the “sick, nonseptic foal”—survival rates typically range from 75% to 95% with proper medical care. Long-term survival rates are lower for all categories of sick foals, and subsequent athletic performance may be adversely affected by sepsis or septic arthritis/osteomyelitis.