Digital arterial thrombosis in a septicemic foal.

This research investigates the case of a 3-day-old foal that presented symptoms of weakness and recumbency. The foal was found to have septicemia, which resulted in a condition called digital arterial thrombosis. Despite aggressive treatment including antibiotics, fluids, immunoglobulins, and thrombolytic therapy, the prognosis was poor. The case study suggests that septicemia in foals can result in an abnormal coagulation profile leading to the formation of thrombi (blood clots) and, consequently, digital arterial thrombosis.

Case Presentation and Initial Findings

• The subject of the study was a 3-day-old Quarter Horse filly exhibiting weakness and an inability to stand.
• Physical examination revealed several abnormalities such as tacky and hyperemic oral mucosa, corneal ulcers, increased respiratory effort, limb edema, and attrition marks on oral mucosa.
• Blood analysis found hypoalbuminemia, hyperbilirubinemia, and neutrophilic leukocytosis with a left shift, strong indicators of septicemia and pneumonia.

Diagnosis and Treatment

• The foal was diagnosed with septicemia and pneumonia based on the clinical and laboratory findings.
• Initial treatment included polyionic fluids, systemic antibiotics, ocular antibiotics, diuretics to reduce limb edema, sucralfate, cimetidine, and a dose of equine plasma to treat hypoproteinemia.
• Despite initial treatment, the frigidness in the left hindlimb advanced, a coagulation profile was requested, and thromboembolism was suspected due to suspected systemic hypercoagulation and potential thromboemboli.

Further Complications and Conclusion

• A digital subtraction angiography (DSA) was performed and confirmed the presence of thromboembolism in the left hindlimb and unexpectedly also in the right hindlimb.
• Thrombolytic therapy with urokinase was administered to dissolve blood clots but reperfusion was not documented.
• The animal was subsequently euthanized due to the poor prognosis of ischemic necrosis on both hindlimbs. Post-mortem analysis revealed thrombosis of palmar and plantar digital arteries along with avascular necrosis of the distal limbs.
• The study concludes that septicemia can lead to abnormal coagulation profiles in foals, increasing the risk of thromboembolism and as a consequence, digital arterial thrombosis.