Pathology in practice. Chylous ascites with secondary neutrophilic inflammation in a foal.

This study discusses a case of an 8-hour old foal suffering from colic, which upon further diagnostic tests, turns out to have chylous ascites and secondary neutrophilic inflammation. Following treatment, the foal showed marked signs of improvement in its overall clinical state.

Background and Initial Diagnosis

• The article starts with an account of an 8-hour-old foal who showed signs of colic, including reluctance to nurse, rolling on the ground, and visible discomfort. The primary vet carried out a preliminary assessment, including an enzyme immunoassay for measuring the serum IgG concentration, which showed normal results.
• The foal was then administered a dose of butorphanol tartrate and given multiple enemas to relieve the colic. However, no significant improvement in the clinical signs was reported which led to the foal’s referral to the Virginia-Maryland Regional College of Veterinary Medicine.

Hospital Evaluation and Clinical Findings

• At the hospital, the foal could stand when aided, but showed general signs of colic and had weak hind limbs. The foal appeared to be dehydrated by 6% and showed signs of mucous membrane inflammation. All other physical examination findings including temperature, pulse rate, and breathing rate were normal.
• The foal’s bloodwork showed a normal neutrophil count within the reference interval for newborn foals, mild left shift, and mild lymphopenia. This was indicative of inflammation coupled with stress.
• All other serum biochemical test results, plasma fibrinogen, and serum lactate concentrations were unremarkable based on age-matched reference intervals, hinting that the foal’s other physiological functions are functioning within the normal range.

Further Investigations and Final Diagnosis

• On the following day, an abdominal ultrasound revealed some free, anechoic fluid in the abdominal cavity, which was extracted for examination. The fluid was yellowish-white and had elevated levels of total protein, red blood cells, and total nucleated cells.
• This finding suggested the presence of chylous ascites, a rare condition where lymphatic fluid accumulates in the abdomen, often causing abdominal distension and discomfort. This, along with the secondary neutrophilic inflammation, explained the observed symptoms in the foal.