© Valerie Kleinheitz 2002

Princess was born 2 weeks premature, in most cases this is no big deal, but for her it was.  Princess greeted us at 11 PM Wed May 1st, Glynn, my husband, was there for the foaling and it was uneventful as to duration and amount of stress to either mare and foal.  Glynn called to let me know that we had another chestnut filly (fillies are very rare for us, and chestnut ones from this stallion are even rarer!) and that she seemed to be okay, he would call me back with an update after she was standing and had nursed.  As many of you know I night watch on a Tbred farm so I was not able to be with my girl.  At 2 AM Glynn called with the bad news, our filly could not get up or stand on her own, would I please come and work with her, he would night watch for me.

Still Down at 14 Hours Old
I arrived with all the possible needed things for a down baby and Glynn went to work with the Tbreds.  Princess woke up around 3 AM and so I tried to get her on her feet, she was very interested in standing but needed help getting to her feet and holding herself up.  I placed her front legs out in front of her, tickled her back to get her to try to stand then lifted her tail and breast bone to help, she helped and so we got her up with only a moderate amount of help, now to see how strong she was...she was so weak in the pasterns that she was standing on the backs of her ankles, her knees bent back a little and she went spread eagle in front if you did not keep a foot on the outside of her foot, her back legs were not even connected to her as far as coordination. 

Okay this was handle able, time, milk, and getting her to try hourly should help.  Prinny was only able to stay up for about 3 minutes so when she went down I milked out the mare and offered her some colostrum (she had nursed a bottle hourly for Glynn so we knew that she was getting the nutrition and antibiotics that she would need if we were going to make it) I was now to keep a chart of how much and how often she nursed, how long she stood, degree of strength and TEMP.

Prinny and I got very attached during these hours, but I had no idea as to how attached Glynn had gotten, you see he has never had to work with a sick /down foal before, I have always done it with his help, but only if needed.  Now for the decision as to put her on antibiotics or not, if she was early because of an infected placenta, or picked something up in the stall than it would give us a little early help, if she did not need it we would see when we did blood work on Thursday and could take her off it, I put her on some oral antibiotics that we keep on hand for just this reason. 

Does this sound calm? Right, it only sounds like it, you really second guess yourself all the time.  At 6 AM I had decided to call our vet and give him the facts and asked what he thought. He said that it sounded like we had it handled and that he would be in our area around 1 PM but to call if things did not improve.  I called my mother for help and company as it looked to be a long day, also to bring food <G> 

Prinny got stronger as the day progressed, I was in heaven, she would be okay and on her feet soon, she was up off her ankles, trying to use her back legs and getting stronger (stayed up longer all the time) we planned on trying to get her to the mare around her 3 PM stand time.  As is normal around here Dr Pete showed up around 3 PM (he had several extended stays at some farms) Dr Pete liked her looks, amount of milk intake (8-14 oz an hour) and the fact that her legs were getting stronger, he recommended that we keep her on antibiotics till we got the blood work back and then dropped the bombshell that I was hoping not to hear.  “IF she does not improve every hour take her to the clinic!  A lot of foals are crashing at 24 hours…be very careful, in fact you might want to take her in just to be sure” said Dr Pete.  “Okay should I just go in, or do you think that we have a chance here?”  Dr Pete said that she looked great, to wake her up every ½ hour and feed her not to just let her get up hourly and to make sure that we did not go backwards cuz with this young a foal anything can happen very fast.  (Please let me add here that I was the ICU Supervisor at the very clinic that we took the filly to, so both of us knew that I could take care of her needs, and could spot most problem areas faster than most owners. I was still a very nervous step mom!)

Glynn showed up after 4 PM, I gave him the facts, showed him how much the filly had improved and figured that he would say to keep trying at home unless Prinny failed to improve. I then found out just how attached he had become, “ Lets not take a chance, I’ll go hook up the trailer.”  Deep bedding was put into the nose of the trailer, a baby blanket was put on her, and extra blanket to cover her with if she was resting quietly seems like overkill but it is much easier to work on a foal that is warm than one that you have to warm up from the beginning.

Let me stop here to talk about Cheyenne, Prinny’s momma, this mare let me sit on a water bucket hourly to milk her out, never lifting a leg she would just nuzzle the filly as I milked, producing 24-34 ozs hourly (yep that’s lots of colostrum).  We took the extra colostrum to the clinic with the filly just in case, we had 4 quarts of extra in a cooler jug.  Prinny’s IgG was over 1,200, the colostrum in the jug was over 1,000 and the new milk from the mare was still at over 1,000 so we donated the colostrum in the jug to the clinic.  During Prinny’s first stay in the clinic Momma Chey fed Prinny and 2 other foals that needed milk.  Please understand that I agreed to this because Prinny was sure to get all the milk that she needed and my mare was sure to be milked out regularly and would not be allowed to dry up!  Cheyenne walked onto the trailer as Glynn carried her foal, stood over her with the utmost of care on the trip to the clinic (I know cuz I was in the trailer with them, did not want to take a chance of momma stepping on her baby)!

I called the clinic and told them that we were on the way, that we had a weak foal, 2 weeks premature that could not stand but did nurse a bottle very well, the vet had recommended that we send her in for observation and feeding through the night, but that she was not intensive care at this point.   Imagine my surprise when we carried her in to her stall, (one for intensive care foals) it was set up with a foal bed, and all the emergency equipment for a crashed foal…oooooh this was going to cost! 

Prinny was placed on the bed and blood was drawn to test her IgG, WBC and other need to know things that we could not see from the outside.  An NG (stomach tube for feeding) was placed and we waited for the blood work to return, talking about things in the clinic and that the filly seemed to be okay without a catheter as she had beat up 4 people putting in the NG tube, she did not appear sick.  I even offered to buy the Lab Tech lunch if she would stay and do the extra tests that would be helpful but not really needed at that moment.  The WBC was very low so now we knew that she had an infection someplace, the IgG was great so we did not need plasma, we cross matched the mares milk and the foals blood as to NI (Neonatal Isoerythrolysis, or jaundice blood) and this was also negative (I normally check this within 30 days pre foaling, but as Prinny was early I had not done it this year).  Prinny had a catheter put in and was started on IV antibiotics to fight the infection.  The plan was to feed her every other hour to encourage her to nurse, get her up hourly to encourage her to use her legs, to try to get more strength and to try to get her interested in her mom.  We went home that night feeling that she was in good hands and would be home soon.

Friday was a sunny day and with good news from Dr Riemer I was feeling pretty good as I got off work at noon and went to see Prinny.  Imagine my surprise when I entered her stall and she was having mild seizures!  

Nurse Working with Prinny Between Seizures
It only took the slightest stimulant to start them but the duration was short and the effect was not overly intense.  Prinny continued with seizures through the afternoon and that evening Mannitol was given to try to get things under control again.  Prinny never had another seizure after the Mannitol, her white count was coming up and by 5 PM on Saturday she was standing on her own and nursing.  Dr Riemer called on Sunday morning to say that Prinny could go home but she was to be kept on antibiotics, did we want to stay with IV or did we want to go oral.  We decided to stay with the IV for the first 2 days and if she were still doing well we would switch to oral when the IV antibiotics ran out.  Prinny looked great, she walked out to the trailer on her own and we felt that we were going to be able to stay home, Prinny did still have a little diarrhea but it was resolving and not felt to be a problem.

Prinny finished her IV meds on Tuesday so we went to orals and she started with straight water diarrhea within 12 hours.  We called our vet and were told to put her on electrolytes (we had already done this) to give her 2 cc of banamine and to give her yogurt.  I will add here that Prinny had been put on Gastro Guard as an ulcer preventative Wed night and had stayed on it. We did draw blood on her to get a set of values just in case things went very wrong.  The blood work showed that we needed to get her Bicarb up (the electrolytes would do this) and that her white cells were slightly high but not bad.  Just after noon the next day Prinny’s belly started to swell and she started to roll.  NOT GOOD, we now knew that we had to return to the clinic.  I called the clinic, loaded our poor baby back in the trailer and with Glynn driving, Chey, Prinny and I made our third trailer trip in her short life.

Dr Bernard was on call this time so he met us at the door to Isolation (all horses that are admitted with diarrhea go to Iso) Prinny walked into Iso on her own this time and word spread like lightening that Chey was back at the clinic (I did not know till then that Chey and Prinny had such a following! You see, million dollar Tbreds are a regular sight at the clinic, but a big beautiful spotted walking mare with her spotted foal now that was something new and different.  Chey had also fed half the foals in ICU the first time so that had earned her a place in their hearts) Glynn, who had left work without the okay from his boss, had to drop us off and hurry back to the Tbred farm before the vet got there to treat those mares.

Prinny was tranquilized, and a catheter was put in the opposite side of her neck from the first catheter (you do not want to stress one vein too much) and then they brought out the ultrasound machine (Dr Bernard joked that it was the same on that we used when I worked there many years ago, surprisingly it really was!)  Prinny’s belly looked like she had swallowed a basketball, she was tight as can be and she hurt, the ultrasound showed fluid filled bowels so now to the really bad news.  “We need to put her on TPN for at least one day” Dr Bernard said, he knew what a bombshell that was cuz it really is expensive. 

TPN is a total nutritional fluid that is in  IV form, it is 50% dextrose and has everything that a foal needs to survive and grow, it can be used for an extended time if needs be.  We used it on very premature foals that had not fully developed their GI tract and could not handle milk yet (when I worked there years ago we used it on foals that could not stand yet, it has to kept sterile and MUST be kept going all the time or really nasty things happen to the foals blood work).  How were they going to keep Prinny on this stuff full time without tranquilizing her into a coma?  Boy was I in for a surprise!  As I sat with my poor girl the Techs brought in a corner cage and fenced Prinny in, this way she could not get to her mom to nurse and she had to be pretty still to stay hooked up to her TPN. 

The other shoe dropped when we got her blood work back and found that her white cell count had sky rocket over night, she had another infection to fight off.  Prinny was on TPN for 48 hours, during this time she pushed over her cage 5 times and managed to get out of her stall once, she may have been down but she was not out yet!  Prinny was on IV antibiotics, metronidazole (a different oral) gastro guard and TPN.

Chey was milked out every other hour again, it was going to be touch and go for a few days. As good as Dr Bernard is I still went home worried about Prinny that night.  Prinny had only been out in the sun for one hour in her short life, I did not want to loose her without her getting to run and play in the grass at least once in her life.  Prinny made it through her TPN days, then horror of all horrors they had the gall to put a muzzle on her when they finally took her out of the cage.  Chey was milked out every other hour and then Prinny was allowed to nurse for 5 minutes, this way she did not get too much milk all at once- try explaining this to a mare who is not sucked bone dry and still has a baby that wants more! 

Prinny’s white count gradually returned to normal and she was also gradually allowed to nurse more and more, she is home now, having finished her course of antibiotics and short turnout times.

Prinny and Cheyenne Home and Well
Prinny and Cheyenne are now turned out all day, Prinny has normal poop and runs bucks and jumps like a normal foal, she has gained enough weight so that she is round over her back and hips.  We owe a great deal of thanks to many people, a greater thank you for answered prayers, and oh yes, a very rare steak lunch to a Lab Tech that did not need to stay but decided to join in the Chey -Prinny fan club. 

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