Health Update: Thursday, April 10
My Special Girl and Boone are progressing well. However, each of them has conditions that their veterinarians are monitoring.
Boone is thriving, weighing in at 137 pounds on April 10, up 33 pounds from his birth weight of 104. He is eating well, is very playful and has lots of energy. His front teeth, or incisors, are just coming in. “This is the expected growth rate for a normal, vigorous foal,” said Dr. Jonathan Palmer, Chief of New Bolton Center’s Neonatal Intensive Care Unit.
However, as described last week, Boone has four fractured ribs. Dr. Palmer also has detected a heart murmur.
Boone’s fractured ribs are healing well and as expected, Dr. Palmer said. The colt’s body has formed a protective cushion over each sharp end, called a seroma, which helps prevent the sharp ends from cutting other tissue. The seroma is formed by a thick, tough outer layer of fibrous tissue surrounding an inner pocket of fluid around the sharp ends. The bone also has begun to “remodel,” or re-form, so that the ends aren’t as sharp.
“As both processes proceed the fractured ribs become less and less a threat of causing further problems,” Dr. Palmer said.
Boone also has a heart murmur. Heard through a stethoscope, heart murmurs and are caused when the flow of blood through the heart becomes turbulent, Dr. Palmer said. This disrupted flow may occur as blood flows normally through the heart in young foals, referred to as a “flow murmur.” Flow murmurs, which are completely harmless, are very common, seen in 80 percent of foals during their first month of life, Dr. Palmer said. Murmurs also can be caused when connections in the heart are not completed, or when there is a heart defect.
“We will be following Boone’s heart murmur carefully during his first month to be sure it is harmless,” Dr. Palmer said. “But if it doesn’t fade and disappear we will do a complete heart examination including ultrasound imaging of his heart.”
My Special Girl is doing very well post-foaling, said Dr. Regina Turner, New Bolton Center Associate Professor of Reproduction. At her last examination, she was pooling urine in her vagina, which is common in mares after foaling, Dr. Turner said, and occurs because the birth canal is stretched during delivery of the foal. Last week Dr. Turner supervised as students performed a lavage to flush out the pooling urine in her uterus.
“The vast majority of mares self- correct this problem after they have their first postpartum ovulation,” Dr. Turner said. “We and our students will monitor her after she ovulates to be sure that this is the case for MSG. We have every expectation that it will be.”
Physical Exam: Tuesday, April 1
My Special Girl’s colt is thriving with normal vital signs and his prognosis is good. However, he has four fractured ribs, as confirmed today in an exam by Dr. Jonathan Palmer, Chief of Penn Vet New Bolton Center’s Neonatal Intensive Care Unit.
“It is not unusual for foals to fracture ribs when they are born, even when it's not such a tight squeeze,” said Dr. Palmer after the Tuesday morning examination. “The birth canal was tight, so we had been looking to see if he fractured any ribs.”
"The four fractured ribs are on the colt’s right side, which is better because they are farther from his heart," Dr. Palmer said. The ribs do not require repair, as they should heal on their own.
“It shouldn’t cause any long-term problems,” Dr. Palmer said. He checked the ribs on Sunday and Monday, but today some swelling appeared on the right side and he checked again.
He does not appear to be in too much pain, and was lying on his right side, sleeping this afternoon. “I’m sure it tingles and it bothers him a bit,” Dr. Palmer said."We don't want to give him any painkillers unless it's absolutely necessary. If he feels too comfortable, he might get overly rambunctious and fall on the fractured ribs, harming himself further."
The colt and My Special Girl will stay in the NICU at least until Monday, instead of leaving today as planned. Dr. Palmer said it takes about 10 days for the ribs to heal to the point that it will be safe to transport him to his new home.
“The bone will remodel and the edges will become less sharp so they are less likely to cut,” Dr. Palmer said. “During that time, the body will also form a protective barrier of fibrous tissue around the sharp ends. The ribs are not displaced. They just need time to heal.”
The danger is that a hard fall could fracture the ribs further. “Fractured ribs have sharp edges. Right now they are fairly aligned, but if he did something to misalign them a rib could puncture his heart or his lungs,” Dr. Palmer said.
The colt was born on Saturday, March 29, at 9:22, after a 22-minute labor. Dr. Palmer and his team had to assist in the birth, by lubricating the birth canal and pulling the foal through. The pulling by the clinicians did not cause the fractures. In fact their assistance probably prevented more from being affected.
Once it is safe for them to leave the NICU, My Special Girl and her foal will go to live at the Hofmann Center for Reproduction on the New Bolton Center campus. They will be confined to a stall there for at least a month, until the colt’s ribs fully heal. Then they will spend much of their time outside.
On April 1, My Special Girl also had her examination, and she is doing very well.