Foaling History Form by Nb56KRh

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									                               FOALING HISTORY FORM
                             Northeast Pennsylvania Equine Clinic
                    Client Question Form for Appointment and Patient Record


Date:___________________ Phone Number(s):______________________________________________

Client:__________________________________ Patient Name:_________________________________

Breed:_________________________________________Age:______________Sex:_________________

Verify Location:_______________________________________________________

Foal:

Approximate time of birth:_____________

Up & Nursing? Yes_________ What time?______________No __________

Breathing normally without flared nostrils or excessive effort? ___________________________

Passed Manure? Yes ________ No ________           Urinating normally? Yes __________ No __________

Navel dipped in 2% iodine? Yes _________ No __________
(If 1%, dip more frequently. If higher percent iodine, dilute down. Can burn skin!)

Alert & responsive? Yes __________ No _____________

Is posture of head, neck and body upright, without tilting? ______________________________________

Walking around normally?________________________________________________________________

Any visible abnormalities of the eyes or any other body part? ____________________________________


Mare:

Placenta passed? Yes _____ How long after birth?_______Please save in pail cold salt-water for vet. exam.
                 No _____ Tie up if hanging below hocks so mare doesn’t step on it or tear it up. Problem
                           and potential emergency if not passed within 6 hours.

Any injury related to foaling? Extent of injury?________________________________________________

Gums pink with normal capillary refill? Yes ____________ No _______________

Mare appears reasonably comfortable? Yes __________ No ___________Any colic signs? ____________

Passing manure? Yes _________ No ___________

Did mare receive tetanus toxoid 3-6 weeks before foaling? Yes ________ No __________

Any concerns with mare or foal? If so, please put in emergency call.

If everything with mare and foal appears normal, the mare and foal should be examined and the foal
tested for normal antibody transfer 12 to 24 hours after birth. Foals absorb maternal antibodies up to 24
hours of age.

NOTE: Approximately 10% of foals have very low antibody levels or complete failure to absorb antibodies
from the mare. Another 10% are moderately low in antibodies, therefore approx. 1 out of 5 foals are at risk.
At risk foals usually look perfectly normal. Any kind of infection of these foals can lead to death.

								
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