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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