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Hypoxic-Ischemic Encephalopathy(HIE)

By: Dr. Mary Rose Paradis

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Foals with uncomplicated HIE generally have a good prognosis. Recovery rate is approximately 70 to 75 percent. Their recovery is the reverse of the presentation of clinical signs. Recovery may be slow with a little progress each day. This is a typical recovery pattern.

  • The seizures stop.
  • The comatose foal begins to show response to stimuli.
  • The foal becomes more aware of his surroundings.
  • The recumbent foal makes successful attempts to stand.
  • The foal may become more aware of his mother, nuzzling around for an udder.
  • Finally the foal regains his suckle reflex. The suckle reflex appears to be the first reflex to be lost and the last to be regained.

    The key to this type of recovery is uncomplicated HIE. As one can see, the HIE foal is at high risk for complications with the chance of failure to ingest a good quality and quantity of colostrum. This leads to all the associated problems of septicemia. It is sad to have a foal recover from HIE only to develop septic arthritis or pneumonia. Other complications, such as corneal ulceration or pressure sores, can prolong the foal's hospital stay.

    Many owners are worried about the mental capacity of their foals after they recover from HIE. Studies that have gone back and questioned owners about their now adult horses that had HIE as foals have been very promising. These foals do not appear to have any training problems. They respond to their training the same as other foals of their age. Since it is difficult to measure the IQ of a horse, it is difficult to assess any subtle changes.

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