Even though spring is winding down and summer is upon us, there are still babies being born on the farm. This time of year, I’m always reminded of vet school, where there was a program called Foal Watch. This was when undergraduate pre-vet and vet students, off for the semester, signed up for volunteer shifts to watch a foal in the hospital throughout the night.
Now, these weren’t just any foals. These were the premature foals that came into the large animal hospital on emergency visits; oxygen deprived, unable to stand or nurse on their own, sometimes suffering from diarrhea, with the constant threat of life-ending blood infections breathing down their necks. These little ones were hooked up to all sorts of tubes and wires and placed in the NICU (pronounced “nick-you” and standing for neonatal intensive care unit) and required 24/7 monitoring and care.
Whatever senior vet student was assigned the case was responsible for the care of the foal throughout the day, but naturally, by the time dinner rolled around, a changing of the guards was required for the rest and sanity of said senior vet student. This is where the Foal Watch crew came in. If a foal was in NICU and required over-the-night monitoring, and our shift was up, we’d come into the clinic for four-hour shifts until the next morning for the return of the assigned senior.
These opportunities were golden for individuals on Foal Watch. Not only did you learn where things were in the large animal hospital (good prep for your senior year), but also you learned basic neonatal foal care as well as some physiology, anatomy, pathology, and bacteriology, along with gaining some upper body strength — those little dudes may be sick, but they can sure put up a fight sometimes!
A four-hour shift from midnight to 4 a.m. may seem like a struggle to stay awake, but often there were so many things going on, the time flew by. Occasionally, there were so many things to do that two students were called in to help. IV fluids would have to be monitored and IV bags changed when empty, physical exams done every hour, blood work including blood oxygen testing done frequently, and feeding. If the foal was too weak to stand and nurse, bottle feeding or feeding via nasogastric tube was performed. Bedding had to be changed when the foal urinated or defecated, eyes had to be lubricated to prevent ulcers, and the foal had to be kept propped up on his chest for as much as possible to prevent pneumonia in under-inflated lungs. If the foal could not rest in this position and instead was lying flat out, he had to be turned from right to left side frequently. We often got very sweaty doing all of this!
I remember there was a time I become a little jaded toward the foals in NICU. There seemed to be a phase where many didn’t survive; they were just too weak and bacterial infections ultimately caused their little bodies to shut down. I was frustrated by all the time and effort the students and doctors put into each creature, only to be consistently disappointed.
As a junior I remember a large, chunky black Percheron foal that was admitted to the NICU. Sick like the rest of them. I helped out, but held back. Here’s another one, I thought. He’ll be gone soon. This colt and his gorgeous mother, a tall horse with black feathering down her legs and the sweetest disposition (her name was Annie), stayed for quite a while. And slowly, he got stronger.
When Foal Watch was no longer needed after he left the NICU, I lost track of him, but when my senior rotation through the large animal clinic came up a year later, who should strut in but a very familiar black colt, feisty as ever. It was the same one from a year before! I was so impressed at how good he looked. No ill effects remained from his rough start at life, and his mother was doing well, too (I’ve forgotten the reason they were back). My faith in the NICU had been restored.
I realized then that a rough start at life for these foals is not a death sentence, and remembering that has given me hope when dealing with challenging neonatal cases in the field. Sometimes, the lessons we most vividly remember are those we realize ourselves.
Dr. Anna O’Brien