Development and application of a focused ultrasound protocol in neonatal foals.
Authors: Ellero Nicola, Maggi Alessandra, Busoni Valeria, Imposimato Ilaria, Castagnetti Carolina, Lanci Aliai, Mariella Jole, Freccero Francesca
Journal: Veterinary journal (London, England : 1997)
Summary
# Editorial Summary: Focused Ultrasound Protocols for Neonatal Foals Rapid, reliable imaging in neonatal foal emergencies presents a genuine clinical challenge, particularly in field settings where extensive equipment and expertise may be unavailable. Italian researchers developed and tested a standardised focused ultrasound (FUS) protocol comprising 12 thoraco-abdominal acoustic windows to assess its practical utility in identifying common pathologies in sick foals, with all examinations performed by a clinician having limited prior ultrasound experience. The FUS protocol proved effective for detecting gastrointestinal disease and peritoneal effusion in the 23 sick foals examined, though operational constraints—including the need for multiple recumbencies, considerable staff resources for foal restraint, and competition with other urgent clinical priorities—prompted development of a streamlined alternative. A condensed seven-window protocol termed FOCUS, executed entirely in right recumbency, reduced median acquisition time to just 7 minutes (range 3–10 minutes) whilst maintaining diagnostic capability, with testing across three operators of varying experience levels. For equine practitioners, these protocols offer an accessible first-line imaging approach requiring minimal specialist training, though FOCUS appears more practical for emergency situations where rapid assessment is paramount, whilst full FUS may provide superior diagnostic sensitivity when clinical circumstances permit more thorough evaluation.
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Practical Takeaways
- •If you need to screen foals for abdominal disease, the FOCUS protocol offers a practical time-efficient alternative (median 7 minutes) suitable for emergency situations where speed matters
- •You don't need extensive ultrasound experience to perform these protocols—even clinicians with limited US training achieved good results, making this accessible to most equine practices
- •In stable settings with healthy foals, the more comprehensive 12-window FUS protocol provides better diagnostic coverage; reserve the 7-window FOCUS for emergency cases where single-position imaging is needed
Key Findings
- •A 12-window Focused US (FUS) protocol was successfully developed and demonstrated good feasibility in assessing healthy (n=17) and sick (n=23) foals, with high diagnostic usefulness for gastrointestinal disease and peritoneal effusions
- •A shortened FOCUS protocol using 7 windows from single right recumbency achieved significantly faster acquisition time (median 7 min, range 3-10 min) compared to FUS
- •FUS protocol can be performed by veterinarians with limited ultrasound experience, though clinical constraints in emergency settings may limit applicability
- •FOCUS protocol showed promise in preliminary testing (n=6) but requires further validation before widespread recommendation in clinical practice