HistoryA 9-day-old pony colt was referred for evaluation of tachycardia and tachypnea observed since birth. Gestation and parturition had been normal. Since birth, milk had been observed coming from both nostrils when the foal was in lateral recumbency. During the first week after birth, a mild upper respiratory tract noise developed that was persistent.On evaluation, the foal was bright and alert and in fair body condition. Physical examination revealed a rectal temperature of 38.4°C (101.2°F), a heart rate of 110 beats/min, and a respiratory rate of 80 beats/min. No murmurs or arrhythmias were detected on thoracic auscultation, and bilateral diffuse wheezes were heard over the lung fields. No nasal discharge was observed when suckling; however, copious amounts of milk were seen in both nostrils when the foal was in lateral recumbency. A CBC and serum biochemistry analysis revealed a mildly high plasma fibrinogen concentration of 500 mg/dL (reference range, 100 to 400 mg/dL) and a high serum lactic acid concentration of 54.7 mg/dL (reference range, 4.5 to 18.4 mg/dL). Thoracic radiography was performed with the foal standing (not shown) and in right lateral recumbency (Figure 1).Determine whether additional imaging studies are required, or make your diagnosis from Figure 1-then turn the page →