Preparing for Foaling
You have spent months, or perhaps years, planning and deciding on the perfect mate for your mare. Now, after a few appointments with your veterinarian and a couple of trips to the breeding shed, your mare is happily in foal. In a few short months, it will be time for her to deliver. Are you ready? Do you know what signs to look for that will tell you she is getting close to foaling? Also, very importantly, will you know if the mare or foal is in trouble and when to call your veterinarian?
This article will describe procedures that should be done before foaling, the events that take place just prior to foaling, what events take place during a normal foaling--along with the normal post-foaling events--and will describe some of the warning signs that indicate there is a problem and when to call your veterinarian for help.
Considerations for the Pregnant Mare
It is important to keep a record not only of the mare's routine vaccinations and deworming, but breeding or insemination dates and veterinary examinations and/or ultrasound examinations in case there is ever a question about the foal's true gestational age. If your mare has had foals in the past, it is of great value to have the records of her previous gestations (if available). The mare's previous gestational length(s) can be determined. For example, if a mare normally carries a foal for 350 days, then delivers her current foal at 335 days, that foal might be premature even though it is of a considered "normal" gestational length because it is not a "normal" gestational length for that particular mare.
Furthermore, records might indicate the mare had a foal which developed neonatal isoerythrolysis (reaction of the mares colostrum with the foal's red blood cells, commonly known as jaundice, and sometimes resulting in fatal anemia in the foal). Knowing this, you and your veterinarian can take precautions to prevent this from occurring in the upcoming foal.
Because the neonatal foal derives its immunity from the quality of the mare's colostrum, it is imperative to vaccinate the mare during her pregnancy. Although specific vaccination schedules are difficult to recommend, the basics will be discussed. Please consult your veterinarian for tailored vaccinations that are appropriate for your farm and/or individual mare.
At approximately one month prior to foaling, your mare should receive a tetanus toxoid, equine influenza, and Eastern/Western encephalomyelitis (4-way). Other vaccines that are recommended include equine rhinopneumonitis (EHV-1/4), Clostridium botulinum toxoid, and rabies. If your farm lies within a deficient area, you should also supplement with Vitamin E and selenium during the mare's pregnancy to help prevent "white muscle disease" in the foal. If you mare grazes from a pasture of mostly fescue grass, she should be removed from pasture approximately three or four months prior to foaling and fed good-quality grass (no fescue) or alfalfa hay with vitamin and mineral supplementation. Some fescue grasses are infected with a fungus (Acremonium conenophialum) that produces a toxin. The toxin can lead to abortion, aglactia (no production of colostrum by the mare), delayed parturition with subsequent dystocia, and thickened placenta.
Routine deworming is also recommended during the mare's pregnancy and again two to three days after foaling to minimize the transmission of parasites through the milk and in the environment.
If your mare has had a Caslick's operation (sutures within the vulva), the suture line should be opened by your veterinarian two to three weeks prior to the anticipated delivery.
Now that it is getting closer to the due date, the mare should be monitored daily for physical changes that indicate that she is getting ready to deliver. Physical signs of impending parturition include vulvar laxity and edema (swelling), and small amounts of clear (mucus) discharge. The pelvic ligaments will relax and create a sunken appearance on either side of the tailhead. The mare's udder will enlarge and begin to produce a "waxy" yellow secretion (colostrum) as near as one to two days before foaling, but sometimes as long as two weeks prior to parturition.
Normal gestation in the mare is somewhere between 320-365 days, with the average being 341 days. Foals born before day 300 are considered nonviable, and when born between days 300 and 320, are usually considered premature. Some foals are born of "normal" gestational age, but are premature in physical appearance. These are called dysmature foals. This is why it is of great value to know the length of a mare's previous gestations.
Here are some terms you might hear in association with foaling problems:
- Nonviable--A foal which is born so prematurely that it is extremely unlikely to survive even with intensive care (mechanical ventilation, parental nutrition, antibiotics, etc.) simply because it is not developed enough to survive outside of the uterus.
- Premature--A foal born before gestational age of 320 days which displays immature physical characteristics, such as low birth weight, general weakness, short and silky hair coat, and soft, pliant ears.
- Dysmature--A foal born of normal gestational age, but displays immature physical characteristics, suggestive of prematurity.
The Three Stages of Labor
A mare's parturition is divided into three stages. Stage I is the period where a foal in the uterus turns from lying on its back with its head toward the back of the mare to lying on its stomach with its head between its two front legs. During this stage of labor, the initial uterine contractions begin. It is characterized by the mare acting restless, frequently getting up and down, urinating often, and sweating (acting colicky). This stage of labor can last anywhere from 20 minutes to several hours. The mare should not be disturbed during this time, as she can postpone delivery of the foal if she feels nervous or uncomfortable. If you are planning to have your veterinarian present for the delivery, call at this point.
At the end of Stage I, the mare's "water breaks," releasing the amniotic fluid, which appears straw colored and begins Stage II labor. If someone is present, the mare's tail should be wrapped and her vulva cleaned with warm water and soap (liquid soap or betadine).
Stage 1 Potential Problems:
- Your late-term mare seems to be going into Stage I labor, although she hasn't really shown any other signs of impending parturition. She remains uncomfortable for several hours with rolling and pawing. Have the mare examined by your veterinarian. Late-term pregnant mares can develop a uterine torsion (twisting of the uterus), and it must be corrected. Some of these can be corrected without surgery, by rolling the mare while anesthetized, but others require surgery.
- Your mare has been "waxing" for several days, then late one night, goes into Stage I labor. Your whole family comes out to watch, but she never progresses to Stage II. Call you veterinarian and have the mare examined to check for problems with her reproductive tract and/or placenta. However, she may have just gotten nervous from the crowd.
- Your mare has had a vulvar discharge for several days, then goes into labor. As her "water breaks," the fluid is cloudy and has a terrible odor. Have your veterinarian summoned to check the mare and placenta to rule out infection of the placenta (placentitis), which could put the foal at risk of infection. Any pregnant mare with a suspicious vulvar discharge should be examined to rule out infection of the placenta or reproductive tract, so that if necessary, treatment can be started immediately.
During Stage II, active contractions will begin within a few minutes and the mare will begin actively straining. During this stage of labor, the foal will be delivered. Time is of the essence, so keep track of time from when the water breaks! The mare's contractions are very forceful, and the foal must be delivered within 30-40 minutes or is in danger of dying. The mare might get up during this stage of labor once or twice, but usually is lying on her side (lateral recumbency) to push.
The amniotic sac will protrude first from the vulva as the contractions begin. The foal should present with its front feet, soles pointing down, covered in the amniotic sac, which is milky white. The front legs are usually presented one ahead of the other. As the contractions continue, the head should be visible with the chin resting on the front legs. After the front legs and head are visible, she will really begin to push and the shoulders followed by the torso of the foal will be delivered, then the hips and hind legs. The amnion usually ruptures when the shoulders are delivered.
Now, the mare should be resting and the foal completely delivered. If the amnion around the foal was not ruptured during birth, you should gently open the sac and remove the membranes from around the foal's nose and muzzle. If the membranes were ruptured during foaling, the foal should be breathing comfortably and should begin to struggle to get into sternal recumbency within a few minutes of birth. If the mare and foal are both resting comfortably and quietly, they should be left undisturbed. Leaving the umbilical cord attached at this point can allow a substantial amount of blood to be transferred from the placenta to the foal. The mare will break the cord when she stands.
If at any time the delivery does not appear to be proceeding as normal, or more than 10 minutes passes with the mare straining and no sign of front feet or nose, notify your veterinarian immediately.
Stage 2 Potential Problems:
- The mare is in labor (lying down and straining), but the mare's water never breaks. Instead of the milky white amnion presenting first, a red velvety membrane protrudes or "red bag" delivery. This is a serious emergency as the foal is being deprived of oxygen, due to premature separation of the placenta, since the chorioallantois has failed to rupture. The red bag (chorioallantois) needs to be ruptured and the foal delivered as soon as possible. Call your veterinarian immediately.
- The delivery is proceeding as normal, but the foal is noticed to have (a) its soles in an up position, (b) more than two feet are noticed, (c) its front feet presented without a nose, or (d) too much time has passed without the feet being seen, a dystocia (difficult birth) is occurring and the mare will need help to deliver the foal. If taught by your veterinarian ahead of time, you can place a sterile sleeve and lube on your arm and check the mare for correct position of the foal, if the foal is in an incorrect position, your veterinarian should be summoned immediately.
- Once the foal is delivered, the mare jumps to her feet and breaks the umbilical cord prematurely, and blood is gushing from the foal's umbilical stump. Call your veterinarian immediately, and in the meantime, tie a knot around the remaining umbilical stump, using umbilical tape to stop the flow of blood. If the mare is restless or nervous after birth and will not lie still and you are concerned the umbilical cord will break prematurely, or does not break after 20 minutes or so, you can manually break it with your hands. There is a natural "break point" about one inch from the foal's abdomen, where the cord becomes thinner. The cord should be grasped above and below the breaking point, then twist and pull to break it. Care must be taken NOT to pull too hard in order to avoid exerting tension on the foal's abdominal wall. The cord should not be cut as this is more likely to result in excessive bleeding.
During Stage III, the placenta is passed and the uterus will begin to return to normal size (involute). The placenta should be tied to itself with umbilical tape or twine to keep it from being stepped on and becoming entangled on the mare's hind legs. Once the placenta has been passed, remove it from the stall or paddock and place in a bucket for your veterinarian to examine later. Your veterinarian can examine the placenta and determine if all of it has been passed and also determine if there is any evidence of placentitis (infection within the placenta), which can put your foal at risk of becoming sick. The placenta is usually passed within 30 minutes of parturition, and should be passed within three hours. As the uterus is involuting, the mare might show signs of mild colic.
Stage 3 Potential Problems:
- If the placenta has not been expelled within three hours of foaling, your veterinarian should be called. A retained placenta left untreated can lead to infection within the uterus (metritis) and subsequent laminitis (founder), so treatment should be prompt.
- Mild signs of colic become more severe and the mare loses interest in the foal. Your veterinarian should be called to evaluate your mare, as serious problems could have occurred, such as a uterine tear or uterine artery rupture, which leads to severe blood loss, shock, and sometimes death.
Now that the foal is delivered and starting to move about, the mare and foal should be left alone to bond. The mare will nicker and nuzzle the foal and begin to lick the foal all over. The foal should show a suckle reflex (sticking out tongue and making sucking noises) within 20-30 minutes of birth. The foal also will begin to make attempts to stand, taking several spills in the process. The foal should be able to stand within one hour of birth. Although at first the foal will suckle everything but the mare's nipple, the foal should be nursing from the mare within two hours after birth. The foal's umbilical stump should be dipped in dilute (0.1-1.0%) povidone iodine or chlorahexadine (0.5%) solution 2-3 times a day for 3-4 days. The harsher iodine solutions or tinctures, such as Lugol's (5%), have actually been shown in some cases to lead to infection because they are extremely irritating and cause tissue death.
Post-Foaling Potential Problems:
- The foal does not stand and nurse by three hours, or stands but shows no suckle reflex and/or little interest in the mare. Your veterinarian should be called to examine the foal and check for musculo-skeletal problems such as contracted tendons that might prevent the foal from standing. Also, "dummy foals," or foals suffering from neonatal maladjustment syndrome, might not be able to stand, or can stand, but wander the stall with little interest in the mare. They will not have a suckle reflex, must be administered colostrum, and might need intensive care. You can check for a suckle reflex by placing clean fingers within the foal's mouth. This should stimulate them to suck on your fingers.
- Foals must receive colostrum, the "first milk," within six to eight hours of birth as their gastrointestinal tract can only absorb the immunoglobulins (antibodies) present within the colostrum during this window of time. The colostrum is what gives the foal its immune status as foals are born with virtually no ability to fight off infection other than the antibodies they absorb from the colostrum. Foals also need the colostrum as nutrition to prevent hypoglycemia. Foals have little or no fat stores at birth and need frequent meals. Several hours without colostrum or milk can leave a newborn foal very weak and unable to stand.
This article was intended to serve only as a guideline for foaling. There is no substitute for pre-foaling examinations by your veterinarian. You should formulate a plan with your veterinarian to know when and how he/she can be reached when the moment arrives, and make sure you have all available numbers at which your veterinarian can be reached. Furthermore, both mare and foal should be examined by your veterinarian in the immediate post-foaling period to check the overall health of the mare and examine for any congenital deformities in the foal.
About the Author
Christina S. Cable, DVM, Dipl. ACVS, owns Early Winter Equine in Lansing, New York. The practice focuses on primary care of mares and foals and performance horse problems.
POLL: Laminitis Experience