Q:My mare suffered a dystocia and the foal had to be taken to a local veterinary hospital for care. The veterinarian termed him a "dummy" foal, but said his chances of being a normal adult were very good. What can you tell me about a "dummy" foal?

A:The term "dummy" foal is one that is given to foals that act "dumb" at birth, or even hours thereafter. You might have heard them referred to as wanderers, barkers, or sleepers. However you know this condition, all these syndromes fall under the broad category of neonatal maladjustment syndrome. While the cause of this condition is not fully understood, what happens is that the tissues of the brain essentially hemorrhage and there is swelling around the nerve cells of the brain due to edema. Hemorrhages may result from low oxygen concentrations (hypoxia) in the blood and episodes of low and/or high blood pressure surges in the blood circulating through the brain. Metabolic insult can include hypoxemia, low glucose, and electrolyte imbalances.

Some of these "dummy" foals are normal at birth, then suffer a seizure, followed by a lack of the suckling response. Seizures may be the result of inflammation associated with septicemia that establishes itself in the central nervous system. In addition, seizures can be caused by trauma during or after birth, which should be kept in mind when treating the foal. At birth there is an incomplete blood/brain barrier, which essentially means that if there is an infection in the bloodstream, it can make its way to the central nervous system. If these infections cross the barrier into the brain, they can cause inflammation. For example, you would not expect an older foal which develops a lung infection to have a seizure, but a newborn foal which develops the same infection could have a seizure because the blood/brain barrier has not yet formed. This membrane develops and becomes a true barrier in the first couple weeks of life, after which time infections and toxic insults will no longer easily pass from the bloodstream to the brain.

Foals with neonatal maladjusted syndrome will behave abnormally for a number of reasons, such as a lack of oxygen due to dystocia, low glucose levels in the blood, septicemia, or other susceptibility due to the failure to receive adequate colostrum. These problems which can lead to a "dummy" foal, or neonatal maladjustment syndrome foal, are accompanied by symptoms that range from mild to severe.

The more mild symptoms include the lack of a suckling response, disorientation, and irritability (which can manifest itself as grinding of the teeth, sneezing, or wandering aimlessly). More severe symptoms include convulsions, seizures, or the foal becoming comatose. Whatever the symptoms, they should be treated as soon as possible to ensure a positive outcome.

Many of these neonatally maladjusted foals will return to normal within a few days with the aid of therapy that may be administered on the farm or more intensively at a clinic. Therapy includes giving the foal glucose and oxygen as well as oral and intravenous nutritional support, if necessary. If personnel and equipment are available on the farm to provide nursing support, these foals do not necessarily have to travel to a clinic. Keeping oxygen handy and administering it for three to five minutes after birth will help the foal if it is lacking oxygen.

A feeding tube may also be used at the farm or in a clinic. Using a nasogastric tube to provide nutritional support directly into the foal's stomach is necessary if the foal is not exhibiting a suckling response. With astute management and capable people on the farm, a hospital stay sometimes can be avoided in foals with mild cases of neonatal maladjustment syndrome.

However, in more severe cases, treatment may involve prolonged medical and nursing care to control convulsions, maintain salt and water balances, and provide proper nutrition through a nasogastric tube, along with other nutritional support.

What needs to be kept in mind when dealing with these maladjusted foals is that the window of opportunity for response is usually five to seven days, so action must be taken as soon as possible. If after five or seven days these foals are not responding to treatment, alternative or underlying problems should be investigated. It may be that the foal has been kicked or is suffering from more extensive neonatal problems such as hydrocephalus (crown headed foals), or internal hydrocephalus, which does not deform the outer portion of the skull. (Hydrocephalus is commonly known as water on the brain.)

As an owner, you need to be aware that neonatal maladjustment syndrome is a broad term that encompasses many problems with foals. If a particular foal does not respond to conventional treatment for neonatally maladjusted foals within a couple of weeks, then another source of the problem should be investigated. Again, any of these problems should be addressed as soon as possible.

Foals exhibiting neonatal maladjustment syndrome usually recover. In most cases--90% or more--the foal develops normally into a mature horse and performs the same as his stablemates that were not afflicted with the syndrome.

About the Author

William Bernard, DVM, MS, Dipl. ACVIM

William Bernard, DVM, MS, Dipl. ACVIM, is an equine medicine specialist with Rood and Riddle Equine Hospital in Lexington, Ky.

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