This term applies to foals that exhibit ­abnormal ­behaviors and/or ­neurologic signs during their first few days of life..

Dummy foal syndrome is not a disease but, rather, a broad term that applies to foals that exhibit abnormal, often vague behaviors and/or neurologic signs during their first few days of life. These signs include sleepiness, ataxia, weakness, circling, disinterest in the mare or in nursing, loss of suckle reflex, chewing or licking stall walls, abnormal vocalization, hypersensitivity to the touch, depression, or seizures. Other names used to describe this syndrome are neonatal maladjustment syndrome, hypoxic ischemic encephalopathy, peripartum asphyxia syndrome, wanderer foal, or barker foal (for foals having abnormal vocalizations).


Although commonly associated with an adverse periparturient (around the time of birth) event, dummy foal syndrome also occurs in foals that haven't had an obvious periparturient problem. "Thus, dummy foal syndrome could result from some type of unrecognized in utero hypoxia (inadequate oxygen supply)," says Bonnie Barr, VMD, Dipl. ACVIM, an internist at Rood & Riddle Equine Hospital in Lexington, Ky.

Hypoxia can affect a number of the foal's organs, including the central nervous system and brain, gastrointestinal tract, liver, and kidneys. Caused by a decreased blood flow to the placenta or the foal, hypoxia can occur:

  • in utero, due to placentitis (inflammation of the placenta) or a decrease in blood flow to the uterus secondary to a maternal illness;
  • at birth, from dystocia (difficult birth), redbag delivery (when the placenta separates prematurely from the uterus and exits the birth canal with the foal), or a Cesarean section; or
  • shortly after birth, because of prematurity, recumbency (inability to rise), pulmonary (lung) disease, sepsis (infection in the bloodstream), or anemia (a decrease in normal number of red blood cells).

Clinical signs could be present either at time of birth or within 24-48 hours after foaling. In these cases the veterinarian usually has identified risk factors during pregnancy (i.e., placentitis) or during foaling (i.e., dystocia), says Lucas Pantaleon, DVM, Dipl. ACVIM, equine internal medicine specialist in Versailles, Ky. "Foals that are normal at birth, have an uneventful delivery, and have no identified prefoaling risk factors usually don't develop clinical signs until 24-48 hours after birth."


"The diagnosis is mainly based on history and physical examination," says Pantaleon. "Complete blood work is usually performed to rule out infection or involvement of other organ systems (i.e., kidneys). The antibody level (IgG) is routinely checked, since a low level of antibodies would make that foal very prone to infections. If warranted, other tests such as radiographs, ultrasonography, or spinal fluid analysis can be done. These tests are performed in order to identify other organ involvement or, for example, in a case where meningitis is suspected, a spinal tap would be done to confirm or refute the diagnosis."


Treatment begins with general supportive options. "Most foals are placed on antibiotics, as they are more prone to infections, and on anti-inflammatory agents such as DMSO (dimethyl sulfoxide) to control the inflammation in the brain," notes Barr. "Thiamine and vitamin C are routinely administered; these antioxidants can, hopefully, help the brain heal. Intravenous fluids and intranasal oxygen supplementation are also usually given, because it is important to maintain adequate blood pressure and circulation."

In addition, a foal could require intensive nursing care and/or medications specific to his condition. "For example, foals that are ambulatory but not nursing will require regular feedings and will need to be taught how to nurse," says Pantaleon.

This often involves providing nutrition intravenously or through an indwelling nasogastric tube. "Critically ill foals will need a higher level of care," Pantaleon says. Besides nutritional and general support, these foals require regular monitoring of vital signs, turning on the bed, intravenous fluid therapy, and medications that could include gastroprotectants, anti-inflammatories, antioxidants, diuretics, and anticonvulsive drugs.

Pantaleon cautions that treatment targeted to help with central nervous system healing must be administered within hours of the insult to be effective. "Most of the drugs have a narrow therapeutic window."


Although there is no surefire way to prevent dummy foal syndrome, carefully monitoring and promptly addressing problems during the mare's pregnancy reduces the risk of dummy foals.

"Look for and treat signs of placentitis such as premature udder development and vaginal discharge," suggests Barr. "Make sure the mare stays away from fescue because ingestion of fescue (which can contain a fungal endophyte that affects pregnancy) can result in placental abnormalities, difficult birth, or prolonged gestation, all which can result in dummy foal syndrome."


The worst prognosis is for foals that suffer problems involving multiple organs and/or infection. These foals could die or have long-term defects.

Foals that never learn to nurse or that take longer to resume nursing require more intensive nutritional management until they start eating solid feeds at three to four weeks of age.

Fortunately, the outlook is cheerier for most foals. Says Barr, "With appropriate and timely treatment, about 80% of affected foals recover completely within five to 10 days."

About the Author

Marcia King

Marcia King is an award-winning freelance writer based in Ohio who specializes in equine, canine, and feline veterinary topics. She's schooled in hunt seat, dressage, and Western pleasure.

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