Sick Baby? Calories Count!

You agonized over selecting the right stallion for your mare. You waited patiently for 11 months until the foal was born. You fell in love as soon as those little hooves hit the ground. And now, you're worried sick because that precious baby isn't thriving as he should. Luckily, a focus on proper nutrition can play a key role in getting your foal back on a healthy track, and giving you some peace of mind.

Photo: Anne M. Eberhardt

Energy, Weight, and Calories

Nutrition is even more important for foals than adult horses because foals are born with relatively few energy reserves, explains Wendy Vaala, VMD, Dipl. ACVIM, a practitioner with BW Furlong and Associates in Oldwick, N.J. The glycogen stored in a foal's liver during gestation will support metabolism for just a few hours without additional nutrition. Foals born premature or dysmature, or those having experienced placental insufficiency in the womb, might have even fewer reserves, Vaala adds. Even the energy supplied by those first few drinks of colostrum will last less than 20 hours.

So, if your new foal hasn't stood to nurse within six hours of birth, you need to intervene, says Nathan Slovis, DVM, Dipl. ACVIM, a practitioner with Hagyard Equine Medical Institute (formerly Hagyard-Davidson-McGee) in Lexington, Ky. In addition, he says, "Any sick foal that is 10 days old or less, we make sure that we address their daily caloric needs. They can get weak quickly because they may be immuno-compromised and prone to becoming energy-deprived."

Keeping close tabs on your foal's weight can give you early notice of malnourishment or other illness. "When a foal gets sick, the main thing is caloric intake, and caloric intake equals weight gain," says Slovis. "The foal should be gaining a pound or more a day. If he's losing weight or are staying steady for a day or two, that's a red flag."

To keep track of your foal's weight, get a scale that goes up to at least 300 pounds. Weigh yourself, then pick up the foal and step on the scale again; subtract your weight from the total to get your foal's weight.

To just maintain weight, not gain it, a newborn foal should ingest 10% of his body weight in fluids per day, says Slovis. For a 100-pound foal, that's five liters of milk. To actually gain pounds, milk consumption should be 20-30% of body weight.

"This is equal to 10 to 13 liters of milk per day for light breed foals (such as Thoroughbreds and Arabians) and 14 to 17 liters for warmblood or draft foals," says Vaala.

Of course, a suckling foal's diet and health is closely tied to his dam. If she's not producing enough milk, a foal could easily lapse into malnutrition. To check your mare's production, says Slovis, you can muzzle the foal for a couple of hours and let the mare's udder fill. Then milk her by hand and measure the results. While different breeds have different norms, anywhere from 18-20 ounces is a good amount, says Slovis.

Or, says Vaala, you can figure that a light breed mare should produce about 3% of her body weight in milk each day during the first three months after delivery (about 30 pounds of milk, or 13.36 liters, for a 1,000-pound mare).

If the mare is under-producing, says Slovis, talk to your veterinarian about administering drugs (such as domperidone) that stimulate milk production. On the other hand, if she's producing enough milk but your foal is still doing poorly, the baby might simply not be aggressive enough in his feeding habits (which could be caused by illness) or he might have a digestive disorder that prevents him from absorbing all the nutrition from the milk he does drink. Such health issues include rotavirus, salmonella, Clostridium difficile, Clostridium perfringens, and septicemia.

Get Milk

If a foal is not getting enough milk, then providing supplemental milk or milk replacement enterally (orally) is the first choice of treatment. As Vaala says, "If the gut works, use it! Enteral nutrition seems to be a critical stimulus for normal intestinal function and development."

Not surprisingly, mare's milk is the preferred form of nourishment in terms of digestible energy and nutrients, notes Vaala. If your mare is a good producer and the foal is not an aggressive nurser, you can hand-milk the mare and feed the foal by bucket or bottle. If your mare is under-producing, you can try using a nurse mare. Just keep proper rate of growth in mind when selecting one, advises Vaala.

For example, a small, light breed foal shouldn't have a Belgian mare with excessive milk production as a foster mom. "This scenario sets the stage for excessive growth and weight gain, leading to physitis and other forms of developmental orthopedic disease," explains Vaala.

If mare's milk isn't an option, Vaala says you can substitute goat's milk, cow's milk, or commercial replacement formulas. Goat's milk is preferable to cow's milk, although you can increase digestibility of the latter by using 2% milk and adding sugar (approximately 20 grams of dextrose per liter of milk), says Vaala. If you choose a commercial milk replacement, try to match the energy density of mare's milk as closely as possible, she adds. That means approximately 0.5 kcal/mL (as fed), with 23% crude protein, 15% crude fat, 59% sugar, and less than 0.5% fiber. This might require diluting the formula beyond the manufacturer's recommendation for other species, she notes, so read product labels carefully.

Specific Needs

Beyond milk and milk replacements, other dietary elements can play a role in nutritional support, depending on the foal's particular problem. Here are seven examples.

Premature and dysmature foals--The nutritional requirements for these babies are not well defined, says Vaala. However, she adds, experts believe that premature foals have higher energy and protein requirements, but less ability to absorb fat, than a normal foal. Dysmature or growth-retarded foals could have increased calcium and phosphorus requirements that might not be met by mare's milk alone, she says.

Diarrhea--"If a foal has diarrhea, people think they should take the foal off the mare. That's a mistake," says Slovis. "The foal still needs the caloric intake." Instead, he says, consult a vet and offer the foal a bucket of electrolytes in water or loose salt. In addition to any treatment for a specific cause of the diarrhea, the foal might benefit from supplemental vitamin B, energy, and protein. Probiotics (commercial products, yogurt, or even buttermilk) might aid foals with diarrhea or other digestive upsets, says Vaala. (Slovis believes "the jury is still out on probiotics, but I don't think they hurt.")

Rotavirus--This ailment can cause foals to become lactose-intolerant. Their digestive systems literally can't tolerate the lactose in milk, preventing the foal from properly absorbing nutrition, says Slovis. In these cases, your vet might prescribe adding lactate tablets to the foal's milk before feeding. Treatment could last a week or two, but once the disease is controlled, the foal typically regains lactose tolerance and no longer needs the tablets, says Slovis.

Sepsis--"Gram-negative bacterial sepsis is the leading cause of death in neonatal foals," says Vaala. "It disrupts intermediary metabolism, increases metabolic rate, and sequentially hinders utilization of carbohydrates, lipids, and finally protein for energy." Foals with sepsis require extensive treatment and will likely need IV drugs, fluids, supplemental oxygen, and feeding via a nasogastric tube.

Stress--"In stressed horses, vitamin C supplementation has been shown to improve immune function, and antioxidant supplementation has been associated with improved immune function," says Vaala. Specific guidelines don't exist for vitamin supplementation in newborn foals, she adds. However, in a Rutgers University study of PMU foals, Sarah Ralston, VMD, PhD, Dipl. ACVN, showed that shipping fever symptoms significantly improved when the foals were given 5 grams of vitamin C twice a day, plus 800 IU of vitamin E once a day, for five days after shipping.

Growth disorders--Problems such as epiphysitis, contracted tendons, and developmental orthopedic disease (DOD) all have links to a growing foal's nutritional intake. Often, vitamin or mineral deficiencies are a root cause, but excess energy can also contribute to the problems. The best solution might be to supplement the baby--from nursing and throughout the weaning period--with feed designed specifically for growing foals. A recommended ration includes 16% crude protein, 0.8% calcium, and 0.6% phosphorus, as well as a balanced offering of vitamins and minerals.

Lethargy--You can give a quick energy boost to a lethargic foal by feeding 50-60 cc of Karo syrup, says Slovis. The pure sugar can keep a foal hanging in there until your veterinarian arrives.

Buckets and Bottles

It's easy to say what nutrition a foal needs, but not always so simple to actually get the necessary rations into a youngster accustomed to feasting from his dam's udder. But when nutritive support is needed, buckets and bottles become the feeding options of choice. That said, Slovis discourages bottle feeding unless you have experience with the process, since incorrect technique can cause a foal to inhale fluid, possibly setting the stage for aspiration pneumonia.

Slovis prefers bucket feeding as a safer method that also makes it easier for you to provide the foal with a larger ration at one time. Plus, the bucket meal can be left out for an hour or two, allowing the foal to feed on demand.

Vaala notes that bucket feeding is also useful when a foal has a weak swallow reflex. If you're bucket feeding fresh mare's milk, Vaala recommends reheating it with a bottle warmer rather than a microwave to prevent overcooking, uneven heating, and destruction of normal bacteria.

If a foal's suckling and swallow reflexes are weak, your vet might insert a nasogastric tube, possibly leaving it in place and secured by sutures or tape. Any fluids that you would feed by bottle or bucket can be used for tube feeding the foal.

Meeting Partial Needs

If your foal's intestinal tract can't absorb nutrition properly or if he isn't able to consume at least 10% of his body weight in milk per day, then intravenous (IV) feeding, also known as total parenteral nutrition (TPN), is required. Typically, TPN solutions for foals contain fluids, glucose, lipids, amino acids, electrolytes, and trace minerals (see for more information on TPN).

"TPN can't support (the foal) completely, but it can give partial caloric needs, partial lipid needs, and partial protein needs," says Slovis.

Agrees Vaala, "These solutions provide temporary nutritional support, but do not contain nearly enough calories for long-term nutritional support. It would require 35 liters of a 5% glucose solution per day to provide a 50 kg foal with adequate calories."

What's more, she adds, foals on IV nutrition must still be fed orally to help feed the gut and prevent gut atrophy. Since antiseptic conditions and close monitoring are also required, foals must typically be hospitalized when TPN is used.

Post-Recovery Caution

As your foal recovers from his illness, nutrition continues to play a role. While babies might lose weight when sick, they often experience a period of "catch-up growth" during recovery. At this time, cautions Vaala, you must be particularly careful to control growth spurts, which could lead to developmental problems such as DOD. That means keeping a tight rein on caloric intake and making sure the foal has enough for slow, steady growth, but not enough to cause sudden bursts of growth.

In many cases, providing nutritional support for an ill foal is something you can accomplish fairly easily on your own. But even in the seemingly straightforward cases, veterinary consultation is a good idea, since a professional can help pinpoint the specific health problem your foal faces, guide you in making the optimal nutrition decisions, and, if necessary, provide additional medication to get your foal back to bouncing health in the fastest time possible. 

HEALTHY FOAL HABITS: Detecting Problems

To spot a problem with your foal's eating habits--often a warning sign of existing or potential illness or disease--you need to know what's normal. Wendy Vaala, VMD, Dipl. ACVIM, a practitioner with BW Furlong and Associates in Oldwick, N.J., provides this summary:

  • Healthy newborn foals should have a suckle reflex within 20 minutes of birth, and they should stand and nurse within two hours.
  • Newborn foals nurse on average four to six times an hour during the first week of life, consuming 20-30% of their body weight in mare's milk daily and gaining one to three pounds per day.
  • Nursing frequency decreases to 1.5 to two times per hour during the months before weaning, and the foal begins to mimic its dam by eating solid food.
  • Coprophagy (eating manure) is normal in young foals and occurs once every few hours during the first week of life, then with decreasing frequency over the first three months. This behavior probably helps in the bacterial inoculation of the gut and even the acquisition of vital nutrients.--Sushil Dulai Wenholz

TIPS FOR BUCKET FEEDING: Supplementing Nutrition

Need to feed your baby by bucket? You might get lucky and find that it's an easy transition. "Some foals will just do it naturally when they're hungry," says Nathan Slovis, DVM, Dipl. ACVIM, a practitioner with Hagyard Equine Medical Institute (formerly Hagyard-Davidson-McGee) in Lexington, Ky. If your foal doesn't dive in nose first, try these tactics:

  • Place a bottle-feeding nipple in the bucket with the milk, so that the foal can drink milk through it. When the foal is accustomed to using the bucket, you can remove the nipple.
  • Alternatively, you can dip your finger in the bucket of milk (make sure your hands are clean), then let the foal suckle from your finger. Dip your finger in again and encourage the foal to suckle your finger closer to or inside the bucket. Continue until the foal gets the idea and begins drinking from the bucket.
  • If your mare is gentle and doesn't mind being handled, you can try positioning the bucket near her udder. When the foal goes to nurse, gently guide his nose to the bucket.
  • You can also offer milk-replacement pellets in a creep feeder. Foals tend to be curious, and they might readily begin nibbling on the feed.

Slovis offers two additional tips: "Fill the bucket with enough milk so the foal won't hit the bottom of the bucket with his nose, which could make him nervous. And don't ever try to force the foal's head into the bucket or you'll scare him. You must have patience. It can take 24 to 36 hours for the foal to go for it."--Sushil Dulai Wenholz

About the Author

Sushil Dulai Wenholz

Sushil Dulai Wenholz is a free-lance writer based in Lakewood, Colo. Her work appears in a number of leading equine publications, and she has earned awards from the American Horse Publications and the Western Fairs Association.

Stay on top of the most recent Horse Health news with FREE weekly newsletters from Learn More