Dana Zimmel, DVM, Dipl. ACVIM, Dipl. ABVP, assistant professor of equine extension in the department of large animal clinical sciences at the University of Florida, discussed both routine and emergency care of the newborn foal at Horseman's Day at the 50th annual American Association of Equine Practitioners (AAEP) Convention in Denver, Colo., Dec. 4-8, 2004. The best chance to improve the survival rate of a newborn foal, she said, is adequate advance disease prevention and planning. The disease prevention includes a comprehensive vaccination program, Zimmel told her listeners.

She offered these suggestions on vaccinations:

  • All pregnant mares should receive vaccination against rhinopneumonitis at the beginning of the fifth, seventh, and ninth months of pregnancy.
  • Thirty days prior to foaling, the mare should be vaccinated against the most important diseases, such as West Nile virus, Eastern and Western equine encephalitis, influenza, and tetanus. "This time frame is critical to allow the mare to generate a strong immune response that can then be passed into the colostrum. Foals are born completely naive to their environment and do not receive any immunity across the placenta. This means that all of the protective antibodies that the foal will possess are obtained from the colostrum," she explained. "This protection will last until the foal is between four and six months of age, when the immune system is fully functional and can respond to vaccinations."
  • The need for additional vaccinations for botulism, strangles, rabies, Potomac horse fever, and rotavirus should be discussed with the farm veterinarian.

Close observation of the mare prior to foaling is highly important, Zimmel advised. For example, if there is a vaginal discharge, it could mean that the mare has placentitis and immediate treatment might be called for to save the foal.

Still another signal that something could be going wrong, she said, is the dripping of milk in advance of foaling. Not only is this a danger signal, but it means that valuable colostrum, vital to the foal's survival, is being lost. "That first milk is liquid gold," she said. "If the mare is losing milk, it is wise to obtain some colostrum from another source before the foal is born." The foal needs two liters of colostrum in the first 24 hours of its life, she said.

As for the birthing procedure itself: "You should be present for foaling. It can mean the difference between life and death for the foal," Zimmel recommended.

Once the chorioallantois (placenta) ruptures and the allantoic fluid escapes, she added, the foal should be delivered in 20-30 minutes. A normal foal should be able to rest on its sternum within two to three minutes after birth. After the foal is born, she said, the one-two-three rule goes into effect--one hour for the foal to stand, two hours for it to nurse, and three hours for the mare to pass the placenta.

If the above schedule isn't followed, she said to contact the veterinarian because foals that don't stand and nurse soon after birth will become hypoglycemic (have low blood glucose) and lose the ability to stand. In addition, they are prone to become septic (with bacteria in the bloodstream) if they do not ingest colostrum as soon as possible after birth.

If a mare doesn't pass the placenta in a minimum of six hours, Zimmel said, she becomes at risk for metritis (uterine inflammation) and laminitis. When problems occur either in the birthing process or with passage of the placenta, a veterinarian should be called immediately, she said.

With some foals, a blood screening for neonatal isoerythrolysis (NI) might be necessary. She said that NI occurs in 1-2% of the equine population and shows up most often with Thoroughbreds. The disease is a result of the foal absorbing antibodies in the colostrum that attack its own red blood cells, resulting in anemia, Zimmel explained.

She also outlined three major problems that can occur at birth.

  • Red bag or premature placental separation. Under normal conditions, the chorioallantois ruptures and a stream of fluid is released. "Normal delivery should proceed with the protrusion of a white sac from the vulva. If a red velvet structure is protruding from the vulva, the person present should immediately cut it with scissors and try to gently pull the foal. The red structure is the chorioallantois, which did not rupture at the cervical star and the foal and the whole placenta are being expelled at the same time. When the placenta detaches from the uterus in this manner, the foal is no longer receiving oxygen and can die quickly."
  • Dystocia, which is defined as abnormal labor. Under normal circumstances, Zimmel said, the foal is born with both front feet first with the soles of the feet pointing downward. Any other presentation can mean dystocia. The rule of thumb if there is an abnormal presentation is to call the veterinarian immediately.
  • Not breathing. Regular breathing, Zimmel said, should start within three seconds of birth. The heart rate should be regular and about 70 beats per minute. "Implement resuscitation if the foal is not breathing, if the breathing is irregular, or if the heart rate is less than 40 beats per minute." Resuscitating a foal manually, Zimmel said, can be exhausting, and she recommended that a commercial resuscitator be included in equipment available at birthing. A resuscitator can be purchased for about $140, she said. (For more information on manual resuscitation of foals, see www.TheHorse.com/ViewArticle.aspx?ID=3785.)

Zimmel said that after the birthing process is complete, the umbilical cord should be left intact for as long as possible, allowing the mare to break the connection when she stands. "This allows maximal transfer of blood from the mare to the foal," she said. "If the cord must be broken, do not use scissors, but pull the cord apart while holding close to the foal's abdomen."

Using straight iodine to treat the umbilical stump is unwise, Zimmel said, because it might scald the skin. The iodine should be diluted to the point of being iced-tea in color, she said, or a 1:4 solution of chlorhexidine can be used.

She left her horse-owning audience with these warning signs on the part of the newborn foal and what they might mean:

  • Milk coming from the nose--aspiration pneumonia.
  • Orange fluid coming from nose or staining hair--meconium aspiration.
  • Changes in behavior, such as lack of affinity for the mare, or wandering aimlessly--dummy foal.
  • Milk on face--not nursing.
  • Red gums--septicemia.
  • Yellow gums--NI.
  • Eyes sunken or tearing--dehydration, malnutrition, or eye problem.
  • Weak pasterns, contracted tendons, joint or tendon laxity--serious limb problems.
  • Swollen joints, lameness--infection.
  • Diarrhea--bacterial, viral, or parasite problem. Foal diarrhea at seven to 10 days of age might be normal and a sign of foal heat diarrhea, but consult your veterinarian to rule out other possible illnesses that cause diarrhea.
  • Bloat--colic.
  • Weak and lethargic, inability to stand--sick foal.

About the Author

Les Sellnow

Les Sellnow is a free-lance writer based near Riverton, Wyo. He specializes in articles on equine research, and operates a ranch where he raises horses and livestock. He has authored several fiction and non-fiction books, including Understanding Equine Lameness and Understanding The Young Horse, published by Eclipse Press and available at www.exclusivelyequine.com or by calling 800/582-5604.

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