By By Dr. Corine Selders

We are in the middle of foaling season, and many of the veterinary
appointments are related to the new bundles of joy.  Along with the
irresistible neonates come new problems and issues.
Neonates are pretty fragile and horse owners need to keep a close
watch.  Key items to monitor are the foal's ability to nurse, body
temperature, and behavior.  Foals can look and behave healthy and begin
to fade within a few hours.

A foal that has experienced an uncomplicated birth should stand within
1 to 2 hours, nurse within 2 to 4 hours, and begin to defecate meconium
within 3 to 6 hours.  If this timeline does not occur, it is time to
call your veterinarian.
Furthermore, we recommend a foal exam and a blood test that checks for
antibody levels within the first 18 to 24 hours of life.  The post
foaling exam is very important in detection of prematurity, neonatal
maladjustment syndrome (dummy foal), patent urachus (urinating through
umbilicus), meconium impaction, or a septic (infected) foal.  Other
reasons to call a veterinarian at any time (and especially during the
neonatal period) are colicky behavior, diarrhea, and any decrease in
nursing.

Even with our medical advancements, premature foals (less than 320
days) have a poor survival rate. Once the intensive medical care has
been provided and they have survived the initial neonatal period, these
little guys are often plagued with crooked legs and poor growth.
Some of the signs of a premature foal are weakness, smaller size, silky
skin, floppy ears, domed foreheads, and an inability to nurse.  Their
carpal (knee) bones and their tarsal (hock) bones may not have ossified
(turned from cartilage to bone) yet, and an angular limb deformity may
form.
Veterinary care is crucial for the premature foals and can be very
expensive.  There is also a syndrome called dysmature/immature foal,
where the foals may have gone full term (320-360), but still looks and
behaves premature.  This type of foal needs similar medical attention.

Neonatal maladjustment syndrome is commonly called a "dummy foal."  It
can occur because the foal experienced a period of time without oxygen
(hypoxemia).  As a result, the brain begins to swell and the foal
suffers some form of neurologic compromise.  This neurologic compromise
can be as mild as an inability to figure out how to nurse, to the more
severe inability to stand, and seizures.
Sometimes the foal has a good start. It gets up, nurses well, and is
active.  Then within a few hours the foal regresses. It cannot find the
nipples, and may have increasing difficulty in getting up.  This can
happen if the brain is not swollen at birth, and the effects of the
lack of oxygen have not yet taken effect.
The dummy foal syndrome often carries a good survival rate if they are
aggressively treated early (before the seizures set in), do not become
septic, turn around within five days, and do not have other
complicating factors.

Septic foals are foals that have contracted a bacterial infection.  
The bacterial infection can cause pneumonia, severe diarrhea, inflamed
joints, generalized septicemia, and meningitis.
The reason neonates are so susceptible to this condition is due to
their naive immune system.  Foals are born without an active immune
system to fight against disease.  In the first 12 to 18 hours of life,
their GI tract is able to absorb large molecules.  This is the key to
the foals being able to absorb the antibodies from the mare's colostrum
(first milk), and thereby gain an immunity that will last until the
foal's own immune system is up and running.
Unfortunately, during this period of time foals are also able to absorb
large amounts of bacteria in their GI system.  The bacteria that are
the main culprits are ones found in manure.  That is why a clean
foaling stall and a clean mare are so important.
Once the foal has absorbed enough antibodies from the mare's colostrum,
the GI tract begins to close, unable to readily absorb colostrum and
bacteria.  After 18 to 24 hours, the GI tract will close on its own
even without adequate colostrum absorption. After this period of time,
giving a hyperimmune plasma transfusion is the only way to give the
foal an adequate amount of antibodies.   Furthermore, intensive IV
antibiotic therapy will be necessary to save the foal.
Foals can also become septic through the umbilical cord.  Therefore,
dipping the umbilical stump in 2 percent nolvasan diluted to 0.5
percent with sterile water or 2 percent betadine immediately after it
is severed (by the mare and foal) is also crucial.  The umbilicus
should be dipped every six hours for 24 hours.
General signs of sepsis can include decreased  nursing, weakness, fever
(only 50 percent of the time is fever evident), swollen joints,
difficulty breathing (increased rate), possible coughing, thickened
umbilicus, and seizures.  Infection can be decreased in foals that were
given antibiotics within six to 12 hours of life, so do not delay in
calling the veterinarian.

Colic during the neonatal period is another critical symptom.  It can
be due to a variety of reasons from meconium impaction, pending
diarrhea (enteritis), a ruptured bladder, stomach ulcers,  twisted
intestine, and congenital defects.  Since foals are fragile creatures,
a veterinarian should be immediately called to determine the cause of
the colic.

Luckily most foals do well in the postpartum period.  However, some
foals need special medical attention.  An astute owner who diligently
monitors the neonatal foal will be able to notice the early subtle
signs of a foal needing medical attention.   Early medical intervention
can often save time, money, and the foal.  Next month will cover
postpartum issues of the mare.

* Reference: Madigan, John E.:  Manual of Equine Neonatal Medicine.
Live Oak Publishing, Woodland, Calif. 1997.

Dr. Corine Selders, an equine veterinarian, owns Cedar Creek Equine
Veterinary Practice Inc. She lives in Ramona with her husband Todd and
their two daughters. She may be contacted at 760-484-4426 or via e-mail
at dr.selders@cedarcreekequine.com.