Signs and Stages Usual Time of Occurrence Distended udder (minimal in many maiden mares) 2–4 weeks before foaling Dropping of the abdomen (more with age), followed by relaxation evident on each side of tail head 1–3 weeks before foaling Teats fill with a clear, watery secretion 4–7 days before foaling Secretions become cloudy and wax-like and cover end of nipples (waxing-over), and calcium exceeds 320 ppm (8 mM/L) 1–4 days before foaling Vulva becomes loose, soft, and relaxed and no evening drop in rectal temperature ½ –1½ days before foaling Foaling stage 1 Stop eating; pacing, restlessness, lying down and getting up which helps get foal into position for birth. Tail switching, sweating and frequent urination. If disturbed, mare can delay progression for many hours. Begins 2–5 hrs before delivery and 2–3 hrs before water breaks Membranes rupture and several gallons of fluid are expelled. Mare now can no longer delay foaling. 30–60 min before delivery Foaling stage 2^* Amnion, forefeet soles down, then nose appears. If not, provide help. Mare usually standing. 5–15 min after fluid expelled. If over 20–30 min, help needed. Foaling stage3^* Most mares lie down, and labor using abdominal effort begins. 15 min or less before delivery Foaling stage 4 Expulsion of the placenta (fetal membranes) 15–90 min after delivery

^* Some define stage 2 as what is given here as stages 2 and 3, which then makes expulsion of the placenta stage 3.

Calcium and magnesium concentrations can be measured using water hardness test kits or those adapted and sold specifically for predicting when foaling will occur. These include Titrets Calcium Hardness Test Kit (CHEM-etrics, Calverton, VA) and Merckoquant Total Water Hardness Test Strip (EM Science, Mickleton, NJ, or E. Merck, 6100 Darmstadt, Germany), which measure calcium only, and Predict-A-Foal Kit (Animal Healthcare Products, Vernon, CA) and Sofcheck Water Hardness Test Strip (Environmental Test Systems, Elkhart, IN), which measure calcium plus magnesium concentrations. Those that measure calcium only may be the easiest to interpret and give the most consistent results. To conduct the milk calcium test, add 6 parts distilled water to 1 part milk, mix thoroughly, insert the test strip for several seconds, remove and shake off excess liquid from the strip, wait about 1 minute, and read the results. Accuracy depends on preventing calcium contamination by using distilled water, and rinsing everything used following washing with tap water followed by distilled water.

The best procedure for ensuring that someone is present at foaling would appear to be the following:

INDUCING FOALING

The mare may be induced to foal at a predetermined time to minimize the amount of time necessary to monitor the mare; to ensure that someone, or that veterinary assistance, is present during foaling; or because of problems such as a history of premature placental separation, prolonged pregnancy, uterine paralysis, rupture or impending rupture of the mare’s prepubic tendon, pelvic abnormalities, or other potential causes for foaling difficulty, hydrops amni (“dropsi”), colic, painful skeletal disease that becomes more severe as pregnancy nears full term, or for preventing neonatal isoerythrolysis (a disease in which the foal’s red blood cells are destroyed by antibodies in its dam’s colostrum).

Some have reported high success rates, while others report incidents of foal loss and other problems when foaling is induced. Improper foal presentation for delivery, inadequate milk production, weak foals, foals with reduced resistance to infectious conditions, retained placenta, or premature placental separation during delivery (predisposing the foal to suffocation), are complications that may be encountered following induction. Because of these potential problems and complications, inducing foaling is discouraged unless there is a compelling reason for it or there is a wide margin of safety for both the mare and the foal. Problems and complications may be minimized or eliminated and foaling induction utilized successfully by paying careful attention to the following prerequisites for induction.

Except for conditions in which inducing foaling is indicated for the well-being of the mare, the major objective of inducing foaling is to increase the chances for the safe delivery of a live healthy foal. To do so it is recommended that all of the following criteria be met before foaling is induced.

An elevated milk calcium concentration is a very helpful indicator and precaution that foaling may be safely induced. Ideally, the milk calcium carbonate concentration should be 200 ppm (5 mM/L or 20 mg/dl) or greater (by Titrets Kit) or the calcium concentration (with or without magnesium) should be above 300 ppm (7.5 mM/L) (a color change has occurred in two or more zones of the four-test-zone Merckoquant Strip).

FOALING

There are three or four stages in foaling, depending on whether what some consider as stages 2 and 3 are considered separate or combined. Knowing these stages of foaling and their durations, as summarized in Table 14–1, helps alleviate unnecessary anxiety and disruptive and occasionally harmful interference during normal delivery, and when help should be provided. During foaling, do not try to help;.stay away and out of the mare’s sight as much as possible, unless there is trouble.

Over 80% of mares foal between evening and dawn. So most foals are up and going by morning, which is probably an inherent protection mechanism in the wild. The first stage of foaling usually begins 2 to 5 hours before delivery and lasts 1 to 4 hours, although the mare can delay it for much longer. It begins with the primiparous mares in a herd seeking isolation if possible; whereas multiparous mares may remain with the herd. The mare stops eating and becomes restless; she paces and lies down and gets up repeatedly. It is important that she be allowed to do this, as it, and the initial uterine contractions which are occurring, assist in getting the foal into proper position for delivery. The uterine contractions cause mild signs of colic such as tail switching, sweating, and frequent urination. These signs may be transitory and intermittent. When these signs begin to occur, wrap the tail (or it may be easier to put it in a tube sock taped at the top around the tailhead) and wash down the perineal area with a mild soap and disinfectant. This will decrease infectious diseases in the foal. If the mare has a Caslick’s closure of the top of the vulva, it should have been opened previously, but if not, snip it open with a pair of sharp, clean scissors. Following this, leave the mare alone but watch her, preferably from where she cannot see you. The mare can delay progression of foaling for probably as long as 10 hours at this stage. Continued uterine contractions force the chorioallantois or “water sac” through the cervix, dilating it until the “water sac” breaks, expelling 2 to 5 gallons (8 to 20 L) of fluid.

In the second stage of foaling, continued uterine contractions force the white, glistening amniotic sac, with the foal’s foot inside, through the cervix, further dilating it. If instead of the white, glistening amnion, a reddish velvety membrane appears, it is the prematurely separated chorioallantois or placenta. This means that the placenta has separated and the foal is no longer receiving oxygen; it must be delivered quickly or it will suffocate. The placenta should be ruptured immediately and delivery assisted. However, if nothing appears at the vulva within 20 to 30 minutes after the water breaks, this generally indicates that the foal is breech (coming butt first, which occurs in 2% of cases) or in a transverse dorsal presentation (withers coming first, with head and legs down and usually to one side). The foot normally should appear covered by the amnion with its heel and sole down. If the heel and sole are up, this generally indicates that it is a back leg and, therefore, that the foal is being delivered backwards.

From the moment the water breaks until the amnion is visible at the vulva usually takes 10 to 15 minutes and occurs with the mare standing. If there is an indication of abnormal presentation, or the amnion is not visible within 20 to 30 minutes after the water breaks, the veterinarian should be called. If veterinary assistance must be awaited, walk the mare and keep her standing to delay foaling.

In the third stage of foaling, most mares lie down and exertional labor using abdominal effort begins. However, 3 to 10% of mares will deliver the foal while standing. Both of the foal’s feet should appear with their heels and soles down and with one foot 4 to 6 inches (10 to 15 cm) behind the other. If the distance is greater than this, there is a chance that one elbow is caught on the mare’s pelvis. Normally the foal’s nose should become visible and be near its knees; if it is not, this may indicate that the foal’s nose is down and caught on the brim of the pelvis or that its head is turned back. Once a foot is showing, there should be progress within 5 minutes. The feet will generally rupture the amnion. After the foal’s shoulders are expelled, the mare may rest for 2 or 3 minutes. Continued uterine contractions and abdominal effort normally deliver the fetus, completing the third stage of foaling in about 15 minutes or less after intense exertional labor using abdominal effort begins.

If there is any variation from normal presentation or duration, veterinary help should be sought. Get the mare up and walk her—this could correct a minor abnormality in presentation such as a caught elbow. Getting the mare up is generally necessary to, and greatly assists in, correcting an abnormal presentation, such as a leg or legs, or the head, back.

Difficulty in foaling, in contrast to calving, particularly heifers, in over 95% of the cases is a result of abnormal presentation, position or posture of the foal or twinning, and not of a fetus too large for the mare’s pelvic opening. Of these, the great majority are positional or postural problems involving the head or forelegs which can be resolved by experienced individuals when detected early. More difficult foaling problems are uncommon and include combined neck and foreleg flexion, total shoulder flexions, posterior presentations and its variations, transverse presentations, contracted or malformed foals, and anterior presentation with one (hurdling) or both (dogsitting) hind feet drawn up into the birth canal under the chest. If the foal is dead, dismembering it may be the best treatment to avoid risk to the mare from a cesarean; however, a cesarean may be necessary in some cases.

The last or fourth stage of foaling is the expulsion of the placenta or afterbirth. This usually occurs 15 to 90 minutes after delivery of the foal. Occasional cramping pains, like a mild colic, may occur during placental expulsion, and for a few hours afterwards, due to continued uterine contractions. Before the placenta is expelled, some mares become frightened by the hanging fetal membranes and kick at them, occasionally injuring the foal. If the placenta is retained beyond 4 to 6 hours following foaling, treatment is indicated (see section on “Mare Care After Foaling” later in this chapter).

BEHAVIOR OF THE MARE AND FOAL AFTER FOALING

The normal and common behavior and activities of the mare and foal and their time of occurrence after foaling are summarized in Table 14–2. The mare after delivery usually remains lying down for 5 to 30 minutes. This serves three purposes: (1) to rest following the exertion of foaling, (2) to allow the foal to orient itself to its new environment, and (3) to allow continued umbilical cord attachment. Continued attachment of the umbilical cord allows the foal to receive as much as 1.5 qts (1.5 L) of blood from the placenta during the first several minutes following birth. Although this additional blood isn’t necessary, it is helpful.

TABLE 14–2 Mare and Foal Activities after Foaling

^a An anxious, excited foal may not exhibit these reactions.

Following foaling, either before or after standing, the mare may initially sniff the foal nostril to nostril in the normal response to a strange horse. But many mares, particularly those with their first foal, usually don’t concentrate on the foal until they have completely investigated the fetal fluids and membranes. This behavior should not be discouraged, as it is thought that the mare identifies the fetal fluids as hers and subsequently identifies the foal as hers because it smells like these fluids. In contrast to many species, the mare rarely eats the fetal membranes. The membranes should not be removed for the first 2 hours after foaling. Following her investigation of the fetal fluids and membranes, most mares will smell and lick the foal. But in contrast to many species, mares lick their foals for the first few hours only. This grooming is beneficial for the development of the maternal-neonatal bond and shouldn’t be interfered with. If the foal is lethargic, the mare may strike it gently with her forefoot. A stillborn foal is eventually pawed more forcefully by the mare as she attempts to rouse it or make it move. Mares will voluntarily leave their dead foal after a day or so.

Most neurologically normal foals will sit up within 3 minutes following birth and will suck fingers placed in the mouth 2 to 20 minutes following birth. Using foreleg and neck movements, the foal will struggle to free itself from the membranes and its mother. During these movements and the ensuing creeping forward, the umbilical cord usually breaks and the hind legs are pulled free of the mare and membranes. Once free, these withdrawal movements stop. Mares commonly view this foal activity while lying on their sternum and occasionally may nicker quietly.

Most foals will stand within 15 to 180 minutes following birth. This averages about 60 to 70 minutes for colts and 40 to 55 minutes for fillies. It isn’t affected by birth weight, although it tends to be faster for pony breeds. It may take as much as 2 hours of effort for the foal to stand. Most will fall several times during the effort. Don’t try to get the foal up or help it. Trying to help exhausts the foal. In addition, it is important that a foal not be lifted by its chest or abdomen as this may fracture its ribs or damage internal organs. If the foal must be moved, pick it up with an arm under its rump and the other arm under its chest in front of its forelegs. If the foal doesn’t stand by 3 hours of age yet appears normal, assistance may be given by extending its front legs in front of it, lifting its hind quarters, and helping it maintain its balance. The quicker the foal stands and nurses the better. Although you can’t make the foal nurse, helping it up and aiming it in the right direction, if necessary, may be helpful.

The foal’s initial standing stance is wide-based, and the first steps are exaggerated and short-strided. The soft collagenous pads over the soles of the foal’s feet rapidly become shredded and are lost, which makes walking easier. Within 3 to 9 minutes after standing, most foals walk with relative ease, and, no matter how unsteady and uncoordinated, search for the mare’s udder. This search may be misdirected, leading to an attempt to suckle nearly anything encountered, particularly anything under an overhang such as the mare’s body. The foal should be allowed to find the udder unassisted, as this helps imprinting and recognition by both the mare and the foal of each other. Both successful nursing and the passing of meconium (fetal feces) usually occur at 1 to 2 hours of age but may take place from ½ to 6 hours. About 5% of foals need help nursing, and about 2% need help passing their first stools. To pass stools some straining is normal, but prolonged straining may indicate impaction. Following passage of stools, repeated defecation occurs about once every 10 hours and increases in frequency with age to 3 to 5 times daily. Urination first occurs at an average of 6 hours of age by colts and 11 hours of age by fillies, and thereafter a dilute urine is excreted 4 to 10 times per day.

The foal’s difficult task of lying down will generally be accomplished shortly following nursing, although some foals will fall asleep while they are standing if they haven’t mastered lying down, and may fall down if they go into deep sleep. Drowsiness and sleep occur 1.5 to 4 hours, averaging 3 hours, after birth, for an average duration of 7 minutes. After sleep, the foal will stand and nurse again. Most foals will have nursed twice by the time they are 2.5 hrs of age. Frisky play movements may occur as early as 2 hours, and galloping at 6 to 7 hours of age. Thus, by the end of its first day of life, or most commonly by the first morning of its life, the foal will be self-grooming, galloping, grazing, urinating, and defecating—all the functions of a normal adult. For the first several weeks, most foals will nurse for one-half to 2 minutes 18 to 24 times per day and lie down on their side and sleep for 15 to 30 minutes 20 to 25 times per day. The foal spends about one-third of its time lying down during the first 2 months of life (as compared to 5 to 10% for adults). Even the first day of life the foal on pasture with its dam spends 6 to 9% of its time grazing, with this increasing to 23% by 1 to 8 weeks of age and to 40 to 50%. by 21 weeks. Excessive human interference can hasten or delay the occurrence of these normal behavioral activities.

The mare and foal’s investigation of each other or the placenta should not be disturbed, as this is necessary for their bonding. Maternal imprinting is necessary for the mother to identify her newborn as an individual to be cared for, protected, and allowed to nurse. Foal imprinting enables it to identify its mother as the specific individual to follow and stay near. The critical period for the foal’s recognition and acceptance of its dam is longer than that of the dam for her foal. Foals do not learn to follow their dam to the exclusion of any other large moving object for the first 1 to 2 weeks of life, and as a result are more easily separated from their dams than when older. But the foal will begin to nuzzle the mare’s head and forequarters and to follow the mare and take shelter beside or behind her by 1 to 3 hours of age. Different species have different protective behavior tactics. Fawns and kids hide, calves and lambs lie together in groups, and foals and mares stay close together. During the first week of life the foal spends 85% of the time within 3 ft (1 m) of its mother, 94 to 99% of the time within 15 ft (5 m) of her, and rarely is more than 30 ft (10 m) from her. As the foal becomes older it begins to wander farther and spend more time away from its mother. Although there is some variation among individual foals, in contrast to an old horseman’s myth, colts are not more independent than fillies; i.e., these activities and distances are not different between colts and fillies.

Foals identify their dam by both smell and sight but not by sound. Foals cannot readily distinguish one mare’s neigh from another and regularly will approach the wrong mare if she is neighing. Because of this, foals with quiet mothers take longer to find them. Sight, smell, and sound are all important to the mare in identifying her own foal — not just smell, as some have thought. Even when smell is blocked, the mare can identify her foal, although it does take her longer. Mares also respond more to the sound of their own foals. Foals neigh when they are separated from the dam, and nicker when they are asking for care and attention. Neighs probably are highly individualized, making it easier for the dam to recognize her own foal.

Stretching or pandiculation, which is an indication of well-being and therefore important to note, generally first occurs after the foal’s first sleep, or at about 4 hours of age. Thereafter foals stretch during sleep, typically after sleeping, and during lying down as well as when standing. The healthy foal stretches 20 to 40 times the first day of life with this increasing to 40 to 100 times/day during the 3rd to 5th day of life. This frequent stretching is needed and beneficial in straightening tendons and stiff joints after their 11-month period in the womb, in ensuring that all major parts of the body are extended and exercised, and in assisting the foal in its athletic development. Because of frequent stretching, minor degrees of contracted tendons in foals are self-corrected during the first week of life. Stretching occurs as a brief exercise performed casually when the foal is relaxed and undisturbed, and thus requires a quiet peaceful environment.

Play behavior is also beneficial for the foal’s athletic and social development. Because of this and the benefit of exercise, the mare and foal with no problems should be placed on pasture of sufficient size to allow the foal to run and play with other foals by 1 week after foaling. Even the day-old foal will show sudden bursts of playful, solitary leaping, running, and bucking, which progresses to mock fighting and chasing among colts, and simple solitary running among fillies. Although fillies don’t play as much as colts, they tend to groom one another more.

Self-grooming is standard behavior among foals, as are biting and scratching. The absence of much tail may be the incentive for some foals’ standing head to tail with the dam; her fully grown tail offers insect-chasing benefits. The flehmen response (curling the upper lip), which is seen more often in colts than fillies, occurs most frequently during the colt’s first month, probably in response to the mare’s first heat or estrus following foaling.

Foals, like other young of most species, including people, show that play is an important business and a necessary part of life. Play is important for both exercise and socialization for foals as they grow. It functions as a means of physical development and of practicing adult behavior skills that are beneficial later in life for a wide range of activities. Play is valuable for the development of normal behavior. In all of the various play activities there is the single emotion of pleasure, whereas in nonplay activities there are numerous emotions: anger, fear, and others. Horse play is a good demonstration of play as a purely kinetic activity. For foals, 75% of kinetic activity is in the form of play.

Foals in groups gradually change from being primarily aware of and with their mothers, to being primarily with their peer group, but do form peer groups even in the first week of life. As the need for self-maintenance increases, peer group activities change from play and rest to primarily grazing. The foals move between their peer group and their mothers in various activities. As a result of these activities, their primary social bonding is in kinship groups. All of this is, of course, quite similar to what should and generally does occur with children as they grow and mature.

Maternal Aggression by Mares

Maternal protective aggression directed toward other horses particularly, but also toward other animals or even people, is normal in the first few days to week following foaling. Even when the foal is considerably older, some mares remain protective, particularly when the foal is lying down. Thus, if it is necessary to approach a mare and foal when the intensity of the mare’s protective aggression is unknown, it is best to wait until the foal stands up. Protective aggression is helpful not only in protecting the foal from harm from other animals, but also in preventing it from following other horses or animals. Protective aggression when the foal is not lying down usually decreases within a few days following foaling; however, some mares may show extreme protectiveness until they become pregnant again or the foal is weaned.

Even good mothers normally take aggressive actions against their foal as it gets older and too rough, particularly if they have a painful udder. This aggressive behavior includes threatening signs such as laying the ears back, squealing, switching the tail, bunting with the head, making a smacking noise with the mouth, and threatening to or actually biting or kicking the foal. This normal maternal aggression is uncommon toward foals under a month of age, but it increases as the foal gets older and may be a part of natural weaning. This aggression toward the older foal, in which the foal is not harmed, is normal, but, abnormal if the mare pursues and repeatedly bites or kicks the foal.

Normal aggression is most commonly caused by a painful udder. It occurs most often prior to the first suck in any nursing bout and when the foal repeatedly pushes or bunts the turgid udder; once the mare is aggressive toward it, most foals will either begin sucking or quit pushing hard. Some will briefly interrupt their nursing, less commonly return the aggression against the mare, and least commonly stop that nursing bout. Once the foal stops bunting the udder and begins to nurse, aggression toward it normally decreases or stops.

Excessive abnormal aggression toward the foal (usually biting) when it tries to nurse is the most common behavioral problem in foaled mares. Less commonly, a mare may not take aggressive action against the foal but will not allow it to nurse. Even less commonly, a mare may attack her foal when it is not trying to nurse, for example, when it comes between her and her feed. Others may attack their foal whenever it stands, but not when it is lying down.

Abnormal maternal behavior occurs most commonly in young, often nervous mares with their first foal; causes are unknown. Lack of experience, hormonal imbalance, stress during foaling, or lack of contact with the foal during the sensitive period for bond formation may be factors. Pain and stress can interfere with maternal behavior. Too much disturbance by too many people and having other horses nearby increases the risk of maternal rejection and aggression toward the foal, particularly by first-foaling mares. Free-ranging mares can withdraw from the herd to foal if they desire. Because stalled mares can’t do this, they may be aggressive against horses in adjacent stalls, especially stallions. Frequently, the mare that is aggressive toward her neighbors may displace the aggression onto her foal. A nervous mother may also attack her foal if it looks, tastes or smells different: e.g., if it is seen wearing a halter or blanket which it hasn’t been wearing previously, or if the foal’s odor changes as a result of a clinical treatment or procedure.

To assist in preventing maternal rejection and aggression toward the foal, the following procedures prior to, during, and for at least 2 days after foaling are helpful: (1) the mare should be isolated from seeing, smelling, or hearing other horses as much as possible; (2) her contact with people should be minimized (number of people, instances, and duration, particularly with those with whom she is unfamiliar); (3) nothing should be done to change the foal’s appearance or smell; and (4) the placenta should not be removed from the stall for at least 2 hours after foaling.

If the aggression may be due to a change in the foal’s appearance, this should be corrected; if it may be due to a change in the foal’s odor, the new smell can be masked by applying mentholated ointment to both the mare’s nostrils and the foal’s head and perianal area. Sometimes the aggression stops if the mare and foal are turned out of the stall. The freedom to wander from her foal while in a large paddock or a pasture will alleviate aggressive behavior by some mares. When this is done, however, someone should be present to protect the foal if necessary. Another approach is to turn the mare and foal out with other horses. Faced with other horses, she may begin to protect her foal.

The safest and most successful technique for getting a mare to accept a foal is to restrain her until she accepts and allows the foal to nurse. Procedures for doing this are described in Chapter 15 under “Nurse Mares” for orphan foals. If the mare can be forced to accept the foal, the aggression usually diminishes and is replaced by normal maternal behavior. However, this may take up to 3 weeks, and some mares will not accept their rejected foal. Thus, as with most problems (behavioral, nutritional, infections, traumatic, or parasitic), procedures to minimize risk of the problem’s occurring is always best, or, as an old saying goes, “An ounce of prevention is worth a pound of cure.”

NEONATAL FOAL CARE

All interference or “help,” no matter how well intentioned, should be avoided unless necessary for the health of the mare or foal as summarized in Table 14–3. Foaling should take place where the mare can’t see people or other animals, including horses, or ideally even hear them unless she is accustomed to the sounds. Thus, foaling should be observed from a location where the mare can’t see or hear the observer. Videocameras work well, allow one person to watch several mares, and are commonly used to observe foalings on many breeding farms. It is important to watch the mare and foal until both are on their feet and moving fairly steadily. Make sure that when the mare attempts to get up following foaling the foal is not where she can step on it. Frequently the mare will lie down and rest for 15 to 60 minutes after foaling.

Respiratory Assistance for Foals

The fetal membranes generally are pulled off the foal’s head during delivery. If the membranes remain on the foal’s nose after its chest has been expelled, they should be taken off so that it can breathe. If the foal doesn’t breathe within 5 minutes following expulsion of its chest or, if delivered backward, its hips, permanent brain damage or death will occur.

If the foal or amniotic fluid are stained yellow brown, material should be gently suctioned from the upper respiratory tract, ideally before the foal takes its first breath. If vacuum suction equipment isn’t available, a soft tube on a large syringe can be used. The yellow brown stain is due to stools passed by the fetus in utero, usually because of fetal suffocation due to compression of the umbilical cord. Fetal gasping in utero can draw fluids and stools into the upper respiratory tract. Following birth, this material is drawn further into the respiratory tract when breathing begins. This causes aspiration-induced pneumonia, unless the material is removed prior to the foal’s first breath.

Respiratory assistance, if needed, should be provided in a step-wise fashion as summarized in Table 14–4. If the foal does not breathe within 30 seconds following delivery, place it upright, on its chest or sternum with its head and neck extended, remove material from the mouth and nostrils and briskly rub its back and sides with a dry towel. This helps stimulate respiration. Setting the foal upright on its chest is helpful because respiration is easier and more efficient from this position than it is when the foal is lying on its side. If not excessive, fluids not removed by chest compression during birth can be removed from the nasal cavity by stripping the nostrils with the thumb and forefingers. Stimulating the inside of the nostrils or the ear canal with a straw, and flexion and extension of the limbs, may be helpful in initiating breathing efforts. Although usually not necessary for normal-birth foals, the hindquarters may be raised to help drainage if necessary. Elevation should be only 1 foot or so (one-third meter) as excess elevation increases abdominal pressure on the diaphragm and, therefore, may be detrimental. Suction if available may also be used. A small, soft, rubber or latex tubing on a 60-ml syringe may be used. Excessive negative pressure and prolonged pharyngeal and tracheal aspiration should be avoided because these remove oxygen and can be detrimental. Suction should be applied for only a few seconds at a time and only during withdrawal of the tubing from the airway. If breathing doesn’t occur within an additional 30 seconds, or 60 seconds of birth, close the foal’s opposite nostril and lips, inflate the lungs by blowing into one nostril until the chest rises, then release both nostrils. This initial inflation, or a few short puffs, may be all that is necessary to get breathing started. Next check the quality of the peripheral pulse, the heart rate, the color of the membranes, and the capillary refill time. If the foal doesn’t begin breathing on its own within 2 minutes after a few short puffs to inflate its lungs, establish a respiratory rate of 20 to 30 breaths per minute until the foal begins to breathe normally. If pulse, heart rate, respiratory rate, membrane color, and capillary refill time aren’t normal, or the foal is unable to remain sitting up on its chest, veterinary assistance should be obtained.

The foal’s normal respiratory rate is 60 to 90 breaths/ min at birth, and is higher in colder conditions. It decreases to one-half this rate by 1 to 2 hours of age. The heart rate should be at least 60 beats/min, increasing to 80 to 130 after the first 5 to 10 minutes of life.

Umbilical Care for Foals

Allow normal activity of the mare and foal to break the umbilical cord without interference. If the umbilical cord is broken too quickly (within less than a few minutes of birth), blood may squirt from the foal’s umbilical stump. In the majority of cases, the amount of blood lost is small; but if blood loss does occur when the umbilical cord is separated, the cord should be pinched closed with the fingers and held for 1 to 2 minutes. During this time, the artery constricts and the cord can generally be released without further loss of blood. If bleeding persists, however, an umbilical clamp or sterile, nonabsorbable ligature can be put around the end of the stump and removed in 6 to 12 hours.

TABLE 14–3 Care of the Foal at Birth

If the umbilical cord hasn’t broken by itself by 15 minutes after delivery, find the constriction in it, which is usually about 1 to 2 inches (3 to 5 cm) from the foal’s abdominal wall, grasp the cord with one hand on each side of the constriction, then twist and pull it apart. Be careful not to pull on it from the foal’s abdomen. Cutting the cord results in excessive hemorrhage from the umbilical stump and Possibly in urine leakage from the stump. In contrast, the elastic muscular walls of the two umbilical arteries generally result in prompt, prolonged constriction of the umbilical stump when it is separated by stretching.

Following umbilical cord rupture, soak the stump for several seconds in a 2% tincture of iodine, a 1% povidoneiodine, or a 0.5% chlorhexidine solution. This should be repeated twice daily for the next 3 days—once is not adequate. A strong (7%) tincture of iodine solution is quite damaging to the tissue and should not be used. Avoid getting iodine on the foal’s abdominal wall or thighs as it can irritate and damage the skin. Evaluate the stump daily for signs of infection (moistness, reddening, heat, swelling, or pus discharge), abscess, and urine leakage. If these don’t occur, the umbilical stump dries up in less than 2 days. A failure to follow these procedures, or a dirty environment at the time of birth, greatly increases the risk of umbilical infection (“navel ill”). An infected umbilicus is a major portal of entry for infectious organisms, resulting in septicemia, joint infections (joint-ill), abdominal cavity infections (peritonitis), internal abscesses, and pneumonia. These conditions, even with treatment, often result in death of affected foals. Even if the affected foal survives, its future health and performance ability may be impaired. Umbilicus infection, and as a result these effects, are prevented by proper umbilicus care as described.

TABLE 14–4 Foal Respiratory Stimulation and Assistance

Imprint Training

Imprint training permanently desensitizes the foal to handling and other external stimuli, and sensitizes the foal to respond appropriately to human requests. Imprint training can make handling easier for the rest of the horse’s life, enhance later training, decrease injuries to both the horse and the people associated with it, and increase responsiveness to stimuli which will later enhance performance and pleasure for both the horse and its handler in working together. Through imprint training, the foal can be taught not to fear or respond inappropriately to touch anywhere on its body, loud or strange noises, or fluttering or whirling objects, and will respond in the manner desired to touch or pressure. But the foal can learn what to fear as quickly as what not to fear so it must not be hurt or scared. Little restraint, a low-voiced comforting murmur. and scratching should be used.

Imprint training of foals ideally should start within a few hours following birth. There is only a narrow period of opportunity in which desensitization can be quickly and easily accomplished: for example, for ducklings from 7 to 22 hours following hatching. Prey species, such as foals, ducklings, calves, lambs, etc., as soon after birth as possible must be able to perceive danger and flee it in order to maximize their chances for survival. Thus, very soon following birth they must be able to determine if a stimulus is or is not something to fear. In contrast, non-prey species, such as carnivorous animals, do not need to be able to flee immediately following birth and are born unable to see, hear, or flee. Their imprinting period is delayed until they are more mature — e.g., in puppies between 6 to 12 weeks of age.

Some have feared that beginning imprint training of the foal at birth may interfere with normal bonding between the foal and its dam. This, however, does not appear to be a problem, at least in the vast majority of cases of gentle well-mannered mares. It does require that the mare be brought in from pasture for foaling and that she be gentle and well mannered. In addition, when approaching the mare and foal, always greet the mare first. When working with the foal, have the mare haltered and facing the foal. Injury to the foal, mare, or person may occur if the mare becomes aggressively defensive of the foal, or later in trying to get her to accept the foal, if she rejects it. If the mare is not gentle and well mannered, and this has not been corrected before foaling, it is probably best not to begin imprint training until the foal’s second day of life.

For a short time following birth the foal will apparently bond simultaneously with its dam and with one or more persons handling it. It then appears to consider people dominant but nonthreatening and nonfearful. This is the ideal relationship between a horse and people. The horse must be submissive if it is to work with us, but that submissiveness should be created by dependency on and trust in a dominant leader (people), and not by fear. In contrast to what some have believed, bonding of a foal to people will not result in a spoiled pet that is indifferent to stimuli that allow it to race or perform well. To the contrary, imprint training will teach the foal good manners and increase its responsiveness to stimuli that will later improve its performance.

It is recommended that the initial training session begin after disinfecting the umbilical cord, but that care be taken not to interfere with the mare’s smelling and licking of the foal or the placenta. Begin by rubbing the foal dry with a towel and by gently but rapidly rubbing each area to be desensitized until the foal is oblivious to it. This is indicated by calm resignation, relaxation, and a sleepy expression. Continuing this procedure on each area until this response is obtained is important. If you stop the procedure while the foal is struggling, it will be taught escape behavior instead of being permanently desensitized to handling or touching that area. You cannot overdo stimulus of an area, but you can underdo it. Desensitize the foal to noises, motions, and touch anywhere on its body, including body openings. The initial session to do this takes about an hour. It and shorter subsequent periods are quite likely the most effective and valuable time anyone will ever spend with that horse.

Any number of patterns may be followed in desensitizing the foal. The following may be helpful. Start at the poll, next the ears, then insert a finger into the ear canals, next the face, followed by the underside of the upper lip, the mouth, the tongue, and both nostrils. All of this takes 10 to 15 minutes. Next do the eyes, neck, chest, saddle area, and all four legs, including repeated flexing of each joint. Tap the bottom of each foot 50 to 100 times. Do the rump, tail, area between the hind legs, including the genitalia, udder region of the filly, perineum, and anus. Rub a running electric clipper all over the foal’s body, especially around the face and ears (without cutting any hair). Even though desensitized to the sound of one kind of clipper, later in life the horse may still be frightened the first time it hears another kind. Rub the entire body with a piece of crackling plastic. Take lots of time. Watch for habituation, as indicated by relaxation, before any stimulus is stopped. If desired, you can desensitize the newborn foal to gunfire, whistles, loud music, flapping flags, whirling ropes, hissing sprayers, and recorded noises such as dogs barking.

A second desensitization session should be done on the first or second day following birth. It is imperative that the foal not learn to escape when being handled, so it is best to have an assistant hold it. Stand the foal nose to nose with its dam to allay apprehension for both. Quietly test all areas previously desensitized. If an area is not adequately desensitized, repeat the process. Standing beside the foal, reach around it and clasp your hands together under its chest. Rhythmically squeeze and relax until desensitization occurs. This will later prevent the horse from being “coldbacked” or “cinch-bound.” Desensitize the foal to additional stimuli, such as flapping blankets, running water from a hose, going through and standing in belly-deep running water, livestock, dogs, etc. The foal should experience in a small way whatever people may want it to tolerate when it is older. At several days of age, load the mare and foal in a trailer and take them for a short ride. Each session should not exceed 15 minutes but can be repeated several times a day if necessary. Twice-daily sessions are generally adequate.

Following desensitization, the foal should be sensitized to certain responses, beginning with moving its hind end when requested. Standing beside the foal, put one arm under its neck so it can’t move forward. With the other arm, reach over its back and poke a finger into its flank on the other side of you. To escape the pressure, the foal will eventually move toward you and away from the pressure of your finger in its flank. When it does so, even slightly, immediately relieve the pressure. Be sure you are standing away from the foal enough to allow it room to move its hind end toward you and away from your finger pressure. Wait 20 to 30 seconds and repeat the stimulus, immediately rewarding even the slightest movement away from your finger by stopping the pressure. Most foals learn with 3 to 5 repetitions to move whenever they feel pressure on their flank. Don’t ask for more than one step in the first training session, but do both sides. In a day or so, when the response is consistent, you may then ask for a second step and later a third.

Next, put a well-fitting halter on the foal. Remove it after the training session to avoid accidents. Working with an assistant in a well-bedded stall, gently pull the halter to one side. The assistant should prevent the foal from moving forward, back, or to the opposite side. Eventually, in order to maintain balance, the foal will move in the direction its head is being pulled. When it does, even slightly, immediately quit pulling. Proceed just as described previously for training the foal to move its hind end until the foal can be circled both ways. Gradually expand the circle until the foal is leading in a circle. After several sessions the foal will be leading. If desired, a loop of rope behind the foal’s rump can be used to encourage forward movement. It also helps if initially the foal is encouraged to lead toward its dam. By one week of age, if the mare can be ridden, lead the foal while riding the mare in a small corral or paddock.

Stool Passage Enhancement for Foals

Meconium—dark green, brown to black, tarry stools formed prior to birth—normally begins to be passed without difficulty within one-half to 6 hours, and usually within 1 to 2 hours, after birth, or one-half hour after standing. In most foals, all meconium has been excreted by 24 to 48 hours of age, although some may take 96 hours. Masses of meconium often are quite firm, sticky and large, resulting in various degrees of constipation and pain upon defecation. As a result, impaction of the meconium and an inability to pass it without assistance occurs in about 2% of foals. This occurs more commonly in colts than fillies because the inside diameter of the colt’s pelvis is smaller, making it more difficult for the colt to pass meconium. Foals born after 340 days of pregnancy also appear to be more prone to meconium impaction.

Meconium impaction results in signs of mild colic, which become evident 6 to 24 hours after birth, and include repeatedly getting up and down, straining with an elevated tail and arched back, switching the tail, squatting, and frequent attempts to defecate and urinate. It is the most common cause of abdominal discomfort in neonatal foals. The offending impaction sometimes can be felt by digital rectal palpation, which should be done only with a well-lubricated finger. However, sometimes the impaction is in the small colon instead of the rectum and cannot be palpated. A distended colon may become evident even before abdominal distention. In some foals the urachus may reopen as a result of straining to defecate. If the meconium impaction is not relieved, the signs of abdominal pain become more severe. The foal may roll or lie on its back, become more restless, and nurse intermittently and less frequently with increasing duration of impaction, leading to dehydration. If not relieved, depression, sweating, and ultimately death occur.

Clinical signs of meconium impaction are similar to those of a ruptured bladder. However, symptoms of a ruptured bladder usually are not apparent until 48 to 72 hours after birth (instead of 6 to 24 hours, as they are with meconium impaction), and urine can be obtained from the abdominal cavity. Other causes of colic in the young foal include small intestine displacements, and occasionally gas distention and diarrhea due to acute enteritis, such as that caused by Clostridium perfringens. However, intestinal displacements rarely occur in the first few days of life and result in much more acute and severe signs. Clinical signs of developmental anomalies of the intestinal tract, such as the absence of a colon or anus, or ileal innervation, also resemble meconium impaction. However, with the absence of a colon or anus, signs generally don’t occur until the foal is 2 to 3 days old and tend to be less severe. The absence of ileal innervation, or lethal white foal syndrome, occurs in white foals born to overspotted horses (ventral portion of the body is spotted white, and the dorsal aspect of the body is a dark color). Inguinal and diaphragmatic hernias may also cause abdominal pain in young foals. Inguinal hernias occur in colts and are characterized by enlargement of one or both sides of the scrotum. Despite their rather common occurrence, inguinal hernias usually don’t cause symptoms and self-correct within the first few weeks of life. Foals with congenital diaphragmatic hernias usually have difficulty breathing.

To prevent meconium impaction, an enema should be given within 2 hours of birth. Most commonly it is given 15 to 30 minutes after birth, following umbilical care. The enemas most commonly used are warm, mild, soapy water (1 to 2 pints, or ½ to 1 L) or commercially available enema solutions. The enema solution should be given very carefully to prevent rectal trauma or perforation. The newborn foal’s rectal walls are frail and easily damaged. The enema tube should not be advanced more than 10 to 12 inches (25 to 30 cm) into the rectum, and the fluid should flow by gravity.

If the meconium isn’t passed or clinical signs occur, enemas may be repeated at 4-hour intervals, and 4 to 8 ounces (120 to 240 ml) of mineral oil and/or 2 ounces (30 ml) of castor oil may be given orally by way of a stomach tube. If no response occurs after two to four enemas, a commercial Fleet enema may be used, but it should not be repeated more than twice. Oral laxatives are almost always effective in relieving impaction when administered before intestinal motility has been decreased by gas distention and persistent colic. Even in refractory cases, repeated enemas and oral laxatives are safer than attempting to remove the meconium with the finger or a surgical instrument. Surgery is rarely necessary to relieve the impaction; it is only necessary if the impaction is not responsive to persistent medical therapy and the foal’s condition is deteriorating.

Antibiotics, Nutrients, and Intestinal Inoculant Administration to Foals

The administration of antibiotics to the newborn foal to help guard against infectious diseases is controversial. A long-acting penicillin injection is commonly used. Proponents contend that it helps protect the foal when it is most vulnerable and exposed to a variety of infectious organisms in its new environment out of the uterus. Adversaries, including this author, assert that using antibiotics in this manner has a greater potential for harm than benefit. It is unlikely to help the foal, and it increases organisms resistant to that antibiotic. In addition, penicillin is a poor choice because many septicemias in foals are not susceptible to it. The incidence of diarrhea in foals is several times higher in those given antibiotics at birth than those not given them. It is recommended that antibiotics not be given to healthy foals to try to prevent disease unless foals are born and raised in filthy environments or have low plasma immunoglobulin levels, in which case cleaning the environment and increasing the foal’s plasma immunoglobulin levels, as described later in this chapter, are much more beneficial than is antibiotic administration. Proper hygiene, colostrum intake, and good management cannot be replaced by giving antibiotics.

The only supplemental nutrients whose administration to the newborn foal appears to have a potential for being beneficial are vitamins A and E, and selenium in areas deficient in it (Fig. 2–4). Vitamins A and E, are not transferred across the placenta. Therefore, regardless of the mare’s intake or body content of these vitamins, the foal is deficient in both at birth. Selenium is transferred across the placenta, depending on the mare’s selenium status. Thus, in selenium-deficient areas, without supplementation the foal at birth will be deficient in selenium, as well as in vitamins A and E. All three of these nutrients are secreted into the milk and are particularly high in the colostrum if the mare has adequate intake, or for vitamin A only, if the mare has adequate body stores available. If not, the foal’s deficiency will persist. The foal is quite susceptible to and commonly affected by vitamins A and E and selenium deficiencies. The effects of these deficiencies are described in Chapters 2 and 3. One effect of a deficiency of any one of these three nutrients is increased susceptibility to infectious diseases, particularly of the respiratory and intestinal tracts, resulting in pneumonia, septicemia, or diarrhea.

Because of these factors, it is frequently recommended that within 6 to 24 hours of birth all foals be given an intramuscular or subcutaneous injection of 250, to 500, IU of vitamin A, 50 to 200 IU of vitamin E, and in areas where selenium deficiency is known to occur (Fig. 2–4), selenium at the manufacturer’s recommended dosage. Vitamin D is present in many vitamin A preparations at a nonharmful level, and, therefore, may be given along with the vitamin A. However, if the brood mares are on a good feeding program, as described in Chapter 13, and the foal receives the amount of colostrum necessary for adequate immunity, as discussed later in this chapter, giving newborn foals vitamins is unlikely to be of benefit. Although it is unlikely that their administration in the amounts given above is harmful, in one study diarrhea in 1- to l4-day-old foals was higher in those given vitamins than in those not given vitamins. Differences other than vitamin administration may have been responsible. However, there was no indication of any benefit from the administration of the vitamins, and the administration of some nutrients to newborn foals may be harmful. This was dramatically illustrated by the death of many foals following the oral administration of an iron-containing intestinal inoculant.

In 1982 and 1983, a previously unrecognized form of acute liver failure occurred in many newborn foals in many locations in the United States. The disease was characterized by lethargy and jaundice at 2 to 3 days of age, followed by diarrhea, bleeding from the nose and in the urine, increased excitability, often blindness, and incoordination with death at 4 to 6 days of age. The disease was found to be caused by the oral administration of a digestive inoculant made and recommended for foals. This inoculant contained several viable bacterial cultures and fermentation products, vitamins A, D₃, E, and B₁₂, and iron, which later was found to be the toxic principal in the inoculant. The dose of iron that will cause acute toxicosis in newborn foals is much lower than the amount toxic to other species or to the foal after the first several days of life. A vitamin E or selenium deficiency also appears to increase the foal’s susceptibility to iron toxicosis, as it does in baby pigs.

Fig. 14–1. Effects of immunity and exposure to infectious organisms on disease occurrence and severity.

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