The Care of the Foaling Mare and Neonatal Foal

CARE OF THE MARE FROM PREGNANCY TO FOALING

Care of the new foal begins before the mare is bred. At breeding, the mare should be in good body condition (body condition score between 5 to 7 on a scale of 1 to 9). Her vaccinations and deworming program should be up to date. In addition to a prebreeding reproductive exam, a thorough dental exam should be done and any abnormalities corrected. Hooves should be inspected and trimmed if necessary. Good records of all breeding or insemination dates of each breeding cycle and all veterinary and ultrasound exams should be kept. If the mare has had foals previously, knowledge of any foaling problems or health problems of those foals should be discussed with your veterinarian.

For the first 6 months of gestation, if she is not being worked, all the average mare needs is access to free choice minerals, a source of salt and good pasture or hay. Free choice good clean water goes without saying. Her body condition score should stay between 5 and 7. At this point the fetus is about the size of a cat and is not putting much nutritional demand on the average mare. She does not need much additional supplementation for the fetus. If not in work, exercise is important to keep the mare fit and muscles healthy for foaling.

The majority of the growth of the fetus occurs after the seventh month of gestation placing greater nutritional demand on the mare. The second half of gestation she should continue to have plenty of gentle exercise. If she is working, the intensity of work should to be reduced. Free choice mineral and good quality hay or pasture should continue to be fed. Grains in the form of sweet feed or pellets can gradually be added during the last three months of gestation to maintain body condition score between 5 and 7. Continual monitoring of body condition and feeding regimen is needed and increases or decreases in quantity of food made gradually to keep the mare in ideal condition as mares that are either too fat or too thin can pose dangers to the fetus.

Lactation is the greatest nutritional demand on the mare. A mare can produce 2.5 to 4.7 gallons of milk a day during peak lactation. The mare should have good pasture, high quality grass/alfalfa hay, free choice water, salt and mineral mix with grain as needed to prevent the mare's body condition score from changing from the pre-foaling score. Biweekly body condition scoring or weighting with a tape measure can help maintain the mare in peak condition before foaling and during lactation. Monitoring the foal's weight at the same time can provide an early warning of changes in the foal's health.

Deworming should be done on a routine schedule. Most of the paste dewormers and daily dewormers are very safe for the mare and fetus. If you have any doubt about the safety of the dewormer, ask your veterinarian. The mare should be kept on the same deworming and hoof trimming schedule as the rest of the horses on the place.

Rhinopneumonitis vaccinations should be done the fifth, seventh and ninth months of gestation, especially if the mare has contact with other horses. Rhinopnuemonitis is caused by a herpes virus. Usually it causes mild disease in horses, but can cause abortion in the pregnant mare. Other vaccinations such as rotovirus and botulism which are given the eight, ninth and tenth months of gestation may be recommended by your veterinarian depending on your farm's history and location.

30 days prior to foaling THE MARE MUST BE REMOVED FROM ALL SOURCES OF FESCUE PASTURE AND HAY if not already done. The mare should be vaccinated for eastern and western encephalomyelitis, tetanus, and West Nile virus. She should be dewormed and a dental exam done and any needed corrections performed. Body condition scoring should be done and diet changed as needed. Hooves should be carefully inspected and trimmed. A foaling kit should be readied and phone numbers of the veterinarian should be written in an easily seen place in the foaling area. The foaling area should be inspected and made foal safe.

Horses evolved to survive predators by running away. Anything that prevents them from running is a psychological stress on the horse. In nature, the foaling mare is at great risk from predators during foaling, so she prefers to foal in a secure and secluded area in the dark away from other horses. Although she can foal any time of day or night, common foaling times are between 2 and 4am. Since flight is the horse's primary means of defense, the foal must be delivered quickly and be ready to travel rapidly many miles with its dam in only a few hours after birth. This ability makes foals one of the most precocious neonates in nature.

Ideally, the mare would foal in a clean grassy paddock reserved only for foaling with sufficient time between foalings for harmful bacteria and viruses to be killed by normal environmental conditions. The area would be small enough to allow monitoring any time day or night with appropriate lighting available. Over 90% of mares foal with no difficulty. But, if there is a problem foaling, there is only a very short time in which a foal can be delivered alive. Close monitoring of the term mare can alert owners to possible problems in time to save the foal. Therefore many mares are foaled out in foaling stalls rather than outdoors for easier monitoring. The foaling stall should be a minimum of 12 feet by 24 feet with good lighting. The stall should be cleaned between each foaling (see appendix).

Modern technology can simplify monitoring the term mare and enable the owner to attend foaling. There are devices are attach across the lips of the vulva or are placed in front of the cervix and trigger a beeper or phone number when the foal's feet enter the vagina (see appendix for examples). Other devices attach to the halter or a surcingle and also trigger a beeper if the mare lies down for a certain period of time. Surveillance videos can be installed in the foaling area with monitoring equipment in the owner's bedroom. Wireless technology is now available that does not require coaxial cables. Infrared systems are available so mares can be monitored in the dark.

Mammary development begins about 4-6 weeks prior to foaling. The major increase in udder size occurs about 2 weeks prior to foaling. The mare may leak milk several days prior to parturition. Waxing on the teats may occur 24-48 hours prior to birth but is not always seen. The ligaments around the tail head relax a few days prior to foaling. In some mares an obvious sinking along side the tail head can be seen. In other mares palpation of the muscles around the tail may be necessary to feel this relaxation. A few hours before birth, the vulva may soften and lengthen and a clear mucus discharge seen.

Changes in the mammary secretions over time can be used to help pinpoint the day of delivery. As the mare nears foaling, the levels of calcium in the mammary secretions gradually increase. This increase can be measured using commercial kits such as Predict-A-Foal or water hardness test strips. Calcium levels are better at predicting when foaling will not occur than it is at predicting when foaling will occur. When calcium levels reach 40mg/dl or greater, 80% of mares will foal within 24 hours. If calcium is less than 40 mg/dl, there is a 90% chance she will not foal. Always remember mares don't read the textbooks on any aspect of foaling.

Although average gestation for thoroughbreds is 340 days, normal gestation can range from 320 to 365 days. Normal foals have been born outside this range, but if foals are born outside this range, they should be considered high risk foals. Draft horses tend to carry closer to 365 days. The gestation length for individual mares is usually consistent from one foaling to the next. A mare that carries her foal 365 days usually carries about that same length of time each pregnancy. Gestation length can vary a few days from a mare's normal length because of the time of year, breed of horse, stallion, or sex of the foal. Good records of gestation length for the multiparous mare can be an important clue to the newborn's health. If a mare usually foals at 365 days, but one year foals at 340 days, that foal may be premature for that mare and should be considered a high risk foal.

PARTURITION

Parturition or birth is divided into three stages. Stage one is the most inconsistent. The mare may be uncomfortable and restless. She may act colicky, kick at her sides, or urinate a small amount frequently. She may or may not eat. She may pace the fence or stall or walk with a raised tail. She may lie down and get up frequently. She may sweat in the flanks and behind the elbows. Some mares show no signs of stage one at all.

The fetus is an active participant in stage one. During gestation, the fetus is lying with its back directed at the mare's abdomen and its head at the mare's tail. The head and front legs are tucked over its chest pointing towards its tail. During stage one, the fetus rotates so its back is parallel with the mare's spine and extends its head and forelegs so that birth occurs with the front legs coming first, one slightly in front of the other with the nose between the knees. Stage one can be last from a few minutes up to 24 hours. During stage one mares can delay parturition for several hours or even days if disturbed.

Stage two starts with the rupture of the chorioallantois (the water breaks) and ends with the birth of the foal. Stage two is explosive, rapid and should not take longer than 30 minutes. Within 3-5 minutes of the water breaking one hoof should seen with the other hoof about one length behind. Since the shoulders are the largest part of the foal, to make delivery easier, one foot is more advanced to allow the shoulders to pass through the birth canal separately. The soles of the feet should point down. The feet are usually covered in the amnion, a milky white clear sac. The nose and both front legs should be presented at the vulva within 5 minutes.

The mare is usually lying on her side at this point. She may get up once or twice after the feet and nose are delivered, then lie back down. She may rest a few minutes for delivering the rest of the foal.

The mare's contractions during birth are extremely strong and propulsive. The foal should advance through the vulva with each contraction. The amnion usually ruptures as or before the shoulders are delivered. If the amnion does not rupture, cut it with scissors and remove it covering from the foal's nose. Normal delivery should be completed 15-45 minutes after the water breaks. IF YOU DO NOT SEE FEET AT THE VULVA WITHIN 10-15 MINUTES OF THE WATER BREAKING, CALL YOUR VETERINARIAN. IF YOU SEE FEET AT THE VULVA AND THE FOAL IS NOT DELIVERED AFTER 10 MINUTES, CALL YOUR VETERINARIAN.

Stage 3 starts after the foal is born and ends with the expulsion of the placenta. The mare rests quietly. She usually looks at the foal and nickers at it, beginning maternal bonding. If the amnion is not covering the foal's nose and the foal is breathing normally, do not interfere with the mare and foal at this point. The umbilical cord is still attached. When the mare or the foal tries to stand, the umbilical cord will break. Normally the placenta will be expelled within 30 minutes to one hour of birth and should be expelled within 3 hours. During this stage the mare will continue to have uterine contractions, some of them quite strong. Some mares may be uncomfortable, lying down or rolling, or even colic at this stage. IF THE MARE'S PAIN IS EXCESSIVE OR DOES NOT QUICKLY STOP, CALL YOUR VETERINARIAN. IF THE MARE DOES NOT PASS THE PLACENTA WITHIN 3 HOURS, CALL YOUR VETERINARIAN.

Occasionally the placenta will be delivered before the mare or the foal ruptures the umbilical cord. If this happens, there is a natural weak spot in the umbilical cord about one inch from the foal's abdomen. Place one hand firmly on the cord between the abdomen and the weak spot. Place the other hand below the weak spot and pull. Do not use excessive force. Break rather than cut the cord. If the cord bleeds excessively after natural or manual rupture, umbilical tape can be tied around the end to stop bleeding.

PARAMETERS FOR THE NORMAL NEONATAL FOAL:

Gestational age: mean 341, range 315-365

Time taken to begin suckling reflex: 1-20 minutes after delivery

Time taken to stand: mean 57 minutes, range 15-165 minutes

Time taken to nurse: mean 111 minutes, range 35-420 minutes

Body temperature: within first 4 days 99^o-102^oF

Heart rate: mean 70, range 40-80, 130-150 when first standing

Respiratory rate: 20-40

Pass meconium: within 12 hours or less

CARE OF THE NEONATAL FOAL

Once the foal has stood and nursed normally, the umbilical stump should be treated with a dilute iodine or chlorhexidine solution 2-3 times a day the first 2-3 days. DO NOT use strong iodine (anything stronger than 1%) as the iodine can burn the sensitive skin on the neonatal foal. Monitor the umbilical stump the first 2 weeks of the foal's life as this is when umbilical infections usually occur. Abnormalities to watch for are urinating through the umbilicus, swelling of the umbilicus, or any discharge, moistness, pain or tenderness of the umbilicus. IF ANY OF THESE SIGNS ARE SEEN, CALL YOUR VETERINARIAN IMMEDIATELY.

The foal should nurse within 2 hours. It is vital that the foal receives colostrum, the first milk the mare produces. Good colostrum is very sticky, and clear to honey colored. It may not look like milk at all. HIGH QUALITY COLOSTRUM IS THE BEST DEFENSE AGAINST DISEASE IN THE NEONATAL FOAL. Although the foal is born immunocompetent, it is born without any antibodies because of the anatomy of the placenta. The foal depends entirely on antibodies derived from colostrum for protection against disease the first few months of life. The mare only produces colostrum once each foaling, before the foal is born and for about 12 hours after birth. The foal can only absorb these maternal antibodies the first 24 hours of life. To be sure the foal receives adequate colostrum, serum antibody levels of the foal can be measured. If serum IgG is less than 800 mg/dl, supplemental colostrum can be given orally if the foal is less than 24 hours old, or by intravenous administration if over 24 hours old. 12 hours old is a good age to check the serum antibody level in a normal foal as the level should be adequate by then. If not, the foal can still be supplemented orally.

If a foal does needs supplementation and no banked source of colostrum is available, plasma can be used both orally and intravenously. If supplementation is needed, colostrum is preferred over plasma as it has additional intestinal protectants not available in plasma. A banked source of high quality colostrum should be available. Colostrum can be frozen and kept for up to 2 years without losing quality. Up to one cup of colostrum can be milked from a mare. Each time the foal nurses, colostrum is diluted and the IgG levels decrease. Therefore colostrum should be harvested before the foal nurses. Colostrum can be pooled from several mares and given to one foal. Foals should receive about 1 liter of good quality colostrum.

The foal should pass the meconium or first manure within the first few hours. Meconium is made of the amniotic fluid the foal swallowed in utero. It is dark brown to black and very sticky. Once the meconium has passed, the manure will be softer and lighter colored. Enemas can be given shortly after birth to aid passing the meconium. Commercial enemas such as Fleet, or warm soapy water may be used. Always use lots of lubrication. Do not repeat enemas without first consulting your veterinarian as repeated enemas may be very irritating to the foal. If the foal is straining to defecate, an enema should be given. If a foal is straining to defecate, it will arch its back. If it is straining to urinate, it will sink its back. IF IT APPEARS TO BE STRAINING TO URINATE, CALL YOUR VETERINARIAN.

A foal that is not able to stand and nurse by 2 hours of age should be considered potentially abnormal and a high risk foal. Foals younger than 320 days gestational age are premature and should be treated as high risk. Any abnormality during parturition or deviation from normal parameters should make the foal a high risk foal. IF ANY OF THESE OCCUR, CALL YOUR VETERINARIAN IMMEDIATELY.

FOALING ABNORMALITIES

Dystocia (difficult birth) occurs in less than 8% of foalings, but when it does occur, there is only a very narrow window of time to get a live foal and live mare. If stage 2 lasts longer than 45 minutes, the majority of the foal will die and the mare is in danger also. Quick recognition of abnormalities can help save the mare and foal.

Premature placental separation occurs when the placenta is delivered before the foal. This is commonly called "red bag" delivery. The mare lies down and begins to push. Instead of feet covered with the white to clear amnion, a red bag, the placenta, is presented. THERE IS NOT TIME TO CALL YOUR VETERINARIAN. Cut the placenta with scissors being careful not to cut the foal. Pull the foal. The foal receives oxygen during delivery through the umbilical cord. If the placenta has separated from the uterus before the foal is born, the foal is not receiving oxygen, can become hypoxic and die. Premature placental separation is uncommon but can be associated with placental infections or induced parturition.

Retention of the head or legs means that one or more of the head and front legs did not rotate properly during stage one, or that one of the shoulders has not cleared the birth canal. If within 5-10 minutes of the water breaking the nose and both front feet are not presented at the vulva, wash your warms thoroughly with a surgical scrub, liberally use a sterile lube such as KJ Jelly and feel for the nose and feet. If you do not feel the nose or both feet, CALL YOUR VETERINARIAN IMMEDIATELY. DO NOT ATTEMPT TO PULL THE FOAL. If the head has not entered the birth canal, attempting to pull the foal will only seat the head on the wrong side of the pelvis and make it harder to correct the foal's position. Get the mare up and walk her to decrease contractions. Some times walking the mare will reduce the pressure of the foal in the birth canal encouraging it to fall back into the uterus. Occasionally, if the mare is up and walking, the problem may correct itself.

If the nose and both feet are present, pull on both legs with steady even pressure each time the mare has a contraction. Direct the force of the pull towards the mare's hocks. Do not use excessive force. Do not use ropes or chains unless experienced as these can damage the foal's legs. NEVER USE CALF PULLERS!

IF THE SOLES ARE IN AN UP POSITION, MORE THAN TWO FEET ARE PRESENT, OR MORE THAN 10 MINUTES HAS PASSED SINCE THE WATER BROKE, CALL YOUR VETERINARIAN IMMEDIATELY AND GET THE MARE UP AND WALKING.

PROBLEMS OF THE POSTPARTUM MARE

Retained placenta (retained fetal membranes) is the most common abnormality of the post partum mare. Normally the placenta should be expelled within 1 hour of foaling. IF IT HAS NOT BEEN EXPELLED AFTER 3 HOURS, CALL YOUR VETERINARIAN. Knot the placenta on itself or tie it up so the mare does not step on it. Do not tie weights to the placenta as they will not help in delivery, and may cause damage to the uterus. Do not pull on the placenta as that may cause the placenta to tear, or may damage the uterus.

Once the placenta has been expelled, it should be examined to be sure it is complete. Lay the placenta out in an "F" configuration. Examine both tips of the horns to be sure they are complete. There should only be one hole where the foal passed through. Look for any other tears or rips. Look at both sides of the placenta. One side should look like red velvet and the other should be clear. Both sides should be uniform in appearance. Place the placenta in a clean trash bag and refrigerate (do not freeze) until your veterinarian can examine it.

Studies have shown that if the placenta is completely expelled within 8 hours of birth, there usually are no harmful effects on rebreeding the mare. If the placenta is retained longer than 12 hours, the mare may be difficult to get rebred. If the placenta of any piece of the placenta if retained longer than 24 hours, the mare may be in grave danger. If the entire placenta is retained, the umbilical cord is seen coming from the lips of the vulva.

If only a piece of the placenta is retained, the mare frequently shows no signs for the first 24 hours. After that, you may see a red-brown fetid vaginal discharge. The mare may be depressed, off her feed, and running a fever. IF YOU SUSPECT ANY PIECE OF THE PLACENTA HAS BEEN RETAINED, CALL YOUR VETERINARIAN IMMEDIATELY. Retained placentas can be life threatening to the mare as infection can quickly set up leading to toxic metritis and laminitis. The uterus is unable to involute and bacteria are growing rapidly. Resorption of toxins from the bacteria causes metritis and can lead to laminitis.

Older broodmares are at increased risk of ruptured uterine arteries. The arteries that supply the uterus during pregnancy are large and deliver large quantities of blood. In older mares these arteries may weaken and rupture during the delivery of the foal. If bleeding in into the abdomen, the mare may be found dead, or may be found very weak with white gums. Only rarely is the mare saved when bleeding is into the abdomen. If the bleeding is into the broad ligament (the ligament that supports the uterus in the abdomen), a clot may form that stops the bleeding. The mare may act colicky or very painful. If the bleeding stops, the mare can survive.

We tend to focus on things that go wrong. We always hear about the bad foalings and the mares and foals that are lost. Remember, the vast majority of mares deliver a healthy foal with no difficulties at all. HOWEVER, IF YOU SUSPECT THAT SOMETHING IS ABNORMAL DURING GESTATION OR DURING FOALING, CALL YOUR VETERINARIAN IMMEDIATELY. With timely and proper intervention, a healthy mare and foal are possible.