Posted by Scone Equine Hospital on 2nd Apr 2019

The arrival of the first foals of the stud season brings a smile to the face of everyone connected with the breeding industry. It is a symbol of the eternal optimism that characterises those people who make their livelihood out of breeding horses.

To the uninitiated, a healthy, week-old foal frolicking with its mother as the first warmth of the sun lifts the mist from the floor of the valley may seem like the perfect starting point for the development of a champion.

But, as those people who get up early and go to bed late on studs know well, getting this foal and its mother safely to this stage is the result of dedicated care and attention throughout the pregnancy, delivery and post foaling period.


As more research is conducted and more information comes to light via advanced ultrasound scanning techniques, it is now clearly understood that a certain proportion of mares suffer from a condition known as placentitis. Placentitis refers to inflammation and infection of the mare's placenta.

Placentitis occurs most commonly in middle aged mares that have produced a number of foals but can also occur in young mares and in maiden foaling mares .The condition interrupts the blood supply to the developing foetus and can result in the delivery of under-developed, premature and septic foals or in the worst case, abortion of the foal.

Mares suffering from placentitis may show a range of signs including a cloudy white to yellow or brown discharge from the vulva and milk dripping or running from the teats. Mares that show these external signs already have significant damage to the placenta and to the foal they are carrying. They can be treated with appropriate antibiotics, anti-inflammatory drugs and progestagens to help maintain the pregnancy however, the foal is usually born premature, under-developed, and often septic. Some mare suffering from placentitis show no external signs and simply deliver a premature or dead foal.

Mares that have suffered from placentitis during one pregnancy are at a significantly higher risk of the condition occurring again in subsequent pregnancies. Any mare that has aborted a foal or has produced a premature, dysmature or septic foal from a previous pregnancy should be considered to be high risk for placentitis in future pregnancies.

High risk mares can be managed with advanced ultrasound scanning and targeted treatment programs. These mares are usually examined first at 120-150 days of gestation and then re-examined on a monthly or fortnightly basis as required, throughout the pregnancy. Individual treatment programs are tailored and modified according to the results of ultrasonography and the mare's response to the treatment, in much the same way as human mothers and babies are managed.

Research conducted at Scone Equine Hospital has shown that with early case identification based on the history of previous placentitis, regular advanced ultrasound monitoring and individually targeted treatment programs, these high risk placentitis mares can often be managed through their pregnancy to produce healthy, well developed foals that grow to be normal yearlings and can race successfully.


The birth of a foal is usually a relatively straightforward event. It most commonly occurs in the early hours of the morning and while the initial, restless preparatory stage can take several and up to twelve hours, the birth itself if usually over within 20-30 minutes.

During Stage One of labour, the uterus begins to contract, the cervix dilates and the foal moves to position itself with its front legs and head in the pelvic canal. During this stage the mare may show signs of restlessness, sweating, urination and mild discomfort or colic. Signs of severe pain during Stage One are abnormal and may indicate a serious complication.

Stage Two of labour consists of the powerful, active contractions the mare makes to deliver the foal. These contractions occur in groups of three or four, followed by periods of two to three minutes rest during which the mare may rise then lie down again. The white/translucent amniotic sac should appear at the vulva within five minutes of the water breaking, and one or two hooves with the soles facing downward should be visible within it. As the contractions continue, the front legs are presented, usually one slightly in front of the other, then the head with the chin resting on or between the knees. The mare will often stop straining and rest once the foal¹s hips are clear of the vulva.

Stage Two usually takes 20-30 minutes from breaking of the mare's water to delivery of the foal. Signs of severe pain, haemorrhage, abnormal presentation or delayed delivery are all indicators of possible complications.

The final stage of the foaling process involves expulsion of the placenta, this usually occurs without significant straining by the mare and within 30 minutes to three hours of the birth. Failure to expel all or part of the placenta can result in infection and serious or life-threatening complications.

The Neonate

Normal, healthy foals should be able to sit up and hold themselves on their chest within two to five minutes of birth. They should have a good sucking reflex within 20 to 30 minutes, be able to stand within two hours and be capable of nursing from the mare within two to four hours. Foals must receive colostrum from the mare to provide antibodies to fight infection and glucose for nutrition and energy. Following nursing, they should pass meconium (the hard, brown/yellow first faeces), urinate, lie down and sleep. Foals that are woken should be alert and curious, standing without hesitation and seeking the teat.

Within five minutes of birth, the foal¹s heart rate should be 80-120 beats per minute, respiration rate should be 30-40 breaths per minute and lips and gums should be pale pink. Rectal temperature should be between 37.2 and 38.6° Celsius, usually at the lower end of this range immediately after birth and rising slowly to plateau at about four days.

Foals that are delivered from mares with placentitis or those which have undergone a prolonged, difficult or a mal-presentation foaling are at high risk of being deprived of oxygen during the delivery. The lack of oxygen results in damage to the foal's organs and tissues including the brain, lungs, digestive tract and immune system. This tissue damage and its effects on the foal are referred to as Hypoxic-Ischaemic Syndrome (HIS) or Neonatal Maladjustment Syndrome (NMS). These foals were previously referred to as "Dummy Foals" due to the variety of neurological signs they exhibited. However, ongoing research has demonstrated that the tissue damage is usually much more widespread than just the brain and requires therapy to support and treat a variety of conditions.

Research conducted at Scone Equine Hospital and around the world has shown that these foals benefit significantly from intensive care therapy as soon as possible after birth. Over many years, equine veterinarians have adapted advanced techniques from human neonatal care to the care of foals. These techniques include medical therapy, oxygen supplementation and intravenous fluid and nutrition.

Specialized neonatal intensive care results in significantly increased survival rates of sick foals and the foals which are discharged from hospital are likely to grow normally and are able to race successfully.

There are no guarantees in the racing world but the dedication and commitment of the people entrusted to care for our foals is a pretty safe bet.


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  3. I have read and understood that I need to seek immediate veterinary advice if my horse’s condition changes or deteriorates in any way whilst being treated with this prescription medication.

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