Good preparation before the birth of your mare’s foal will help minimise stress for you, your mare and your foal.
Foaling is usually straightforward, however problems can arise which must be dealt with quickly and appropriately in order to make sure that a healthy live foal is born and that the mare remains healthy. It is recommended that you consult your veterinary surgeon for more specific advice before your mare is due to foal.
Good hygiene and a peaceful environment
For mares due to foal, a special foaling stable should be available. This stable should be a large well-ventilated, draft-free stable, and should be deeply bedded with clean, dust free straw. Fresh water and good quality hay or haylage should be available to the mare. It is a good idea to avoid the use of hay nets, just in case the mare or foal become entangled in them. It may also be a good idea to set up a CCTV system so that the mare can be safely monitored without disturbing her.
The majority of foalings tend to occur in the night when there is reduced activity in the yard and it is quiet.
How will I know when my mare is due to foal?
Usually around 24 hours prior to foaling the pregnant mare will start to secrete a waxy substance from her teats. This is known as “waxing up”. However, maiden mares may not always do this.
Figure 1: Teats waxing up just before foaling.
The stages of parturition (labour)
There are three stages of labour.
During stage one, the uterus starts to perform contractions. These contractions help to move the foal into the correct birthing position (the diving position, with forelimbs extended and the head resting on the forelimbs and pointing forwards). During this stage the mare will usually be restless, may sweat and can also show signs of mild colic, such as flank watching and getting up and down. However, some mares may not show any obvious signs. During this stage it is important not to disturb the mare. After the onset of stage one labour the foal will usually be born within the next few hours.
The second stage of labour is where the foal is actually born. This stage starts with the waters breaking as the membranes around the foal rupture and release fluid. Following this, more powerful contractions involving the abdominal muscles then begin. After the waters have broken, the white membranes of the sac containing the foal will appear at the mare’s vulval lips. The foal should present for delivery with two front legs and its muzzle resting on top of the fore legs (the diving position). The foal should then be delivered within 15-20minutes.
The third stage of labour is the expulsion of the placenta (foetal membranes). This should occur within three hours of foaling.
When to call your vet during foaling
During the foaling process the mare will usually adhere to the rough timings quoted above. Any delay may indicate the need for emergency veterinary attention. If you think that your mare may be experiencing difficulties at any stage of the birthing process it is imperative that you contact your veterinary surgeon for advice immediately. Do not intervene unless you are sure of what you are doing or are acting under strict veterinary instruction.
Unlike in other species, such as cattle, dystocia or difficulty in giving birth is an uncommon problem in the horse. This is partly because it is the mare, which regulates the size of the growing foal in the uterus. However, if problems are observed at any stage of labour it is important that your veterinary surgeon is contacted immediately. If the foal is in an abnormal position within the reproductive tract this can impede delivery. In some circumstances the foal can be manipulated within the mare’s reproductive tract to enable normal delivery. This can usually be done on the yard. However, occasionally mares need referred to an equine hospital where an assisted vaginal delivery may be performed under a general anaesthetic with the mare’s hind legs held up on a hoist. This allows for greater room within the mare’s reproductive tract to perform appropriate foetal manipulations to facilitate delivery of the foal. However, it may be that the foal has an abnormality that will make a normal birth impossible, such as contracted tendons. So, when foetal manipulation fails, a caesarean section may need to be performed.
Caesarean section in the mare is really a last resort. It is a major operation, which has to be performed under general anaesthesia at a nearby referral hospital. The decision to perform a caesarean section will be made by the veterinary surgeon following consultation with the owner, as the procedure is not without risk.
Retained placenta (foetal membranes) in the mare
The placenta should be expelled within three hours of foaling. This is the third stage of labour. Should the membranes fail to be expelled within three hours of foaling it is important that you call your veterinary surgeon for assistance. Retained placenta can lead to some very serious and potentially life threatening complications such as endometritis (infection of the uterus) and toxic laminitis.
Figure 2: Retained foetal membranes in the mare. Membranes are classed as retained if they have been present for 3 hours or more.
Caring for newborn foals
In the uterus, the foal does not use its lungs, as oxygen is provided from the mare’s blood and passed through the umbilical cord. At birth, the small air sacs in the lungs (alveoli) rapidly expand in the first few breaths to clear the fluid from within the lungs. This is why foals will tend to gasp initially. To begin with the respiratory rate is usually quite quick and then settles down after about 24 hours to approximately 30-36 breaths per minute. Following delivery the foal is usually able to perform the following:
• Within 5 minutes the foal should be able to sit up and lift its head.
• Within 5-10 minutes the foal should have a strong suck reflex.
• By 1 hour the foal should be able to stand, initially with a wide based stance. It will then start searching for the udder.
• Within 2 hours the foal should be able to suck well from the mare.
Newly born foals will usually do all of the above within the stated times, and any delays in the foal establishing these normal patterns of behaviour may indicate early signs of problems. Should you experience any problems either during the birth of the foal or immediately afterwards it is important that you contact your veterinary surgeon straight away.
First few days with the mare and foal
Assuming that both mare and foal are healthy, it is a good idea to have newly born foals examined by your veterinary surgeon within 24 hours of being born. Of course, the mare can also be examined at this time too.
Examination of the foal: The purpose of the foal examination is to make sure that all of the foal’s vital body systems are functioning properly. As the symptoms of ill health in the foal can be vague and non-specific it is important to try to recognize any clinical signs of ill health in the foal as quickly as possible. This is because, like babies, their health can deteriorate rapidly when unwell. Should the vet detect any signs of ill health in the newly born foal he or she will intervene immediately in order to maximize the chances of survival of the foal. It is important to remember that some conditions, which can make foals ill, may require specialist intensive care at a veterinary hospital. Obviously this can be very expensive.
Examination of the mare: Your vet will take into account the mare's breeding history, as certain problems during the pregnancy can be harmful to the foal. Your vet will check the mare to make sure that she has enough milk to feed the foal, and that there are no tears or major trauma to her vulva and perineum. It is important that the mare's placenta is carefully inspected in order to make sure that it has been passed intact. In some instances the entire placenta may be retained, but more commonly it is a small fragment of the placenta in the non-pregnant uterine horn, which becomes retained. Retaining either all or part of the placenta can quickly lead to an infection in the womb and this can rapidly trigger toxic shock, which can be life threatening or result in serious complications such as laminitis. Certain breeds of horse e.g. Friesian horses and draught horses can be more prone to this condition, and horses which have a history of retaining their placenta are more likely to do it again.
Your vet will also check the foal's navel (the umbilicus) for any swelling, continued wetness, the presence of a hernia, infection and to see if it has closed up properly. The navel should be dipped once to twice a day in an antiseptic solution until dry. Try to avoid using “blue spray” and concentrated iodine dips on the foal’s navel. At Central Equine Vets, we prefer to use a navel dip made with dilute chlorhexidine solution and surgical spirit. This helps to dry the navel stump and prevent bacteria from tracking up into the body.
It is a good idea to take a blood sample when the foal is at least 18 hours old (in reality this is often performed after 24 hours), to determine if the passive transfer of antibodies has successfully occurred from the dam to the foal via the colostrum (first milk). This is called an IgG test. If results are very low then the foal may need a plasma transfusion to help give the foal the essential antibodies which it requires in the first few weeks and months of life.
The initial first few hours are when the mare and foal need to form a strong bond. Most mares will have a very strong instinct to look after their foals and it is important that the foal-dam bond is not interfered with if at all possible. Occasionally maiden (first time) mares may not let their foals in to suckle. If this is the case, contact your vet, as the mare may need sedated in order to allow the foal to suckle. Delaying the time it takes for the foal to ingest good quantities of colostrum can mean that the foal does not get enough important antibodies absorbed through its gut and into the blood stream.
Any delays in the foal establishing a normal pattern of behaviour should be a concern and may indicate the early signs of problems. Call your vet if you are worried.
Keeping your newborn foal healthy
It is best to monitor your foal’s behaviour and overall appearance closely. After observing the foal up close, the foal should then be observed undisturbed, preferably from outside the stable. Once the foal has managed to stand up it should be nursing five to seven times each hour (try to check that the foal is actually latching on to the teat, and not just muzzling the mare’s udder). In between these times the foal should be exploring its surroundings, bonding with the mare and sleeping. Most foals should get up when you enter the box and run to their mother. If the foal fails to get up when disturbed this can be a sign that it is beginning to become unwell.
Basic foal health checklist
When your foal is born it is a good idea to check the following:
• Is the foal bright and inquisitive?
• Are there any signs of prematurity, such as a short silky coat, floppy ears, a domed forehead, slack tendons and small body size.
• What colour are the foal’s gums? Foal’s gums should be pink and moist. They should not be white, yellow, red or blue/purple. If this is the case there could be a serious problem and you should call your vet immediately.
• Is the foal shivering from the cold? Weak or premature foals are particularly susceptible to feeling the cold as they have fewer fat reserves, and therefore poor body insulation and energy reserves. As such they are not always able to regulate their body temperature.
• Check that the foal is suckling the mare correctly. Milk on the foal's head may mean the foal is not nursing correctly, or it may mean that the mare is producing more milk than the foal can ingest. Milk seen coming down the nostrils may mean that the foal has been born with a cleft palate. (At the first foal check your vet will check the mouth for signs of a cleft palate).
• Have a close look at the foal’s legs. Are they straight and able to support the foal when it stands? Are they lax, windswept or contracted? If so, is the foal having difficulty standing up to nurse?
• Does the foal’s chest expand normally, with both sides moving symmetrically with each breath? Have a feel at the ribs and make sure that they all feel smooth and that there are no painful areas or fractures (fractured ribs are rare, but can happen if the mare stands on the foal by accident).
• Has the foal passed the first lot of faeces (meconium)? Mecomium is the dark hard balls of faeces that are an accumulation of allantoic fluid (ingested while in the uterus), gut secretions and cellular debris. Failure to pass meconium can result in complications such as colic due to impaction. After passing the meconium, pale coloured pasty milk faeces should then be passed. Colts that are overdue seem to be most at risk of meconium related colic. If you suspect that your foal is suffering from retained meconium, then your foal may require an enema to help soften the meconium and allow it to pass.
Any deviations from a normal physical appearance need to be seen by a veterinary surgeon promptly.
The foal's immune system
Foals are born immunocompetant, but immunonaïve. This means that although your foal is born with the ability to produce antibodies (given sufficient time), it is not born with antibodies in its system i.e. no antibodies are passed from mother to foal through the placenta. Thus, every foal has to get its antibodies from the colostrum (first milk), which the mare produces. This colostrum is vital for the foal's health over the next 3-6 months, because it contains the vital antibodies that will be absorbed across the foal's gut to protect it.
Specialised cells in the newborn foal's gut are uniquely designed to absorb colostral antibodies for a short period of time. After around 12-24hours these cells close down and stop absorbing antibodies. Therefore it is essential that the foal sucks from the mare and receives the colostrum as early as possible but certainly within 12 hours. After the gut cells have closed the colostrum still has a useful effect within the foal’s gut, as the ingestion of colostrum helps to provide an antibiotic “paint” or “lining” within the gut.
Observe the mare's udder prior to foaling if it starts secreting milk before the foal is born, it may be that she is losing her colostrum. In this case it would be advisable to collect and freeze it until the foal is born. The quality of this thick creamy coloured milk depends on its richness. Very rich, good quality colostrum contains higher levels of proteins. These proteins can be measured on a hand held instrument called a refractometer.
Maiden mares may have poor quality colostrum or inadequate amounts and so it may be advisable to make prior arrangements to buy some from a neighbouring stud farm if needed.
Foals that fail to suckle may need to have a stomach tube passed by the veterinary surgeon and given the stored colostrum. This should be done within the first 4 hours following birth.
As mentioned earlier it is a good idea to perform an IgG test 24 hours after the foal is born to assess its antibody status.