1. Parturition and Foal Neonatal Care
LACP pg. 163

2. Gestation Length Average 335-340 days.
Variable- breed, season, sex of foal, plane of nutrition, fetal genotype

3. Equine Gestation Hormones Progesterone/Progestogens
Progesterone initially rises, followed by a slight ↓ then ↑ to a peak at d 80, then gradually ↓ to 1-2 ng/ml during mid-late gestation (d 150). 
Second ↑ associated with formation of accessory & secondary CL. 
Late gestation progesterone rises (last month of pregnancy)

4. Once embryo enters uterus, it migrates throughout the uterine body and both horns until 16-17d (becomes to big to pass through horn.
This migrations signals the dam that she is pregnant. (contacts endometrial surface repeatedly) FIXATION
Embryo – 40d
Fetus – after 40d

5. 60d-7 months- fetus develops slowly
(fetal organ development)
8 months- increase in size to about 60% of its weight in the last 3 months.

6. Placenta
Placenta takes over progesterone production ~d 100 until foaling.
Complete placental formation is done at 150 days.
DAY Firm placental attachment

7. Placenta
Attachment of placenta to endometrium begins around day 40 of gestation and not complete until 120d.
Endometrial cups (day 25) fetal in orgin, form from girdle cells, and invade the dam’s endometrium . Forms horseshoe like ring of white cups. Produce ECG that stimulates CL to produce progesterone. Cups degenerate at day 70.
Loss after day 40- no return to heat for 3-4 months.

8. Epitheliochorial and noninvasive (materanal and fetal epithelium contact)
Attachement- diffuse in that the membranes are attached to all portions of the uterus with the exception of the cervix- no attachement

9. Chorioallantois- outer fetal membrane, chorionic side attaches to dam- red and velvety, allantoic side- fetal side bluish grey in color.
Amnion is thin, white membrane covers the fetus

10. Impending Birth Vaccinate & Deworm 30 day prior Most Obvious
Hypertrophy mammary glands obvious from 8th month
Maiden may display little until just before foaling
Distention of the teats
4-6 d pre-foaling
Waxing of the teats
1-72 hrs pre-foaling
An increase in milk Ca
1-3 d pre-foaling

11. Fescue Toxicity Pull mare off fescue at least 1 month before foaling.
(endophyte-infected)

12. Calcium concentration rise sharply as the time of foaling approaches

13. Foaling Facilities Stall- 14x14 for light mares
Disinfect between foaling
Good air circulation
Safe, solid construction
Straw bedding
Paddock-
“clean” grassy paddock
Safe, good fencing
Other horses?

14. Impending Birth More Subtle Signs
Softening and flattening of the muscles in the croup
Vulva becomes relaxed & elongated. Maximal hours before parturition
Visible changes in the position of the foal
Vulva – thick & puffy with edema and may elongate
Pear shaped abdomen
In the last week or so, the fetus lungs develop. Legs have strengthened to the point they can support weight and its hair has coarsened.

15. Stages of Parturition Stage 1 Onset: initial uterine contractions
End: rupture of chorioallantois (water bag “water breaks”)
2-4 hr
Mare may stand up, pacing, lie down, roll, pace, look or bite at flanks, sweat, frequent urination
Foal is being pushed toward the cervix

16. Stages of Parturition Stage 2
Onset: rupture of chorioallantois (8-20L)
End: delivery of fetus- cord is broken
Timeline min
Contractions occur in groups of 3-4 followed by a rest period of 3 to 5 minutes
Forefeet visable, soles pointing down
Oxytocin release, uterine contractions reinforced

19. Ensure a clear airway by clearing membranes and fluids from the nostrils
When the chest is through the vulva the foal can breathe on its own. May go in & remove the amniotic sac.
Not breathing – rub foal, take straw and put in nose, breath into nose

20. Foaling Emergencies May Need Assistance
Red mass evident at vulva (placenta seperation)
Strong straining & no feet evident at vulva within 5 min
Heavy straining with feet in vulva but no further progress in 10 min
One foot missing
No progress for more than 15 min after first water breaks
Rectovaginal perforation occurs
Mare foals while standing
“Red Bag”

21. Foaling Emergencies May Need Assistance
If the chorioallantois does not break and the velvety-red surface of the chorioallantois is presented at the vulva, it should be immediately ruptured because this indicates that the placenta is separating from the endometrium and that fetal oxygenation will be impaired
- cut placenta and pull foal (fescue toxicity)

22. Stages of Parturition Stage 3 Examine Placenta
End: passage of the fetal membranes
Expel placenta 30minuets -4 hrs post-foaling
If no passed within 4-6 hours, the placenta is considered to be retained– metritis, necrotic uterine wall, septicemia, laminitis
Can tie placenta in knot above hocks
Examine Placenta

23. http://video. google. com/videosearch

24. Placenta Examination
Arrange the membranes in a capital "F" position, with the pregnant horn uppermost and the body forming the vertical bar of the "F"
Tip of the nonpregnant horn is the most likely part of the placenta to be retained
Placenta Examination
Weight
Length of umbilical cord & location
Appearance of gross lesions, missing pieces

25. Retained Placenta: Treatment
After 2 hrs
Oxytocin
Infusion of fluid into allantoic cavity
Antibiotics
Non-sterioidal anti-inflammatory drugs
Frog support pads
Deeply bedded stall
If a mare has a history of laminitis – good to do everything on list

26. Abortions No common, greater in mares over 14yrs Twins- 90% abort,
Abortion in mid to later gestation may occur in single horse, or many “abortion storm” (viral or bacterial)
If this happens fetus should be placed on ice and examined by vet within 12 hours.

27. Abortion time
Control
EHV
6+ mo
Vaccine
EV arteritis
Lepto
5+ mo
Isolation
Mare Repro. Loss Syndrome
45-120d
10+ mo
Eastern Tent caterpillars
Placentitis
5-9 mo
Caslick
Umbilical torsion
Anytime
None
Twins
Stress
Decrease stress
Endotoxemia
Determine cause and avoid

28. Postpartum Mare & Foal Care
Umbilical Cord Care
Allow foal to break fetal membranes.
Never cut the cord.
Spray or dip umbilical cord stump with antiseptic solution 3-4X per day for 3-4 days
Ascending placentitis
Premature seperation

29. Umbilical cord is made of
Umbilical vein, 2 umbilical arteries, and urachus
Vein becomes the falciform ligament
Arteries become the round ligaments of the bladder
Best to let the cord rupture naturally

30. Neonatal Care
The neonatal period is the period following birth, which most clinicians consider the first 4 to 5 days
This period is one of susceptibility to many diseases and conditions that can be threatening to the immediate and long-term health of the foal
Good neonatal care is a combination of sound management practices and recognition of normal and abnormal conditions

31. Foal Facts
Newborn foal should exhibit a suckle reflex at 20 minutes after birth, stand within min.and nurse within 60 to 180 min.
The first urination occurs within 10 hours and the meconium should be passed by 24 hours after parturition. (Meconium is the first fecal material that the newborn foal normally evacuates. It appears in pelleted form, brown to black in coloration. They must pass this or become impacted.)
LACP pg. 165

32. Colostrum
First milk secreted by a mare coming into lactation (poor lactation can be supplemented with domperidone)
Production
During last 2-4 weeks of gestation
Under hormonal influences
Importance
Transfer of passive immunity to the suckling foal (“Liquid Gold”) Specificity of protection achieved by vaccinating pregnant mares days before parturition
Produced only once – beware of leakage!
Provides energy to foal
Encourages passage of meconium

33. Colostrum Quality Relates directly to antibody content Good quality:
≥ 50 (70) g/L IgG and specific gravity > 1.060
Thick, sticky, yellow secretion
All foals should have IgG measured between 8-24 hours

34. Colostrum Evaluating Colostrum Quality When?
Assess before foal suckles
How?
Physical appearance
Thick, sticky, yellow secretion indicates good quality
Dilute, white or translucent secretion indicates poor quality
Stall Side Tests
Banking of Colostrum
Only good quality colostrum
Storage at ºC:
IgG concentration stable for 12 months
Other immune components (complement, etc) and nutritional components decrease significantly
Storage at -70ºC:
Permanent maintenance of all components

35. Colostrum Evaluating Colostrum Quality ARS Refractometer
Designed for measurement of sugar concentration of
solutions (BRIX type)
1-2 drops of colostrum needed
Results in less than 1 minute

36. Colostrum
Evaluating Colostrum Quality
ARS Refractometer - Results

37. Foal Immune Status Evaluation of serum IgG status When?
Typically at h after birth
Peak serum levels of IgG achieved by 18h
Absorption of immunoglobulins from small intestine essentially complete
If failure of passive transfer: treat with IV plasma
Can measure early at 6-12 h
IgG first detected in foal’s serum at 6 h of age
If no IgG or very low level at 6-12 h: can give colostrum to increase levels

38. Foal Immune Status Evaluation of serum IgG status Snap Foal IgG Test
ELISA
Use whole blood, serum, or plasma
Calibrator spots indicate IgG
levels of 400 and 800 mg/dl
Sample color is proportional to
IgG content
Results in min.
Expensive but convenient

39. Foal Aftercare: within 1st 24 hours
Give enema to prevent Meconium impaction
Give Tetanus antitoxin
Check for presence of suckle reflex
Check for any malformations or deformities
Take blood sample from foal.
Perform a physical

40. Neglected foals

41. Milk can be expressed from the mammary gland by use of an inverted 60-ml dosing syringe to apply suction

44. Common Foal Diseases Sepsis Perinatal Asphyxia Prematurity
Neonatal Diarrhea
Respiratory Disease

45. Sepsis Common in foals Fever, elevated heart rate, or respiratory rate
Causes: improper umbilical care, failure of passive transfer, poor sanitation, maternal illness such as placentitis
Treatment: intensive nursing care, immunoglobulin therapy, antimicrobial treatment

46. Perinatal Asphyxia Lack of oxygen
“dummy foal syndrome” cerebral edema and ischemia and necrosis of the brain
48 hours after birth foal my lose the affinity for the mare, become unable to suckle, wander aimlessly, and potential for seizures.
Prognosis is good if there are no seizures

47. Prematurity Equal to or less then 320 days
Low birth wt, weakness, short hair coat, increased joint motion, rear limb flexural laxity, take longer to stand, suckle reflex may lack vigor, domed forehead, floppy ears
Survival depends on degree of complication

48. Diarrhea
Common
Frequency of diarrhea, suckling of foal, weather other foals are affected
Cause: Foal heat diarrhea, rotavirus, coronavirus, septicemia, salmonella, clostridium, Strondyloides westeri, lactose intolerance.
Iv fluid therapy, probiotics, analgesics, plasma

49. Respiratory Disease
Can be hard to diagnose: restlessness and agitation, increased respiratory rate or distress.
Diagnosis- thoracic radiograph, arterial blood gas, pulse ox, ultrasound
Cough is rarely seen, nasal discharge uncommon, respiratory rate and rhythm can be unreliable, mucous membrane won’t reflect mild to moderate pulmonary disease, Thoracic auscultation can be misleading

50. Bacterial pneumonia
Viral pneumonia
Fungal pneumonia
Milk aspiration
Acute respiratory distress syndrome
Persistent pulmonary hypertension
Fractured rib
Pneumothorax
Pleural effusion

51. Examination of the inner ear reveals petechiation

52. The critically ill neonatal foal should be placed on a warm, well-padded surface in semisternal recumbency

53. The jugular groove is widely clipped and prepared with sterile solutions before intravenous catheter placement

54. Proper restraint of the foal is achieved by gently cradling one hand under the neck and grasping the base of the tail with the other hand.

56. Limb Deformities Angular- Varus, Valgus, Windswept
Axial- off set knees
Rotational- muscular
Spiral- toed in
Flexor – week or contracted flexors
Most are congenital, premature, dietary, blunt trauma to the growth plate, uneven hoof balance

57. Angular
Valgus
Varus
Windswept

58. Treatment Stall rest X-rays Medial extensions Self correction (valgus)
Surgical correction
Therapeutic trimming

59. Axial- off set knees
No treatment, undesirable in race horses, can lead to unsoundness

60. Rotational- toed out Self correction
Muscular development of thoracic muscles

61. Spiral – toed in Fetlock is in normal alignment
No treatment, corrective
shoeing masks problem

62. Flexor- contracted
Bone is longer then the surrounding tendons

63. treatment Tetraclycine- shown to relax the muscle/tendon unit
Bandaging
Passive extension stretching
Air splints
PVC splints
surgery

64. Flexor- laxity
rest

65. Bone growth catches up with tendons
Swimming
Care for soft tissues if damaged