1. Parturition and Foal Neonatal Care LACP pg. 163

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

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 Up to 40d Fetus after 40d

5. 60d-7 months- fetus develops slowly (fetal organ development phase) 8 months-parturition 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 150 - Firm placental attachment

7. 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

8. Impending Birth Vaccinate & Deworm 30 day prior Most Obvious Hypertrophy mammary glands obvious from 8 th 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

9. Fescue Toxicity Pull mare off fescue at least 1 month before foaling.

10. Impending Birth More Subtle Signs Softening and flattening of the muscles in the croup Vulva becomes relaxed & elongated. Visible changes in the position of the foal Vulva – thick & puffy with edema and may elongate

11. 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

12. Stages of Parturition Stage 2  Onset: rupture of chorioallantois (8-20L)  End: delivery of fetus- cord is broken  Timeline 20-30 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

15. 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 Ensure a clear airway by clearing membranes and fluids from the nostrils

16. 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 Mare foals while standing “Red Bag”

17. 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)

18. Stages of Parturition Stage 3  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

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20. 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 Placenta Examination

21. 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 Pictures

22. 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.

23. Abortion timeControl EHV6+ moVaccine EV arteritis6+ moVaccine Lepto5+ moIsolation Mare Repro. Loss Syndrome 45-120d 10+ mo Eastern Tent caterpillars Placentitis5-9 moCaslick Umbilical torsionAnytimeNone Twins5+ moNone StressAnytimeDecrease stress EndotoxemiaAnytimeDetermine cause and avoid

24. 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

25. 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

26. Patent Urachus The urachus is usually patent at birth and close naturally within 48 hr. as the umbilical stump withers and dries If urine passes through the umbilicus after 48 hr.of age, this is referred to as persistent patent urachus.

27. 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

28. Foal Facts Newborn foal should exhibit a suckle reflex at 20 minutes after birth, stand within 30-60 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

29. 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 30-60 days before parturition Produced only once – beware of leakage! Provides energy to foal Encourages passage of meconium

30. 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

31. 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 - 20ºC:  IgG concentration stable for 12 months  Other immune components (complement, etc) and nutritional components decrease significantly Storage at -70ºC:  Permanent maintenance of all components

32. 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 http://www.arssales.com/equine/html/refractometer.html

33. Colostrum ARS Refractometer - Results Evaluating Colostrum Quality

34. Foal Immune Status Evaluation of serum IgG status When?  Typically at 12-24 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

35. 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 10-15 min. Expensive but convenient

36. Foal Aftercare: within 1 st 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

37. Neglected foals

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

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

42. 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

43. 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

44. 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

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

46. 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

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

48. Examination of the inner ear reveals petechiation

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

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

51. 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.

53. 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

54. Angular Valgus Varus Windswept

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

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

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

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

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

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

61. Flexor- laxity rest

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