The Right Start
Equus Magazine
May 2004Issue 319
 

The Birth.  Once the mare’s amniotic sac ruptures (known as the water breaking), the birth is under way.  Within 10 to 20 minutes, you will see one front hoof appear, followed by the other, about three to four inches behind.  In a normal birth, both hooves will be front side up, or just slightly turned.  The muzzle follows, on top of the legs.  Once the body of the foal is on the ground, possibly still encased in the amniotic sac, the mare may stop to rest while his hind legs are still inside her.  If the first two hooves to appear are sole upward, you may be seeing the hind feet, an indication of a breech presentation; a breech birth may also proceed normally, with little harm to the foal.

*Your role: During a normal birth, you are primarily an observer.  Disturbing the mare or interfering with the process won’t help and may cause problems.  Unless something goes wrong, don’t intervene.

**Call your veterinarian if: having medical help at hand would make you feel more comfortable or if what you are observing appears to not be normal.

***It’s an emergency if: more than 20 minutes elapse from the time the mare’s water breaks until the delivery is complete or if an improper presentation seems to be delaying the birth.  The appearance in the birth canal of only one forelimb, or of both legs but not the muzzle, or the soles facing upward indicates that the foal may need to be repositioned by an expert.  If the first thing you see is not the white amniotic sac but rather the bright red surface of the detached placenta, the foal’s life is in immediate danger.

Two minutes. The foal will begin to draw his first breaths within about 30 seconds of birth, and within two minutes, he ought to be breathing regularly at a rate of about 60 breaths per minute.  The first breaths will be irregular and ragged as the lungs inflate for the first time.  As the foal starts to breath, don’t be surprised if you see some clear liquid coming out his nose.  In utero, the fetus’s lungs are filled with fluid; during birth most of this fluid is squeezed out and some is later absorbed into the blood and lymph system, but a small amount may still need to drain, a process that may continue for up to an hour. 

Within a minute or so of birth, the foal’s mucous membranes will become pink, and his heart rate should be 60 to 80 beats per minute, climbing as high as 120 to 150 beats per minute within the first hour.

The normal foal will shake his head, blink, look around and get up on his sternum.  He will respond to lights, sounds and other stimuli, and he may whinny.

*Your role: Don’t interfere if everything is proceeding normally.  Cleaning the foal is the mare’s job, and unnecessary human involvement interferes with mare-foal bonding.

**Call your veterinarian if: the foal’s breathing and heart rate remains significantly lower than normal and/or seems unresponsive to his new environment.  He may eventually grow stronger and develop normally without intervention, but he will require more careful observation over the next hours.

***It’s an emergency if: the foal isn’t breathing within two minutes of birth.  You need to take quick action.  If there are membranes over the foal’s nose, remove them; then rub the foal with straw or a blanket to stimulate breathing.  If rubbing doesn’t work, you can do mouth-to-nose resuscitation by covering one nostril and breathing into the other.  Before the birth, ask your veterinarian to instruct you on performing resuscitation techniques safely.

Ten minutes. When the mare rises, the umbilical cord usually breaks on its own at a point a few inches from the foal’s body.  This natural break allows the blood vessels to retract, which helps to seal them with minimal bleeding.

*Your role: Avoid the temptation to cut the cord; it’s more likely to bleed.  To ward off infection, dip the stump of the cord in iodine.  If the stump continues to bleed for more than a minute or two after it breaks, wrap it with umbilical tape, a clean shoelace or cotton string.  Repeat the disinfection procedure three to four times a day for the first four days. 

**Call your veterinarian: an umbilical vein hemorrhages.  In rare cases, tying off the stump may be inadequate to stop bleeding or a foal may bleed from the umbilicus as he strains to defecate.  A veterinarian may need to clamp or suture the umbilicus.

One hour. After 15 minutes or so, many newborns will make their first attempts to stand, and most succeed in getting up within an hour, though some foals can take two hours or more.  The youngster will be clumsy at first, and poor balance is normal.

            Once up, the foal begins searching for the udder, often in dark places such as walls, corners or the wrong end of the mare.  Most mares will circle or put a hind leg back to help the foal find the udder.  Nursing is a sloppy affair at first but should improve in efficiency over the next few hours.  The mare may be distracted during the first hour as she passes the placenta.

*Your role: If the foal is struggling to rise but the floor is too slippery, add more bedding so he can get his footing.  Do not attempt to help the foal to his feet; if his bones are not yet fully formed, you may do permanent damage to his joints.

            Make sure the foal actually ingests most of his gulps of mother’s milk.  Get yourself in a position to observe the nursing.  The left side of the foal is best as you can see his esophagus and swallowing action.  You want to be sure the foal is actually swallowing the colostrum, which provides antibodies, hormones, antibacterial proteins and anti-inflammatory agents, as well as nutrition.

**Call your veterinarian if: the foal is up but cannot stand normally because of lax tendons, loose joints, crooked legs or contracted tendons.  These conditions often are resolved on their own but your veterinarian may decide supportive bandages or splints would be beneficial.

Also talk to your veterinarian if your foal exhibits any other unusual physical or neurological signs, such as persistent tilt of the head, swelling in the legs or limb deformities.

***It’s an emergency if: the foal has not stood within two hours and nursed within three to five hours.  Failure to do these things may indicate a problem that requires urgent medical care.  Time is critical because he needs to ingest colostrum within the first six to eight hours of birth.

            If the mare is young and inexperienced, she may be too excited to allow the foal to suckle; it may be necessary to sedate her.  Also be sure the mare passes the entire placenta within an hour or two of giving birth; if not, she requires immediate medical attention.

Three hours. With an hour or two of practice under his belt, the foal will settle into a pattern where he stands and nurses about every 20 minutes, and he will become much more efficient at getting the milk.  He will also be active and inquisitive, interacting with the mare and exploring or playing before lying down to rest again-a pattern that will continue for the first days of his life.  At this stage a wide stance, an exaggerated gait and sensitivity to sound and touch are normal.

            By now the foal should have begun passing meconium, dark brown to black pellet like fecal waste consisting of swallowed amniotic fluid, glandular secretions and cell debris.

*Your role: If the foal postures and strains to defecate but does not evacuate meconium after four hours, he may need an enema; foals who had been overdue are more likely to experience these impactions.  It takes some skill to administer an enema properly, and rectal tissue is fragile and easily injured, so it would be wise to have a veterinarian or someone with experience show you how to do it before you try it on your own.  Restraining a foal this young also requires special care.  Unlike an adult horse, the foal’s rib cage is pliant, and his body was most likely bruised during the trip through the birth canal, so grabbing the foal around the barrel is likely to hurt him and may impair his breathing.  Instead, gently hold him steady with one arm in front of his chest and the other behind his haunches.

**Call your veterinarian if: the foal is still straining after receiving a single enema.  Also call if sloppy nursing persists after hours.  Fresh milk on the foal’s forehead could indicate a weak suck reflex, and milk coming from the nostrils could be a sign of weak swallowing muscles, a cleft palate or other problems.

Twelve hour. The foal urinates for the first time and continues to do so every hour or two thereafter.  The foal’s respiratory rate slows to 30 to 40 breaths per minute; his heart rate slows to 80 to 120 beats per minute.  He continues to get up several times each hour to nurse, and his energy levels will increase.  He will become even more inquisitive and playful.

*Your role: Even if everything has gone by the book so far, ask your veterinarian to examine the foal within 12 hours of his birth just to ensure that all is as well as it seems.  Since most foals are born overnight, a good time to place a call is first thing the next morning.  The veterinarian will perform a physical examination to make sure there are no defects or injuries; fractured ribs resulting from the birth can be a serious hidden problem in newborns, especially if the foal is large or the labor was difficult.  When the foal is about 12 hours old, your veterinarian may also want to draw blood to check on the foal’s immunoglobulin levels, which would indicate whether the youngster has ingested enough colostrum to acquire a safe level of immunity from infection.

**It’s an emergency if: the foal is sleepy every time you check on him.  Unusually low energy levels can be a sign of many problems.

Twenty-four hours. Between 12 and 24 hours of age the foal will begin producing the soft, yellowish feces that result from ingesting milk.  The foal’s respiratory rate is now about 30 breaths per minute, with a heart rate of 80 to 100 beats per minute.  The foal continues to nurse approximately every 20 minutes or so, and he is active and playful when up.  Once the foal is 24 hours old, it can be turned out with its dam in a clean safe pasture, if the weather is good and it has bonded with the mare.

*Your role: Continue to observe the foal closely during the first 24 hours for any signs of trouble.  The foal should be checked every couple hours throughout the first 24 hours.  Also check the mare’s udder periodically.  An unhappy mare with an engorged udder is a sign that nursing is not taking place as it should.

**Call your veterinarian if: your foal develops persistent diarrhea during the first days of life.  Diarrhea can be a sign of several different serious infections that require treatment, and even if the cause is not immediately life threatening, the foal may need supportive care -i.e., fluids and electrolytes to recover more quickly.

***It’s an emergency if: a foal who initially appeared healthy suddenly deteriorates.  Sometimes foals who had been progressing normally may suddenly begin to weaken, lose their focus on the mare and quit nursing.  The problem may be an infection, a congenital abnormality, neonatal isoerythrolysis or a hereditary disease.  Whatever the cause, quick intervention is vital.

The first day of a horse’s life sets the stage for his future health, as his early growth and development prepares him for the world outside the womb.  But with vigilance and care, you can help make sure that he’s getting the best possible start in life.  If you have any questions about your pregnant mare, the foaling process or your new foal please feel free to call our office.