STUD NOTES

CASE HISTORY: PREMATURE FOAL

The mare in question was bought to the stud on 4 August, with the stud manager informing us that there was a little bit of wax on one nipple and, due to her considerable value, wanted to get her under our supervision ASAP.

This mare was in foal for the first time and her due date was to be 29 August. She had absolutely no udder development: not even ‘springing’ (when we see the first signs of udder development with something that resembles a fatty pad). I did not see any evidence of the wax he was talking about. Nothing!

Given the stud manager is very experienced, I was only too happy to take his word for it, so the mare was promptly placed on Trimadine, Bute and Regumate. A couple of days later the wax was sighted, but still no udder development of any significance.

Sure enough there was action six nights later (19 days prior to her due date). Our night watch, Tracie, called up just after midnight – very worried – explaining that the mare was suddenly throwing herself down and rolling quite violently: more like a mare with colic. The first thing that springs to mind with this type of description is a uterine torsion (twisting of the uterus, as opposed to a bowel twist). This is not good in the middle of the night!

The mare is bought down to the foaling unit, and once there it became obvious she was in labour. The onset was very spontaneous, so I was quite concerned. Nothing surer, this was a premature placental separation in a mare not ready to foal.

First thing was to confirm that the foal was alive and to check for presentation and abnormalities. A quick internal vaginal examination revealed, firstly, the foal was alive at this stage; secondly, it was very small; third it was in the normal presentation position and; finally, I had very large and thickened placental membranes.

Most of this was good news. The conclusions are I have to get the foal out quick, as this is a premature placental separation in action and the foal has probably lost its oxygenation source. Furthermore, the foal was most likely septic and compromised. The oxygen bottle and resuscitation gear was now in the stable with me.

This mare was not making any headway in moving the foal forward, due to the lack of room via the enlarged membranes. It was a matter of diving in and grabbing feet from behind the pelvic area and working on breaking the placental membranes internally and bringing the foal forward. Naturally, I had to be very careful to make sure it was in fact the membranes I was perforating. This is not easy given septic membranes are often very tough. As soon as these membranes were broken, the foal was delivered quite easily.

I was presented with a very small premature foal (23.4kg) that was barely breathing, but none the less alive. Oxygen treatment was applied, initially using our portable bottle then, once some form of stability was maintained, in the intensive care unit (which is linked to the box the mare foaled in).

This set up allows us to place the foal on oxygen for long periods by fixating the oxygen tube down the foal airway without us having to hold anything. In the intensive care unit, there is also heating, which of course was turned on. Appropriate veterinary prescribed antibiotics were immediately administered, as the foal is regarded as having predisposed infectious issues.

By this time he is still not a happy chap and very much touch and go. Next job is to hook the foal up on supportive fluid therapy which was duly done by heating the Hartman’s and glucose to help stabilise the foal properly. The foal remained on supportive oxygen for a total of nearly an hour, and for a period was hooked up on fluid therapy and oxygen simultaneously.

Frankly I did not like what we had here. This foal was more premature in features than the dates suggested. To me this foal was more like a foal 30 - 35 days plus premature. All possible that could be done by this stage and the foal for the moment is in the lap of the Gods.

Our job on behalf of the owner is to do what we can for the survival of the foal. However, if this foal was my own, I would have probably euthanised the foal at birth as I could not see how the foal had a viable future.

At this point we have not spent too much of the owner’s money, and we are at a stage where the foal was going to die or survive in the next five or six hours. It became evident at approximately four hours old there was some improvement; although he dipped at one stage, looking like he was going to die.

Colostrum was thawed from our bank (remembering the mare has absolutely nothing to give herself) and the foal was tube fed.
We are now in a good position to pause for a bit as the foal was in basically a stable condition. Despite still being very compromised, I no longer think that infection would kill this foal.

By now it’s early morning and the owner is contacted and is asked to come over and look at the foal and discuss what our options are, along with professional veterinary advice.

The fact was this: the foal may or may not survive the infection, and all that could have possibly been done had been administered. But this was not our greatest concern.

I felt we had humane issues to consider and what the balance was for further financial and practical considerations. This foal was barely able to support its own head, could not sit up and offered very little in activity. This in itself is ok if the foal was just a very septic sick, but we have a foal that was weak largely due to the premature nature of his body, both his skeletal frame and probably internal organs.

For the life of me I could not see that his foal was ever going to stand, let alone be a viable foal. The bone on this foal were very immature and very likely there was incomplete ossification of the carpal bones (not completely hardened bone). If the foal should stand, then the carpals would compress. This is hypothetical at this stage, but still a very realistic probability. There were further considerations too: we have a foal whose mother was never going to produce milk, even with the assistance of some of the available drugs to promote this.
Therefore, the foal would be ‘orphaned’ and a foster mare also had to be factored into the equation. But a foster mare is of no use until we have a foal which is able to stand and nurse. The foal will require a great deal of hand feeding, which is simple enough, although intensive. Constant physiotherapy would also have to be performed.

We could spend a great deal of effort and money to find out: plasma, foster mare, intensive care costs, professional veterinary, pathology costs and so on. At the end of the day the other very big question is: “What is the humane consideration here?”
This is not my call, but the owner’s and the vet. The foal was humanely euthanized.
Rick and I were fully supportive of this decision.

Returning to the placenta
This of course came out with the foal as a single package, so the umbilical cord required manual breaking. The placenta showed a large area of scar-like material with a hole in the centre. This is the probable origin of the sepsis. Placental tissue samples of this area were sent of for histopathology, as it could be useful for the cleaning up and preparation of the mare for this year’s pregnancy. Final diagnosis is severe acute necrosuppurative bacterial placentitis caused by Streptococcus.
No Fungi as originally suspected was revealed.