Foal Meets World: Handling Foaling Emergencies

It’s been 11 months in the making. Your mare has been carefully bred, appropriately vaccinated, and closely monitored. As her due date approaches, anticipation of the new arrival begins to soar, with a twinge of anxiousness closing in.

Welcoming a foal into the world on your own can be a daunting endeavor. While many mares are able to deliver their charges with ease, broodmares of all experience levels – maiden and multiparous – face unexpected challenges. With each delivery, every second counts.

“A complicated foaling is one of the true equine emergencies,” emphasized Dr. Jennifer Linton, Associate Professor of Clinical Equine Field Service and member of New Bolton Center’s Healthy Mare Foaling Program team. “After 40 minutes of active labor, the chance of survival for the foal drops off drastically.”

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When an issue arises during birth, there is little triaging that can be done without the hands-on assistance of a skilled veterinarian.

“We cannot stress enough for clients to call us as soon as they notice something unusual,” reminded Linton. “We will do our best to walk our clients through issues over the phone while we are on en route, but there’s only so much that can be done until we can get there.”

A mother and foal If you are foaling out your mare at your own barn, it’s important to be mindful about the amount of time it will take for your veterinarian to arrive onsite, and what it could mean for your mare and foal if things do go awry.

“There are times when putting the mare on a trailer and bringing her directly to the hospital is the best option, especially if a mare or foal’s condition is so dire that it cannot be remedied in the field or if the farm is far away,” noted Linton. “But even then, when the mare arrives at New Bolton Center, we are still in a situation where we’re trying to make up for lost time.”

Keeping a watchful eye and knowing when to call your veterinarian are the two most critical tools in your foaling toolbox. “The key to intervening in a complicated birth is a vigilant eye,” stressed Linton.

“Warning signs can be so subtle. A maiden mare, for example, can develop an udder in 45 minutes and then suddenly foal, and most mares foal in the middle of the night, between 10pm and 2am. You have to be willing to dedicate many hours of monitoring and know when to call your vet as soon as something doesn’t progress normally,” she said.

Planning on welcoming a new life into your barn on your own this foaling season? Know what to expect, what to look for, and when veterinarian assistance is vital with these tips:

Stage I – What to Look For:

In this stage, which can last 12-to-24 hours, the foal is rotating from lying on its back to lying on its belly.

“The foal actually has an active role in getting ready to be born,” shares Linton. “The mare’s uterus has begun to contract, but it’s not quite as organized and uniform as it is during Stage II, where it acts like a tube of toothpaste being squeezed.”

Instead, during Stage I, the contractions are sporadic and spread out through the entire uterus, helping the foal to roll over.

This process occurs before the mare’s water breaks and signs may include decreased appetite, mild colic, or agitation.

When to Call Your Veterinarian:

If your mare has exhibited signs of the onset of active labor for 24 hours without her water breaking, becomes severely colicky, or becomes dull or depressed, it’s time to call your veterinarian.

Vet Tip: Having a trailer hooked up and ready to go when your mare approaches parturition can help to speed up the process in case of an emergency.

Stage II – What to Look For:

Stage II is when the foal is delivered. “This stage should be explosive and very short,” shared Linton. “Ideally, a foal should be born within 15 minutes of the start of Stage II, but absolutely no longer than 30 minutes.”

Any delay during this stage carries heavy consequences, with a fatality almost guaranteed if exceeding 90 minutes. “This is an absolute emergency,” continued Linton.

“Another area of concern is a red bag delivery,” noted Linton. Indicated by the presence of a red or pink “balloon” in the mare’s vulva, the condition is caused by premature separation of the mare’s placenta – ultimately, meaning the foal is no longer able to receive oxygen.

When to Call Your Veterinarian:

Because of the critical role that time plays during this stage, any sign of sluggish progress is cause for concern. At any point, if you have any concerns that things aren’t progressing normally, you should call your veterinarian, especially if:

Feet aren’t visible within five minutes of the water breaking
The foal’s nose is visible with no feet
The mare stops pushing for longer than two minutes
You see a red or pink (rather than clear or white) membrane
The mare isn’t making progress despite her continued efforts

“If your mare is experiencing a troublesome delivery, you may need multiple people to assist the mare and the foal,” said Linton. “This is an instance when having the mare at New Bolton Center prior to her delivery is ideal. In addition to our dedicated mare and foal teams, we also have the ability to intubate the foal while it’s still inside the uterus. By providing high levels of oxygen to the foal, we can buy ourselves more time to safely deliver.”

Vet Tip: If an emergency has surfaced, make sure to have the following items ready for your veterinarian when he or she arrives on the farm: fresh towels, clean scissors, iodine solution, and warm water.

Stage III – What to Look For:

At this point, the foal has been delivered and the attention now shifts to ensuring that the fetal membranes – or fetal portion of the placenta – pass. “Just like in humans, this step is really important,” shared Linton.

Often, a mare will “deliver” the placenta similarly to how she delivers the foal. Once expelled, save the membranes so that your veterinarian can carefully examine them later.

When to Call Your Veterinarian:

If a placenta hasn’t passed within three hours of the foal’s delivery, or there is a lot of blood after the foal has arrived, a veterinarian needs to be called.

“A retained placenta can cause a mare to become incredibly sick, even to the point of becoming septic or developing laminitis, which can have a poor prognosis,” she added.

“One of the benefits of having your mare at New Bolton Center is our ability to intervene if complications arise with the placenta, too,” explained Linton. If the placenta hasn’t passed within three hours of delivery, New Bolton’s foaling team will thread a catheter into the umbilical cord, infuse it with water, and gently remove it.

“Historically, treatment of retained fetal membranes could cost thousands of dollars, requiring intravenous antibiotics, laminitis prevention measure, and anti-endotoxic medications for the mare,” Linton added. “The procedure that we perform at New Bolton is much more cost effective and provides the best prognosis for the mare.”