Foal CPR Guide by a Vet – 2025 Essential Resuscitation for Newborn Horses 🐴🩺

By Dr Duncan Houston, BVSc

Introduction

Welcoming a newborn foal should be a joyous moment—but when complications arise, knowing CPR for foals can make the difference between life and death. Unlike adult horses, foals are small enough that gentle resuscitation techniques can restart their heart and lungs. In this **2025 guide**, I, Dr Duncan Houston, share step‑by‑step veterinary expertise to help breeders, vets, and caretakers respond confidently to birth emergencies. 🍼

Why CPR Is Possible in Foals

• Foals are small enough to perform chest compressions and ventilation.
• They’re particularly vulnerable during compromised births—premature birth, difficult delivery, or placental disease—increasing risk of respiratory or cardiac arrest.
• Prompt resuscitation dramatically improves survival rates when done correctly.

When to Initiate CPR

CPR is indicated when:

• No breathing - no chest rise, no air movement.
• No heartbeat - pulse faint or absent.
• Respiratory or heart rate <1 breath or beat per second after 30 seconds.
• Dusky mucous membranes, limp muscle tone, or weak suckle reflex.

Preparation Before Birth

Help your foal before trouble starts:

• Equip a resuscitation kit: clean towels, suction device, sterile feeding tube, lubricant, tubing, oxygen delivery tools, epinephrine, fluids.
• Have an assistant on standby when foaling high‑risk mares.
• Drape open access to the foal once delivered—keep environment calm, ready to respond.

Step‑by‑Step CPR Protocol

1. Clear Airways Immediately

• Dry foal thoroughly with towels—moisture equals heat loss and suppressed breathing.
• Clear fluids from nostrils/mouth by gentle wiping and head‑down posture. Never hang the foal by the hind legs.
• If mucus persists, suction with bulb device or soft catheter; veterinarians may use passing tubing down the nose into the windpipe.

2. Start Ventilation

• Once airways clear, begin mouth‑to‑nostril breathing at a rate of ~10 breaths per minute.
• Or if available, use Ambu bag connected to endotracheal tube or mask to deliver oxygen-rich breaths (200–400 ml per breath).
• Confirm chest rising—if the abdomen inflates instead, reposition tube until chest moves.

3. Begin Chest Compressions

• Hold foal on its side, with one helper stabilizing head, the other positioned at the chest.
• Place hand over the heart area (between elbow and shoulder).
• Compress chest ~5 cm deep at 80–100 compressions per minute—twice as fast for foals as adults.
• Alternate 30 compressions with 2 breaths, then reassess for heartbeat and breathing.

4. Monitor, Reassess, and Continue

• Every 2 minutes, pause CPR to check respiratory effort, heartbeat, mucous coloration, and reflexes.
• If no improvement, continue cycles and keep airways open—reposition tube/mask as needed.
• Consider advanced interventions (IV fluids, epinephrine) under veterinary guidance.

5. Advanced Veterinary Intervention

• Endotracheal intubation allows consistent oxygen delivery and suctioning.
• Supplemental oxygen through mask or tubing supports respiration.
• IV epinephrine and fluid boluses help stabilize blood pressure and restart the heart—administered by a veterinarian.

Recognizing Success

Signs that CPR is working:

• Spontaneous breathing resumes.
• Steady heartbeat returns and mucous membranes become pink.
• Foal begins to move, stir, or show suckle reflex.

Once stable, keep foal warm and dry and encourage nursing once sternal. If signs remain weak or labored, continue monitoring closely and call your vet.

Post‑CPR Care

• Maintain warmth with blankets or heat pack under supervision.
• Allow gentle nursing once the foal can hold its head up and swallow safely.
• Monitor respiration, heart rate, gum color for first 24–48 hours.
• Request veterinary assessment to check blood sugar, hydration, and potential infection—premature and compromised foals are susceptible to sepsis.

When to Contact Your Veterinarian

• If CPR fails to reestablish breathing or heartbeat after 5 minutes of correct technique.
• If foal remains weak, hypothermic, or not nursing within 30 minutes of resuscitation.
• Any foal born prematurely, with placentitis, dystocia, or needing additional oxygen or IV support.

Foal Spotlight – Case Study

1. A thoroughbred foal is born via C‑section — limp, not breathing, HR ~30 BPM.
2. Drying, clearing, and mouth‑to‑nostril breaths begin within 30 seconds.
3. Chest compressions start; after 3 cycles, a heartbeat appears.
4. Oxygen via mask, IV fluids, and warm towels follow. By 10 minutes, spontaneous breathing occurs.
5. Foal sternalizes and nurses within 45 minutes—vet follow‑up shows stable vitals; full recovery.

FAQs About Foal CPR

Can CPR harm the foal? 🐥

Gentle, correct technique rarely causes harm. Avoid compressions over the diaphragm/abdomen—focusing on thoracic cavity keeps it safe.

How long should CPR continue?

Continue until spontaneous breathing and heartbeat resume, help arrives, or foal cools and no response after ~20 minutes.

Is sedation ever okay?

No. Sedatives decrease blood pressure and can impede resuscitation efforts.

Can owners perform endotracheal intubation?

Only if trained. Preferably, maintain clear airways and use mask ventilation; leave tube insertion to veterinarians.

Essential Foal Resuscitation Kit

• Sterile towels, gloves, sterile suction bulb or catheter
• Feeding tube or oxygen mask and Ambu bag
• Lubricant, IV catheter, epinephrine ampule
• Thermal blanket or heat source
• Sterile saline, syringes, and clamps

Improving Survival—Key Tips

• 📌 Have a well‑stocked resuscitation kit on foaling grounds.
• 📌 Train staff or partners in foal CPR and newborn care.
• 📌 Target quick intervention—CPR within the first minute improves outcomes.
• 📌 Always follow up with professional veterinary care—post‑CPR monitoring and treatment saves lives.

Conclusion

Foal CPR can be a lifesaver—but only if performed calmly, correctly, and quickly. In 2025, having a CPR‑trained team, resuscitation kit, and veterinary support is essential for modern foaling preparedness. With swift action and veterinary partnership, compromised foals can not only survive—but thrive.

If you’re preparing for foaling this season, or facing a foal emergency, reach out to Ask A Vet via AskAVet.com or our app for on‑demand guidance. Our team led by Dr Duncan Houston is available for real‑time decisions and reassessments. 🩺📱