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

By Dr Duncan Houston, BVSc

Introduction

Respiratory failure is the leading cause of death in newborn foals—more than heart issues. In this **2025 expert guide**, I’ll teach you how to quickly identify when CPR is needed and walk you through each life-saving step with veterinary-backed clarity. Prepare for every birth with the knowledge to help foals breathe, emerge stronger, and thrive. 🌟

Why Respiratory CPR Matters Over Cardiac

• Most foal loss immediately after birth stems from insufficient oxygen—not a failing heart.
• Foals gasping, breathing too slowly, or weak at birth urgently need help—with CPR focused on breathing first.
• Early intervention makes the biggest difference in survival outcomes.

When to Start CPR

CPR is essential if the newborn foal shows any of the following signs:

• Not breathing or gasping
• Respiratory rate < 10 breaths per minute
• Heart rate < 60 beats per minute
• Poorly responsive, limp, bluish or pale gums, weak suckle reflex

Preparation and Kit Setup

Have everything ready before foaling begins:

• Clean towels, large bulb syringe or 60 cc syringe with tubing, gloves
• Feeding tube, Ambu bag or mask for artificial respiration
• Stethoscope, clean cord clamps, warm blankets
• IV fluids and epinephrine for emergency use (vet only)

Immediate Steps at Birth

1. Aggressive Drying

Use towels to rub the foal vigorously—drying prevents heat loss and helps stimulate breathing.

2. Clear Airways Thoroughly

• Lower the head and wipe away fluids from nostrils and mouth.
• Suction thick secretions with syringe and tubing or bulb device.
• Do NOT hang the foal upside down—research shows this can inhibit breathing.
• Avoid slapping or shaking—gentle stimulation only.

3. Clamp Umbilical Cord Only if Heavily Bleeding

If blood loss from the cord is severe, clamp once—but routine tying is not advised.

Artificial Respiration: Why & How

If the foal isn’t breathing or heart rate remains low, begin respiratory support:

Method A: Mouth-to-Nostril or Bag Ventilation

• Use Ambu bag or skilled mouth-to-nostril breathing at ~10 breaths per minute.
• Ensure you see chest rise—if the abdomen inflates, reposition airway tools.
• Connect oxygen mask if available.

Method B: Tube Intubation (Veterinarian Only)

Inserting an endotracheal tube through the nose or mouth allows effective oxygen delivery—but is advanced and usually performed by a trained vet.

When to Initiate Chest Compressions

Continue air support until heartbeat is stable (≥60 bpm). If heart rate remains below that, begin CPR compressions:

• Place hand over heart area (just behind elbow on chest wall).
• Compress ~5 cm deep at 80–100 bpm.
• Alternate compressions with breaths in a 30:2 ratio.
• Reassess every 2 minutes, checking breathing, heart rate, and mucous color.

Monitoring Vital Signs

• Listen to heartbeat with stethoscope, check respiratory motion.
• Assess gums frequently—pink means improving oxygenation.
• Track improvement signs: movement, head raising, response to touch.

When to Halt & Call the Vet

• If no heartbeat or breathing returns after consistent, correct CPR for 5–10 minutes
• When the foal remains limp, hypothermic, or unable to nurse after CPR
• Always during or after CPR when oxygen or epinephrine support is needed

Post-CPR Critical Care

• Warm and dry the foal completely—add blankets or heat support.
• Encourage sternal positioning (standing on chest) before feeding.
• Vet may give IV fluids, epinephrine, oxygen, and run diagnostics.
• Monitor every few hours for 24–48 hours—check temperature, breathing, suckle reflex, and general alertness.

Case Study: Breathing Rescue

1. A thoroughbred foal deputies post-caesarean—gray lips, weak heartbeat (30 bpm).
2. Drying, suctioning, and mouth-to-nose breaths began within 1 minute.
3. Chest compressions added when heartbeat remained low.
4. Within 3 cycles (under 2 minutes), heartbeat reached 65 bpm. Oxygen mask and warm blankets followed.
5. The foal sternalized and nursed by 30 minutes. Vet follow-up confirmed stable vitals and no complications.

Frequently Asked Questions (FAQs)

Is CPR harmful to foals?

When done correctly—gentle compressions, secured airway—it’s safe and life-saving. Just avoid compressing the tummy.

How long to continue CPR?

Continue until spontaneous breathing and heartbeat return, the foal reaches 20 minutes without response, or vet arrives.

Can owners perform tube intubation?

Only if previously trained. Otherwise, focus on respiration and compressions, and let the vet manage advanced airway techniques.

What about medications like epinephrine?

IV epinephrine and fluids help restart the heart but must be administered by a veterinarian.

Must-Have Foaling Kit Checklist

• Sterile towels, bulb syringe/60 cc syringe with tubing
• Ambu bag or feeding tube/mask setup
• Stethoscope, gloves, clamps, warm blankets
• Vet-contact numbers and foaling history

Best Practices & Tips

• Train your foaling team in advance on CPR and birthing emergencies.
• Check and replenish your kit before each breeding season.
• Discuss birth plans with your vet, especially for at-risk mares.
• Practice calm confidence—foals respond to your energy.

Conclusion

Respiratory failure in newborn foals is a race against time. In 2025, having the right tools, training, and calm action can rescue lives. With airway clearing, artificial breathing, compressions, and veterinary backup, you empower foal survival and recovery.

Facing a difficult birth or have a foal in distress? Contact Ask A Vet via AskAVet.com or our app 📱 for expert guidance, photo review, and real-time vet support from Dr Duncan Houston and our team 🩺🐴.