Dummy Foal Syndrome: Signs, Treatment and Prognosis

By Dr Duncan Houston

A healthy newborn foal should become progressively brighter, stand, seek the mare and begin nursing within the first hours after birth.

A foal that wanders aimlessly, ignores the mare, loses its suckle reflex, appears unusually sleepy or develops seizures is not simply a “slow starter.”

These signs may indicate neonatal encephalopathy, also called neonatal maladjustment syndrome or dummy foal syndrome. It is a time-critical neonatal emergency because the foal can rapidly become hypoglycaemic, dehydrated, hypothermic, septic or unable to breathe normally.

Quick Answer

Dummy foal syndrome is a neurological disorder affecting newborn foals. Signs include poor awareness, failure to recognise or nurse from the mare, wandering, weakness, abnormal vocalisation, tremors and seizures.

Some cases are associated with reduced oxygen or blood flow before, during or shortly after birth. Others may involve failure of the normal hormonal transition from the sedated state inside the uterus to full consciousness after delivery.

Every abnormally quiet, confused or poorly nursing newborn foal should be assessed by a veterinarian immediately. Early supportive care gives many affected foals a good chance of full recovery. (Merck Veterinary Manual)

What Is Dummy Foal Syndrome?

“Dummy foal syndrome” is an older, commonly recognised name for a collection of neurological abnormalities affecting newborn foals.

Veterinarians more commonly use the terms:

• Neonatal encephalopathy, or NE

• Neonatal maladjustment syndrome, or NMS

• Hypoxic-ischaemic encephalopathy

• Perinatal asphyxia syndrome

These terms overlap, but they are not always completely interchangeable.

Neonatal encephalopathy describes abnormal brain function in a newborn foal.

Neonatal maladjustment syndrome is often used when the foal fails to make a normal behavioural transition after birth, appearing detached, disoriented or unable to bond and nurse.

Perinatal asphyxia syndrome is broader. It refers to reduced oxygen delivery or blood flow affecting not only the brain, but potentially the heart, lungs, kidneys, gastrointestinal tract and endocrine system.

The word “dummy” is historical shorthand. It does not mean the foal lacks intelligence or has permanent brain damage.

What Should a Normal Newborn Foal Do?

A normal newborn foal may look awkward and uncoordinated at first, but it should make steady progress.

Typical early milestones include:

Time after birth	Expected progress
Within minutes	Breathing independently and responding to stimulation
Within approximately 10 minutes	Strong suckle reflex
Within approximately 20 minutes	Beginning attempts to rise
By 1 hour	Standing independently
By 2 hours	Nursing effectively from the mare
During the first several hours	Increasing coordination, strong mare affinity and repeated nursing

There is individual variation, but the direction should be clearly forward. A foal that becomes less responsive, stops trying to stand or fails to nurse by two hours requires immediate veterinary advice. (Merck Veterinary Manual)

The practical rule is:

A newborn foal should improve by the hour, not fade by the hour.

What Are the Signs of Dummy Foal Syndrome?

Clinical signs range from subtle behavioural changes to severe neurological dysfunction.

Early or Subtle Signs

Early abnormalities may include:

• Weak or inconsistent suckle reflex

• Difficulty locating the udder

• Suckling on walls, gates, handlers or other objects

• Reduced interest in the mare

• Standing in a corner

• Aimless wandering

• Unusual sleepiness

• Slow responses to sound or touch

• Failure to follow the mare

• Abnormal or repetitive vocalisation

• Mild weakness or poor coordination

These signs can be easy to dismiss in the first hour after birth. What matters is whether the foal is becoming progressively more alert and coordinated.

More Serious Neurological Signs

More severe neonatal encephalopathy may cause:

• Complete loss of the suckle reflex

• Inability to stand

• Persistent recumbency

• Stupor or coma

• Tremors

• Muscle rigidity

• Repeated paddling

• Facial twitching or chewing movements

• Generalised seizures

• Head pressing

• Circling

• Abnormal pupil responses

• Apparent blindness

• Weak tongue tone

• Persistent tongue protrusion

• Difficulty swallowing

• Irregular or interrupted breathing

Seizures are not always dramatic. Repetitive blinking, chewing, jaw movement, facial twitching or brief periods of staring can all represent seizure activity in a neonatal foal. (Merck Veterinary Manual)

Do Dummy Foals Always Look Abnormal at Birth?

No.

Some affected foals are abnormal immediately after delivery. Others initially stand and nurse, then become detached, weak or neurologically abnormal several hours later.

Signs commonly develop within the first few hours, but onset can be delayed until approximately 24 hours after birth. (Merck Veterinary Manual)

That delayed pattern is one reason careful observation during the first day matters. A normal first nursing session does not guarantee that the foal will remain normal.

What Causes Dummy Foal Syndrome?

Historically, dummy foal syndrome was considered almost entirely the result of oxygen deprivation and reduced blood flow to the brain.

That remains an important cause, but the current understanding is more complicated.

Reduced Oxygen or Blood Flow

Perinatal hypoxia and ischaemia can occur when the foal receives inadequate oxygen or blood flow before, during or after birth.

Risk factors include:

• Prolonged or difficult delivery

• Premature placental separation, or “red bag” delivery

• Placentitis

• Placental insufficiency

• Twinning

• Umbilical cord compression

• Maternal haemorrhage or severe illness

• Caesarean delivery

• Meconium aspiration

• Prematurity or dysmaturity

• Severe fetal stress

• Sepsis

• Congenital abnormalities

Premature placental separation is particularly dangerous because oxygen delivery may suddenly stop while the foal is still inside the mare. (Merck Veterinary Manual)

However, a normal-looking delivery does not exclude neonatal encephalopathy. Some periods of fetal hypoxia are subtle, temporary or occur before labour begins.

Failure of the Normal Neurosteroid Transition

A foal inside the uterus is maintained in a sleep-like, neurologically inhibited state. This prevents the fetus from becoming fully alert and moving forcefully before birth.

After delivery, neuroactive steroid concentrations normally fall and the foal transitions rapidly into wakefulness.

Research has identified persistently elevated neurosteroid concentrations in some foals with neonatal maladjustment syndrome. This supports the theory that some affected foals have not completed the normal biochemical transition from fetal unconsciousness to neonatal alertness. (compneuro.vetmed.ucdavis.edu)

This may help explain why some profoundly abnormal foals recover rapidly and have no lasting neurological deficits.

The honest scientific position is that neonatal encephalopathy probably has more than one mechanism. Hypoxia, inflammation, altered blood flow, metabolic disruption and abnormal neurosteroid activity may all contribute in different foals. Controlled research is still limited. (PubMed)

Why Can a Dummy Foal Have Problems Outside the Brain?

Perinatal oxygen deprivation does not politely stop at the skull.

A foal with neonatal encephalopathy may also develop dysfunction involving the:

• Respiratory system

• Heart and circulation

• Kidneys

• Gastrointestinal tract

• Liver

• Endocrine system

• Muscles

Possible complications include:

• Low blood pressure

• Cardiac arrhythmias

• Poor oxygenation

• Respiratory depression or apnoea

• Reduced urine production

• Acute kidney injury

• Ileus and poor intestinal motility

• Colic

• Meconium retention

• Gastric reflux

• Abdominal bloating

• Diarrhoea

• Gastric ulceration

• Necrotising intestinal disease

• Abnormal blood glucose

This is why treatment cannot focus only on whether the foal is awake. The brain may be the loudest problem while the kidneys, lungs and gut are quietly joining the argument. (Merck Veterinary Manual)

When Is This an Emergency?

Any suspected neonatal encephalopathy is urgent.

Seek emergency veterinary care immediately if the foal:

• Has not stood by approximately one hour

• Has not nursed effectively by approximately two hours

• Loses a previously present suckle reflex

• Cannot find or recognise the mare

• Wanders aimlessly

• Becomes increasingly sleepy or difficult to wake

• Cannot remain standing

• Is repeatedly falling or paddling

• Develops tremors or seizures

• Has milk coming from the nostrils

• Coughs while attempting to nurse

• Has irregular, shallow or interrupted breathing

• Has blue, grey or very pale gums

• Is cold or unable to maintain body temperature

• Produces very little or no urine

• Develops colic or abdominal swelling

• Has diarrhoea

• Has swollen joints or sudden lameness

• Becomes unresponsive

Do not wait for fever. Foals with neonatal encephalopathy are commonly afebrile unless infection is also present, and septic foals may be normal-temperature or hypothermic rather than feverish. (Merck Veterinary Manual)

How Worried Should You Be?

Lower Immediate Concern

The foal:

• Stands within approximately one hour

• Nurses strongly by two hours

• Remains close to the mare

• Has a strong suckle reflex

• Becomes progressively more coordinated

• Is warm, active and responsive

What to do: continue close observation through the first 24 hours and arrange the normal newborn examination and IgG assessment recommended by your veterinarian.

Concerning

The foal:

• Is slow to stand

• Has difficulty locating the udder

• Nurses inconsistently

• Appears quieter than expected

• Wanders away from the mare

• Is not clearly progressing toward normal milestones

What to do: call your veterinarian immediately. Do not give the foal several more hours to “work it out.”

High Risk

The foal:

• Has no effective suckle reflex

• Cannot remain standing

• Appears blind or disoriented

• Suckles inappropriate objects

• Has milk leaking from the mouth or nostrils

• Is recumbent or difficult to arouse

• Has reduced urine production, colic or abnormal breathing

What to do: this foal requires emergency veterinary stabilisation and may need referral to a neonatal intensive care unit.

Critical

The foal:

• Is having seizures

• Is comatose

• Cannot breathe normally

• Has blue or grey gums

• Has severe respiratory depression

• Is collapsed and unresponsive

• Has profound hypothermia

• Shows signs of shock or multiple organ failure

What to do: begin emergency veterinary treatment and arrange immediate referral where possible.

What Else Can Look Like Dummy Foal Syndrome?

Neonatal encephalopathy is a clinical diagnosis made after considering and excluding other causes of weakness or abnormal behaviour.

Important differentials include:

• Sepsis

• Bacterial meningitis

• Failure of passive transfer

• Hypoglycaemia

• Electrolyte abnormalities

• Acid-base disturbances

• Prematurity or dysmaturity

• Neonatal isoerythrolysis

• Kernicterus following severe haemolysis

• Equine herpesvirus type 1 infection

• Head or spinal trauma

• Congenital brain abnormalities

• Hydrocephalus

• White muscle disease

• Botulism

• Rib fractures

• Meconium impaction

• Ruptured bladder and uroperitoneum

• Congenital heart disease

• Primary respiratory disease

Several of these conditions can occur at the same time as neonatal encephalopathy. A foal may have suffered hypoxia during birth, failed to nurse enough colostrum and then developed sepsis. Finding one diagnosis does not mean the investigation is finished. (Merck Veterinary Manual)

Why Sepsis Is the Most Important Rule-Out

Sepsis is one of the most dangerous diseases affecting neonatal foals and can initially look very similar to dummy foal syndrome.

Early signs may include:

• Reduced nursing

• Lethargy

• Weakness

• Recumbency

• Rapid breathing

• Abnormal heart rate

• Poor weight gain

• Swollen joints

• Injected or spotted gums

• Fever or low body temperature

A normal temperature does not rule out sepsis.

Neonatal encephalopathy and sepsis also frequently coexist. A neurologically abnormal foal may fail to nurse adequate colostrum, injure itself, inhale milk or spend prolonged periods recumbent, all of which increase complication risk. (Merck Veterinary Manual)

In practice, the safest approach is often to investigate infection early rather than assuming every abnormal behaviour is purely neurological.

How Do Vets Diagnose Neonatal Encephalopathy?

There is no single blood test that proves a foal has dummy foal syndrome.

Diagnosis is based on:

• Foaling history

• Placental history and examination

• Behaviour and neurological signs

• Physical examination

• Assessment of other organ systems

• Exclusion of other neonatal diseases

Your veterinarian will want to know:

• Was the delivery prolonged or assisted?

• Was there a red bag delivery?

• Was the placenta abnormal?

• Did the foal breathe immediately?

• When did it first stand?

• When did it first nurse?

• Did it initially appear normal?

• Has it passed meconium and urine?

• Was the mare ill during pregnancy?

• Was placentitis suspected?

• Was the foal premature, dysmature or a twin?

Blood Testing

Testing may include:

• Blood glucose

• Complete blood count

• Serum biochemistry

• Electrolytes

• Blood gas analysis

• Lactate

• Kidney and liver markers

• Muscle enzymes

• Inflammatory markers

• Serum IgG

• Blood culture

Bloodwork may appear surprisingly normal in uncomplicated neonatal encephalopathy. Abnormalities may instead reflect secondary organ injury, infection or another underlying disease. (Merck Veterinary Manual)

IgG Testing

A foal that does not nurse normally is at significant risk of failure of passive transfer.

A serum IgG concentration above approximately 800 mg/dL is generally considered adequate. Lower results may require plasma treatment, depending on the result, age of the foal, clinical status and infection risk. (Merck Veterinary Manual)

Further Testing

Depending on the clinical picture, the veterinarian may also use:

• Thoracic or abdominal ultrasound

• Radiographs

• Rib ultrasound

• Urine testing

• Joint fluid analysis

• Cerebrospinal fluid analysis

• Placental culture or histopathology

• Neurological imaging in selected referral cases

The objective is not simply to attach the dummy foal label. It is to identify every treatable problem before one of them becomes irreversible.

How Is Dummy Foal Syndrome Treated?

There is no single antidote.

Treatment is primarily intensive supportive care while the brain and other organs recover.

Oxygen and Respiratory Support

Foals with poor ventilation or low blood oxygen may require:

• Intranasal oxygen

• High-flow oxygen

• Careful positioning

• Mechanical ventilation in severe cases

Respiratory depression can be part of neonatal encephalopathy, but pneumonia, aspiration, prematurity and sepsis must also be considered. (Merck Veterinary Manual)

Circulatory Support

Maintaining adequate blood pressure and cerebral perfusion is essential.

Treatment may involve:

• Carefully calculated intravenous fluids

• Blood pressure monitoring

• Inotropes or vasopressors where required

• Correction of electrolyte and acid-base abnormalities

Fluids must be used carefully. Some compromised neonatal foals are not dehydrated and may have impaired kidney function or altered fluid distribution. Excessive fluid administration can worsen oedema and organ dysfunction. (Merck Veterinary Manual)

Glucose and Nutrition

Newborn foals have very limited energy reserves.

A foal that cannot nurse may rapidly become hypoglycaemic, weak and hypothermic. Management may include:

• Intravenous glucose

• Carefully controlled milk feeding

• Nasogastric tube feeding

• Partial or total parenteral nutrition when the gut is not functioning normally

A weak foal should never be force-fed from a bottle. If swallowing is abnormal, milk may enter the lungs and cause aspiration pneumonia.

Seizure Control

Seizures increase the brain’s oxygen and energy demand and must be controlled promptly.

Veterinary treatment may include anticonvulsant medication, oxygen support and correction of glucose, electrolyte or metabolic abnormalities.

The foal also needs:

• Thick, protective bedding

• A safe padded environment

• Protection from walls and hard objects

• Careful eye monitoring

• Lubrication of the eyes in recumbent patients

• Frequent repositioning

Seizure medication must be administered and monitored by a veterinarian because it can further depress breathing. (Merck Veterinary Manual)

Management of Cerebral Oedema

Specific treatment for suspected brain swelling may be considered in selected cases.

However, not every dummy foal has clinically significant cerebral oedema, and medications used for this purpose have important effects on blood pressure, hydration and kidney function.

This is specialist treatment, not something to attempt from a remembered protocol beside the foaling stall.

Plasma and Infection Management

Foals that have failed to nurse may need intravenous equine plasma to correct inadequate passive immunity.

Broad-spectrum antimicrobials are also commonly considered because neonatal encephalopathy can coexist with sepsis and because affected foals are at increased risk of infection. Ideally, cultures are collected before antimicrobial treatment where this can be done without delaying necessary care. (Merck Veterinary Manual)

Most affected foals do not need a whole-blood transfusion unless there is a separate problem such as severe anaemia, haemorrhage or neonatal isoerythrolysis. Plasma, rather than whole blood, is the usual product used to provide immunoglobulins.

Gastrointestinal and Urinary Support

The veterinary team may need to manage:

• Ileus

• Gastric reflux

• Colic

• Meconium retention

• Diarrhoea

• Abdominal distension

• Reduced urine production

• Kidney injury

• Ruptured bladder

Urine output, abdominal comfort, gastric emptying and manure production are important monitoring parameters, not optional extras.

Nursing Care

Good nursing care is one of the most important parts of treatment.

This includes:

• Maintaining warmth

• Keeping the foal clean and dry

• Supporting sternal recumbency where possible

• Turning recumbent foals regularly

• Protecting the eyes

• Preventing pressure sores

• Monitoring joints and growth plates

• Maintaining safe contact with the mare

• Recording every feed, urination and bowel movement

• Monitoring body weight and blood glucose

• Providing gentle physical rehabilitation

There is rarely a dramatic single treatment that does all the work. Recovery is often built through dozens of small, correct decisions repeated around the clock.

Does the Madigan Foal Squeeze Procedure Work?

The Madigan Foal Squeeze Procedure involves controlled thoracic compression for approximately 20 minutes.

It is intended to reproduce pressure experienced during passage through the birth canal and may help trigger the transition from neuroinhibition to normal consciousness in selected foals with neonatal maladjustment syndrome. (Center for Equine Health)

What the Research Found

A 2017 survey collected information on 195 foals treated for neonatal maladjustment syndrome.

Foals that received the squeeze procedure were more likely to recover normal behaviour and unassisted nursing sooner than foals receiving medical treatment alone. Approximately 68% of squeezed foals recovered within 24 hours, compared with 35% of foals in the medical-treatment group.

However, overall recovery was very similar between groups:

• 86% in the squeezed group

• 87% in the non-squeezed group

This suggests that the procedure may shorten recovery in some foals rather than necessarily improve overall survival. (compneuro.vetmed.ucdavis.edu)

The study was an observational survey, not a randomised controlled trial. The authors identified possible responder bias, inconsistent application and reliance on reported recovery times as important limitations. (compneuro.vetmed.ucdavis.edu)

It Is Not a DIY Replacement for Veterinary Care

The squeeze procedure should only be considered after veterinary assessment.

Contraindications include:

• Respiratory compromise

• Broken ribs

• Cardiomyopathy

• Neuromuscular disease such as botulism

• Other conditions in which thoracic compression may be unsafe

UC Davis specifically advises that the procedure should be performed only by skilled handlers after respiratory disease, neuromuscular disease and rib fractures have been considered. (Center for Equine Health)

Do not delay oxygen, glucose, plasma, seizure control or transport while repeatedly squeezing a critically ill foal.

The squeeze can be useful in the right patient. It is not a diagnostic test, a guaranteed reset button or a substitute for neonatal intensive care.

What Should You Do Right Now?

If a newborn foal appears abnormal:

1. Call an equine veterinarian immediately.
   Give the birth time, standing time, nursing history and current behaviour.

2. Keep the foal warm and dry.
   Use clean bedding and safe external warmth without overheating or burning the foal.

3. Protect the foal from injury.
   Remove buckets, sharp edges and hard obstacles. Use deep bedding if the foal is falling or seizing.

4. Keep the mare nearby when safe.
   Mare contact supports bonding, but protect the foal if the mare is anxious, aggressive or likely to step on it.

5. Do not force bottle-feed.
   A foal without a strong coordinated suck and swallow can inhale milk.

6. Do not pour milk or colostrum into the mouth.
   Feeding-tube placement should be performed by an experienced veterinarian.

7. Record what you see.
   Note suckle strength, urination, manure, abnormal movements, breathing and any seizure duration.

8. Record a short video.
   Subtle facial twitching, staring or repetitive jaw movements may stop before the veterinarian arrives.

9. Do not administer human medication or leftover foal drugs.

10. Prepare for referral.
    Have the trailer ready and contact the nearest equine neonatal intensive care facility where available.

11. Bring the placenta if requested.
    Place it in a clean bag or container and keep it cool, but do not freeze it unless directed.

12. Do not attempt a squeeze procedure before assessment.

Common Mistakes Owners Make

Assuming the Foal Is Just Tired

Normal newborn foals sleep frequently, but they should wake readily, seek the mare and nurse repeatedly.

A foal that sleeps through attempted stimulation, fails to nurse or becomes less responsive is abnormal.

Waiting for Fever

Neonatal encephalopathy is usually noninfectious, and septic foals do not always develop a fever. Waiting for a high temperature can lose critical treatment time.

Force-Feeding From a Bottle

A poor suckle reflex may be accompanied by poor swallowing. Milk from the nostrils or coughing during feeding means aspiration risk.

Focusing Only on the Brain

The lungs, gut, kidneys, heart and immune status may all be affected. Improvement in awareness does not automatically mean the foal is medically stable.

Assuming the Squeeze Procedure Replaces ICU Care

Some foals respond impressively, but the procedure does not treat sepsis, hypoglycaemia, failure of passive transfer, pneumonia, kidney injury or gastrointestinal dysfunction.

Forgetting Colostrum and IgG

A foal that cannot nurse effectively may miss the window for absorbing colostral antibodies. IgG testing and timely plasma treatment can be lifesaving.

Assuming Seizures Mean the Foal Is Hopeless

Seizures are serious, but they do not automatically mean permanent brain damage. Outcome depends on seizure severity, recurrence, concurrent disease and response to treatment.

Can Dummy Foal Syndrome Be Prevented?

Not every case can be prevented. Some foals develop neonatal encephalopathy after an apparently normal pregnancy and delivery.

Risk can be reduced through:

• Close management of high-risk pregnancies

• Veterinary assessment of placentitis

• Monitoring mares with twins or previous reproductive problems

• Appropriate management of maternal illness

• Attended foaling

• Early recognition of dystocia

• Immediate response to red bag delivery

• Proper neonatal resuscitation

• Early newborn examination

• Prompt colostrum management

• IgG testing

• Examination of the placenta

• Early referral of abnormal foals

High-risk mares should ideally foal where experienced personnel, oxygen, resuscitation equipment and rapid veterinary support are available.

The first time the emergency plan is discussed should not be while someone is running around the barn shouting, “Where is the foal oxygen?”

What Is the Prognosis?

Many foals with uncomplicated neonatal encephalopathy recover fully.

Merck Veterinary Manual reports survival of approximately 70% to 75% in uncomplicated cases, with complete recovery in most survivors. (Merck Veterinary Manual)

In a study of 94 hospitalised foals with neonatal encephalopathy, 79.8% survived to discharge. Abnormal udder seeking, poor suckling and inability to stand were common. Recumbency, multiple concurrent diseases and persistent low blood pressure requiring vasopressor or inotropic support were associated with a poorer outcome. (PubMed)

The prognosis is generally better when:

• Treatment begins early

• The foal can maintain blood pressure

• Seizures are controlled

• Oxygenation is adequate

• Sepsis is absent or treated early

• Passive immunity is corrected

• Kidney and gastrointestinal function remain stable

• Neurological improvement begins during the first several days

The prognosis becomes more guarded when:

• The foal remains comatose

• Severe seizures repeatedly return

• There is no neurological improvement within approximately five days

• Sepsis or pneumonia develops

• Multiple organs are affected

• Persistent hypotension is present

• Mechanical ventilation is required

• Significant congenital disease is identified

A severely abnormal appearance at admission does not always predict permanent disability. Some foals improve dramatically once oxygenation, glucose, nutrition, perfusion and infection risk are controlled.

Will a Recovered Dummy Foal Be Normal Long Term?

Many survivors develop normally without obvious permanent neurological deficits.

UC Davis reports that long-term brain injury is not expected in a large proportion of foals that recover with intensive care. (Center for Equine Health)

Follow-up should still assess:

• Vision

• Coordination

• Behaviour

• Suckling and feeding

• Weight gain

• Joint health

• Kidney function

• Respiratory recovery

• Developmental milestones

The long-term outlook depends as much on concurrent disease as on the initial neurological signs. A foal recovering from pure neonatal maladjustment may have a very different outlook from one with severe sepsis, pneumonia or prolonged circulatory failure.

FAQs About Dummy Foal Syndrome

Can a dummy foal recover without treatment?

Some mildly affected foals may improve, but waiting is dangerous. Failure to nurse can rapidly cause hypoglycaemia, dehydration and failure of passive transfer, while sepsis or organ dysfunction may be developing at the same time.

How quickly do dummy foals recover?

Some selected foals improve within hours, particularly after appropriate supportive care or a veterinary-supervised squeeze procedure. Others require several days of neonatal intensive care. Lack of improvement during the first five days is more concerning.

Does every dummy foal need hospitalisation?

Not every case ultimately requires prolonged hospitalisation, but every abnormal newborn foal needs immediate veterinary assessment. Foals with seizures, recumbency, respiratory abnormalities, poor swallowing, organ dysfunction or suspected sepsis are strong referral candidates.

Is dummy foal syndrome caused by a difficult birth?

Dystocia and premature placental separation are important risk factors, but the birth may appear completely normal. Unrecognised in-utero hypoxia, inflammation or abnormal persistence of neurosteroids may also contribute.

Can the Madigan squeeze cure a dummy foal?

It may accelerate behavioural recovery in selected foals, but it is not a guaranteed cure. It does not treat infection, low blood glucose, inadequate antibodies, aspiration pneumonia or organ failure and should only be performed after veterinary assessment.

Final Thoughts

Dummy foal syndrome is not simply a newborn taking longer than expected to find its feet.

A foal that cannot recognise the mare, suck normally, stand reliably or respond appropriately may have significant neurological and whole-body dysfunction.

The most important rules are:

• A healthy foal should stand by approximately one hour

• A healthy foal should nurse by approximately two hours

• Loss of the suckle reflex is an emergency

• Seizures, respiratory difficulty and unresponsiveness require immediate intervention

• Sepsis and failure of passive transfer must be investigated

• Force-feeding an abnormal foal can cause aspiration

• The Madigan squeeze is an adjunct for selected cases, not a replacement for veterinary treatment

• Early intensive support gives many foals a good chance of full recovery

Do not wait for the foal to look critically ill. With neonatal patients, the gap between “a little quiet” and “very sick” can be painfully short.

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If your newborn foal is not nursing, appears confused or has missed an early milestone, ASK A VET™ can help you organise the signs and prepare for urgent veterinary care while your local equine veterinarian provides the examination, stabilisation and treatment the foal needs.