Case Studies

Find our case studies from the vets below. For more information, please call the Practice on 01306 627706 for available packages and helpful advice.

Foaling Your Mare - By Zoe Hayward

Preparation for Foaling

Before your mare foals, it is imperative to ensure that she is in good health and body condition. Do not let her become too thin or too fat and aim to increase her level of nutrition in the last trimester of her pregnancy. The best diet for the last stages of pregnancy is a specially formulated broodmare diet which will allow her the right nutrients to allow the foal to develop. Follow the manufacturer's instructions initially then feed by eye according to her body condition. You want a gradual increase in weight before foaling. If she is getting too fat, you can replace some of the broodmare mix with chaff and balancers.

It is a good idea to remove the mare’s shoes just prior to foaling to reduce the risk of damage if she stands on the foal. Some mares may become foot-sore without shoes, so contact your vet or farrier for advice. It is a good idea to remove the mare’s shoes just prior to foaling to reduce the risk of damage if she stands on the foal. Some mares may become foot-sore without shoes, so contact your vet or farrier for advice.

1: The late in-foal mare in good body condition. photo credit: thinkstock.

Worming

Vaccinations

She should also be up to date with her influenza and tetanus vaccinations, and have a flu/tet booster within the last month of pregnancy to increase the number of antibodies to these diseases in the colostrum for the foal.

Vaccinations to reduce the risk of abortion due to Equine Herpes Virus 1 (EHV-1) should be performed at 5, 7 and 9 months of pregnancy in those mares at risk of exposure to the virus in yards here horses are coming and going. If you are sending your mare away to stud to foal down, they will require her to be vaccinated against EHV-1.

Rotavirus vaccinations to increase the foal’s immunity to diarrhoea caused by rotavirus can be given to the mare at 8, 9 and 10 months of pregnancy.

The Foaling Environment

As the day approaches for your mare to give birth, preparations should be made to create a healthy foaling environment. The length of pregnancy varies greatly in the mare (330-370 days) but a general rule of thumb is 11 months plus 1 week from last covering. About 30 days prior to foaling, introduce the mare to the box where she will foal. This reduces stress and allows her to produce protective antibodies against the microorganisms in the environment. She will then be able to pass these antibodies on to her foal in the colostrum.

2: Waxing up. Photo credit: central equine vets

Your mare may be foaled out in a paddock if the weather is good at the time of foaling, but a suitable stable should be available in case of any complications. As most mares’ foal at night, a warm stable with a deep, clean straw bed is preferable.

Contacting your vet a few days before your mare is expected to foal is a good idea to ensure you and your vet are well-prepared.

A few signs that your mare is ready to foal include the following:

Frequent urination.
Swelling and relaxing of the vulva.
Relaxed croup muscles, producing a sunken appearance over the hips.
Enlarging of udder with “waxed beads” of colostrum.
Restlessness and sweating

Mares will only usually want to foal when all is quiet and they feel safe and undisturbed. Make sure your checks are as unobtrusive as possible. Fit the foaling box with a low wattage lightbulb and if possible, a foaling camera to make checks easier and less stressful for the mare. Vulval and sweat alarms can also be fitted to detect the onset of foaling and can be discussed with your vet.

Foaling

Stage 1 labour – restlessness impending foaling. photo credit: hoursejournals.com

Stage two is the actual birth. It should be rapid, with the foal born within 20 to 30 minutes. Most mares do not require assistance with foaling and should be quietly observed. Only help when necessary and with your vet’s advice if you are not experienced.

Normally the foal’s front feet appear first, with soles pointed down toward the mare’s hocks. In a normal delivery, the foal’s nose should be lying on or about the knees. One front leg usually is slightly forward of the other, speeding the foal’s movement through the birth canal. Sometimes the elbow of the more backward limb can get stuck in the pelvis, so a gentle pull of this limb to even them up can help here if necessary. After the head exits the vulva, you may see a clear, transparent membrane, which covers the legs and head. If this membrane does not rupture and free the foal’s head, open it and free the head so the foal can breathe.

Stage 2
labour – emergence of the foal. photo credit: hoursejournals.com

If the first thing to appear is a red membrane, this is a medical emergency called a ‘red bag delivery.’ This occurs due to premature placental separation resulting in the foal being born inside the placenta. The foal is not strong enough to break through this red bag so if this occurs you must open the membrane quickly and carefully with a clean sharp implement so that the foal can breathe. Then call your vet as a ‘red bag’ foal will have increased risk of deterioration due to lack of oxygen during birth.

The mare should ideally foal lying down eventually. If she does not, then the foal can be assisted down (this may require two careful people) in the last stages of expulsion to ensure the umbilical cord is not prematurely broken and she does not stand on the foal. Once the foal has emerged, it’s best not to disturb them while the umbilical cord is still connected. Premature breaking of the umbilical cord by the mare, foal, or human intervention may result in a loss of very important foetal blood supply. The foal’s hind feet usually remain in the mare 5 to 15 minutes after foaling, while the foal and mare lie resting. The umbilical cord will naturally break at a weak point when the mare stands; it should not be cut and only clamped with a clean (ideally sterile) plastic clamp if there is excessive bleeding from the umbilical stump. Once the umbilical cord is broken, the foal’s umbilical stump should be treated straight away with 0.5% chlorhexidine (dilute hibiscrub) or an antibiotic spray. After a few minutes the foal may be pulled gently by its front legs round to the mare’s nose for her to lick. After this it is best to leave them undisturbed but quietly observed, so that they can form the vital bond.

In stage three, the uterus shrinks, and the placenta (afterbirth) is expelled, normally without assistance. Never try to remove the placenta. Once the mare stands after foaling the placenta should be knotted at the level of the hocks to prevent her from standing on it. The placenta should be kept for your vet to examine. If the placenta is still attached after 2 hours, call your vet because they may need to assist the mare in removing it safely, otherwise she can become seriously ill and get laminitis.

Stage 3 labour – explusion of the foetal membranes or afterbirth. photo credit: hoursejournals.com

After Foaling

A normal foal should be up within 30 to 60 minutes and drinking from the mare within 2 hours. The foal may need gentle steering in the direction of the udder and may take a few tries to latch on successfully. If the mare does not accept the foal readily, you may need to restrain the mare with a headcollar or bridle and ensure that the foal nurses. If the foal has not drunk within 4 hours, call your vet. It is essential the foal gets the colostrum (first milk) within the first 12 hours as it contains the antibodies the foal will need to protect it from infectious disease and this is the period in which it is absorbed into the foal’s gut.

photo credit: hoursejournals.com

Mares are usually thirsty after foaling. Offer your mare slightly warm water; but do not let her drink too much at once. She also may be hungry, a wet mash is advised.

If all has gone well, it is recommended to call your vet for a ‘mare and foal check’ ideally 12-18 hours after birth to ensure that there are no problems with either mare or foal. Your vet will check the mare over for any problems after giving birth. They will then check foal for any abnormalities and give a tetanus antitoxin to protect from tetanus in the environment. Sometimes an enema is needed if the foal has not passed its meconium (first faeces) and a blood test can be taken to ascertain whether the foal has received enough antibodies from the mare’s colostrum.

If mare and foal are healthy, you can allow them outside for exercise in a small paddock near to the stable with an even surface. Exercise will help the mare in expelling post-foaling uterine discharge and speeds the return of the uterus to normal condition. A brown-red vulval discharge (called lochia) for the few days after foaling is normal but if you notice a foul-smelling discharge, this could indicate a uterine infection and you should call your vet.

You should check your mare’s udder regularly. A swollen, hot udder is an indication the foal is not nursing enough or that the mare may have mastitis and you should seek veterinary advice.

Careful monitoring of both mare and foal to ensure they remain healthy in the crucial period after birth is essential, and your vet is always available should you notice anything worrying. Seeking advice quickly is key to avoiding serious problems.

Foaling is an incredible experience that requires careful consideration. Breeding your mare requires dedication and careful preparation. By ensuring that you are able to provide your mare with the necessary means for a healthy pregnancy, you can in turn aid the foaling process to reduce the risk of complications and make it a positive experience for you, your mare and her foal.

Case Report - By Oliver Newman

Meet Charlie, a 5-year-old polo pony gelding who presented to the vets a Shotter and Byers as an emergency as he was displaying extreme lameness. At walk Charlie was 9/10 lame on the right forelimb and had a small 2 inch cut present over his shoulder (see figure 1).

The anatomy of the shoulder joint is complex, meaning that this relatively small wound had the potential to involve many important structures including ligaments and tendons, nerve fibres, synovial outpouchings (the bicipital bursa), the bones of the shoulder joint (the humerus and the scapula), and the large synovial joint capsule of the shoulder joint.

Figure 1: Location of Charlie’s wound at the point of the right shoulder

Initial investigation was undertaken, with radiographs and ultrasound images obtained on site. Fortunately, radiography revealed no evidence of bone fracture, and ultrasonography demonstrated that the major soft tissue structures in the area had been spared, as had the important synovial structures, namely the bicipital bursa and the shoulder joint itself. These findings, together with the degree and nature of lameness present, led to an assumed diagnosis of nerve injury/paralysis.

The nerve injury was treated with intravenous corticosteroids and non-steroidal anti-inflammatories to relieve the inflammation around the nerve. The wound itself was lavaged thoroughly with sterile saline, and a course of injectable antimicrobial medications was initiated.

Figure 2: X-ray (top) and ultrasound (bottom) images of Charlies’ shoulder. The red arrows point to the same area of irregular bone, the appearance of which was indicative of infection.

Charlie responded favourably to these medications, and his degree of lameness improved drastically over a couple of days. He was maintained on box rest and treated with a 2-week course of antimicrobials whist the wound granulated.

Unfortunately, 1 month later, Shotter and Byers were called back to re-examine Charlie as his lameness had returned. On this occasion, the lameness was not as severe (graded 4/10), but nevertheless was cause for concern.

Repeat diagnostic imaging of the shoulder was performed, which demonstrated that Charlie had developed a bone infection of his humerus despite his long course of antimicrobial therapy (see figure 2).

The location and severity of this bone infection necessitated surgical intervention in a hospital setting. Charlie was therefore referred to a European Specialist in Equine Surgery. Under general anaesthesia, he had the infected area of humerus surgically debrided, curetted, and removed.

Charlie recovered well from his procedure and was back home within days of his operation. The surgical site has now fully healed, and he is completely sound! He can now look forward to many more successful seasons playing polo!

‘What should I do if my horse has a shoulder wound?’

As Charlie’s case demonstrates, shoulder wounds in horses can cause profound lameness, and owing to the many important anatomical structures in this area, may result in serious pathology. Therefore, veterinary advice should always be sought should your horse incur an injury in this area.

Case report written by Dr Oliver Newman MRCVS. Patient name changed for client confidentiality purposes.

Weight management – How to control and prevent weight gain?

Facing a coronavirus outbreak, most of the yards and riding centres are now closed or with restricted acess to the riders, so horses are not being exercised as normal. It is therefore essential to make a diet and exercise plan to prevent any weight excess.

The weight gain can lead to other complications such as laminitis, hyperlipaemia, equine metabolic syndrome (EMS), colic, and certain orthopaedic conditions (ex: osteoarthritis) as result of the extra strain on tendons, ligaments, joints and bones.

Control:

Monitor body condition score regularly;
Body condition (1-6): 1- Very poor; 6- Very fat
Estimate body weight by using a weight tape and record it;

Diet:

Keep the horses on a high forage, low sugar and starch diet with an additional balance for vitamin and mineral supplement;
To help reduce the risk of colicit is important to gradually change routine and diet over a minimum of 10-14 days;
Restrict the grazing (more important to control the amount of grass eaten rather than the time spent grazing);
Control the amount of given dry forage : advisable to feed 2-2.5% of their bodyweight per day (no less than 1.5%);

Exercise:

Encourage movement in the field :
- Place water and food far apart in the field ;
- Add toys in the field that can allow extra movement;
Make sure that the horse is turned out (at least 4h/ day) ;
If possible exercise horses in the walker or on the lunge for 30 min/day to maintain the fitness levels as much as possible.