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Dummy Foals/Madigan Foal Squeeze - Event Date: 11 Nov 2014

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PhillipC View Drop Down

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    Posted: 11 Dec 2014 at 7:43pm
Someone posted this YouTube video and it came up in my Facebook feed. It was rather interesting in dealing with a dummy foal who didn't have the suckle reflex.

I then Googled John Madigan Foal Squeeze and found the following. His theory is that by artificially recreating the foal being squeezed through the birth canal, the foal starts suckling as normal and the 'dummy foal' syndrome appears to dissappear.

Foal Squeeze

Fetal Consciousness' Impact on Equine Neonatal Health

By Erica Larson, News Editor • Jul 28, 2013 • Article #32273

Somewhere between when the birthing process begins and when the long-legged foal takes his first wobbly steps, he transitions from an unconscious fetus to a conscious horse. And while owners might just be happy to see their new arrival waking up to the world, researchers now believe that the fetal consciousness transition could have a significant impact on neonatal health.

John Madigan, DVM, MS, Dipl. ACVIM, ACAW, professor in the Department of Medicine and Epidemiology at the University of California, Davis, School of Veterinary Medicine, presented a lecture entitled "Why Foals Don't Gallop in Utero: Studies in Transitions of Fetal Consciousness with Implications for Neonatal Health," at the 2013 American College of Veterinary Internal Medicine Forum, held June 12-15 in Seattle, Wash.


For many years, Madigan said, veterinarians and researchers believed neonatal maladjustment syndrome (or NMS, also known as dummy foal syndrome) to be caused by pre-, intra-, or postnatal hypoxia (lack of oxygen). This oxygen deprivation results in neurologic deficits, behavioral abnormalities, and sometimes death.

Madigan said common clinical signs are consistent with brain hypoxia and include:
• Altered states of consciousness, ranging from mild mental deficits to coma;
• Abnormal behavior, including lack of affinity for the mare, not nursing, excessive vocalizations, and wandering;
• Blindness; and
• Paroxysmal (spasmodic or seizurelike) behaviors.

"Histopathologic (microscopic) evidence of cerebral hemorrhage and hypoxia has been detected in some severely affected foals in the mid-1970s," Madigan said. "However, many foals in recent studies do not have histological evidence of hypoxia, edema, or hemorrhage." Additionally, he noted, about 80% of foals with NMS fully recover, unlike hypoxic human infants who retain neurologic deficits.

These disparities prompted Madigan and colleagues to take a closer look at what else might cause NMS.

Recent Research

Madigan and colleagues began by looking at steroids with important neuromodulatory roles, called 5?-reduced pregnanes (such as progestogens), which are often referred to as neurosteroids. He explained that foals are subjected to high levels of progestogens while in the dam's uterus; these steroids essentially keep the foal in a quiet state to prevent damage to the mare.

"Neonatal foals have high concentrations of pregnanes at birth, which begin to decrease rapidly within an hour of birth and continue to decline over the first 24-48 hours of life," Madigan said.

"Compared to healthy age-matched neonatal foals, NMS foals show significant ongoing elevation of plasma pregnant concentrations."

He noted that his team's research has shown that other ill neonatal foals with weakness and lethargy believed to be associated with conditions such as sepsis also have elevated plasma pregnane levels, although not has elevated as that of NMS foals.

Madigan and colleagues administered a pregnane called allopregnanolone to healthy equine neonates in the experimental setting to produce clinical signs consistent with NMS (e.g., the foals don't want to nurse, don't recognize the dam, etc.). These effects were short-lasting, and foals returned to normal after administration ceased, he said.

Madigan said that while the team administered allopregnanolone, Monica Aleman, DVM, PhD, Dipl. ACVIM, used an electroencephalogram to evaluate electrical impulses in the foals' brains. He said the readings were consistent with slow wave sleep while the foals were standing.

"These data suggest that these steroids can cross the blood-brain barrier and exert neuromodulatory effects, which at high concentrations may have a dampening effect in the central nervous system with resulting alterations in states of consciousness, altered behavior, and responsiveness to stimuli, such as observed in NMS cases," Madigan said.

Madigan hypothesized that a possible reason neurosteroids might persist and prompt NMS-like signs in some foals is that normal signaling events during the birthing process don't take place properly. For instance, he said, if a foal passes rapidly through the birth canal or is delivered via cesarean section, normal transition signals that prompt a reduction in fetal pregnane levels might not take place, leaving the foal with elevated neurosteroid levels.

“There must be a clear and reliable signal that it is safe for the foal to wake up, to transition the consciousness," Madigan said.

Another theory, he said, is that some neonates revert to fetal-like brain status in response to adverse effects after birth.

Possible Treatments

"Based on these findings, the concept of reducing post-birth circulating plasma pregnanes would seem to offer a potential new therapeutic option for NMS foals and perhaps other ill foals which appear weak and are not nursing," Madigan said. He noted future studies will evaluate this more closely.

Additionally, he said, his team is evaluating the possible use of a technique he and his colleagues developed called squeeze-induced somnolence, which is believed to mimic passage through the birth canal. Madigan said this method might signal to the foal that he is outside the uterus and that it's time for pregnane production to decrease, allowing him to stand, nurse, and run. Squeeze-induced somnolence involves applying pressure to the thoracic (chest) area in healthy foals to induce recumbency, non-rapid eye movement sleep, muscle relaxation, and increased β-endorphin levels. It does not appear to have any adverse effects.

During their studies the team noted a unique hormone surge after 20 minutes of squeezing, which is about the normal amount of time a foal is squeezed in the birth canal during a normal delivery, Madigan said. The internal signal for the foal to "wake up" involves the hypothalamic pituitary adrenal axis, which they believe down regulates the pregnane secretion so the foal can transition to birth consciousness.

Also during his presentation Madigan speculated that this new concept might have important human neonatal health implications. He said there have been several reports of premature human babies pronounced dead by doctors that begin breathing and awaken while being held and squeezed by their mothers. Madigan said this practice—termed "kangaroo care"—has been shown to arouse infants better than an incubator.

Take-Home Message

Madigan and colleagues are continuing research on the mechanisms behind NMS and possible treatments. A better understanding of this phenomenon could lead to rapid treatments in the field and less need for intensive care of the dummy or ill foal.

Edited by Gay3 - 24 Aug 2015 at 8:17pm
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Oritah View Drop Down

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Post Options Post Options   Thanks (0) Thanks(0)   Quote Oritah Quote  Post ReplyReply Direct Link To This Post Posted: 11 Dec 2014 at 9:03pm
That is remarkable Philip, footage is from 2012 I wonder why this hasnt hit as a mainstream treatment
Having nursed several dummy foals I found it a frustrating predicament and warmly welcome any new developments in care of the neonate.  
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PhillipC View Drop Down

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Post Options Post Options   Thanks (0) Thanks(0)   Quote PhillipC Quote  Post ReplyReply Direct Link To This Post Posted: 13 Dec 2014 at 7:08pm
Yes, it seems worth a try if in that situation Oritah. It was amazing in the video that the foal was drinking on it's own very quickly after the treatment. It certainly wouldn't do any harm
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Gay3 View Drop Down
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Post Options Post Options   Thanks (2) Thanks(2)   Quote Gay3 Quote  Post ReplyReply Direct Link To This Post Posted: 24 Aug 2015 at 8:16pm
Further to the above which I'd forgotten was here:

Long post, but please read if you are breeding. Daiquiri had a foal during the night Tuesday unattended. (unplanned pregnancy – naughty stallion). We found her around 5AM Wednesday. She was running around acting seemingly normal. When we picked her up, watery diarrhea gushed out. When I went back to check on her, she was continuing to have diarrhea, almost constant hiccups, sneezing and coughing. Had yet to see her nurse. Tried to get her nurse, but she wouldn’t. I milked the mare and tried to force feed. She didn’t want to swallow. Kept force feeding every hour. Gave her Bio-sponge and kaopectate. She continued to get weaker and didn’t want to nurse. Her mom was kinda ignoring her. She collapsed Tuesday afternoon and was shaking and having the hiccups. Karo syrup got her back up. Seemed much better. Wednesday she was more active in the morning but couldn’t nurse and watery diarrhea continued. She collapsed again that afternoon and was almost unresponsive. Once again Karo syrup got her back. Called the equine vet. If the baby made it through the night, she would come this morning. I thought we would have to euthanize her. She said that she may be a partial dummy foal. I had been so focused on the diarrhea and respiratory signs that I hadn’t really considered that. After I got off the phone, I remembered a post by Julie Good (I think) about the Madigan Foal Squeeze technique for dummy foals. Found the post. We got a rope, took the laptop into the stall, and did it. When the rope was removed, she got up from her trance, stretched, and went over to her mother (who had stood totally still for the 20 minute procedure. As soon as the baby got up, the mother went back to eating her hay just like Dr. Madigan said she would do) to get a drink. No hiccups, sneezing, or coughing since. It was truly a miracle. I’ve never seen anything like it. Spoke to the vet this morning and she said she didn’t even think to mention the technique. So this cat veterinarian saved the day. We are not out of the woods yet. We can’t be sure she got the colostrum. I milked the mare and force fed numerous times during the critical period, but I am not sure how much she actually swallowed. So please save this link, maybe even put it with your foaling supplies so you don’t forget about it like I and my equine veterinarian did. I will do this now with any foal that is not nursing within the first few hours. It will do no harm. Big thanks to Yvette Mooney and Michael Mooney-Wells who are always willing to help and support my crazy ideas.

The link has 3 videos and a pdf file.

You may know the term "dummy foal" but have you heard of a Madigan Foal Squeeze? Dr. John Madigan theorized that by artificially recreating the foal being squeezed through the birth canal, the foal starts suckling as normal and the 'dummy foal' syndrome appears to disappear. (Be sure to watch the video links below. Know the signs and learn the step by step foal squeeze procedure.) -> (article) Thoroughbred Village forum/reprint of article originally posted in -> (video) KNOW THE SIGNS. Neurological foal receiving the squeeze technique. Jump to 2:30 to see application of the foal squeeze. - (video) STEP BY STEP GUIDE. Dr. John Madigan shows how to apply the foal squeeze

Experience is something you gain a few minutes after you could have used it!
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JadeLace View Drop Down

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Post Options Post Options   Thanks (1) Thanks(1)   Quote JadeLace Quote  Post ReplyReply Direct Link To This Post Posted: 24 Aug 2015 at 9:24pm
Thats an amazing video!  the hundreds of foals we have helped come into the world I would have loved this info at hand for several dummy births,  very hard work and you feel so helpless especially with the sneezing and seizures....not one vet suggested this method??Confused
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