During the first few days of your foal’s life it is important to observe the foal carefully and notice even subtle changes in its condition. A foal’s condition can deteriorate very rapidly, often within several hours. Therefore immediate veterinary attention will give your foal the best chance of surviving. Ideally, all foals should be given a routine veterinary examination 12-18 hours after birth.

The normal foal will also pass meconium (the foal’s first feces) within one hour after birth. Failure to pass meconium is termed "meconium impaction" and will cause the foal discomfort. If your foal suffers from meconium impaction it will show signs of straining, frequent tail swishing, walking around with its tail elevated, and may show signs of colic. A foal with meconium impaction should be treated by a veterinarian.

Newborn foals normally have a respiratory rate of 20-40 breaths per minute. An excessively high respiratory rate may indicate respiratory problems. The best way to obtain an accurate respiratory rate is to stand outside the stall and observe the movement of the foal’s chest with each breath. This method avoids exciting the foal and causing artificially high respiratory rates. Even if the respiratory rate is normal, any harsh breathing sounds (such as grunting or snoring noises) are abnormal and may indicate pneumonia or an obstruction. These foals should be examined by a veterinarian as soon as possible.

The normal foal will have a body temperature of 99-102 degrees F. If your foal has a temperature outside of this range, contact your veterinarian. Keep in mind the fact that a very sick foal can have a "normal" temperature. It takes energy to create a fever, and a sick foal may not have consumed enough calories to show a fever. Also, premature foals may not show a fever when they are ill. If a foal shows other signs of illness, do not disregard those signs simply because the foal’s temperature is in the normal range.

The first 24 hours of your newborn foal’s life are critical, and should be monitored carefully. The normal foal will try to stand during the first 30 minutes of its life and should be successful by one hour. The foal will soon start trying to find the mare’s udder and will be suckling by the time it’s two to three hours old. If your foal is not standing and suckling by six hours after birth, he needs help. It is very important that the foal drinks colostrum in the first several hours of life.

Colostrum is the first milk produced by the mare, and is different from milk that the mare will produce later in her lactation. The primary difference is that colostrum contains high levels of immunoglobulins (antibodies). Immunoglobulins are an important part of the immune system. They function by attaching to infectious bacteria and viruses and preventing them from causing disease. The foal does not receive any immunoglobulins from the mare before birth, and therefore is born with an immune system incapable of responding quickly to an infection. If the foal drinks colostum during the first 18 hours of its life, it will absorb the immunoglobulins and be well prepared to defend itself against disease.

The best way to improve the quality of your mare’s colostrum is to vaccinate her against tetanus, western and eastern equine encepalomyelitis, and influenza four to six weeks before foaling. Vaccinating the mare will stimulate her to produce high numbers of antibodies against these diseases, and she will then put a portion of these antibodies into her colostrum to pass on to the foal.

If the foal does not receive enough antibodies from the colostrum, he has a condition called Failure of Passive Transfer (FPT). FPT often leads to a very severe, often fatal, blood infection referred to as septicemia.

A disease that affects very young foals is septicemia (a blood infection). Foals can acquire the infection while still in the uterus, and therefore born with the disease. In this case, the foal will be weak and depressed from birth, especially if they do not drink enough good quality colostrum and consequently have low resistance to disease. In this case, the foal often appears normal at birth and starts showing signs of the disease after a couple of days. Signs to look for that may indicate septicemia include: 1. A foal that is depressed, inactive, and/or sleepy. 2. A foal that has decreased suckling activity. Check the mare’s udder-if it is greatly distended with the foal hasn’t been suckling well. 3. A foal with swollen, tender joints. This is often mistaken to be a result of injury rather than a sign of septicemia. If more than one joint is involved, it is most likely not from injury. 4. A foal with diarrhea. 5. A foal with a moist, swollen umbilical stump.

If your foal has any of these signs have your veterinarian examine it.

A common route for acquiring this infection after birth is by the umbilical stump. To help prevent this, soak the foal’s umbilicus in stump softener (put the solution in a paper cup and dip the stump several times over the first week of life). Septicemia is often associated with unsanitary foaling conditions. Make sure your foaling stall is kept clean and well-ventilated.

The umbilical cord is composed of two arteries, one vein, and the urachus (an extension of the urinary bladder). These structures normally close when the cord breaks after the foal is born. If the urachus does not close, the foal will dribble urine from the umbilical stump. This condition may be present from birth (the urachus never closes), or more commonly is seen a few days late (the urachus re-opens) and is associated with an umbilical stump infection. Signs of an umbilical infection include: a swollen umbilical stump that may be warm and painful when touched, pus around the stump, and/or dribbling urine from the stump (patent urachus). Any of these sings indicate the urgent need for veterinary care since without care the infection will likely spread into the foal’s blood stream (septicemia) and the foal’s condition and prognosis for recovery will deteriorate rapidly. The best prevention is to soak the umbilical stump in an iodine solution soon after birth and keep the foal in as clean an environment as possible.

An important neurological disorder is a condition known as Neonatal Maladjustment Syndrome (NMS). The cause of NMS is not known, though it is speculated to be a result of a lack of oxygen at some point during the birth process. This syndrome is seen after both complicated and seemingly normal deliveries. The foal may appear abnormal from birth or may seem normal for up to 24 hours before the signs are noticed. Usually the first sign noticed is loss of the suckling reflex. This is followed by weakness, aimless wandering, seizures, and sometimes death. Foals affected from birth often are unable to stand, have no suckle reflex, and have seizures that include abnormal whinnying ("barking sounds"). NMS foals require veterinary care to control the seizure and associated problems the foal may have.

Angular limb deformities, contracted flexor tendons, and flexor tendon laxity all affect newborn foals. Most foals born with mild abnormalities often correct within a few days without treatment. Foals that show no improvement or foals that get worse over time require a veterinary exam and some type of treatment in order to have a future as a performance horse. A newborn care foal exam, will help you determine if the leg problems will require therapy or not. Often the conditions should be treated, or at least examined by your veterinarian, before the foal is 30 days old. Some foals will require 2 or 3 treatments. Also, some foals have normal legs at birth and become affected days to months alter. These foals also need veterinary treatment.

Angular limb deformities are the outward signs of complex problems in the joints, often involving abnormal or incomplete bone formation or laxity of the tissue surrounding the joint. Treatment often involves corrective trimming, casts, and/or surgery.

Foals with contracted tendons appear to be walking on their "tiptoes". The front legs are most commonly affected and when present at birth is usually caused by the cramped position of the foal in the uterus late in gestation. Foals normal at birth can become affected later in life with contracted tendons, due to a variety of causes. Treatment usually involves corrective shoeing, casts, or surgery.

Flexor tendon laxity is the opposite of contracted tendons and the affected foal will stand with the fetlock dropped near or even touching the ground. If severe, the fetlock can become significantly injured from constant contact with the ground. Corrective shoeing is the usual treatment.

Diarrhea is a common problem of young foals that has many causes, and can range from being mild to very severe and life threatening. Diarrhea in foals less than one week old is highly suspicious of septicemia, especially if the foal did not receive adequate good quality colostrum during the first few hours after birth. These foals require urgent veterinary care. Diarrhea can also be caused by bacterial or viral infection of the intestines and the severity of signs varies with the particular micro-organism involved. Some of these infections may appear as outbreaks of foal diarrhea on a farm that can reach epidemic proportions. Diarrhea commonly has a nutritional cause such as simple over-eating or is a result of feeding milk replacers. The parasite, Strongyloides westeri, can cause diarrhea in a young foal, and the incidence can be decreased by deworming the mare after birth of the foal to prevent transmission of the worm from mare to foal.

Another common problem is "Foal Heat" diarrhea. The exact cause is unknown but affects foal 6-14 days old. The diarrhea is usually mild and the foal shows no other signs of illness, with the diarrhea lasting less than one week. Any foal with diarrhea should be carefully watched for other signs of illness: depression, fever, decreased appetite, swollen joints, swollen umbilicus, etc. The foal should receive veterinary care if the diarrhea persists or worsens or is associated any other signs of disease.