Dr. Carolina Palacios: "Owners should at least feel comfortable giving some breaths and giving some compressions [to the foal] until the veterinarian arrives."

CPR and preparation can save foal’s life

"The important thing is to act right away," says Dr. Carolina Palacios, a veterinary anesthesiologist at the Western College of Veterinary Medicine's Veterinary Medical Centre. "If a foal is born and not breathing or has a low heart rate, the owner should be the first one to start CPR (cardiopulmonary resuscitation)."

Cardiopulmonary arrest is when the body's heart and lungs stop working. The result is a lack of adequate blood flow and oxygen to the brain and body — a severe, life-threatening event that requires urgent intervention.

A foal needing cardiopulmonary resuscitation will have a heart rate less than 50 beats per minute and will be gasping for breath. This medical emergency often happens after a long, difficult birth (dystocia).

As a first effort to save a foal's life, a horse owner or veterinarian can try CPR. The success of this emergency procedure is improved by early intervention so preparedness is key, says Palacios.

She adds that owners should be able to check the vital signs of their foals so they can detect any problems early — especially during the foal's first five minutes of life. Here are key facts to remember:

    • A newborn foal's heart rate should be between 80 and 100 beats per minute. Check the heart rate by putting your hand over the foal's chest and feeling for the heart beat.

    • A newborn foal's respiratory rate should be between 60 and 80 breaths per minute. This can easily be accessed by watching the foal breathe.

    • You should also know how to check capillary refill time — an indicator of cardiovascular function. Press on the foal's gums until the spot turns white. In a normal foal, the white spot will return to pink in less than two seconds when pressure is released,

    • Clear any membranes or remaining placenta from the newborn foal's nostrils and mouth. Drying the foal vigourously can help to stimulate breathing and warm the foal.

"Cleaning the whole foal is the first thing that should be done," says Palacios. "If the owners see any membranes or they can see any fluids, get rid of all these. If needed, start CPR which is compressions and ventilation."

She adds that if you suspect that your mare is struggling and your new foal may be at risk, call your veterinarian immediately so he is at your farm or acreage before the foal is born.

But if your veterinarian hasn't arrived yet and your newborn foal is in distress, you will have to start CPR since time is of the essence. Ideally there should be two people present: one to start CPR and the other to call the veterinarian.

"Owners should at least feel comfortable giving some breaths and giving some compressions until the veterinarian arrives," say Palacios, adding that basic CPR consists of chest compressions and assisted breathing.

To give chest compressions, interlock you fingers and place your hands over the widest part of the foal's chest. Compress the chest by one-third of the width and allow the chest to completely recoil between compressions. Give compressions at a rate of 100 to 120 beats per minute.

You can provide breaths to the foal with a mask and pump or by mouth to nose. To perform mouth to nose, close off one nostril and place your mouth over the other. Blow into the nostril and watch the chest rise while doing so. Give breaths at a rate of 10 to 20 breaths per minute.

If there are two people available, breaths and compressions should be given simultaneously, says Palacios. The person doing compressions should switch roles every two minutes to avoid fatigue. If you're alone, alternate giving 15 compressions and then two breaths.

Prevention and preparedness are key in increasing your foal's chance of survival, stresses Palacios. Here are some tips:

    • Post your veterinarian's contact information in the barn.

    • Call your veterinarian immediately if you suspect there may be a problem with the mare or foal, especially in the event of a difficult birth.

    • Know how to assess vital signs in your newborn foal and know what is "normal." A foal's normal temperature is 37.5 to 37.9 °C, a regular heart rate is 80 to 100 beats per minute, normal respiration rate is 60 to 80 breaths per minute and the accepted capillary refill time is less than two seconds.

    • Be comfortable performing basic CPR while waiting for your veterinarian to arrive. Palacios recommends Foal CPR — a phone app (available from Veterinary Advances Ltd.) that provides notes, pictures and videos.

When it comes to the life of your foal, don't take any chances, says Palacios. Taking a few minutes beforehand to prepare yourself for a possible emergency may be a life-saving decision for your foal.


Hayley Kosolofski is a third-year veterinary student from Sherwood Park, Alta., who is the undergraduate student representative for the WCVM's Equine Health Research Fund.
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