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Potential Problems and Clinical Signs to look out for in your New Foal

Scone Equine Hospital - Wednesday, July 31, 2019
Potential Problems and Clinical Signs to look out for in your New Foal

Meconium Retention

Meconium is a newborn foal’s first manure and is composed of intestinal secretions and fluid ingested by the foal while in utero. Meconium can range from firm pellets to pasty consistency and is typically dark brown, black or green in colour looking more like dog poo than horse poo. Meconium is generally passed within the first 3-4 hours of birth. If it is not passed in the first 24 hours of birth it is considered impacted or retained.

Signs of meconium impaction can occur up to 3-4 days after birth. Clinical signs that may indicate a foal has retained meconium include:

  • Straining to defecate/ “constipated”
  • tail lifting / tail flagging
  • restlessness
  • increased heart rate
  • abdominal distension
  • rolling / colicky
  • lying upside down
  • abnormal stance
  • hunched back
  • The discomfort can lead to foals being depressed and reluctant to nurse. This is a vicious circle as the mare’s milk is a natural laxative and failure to suck leads to the meconium becoming more concreted and difficult to pass.


Meconium impaction can occur in any foal, however is more frequently seen in males. Foals may also be predisposed if they are weak or dysmature foals (pre-mature or post-mature). As foals may have not had adequate nursing they are also at risk of failure of passive transfer and it is recommended that an IgG test is performed.

Diagnosis may be made by history of failure to defecate. Meconium may be able to be felt on gentle rectal examination, however radiographs or ultrasound may be required if ther impaction is more proximal, in the large colon.

Treatment for meconium impaction may include manual removal combined with an enema. Fleet enema’s may be routinely given on some farms to reduce the risk of impactions. Care is needed with Fleet enema’s as they may cause rectal irritation and are best warmed before use. Other treatments that your vet may use are soapy water enemas, mucomyst (retention enema), fluids and pain relief. If severe, surgical intervention may be required.

Septic Arthirtis / ‘Joint Ill’

Septic Arthritis or Joint ill is the term used to describe infection of a joint, including the surrounding synovium. If the infection spreads to the bone either side of the joint, this is called osteomyelitis (infection of the bone). Haematogenous circulation of bacteria results in septic arthritis in foals and if more than one joint is involved systemic sepsis has often occurred. It is unusual to occur in foals older than 30 days old although when it does occur these foals often have osteomyelitis (bone infection)

Any time a foal presents with lameness and fever, septic arthritis (joint ill) is the first differential diagnosis to rule out. Prompt and aggressive treatment is very important in achieving a good outcome.

Causes of Joint Ill include:

Environmental factors – overcrowding, poor sanitation, poor ventilation

Umbilical remanent complications

Problems with the mare – placentitis

Foaling difficulties

Clinical Signs include:

A lame foal should be assumed to have joint ill until proven otherwise

Hot, painful and swollen tissue around the joints

Depressed foal that is off suck


Veterinary clinical exam

Arthrocentesis; collecting a sample of joint fluid for analysis and culture


Bacterial culture from joint fluid is best to be collected prior to commencing antimicrobial therapy – maximising the opportunity to bacterial growth and gaining an antimicrobial sensitivity information.

Treatment includes some or all of the following:

Antimicrobials is the primary treatment (possibly intra-articular but definitely systemically) combined with a reduction in contamination of the affected joint

Arthroscopic or needle lavage of the joint is often recommended.

Some may need intravenous fluid therapy, plasma and other supportive care if the foal is systemically unwell and not nursing well

Regional limb perfusion with appropriate antimicrobials gives high concentrations of medication at the site if the infection

Exercise restriction

Anti–inflammatories for analgesia

Gastro protectants (ulcer protection) while being treated

Whilst prognosis is generally fair with this condition, failure to treat promptly can result in a poor outcome with ongoing complications. Always contact your veterinarian immediately if you are concerned.

Written by Dr Lucy Cudmore