Restraint and Handling of Foals

I. Normal Foals

1. Holding the foal.

1. Foals should not be restrained by their heads with halters as we do with adult horses. For holding and moving neonates we place an adult horse halter upside down and attach through front legs and buckle under thorax and use as a harness that controls the mid-section of the foal. See Fig. 1.
2. For short procedures the foal can be placed up against a stall wall or corner and restrained with hand around chest and other arm around rump or if needed grasping the tail.
3. Flopping reaction of foals occurs when pressure is applied to body and foal will sink to the ground and suddenly arouse with pressure being decreased on the body.
4. For prolonged procedures in foals less than 1 week old consider placing foal in lateral recumbency using the Madigan Squeeze Induced Somulence method [1] (see below).

2. Placing in lateral recumbency for brief procedure

1. Editor's Comment - Perform this after allowing the foal nursing access to mare so it is full.

1. The foal is restrained by placing the arms around the neck area and rump and holding the tail
2. The right forearm of the handler is placed against the head of the foal, and the head is folded back toward the rump area while pressure is applied to the rear quarters with the other arm
3. The foal leans backward and sags toward the handler, becoming recumbent
4. Without releasing any pressure, the foal is allowed to sag to the ground and is kept in the folded position until completely recumbent and relaxed.
5. The front legs are then grasped with the right hand, and the forearm is placed on the neck areThe rear legs are held with the left hand
6. The foal is held steady in this position until it is blindfolded and struggling stops.

3. NEW METHOD [1,2]
   Restraint for procedures 20 minutes – foals <7 days
   SQUEEZE INDUCED SOMULENCE: this method puts the foal into a sleep state, lowers heart rate, slows breathing, raises endorphin levels and raises pain threshold (see Manual of Neonatal Foal web site for video).
   Briefly, using a cotton rope, place a loop around the foals neck with non-slip bowline knot. A half hitch is placed twice over the thorax and rope is held with tension from behind the foal and the foal lays down and goes to sleep (Fig. 2). Keep tension on foal. Be careful, just asleep not anesthetized but easier to do procedures such as ultrasound of umbilicus, glue on shoe, treat an eye, suture a wound (with local anesthetic) etc.
4. Moving the Foal

1. Do not allow foals to run loose. We prefer to harness with the halter as described above and have 1 person lead mare and 1 handle the foal.

5. General Comments

1. Foals have a short attention span so have everything arranged and ready prior to restraint efforts.
2. Don’t over restrain for routine exams etc. Over handling foals can lead to pressure related patent urachus problems where urine is forced through involuting urachus
3. Let foals settle in between activities
4. Keep the mare as close to the foal as possible during the first 14 days that means within a foot or two of the foal.

II. Critical Care Environment

1. Physical restraint

1. We rely heavily on human bodies to provide restraint and protection for tractable and intractable foals.

1. Lateral recumbency with the down eye protected.
2. Head and legs restrained.
3. Violently thrashing foals may require another person at foal's hindquarters.
4. Foal bed or platform is helpful to place catheters, etc.
5. When sternal recumbency of the severely depressed foal is required, heavy wedge-shaped blocks or bags may be placed at shoulders and hips to maintain this position.
6. Standing immobilization.

2. Chemical restraint

1. For restraining purposes Diazepam (Valium) 0.05-0.1 mg/kg IV initial dose has been helpful.
2. Xylazine should not be used in a compromised foal (See Sedation and Anesthesia).
3. Phenobarbital 5-20 mg/kg slowly IV over 20 minutes provides longer term sedation.

3. Where to put foal in need of critical care

1. The advantage of mare and foal in a stall:

1. Preservation of the maternal-foal bond.
2. Allow intermittent nursing of the mare.
3. Minimizes restraint and continuous presence of an attendant.

2. The disadvantages of mare and foal in a stall:

1. Unsanitary.
2. Variable temperature, humidity (lacks thermoneutrality).
3. Poor lighting.
4. Easily inhaled/swallowed bedding.
5. Poor maternal cooperation.
6. Difficult to hang continuous IV fluids.

3. Provide an environment which minimizes potential for self-inflicted trauma.

1. Prevention of decubital and corneal ulcers.
2. Allows frequent change of foal's position and maintenance of sternal position.
3. Minimizes injury from thrashing and seizures.
4. Prevention of urine scalding in the down foal.
5. Prevention of development of patent urachus, reported to be a common complication in the down foal.
6. Management of premature/dysmature bone and connective tissue and resulting angular limb deformities.
7. The foal should be removed from a foal table and intensive care setting as soon as possible to encourage the foal to develop into a functioning horse, suckle, stand, walk and attach to the dam or a nurse mare.

Figure 1. Use of an adult horse halter upside down as a foal harness.

Figure 2. Foal in somnolent recumbent state following application of Madigan Squeeze Induced Somulence method.