Case History 6 - LILLY
 

	This beautiful filly foal caused all sorts of trouble when she arrived in the world. She was her mother, Lilly’s, first foal. Lilly, rather unusually, started foaling during the afternoon out in the field. It was soon apparent to her owner that all was not well; normally once labour begins everything happens very quickly and a foal arrives in 15 to 20 minutes.  The foal’s head was visible but no legs.  We received a call to attend and arrived at the stud in about 15 minutes. Lilly was fairly upset by the whole business and was not amenable to being examined internally.  In fact she was kicking out and we were obliged to give her some sedation. This is not ideal as it inevitably sedates the foal as well.  With the sedation on board we could establish that the head was present but the rest of the body was upside down with both forelimbs back along the mare’s dorsal midline.
The mare was still straining badly and it was impossible to push the head back in and turn the foal. We gave the mare some intravenous Clenbuterol (Ventipulmin) which causes uterine relaxation whilst we considered our options. We could either admit the mare to the surgery to perform a caesarean section or else we could anaesthetise her then and there to try and reposition the foal.  If we failed then we would have to allow the mare to wake up and then transport her in for a caesarean which would almost certainly result in a dead foal.  Despite this risk we decided to go for anaesthetising in the field. Luckily we were on a slope, so we made sure the mare’s head was facing down hill when we gave the ketamine. The slope of the hill assisted us in pushing the foal back into the now relaxed uterus (thanks to the Clenbuterol). After a lot of physical exertion by Tim, stripped off and lying on the grass, the foal was turned and delivered whilst her Mother was still asleep.  Lilly was a bit confused when she came round from the anaesthetic but instinct took over and she began to bond with her foal. Like many maidens she needed a bit of persuasion to allow her baby to suckle but within a few hours she had accepted her new role. Lilly had run a lot of milk prior to foaling and so had lost most of her colostrum. This meant that there were no antibodies left in her milk to protect the foal. We were able to confirm this by taking a blood test from the foal on the second day of her life. The level of IgG (the most essential antibody) was negligible and so we had to give two litres of hyper immune plasma intravenously to the foal by way of replacement. As you can see by the photograph the foal is doing really well and has no idea how precarious her birth had been.