The fol­low­ing note (edited for length and clar­ity) was sent to John Madigan, DVM, from Les­lie Schur, DVM, a vet­eri­nar­ian in Desert Pines Equine in Las Ve­gas, Ne­vada, de­scrib­ing her ex­pe­ri­ences us­ing the rope-squeeze tech­nique on a mal­ad­justed foal:

EQUUS - - Conversati­ons -

Af­ter vis­it­ing with you and learn­ing about your foal rope tech­nique, I had the op­por­tu­nity to use it on sev­eral foals last year, but just as re­straint for treat­ment. Up un­til this past week I had yet to have a true mal­ad­justed foal to try it on. Last Mon­day I re­ceived one of those lovely 1 a.m. calls on a new foal who was stand­ing but had not yet nursed. I gave [the clients] my typ­i­cal coach­ing ses­sion on as­sist­ing the foal to find Mom’s teat and nurse. I in­structed them to get busy help­ing the foal and if they were un­suc­cess­ful they should call me back in an hour as it is im­por­tant we get colostrum into the baby. My phone rang again at 2:30 a.m. They said the filly still had not latched on and was run­ning into walls. They thought she may be blind.

I ar­rived to look at the filly about three hours post de­liv­ery. She was down and took quite a bit of stim­u­la­tion to rise. I then stood back and ob­served for a while. The filly had no con­nec­tion with the dam. She would wan­der around, bum­bling along the walls. When the mare would nuz­zle her hind end she would just turn and wan­der off. Her phys­i­cal ex­am­i­na­tion was rel­a­tively nor­mal and she was a large and healthy foal with an ob­served nor­mal de­liv­ery.

I had a dis­cus­sion with the clients about neona­tal mal­ad­justed syn­drome and the new­est the­o­ries com­pared to what we used to think. I ex­plained the use of ropes and told them that we would

lay the filly down for 20 min­utes while I milked the mare, so we could ad­min­is­ter colostrum through a na­so­gas­tric tube. I set my timer for 20 min­utes and had my client hold some ten­sion on the ropes while I milked the mare.

At the com­ple­tion of those 20 min­utes we let her up. The filly was now 4½ hours old, had not nursed and had not shown even the slight­est in­ter­est in the mare. When she rose she whin­nied at Mom and went straight to nurs­ing within one minute. She never looked back.

Af­ter 20 years of prac­tice it takes a lot to get me ex­cited about a case any­more, but this hap­pen­ing right in front of my eyes was amaz­ing. While I was floored, my ex­hausted client had ab­so­lutely no clue what ex­actly had just oc­curred, nor how much money they just saved with this sim­ple tech­nique. Driv­ing home at 5 a.m. I had to think of friends and col­leagues in dif­fer­ent time zones I could call and share this with. I bet had we known about this 20 years ago I would have a lot less gray hair! You have taught us all so much over the years but this ab­so­lutely ranks at the top of the list. Best Re­gards, Les­lie Schur, DVM Desert Pines Equine Cen­ter

suc­cesses, Madigan is re­al­is­tic about the many chal­lenges a new­born foal might face. “Some cases that fall into the ‘mal­ad­justed foal’ cat­e­gory can have had some de­gree of hy­poxia and in­fec­tion, which can pro­duce very sig­nif­i­cant meta­bolic prob­lems and re­quire in­ten­sive care,” he says. And in a study of foals ad­mit­ted to neona­tal crit­i­cal care units, Madigan found that sep­tic and other very ill young­sters have switched back to pro­duc­ing neu­ros­teroids af­ter their lev­els ini­tially dropped. All of this, he says, un­der­scores the ne­ces­sity of fur­ther re­search.

Madigan adds that there’s the po­ten­tial to de­velop a drug that would re­verse the hor­monal state---a medic­i­nal way to flip the switch, as it were. “There’s a neona­tal mal­ad­just­ment con­di­tion in gi­raffes,” he says. “They get hy­pother­mic and just start fad­ing. Zoo vet­eri­nar­i­ans deal­ing with this have had some suc­cess with med­i­ca­tion to change hor­mone lev­els by block­ing the syn­the­sis of spe­cific neu­ros­teroids.” Whether or not a sim­i­lar med­i­ca­tion can be de­vel­oped for horses is un­clear, but for now Madigan says he is go­ing to con­tinue fo­cus­ing on us­ing pres­sure to help the foals tran­si­tion to life out­side the womb.

In the space of a decade, Madigan has not only un­rav­eled many of the mys­ter­ies be­hind NMS but has de­vised a stun­ningly sim­ple method for treat­ing the con­di­tion. As a re­sult, the fu­ture of af­fected foals no longer de­pends on phys­i­cally and/or fi­nan­cially drain­ing in­ten­sive care. Even as re­search con­tin­ues, his tech­nique for “wak­ing up” dummy foals is sav­ing lives. “I’m su­per ex­cited for what all of this might mean and what we are go­ing to learn,” he says. “But the fact that it’s work­ing for some foals right now, even be­fore we to­tally un­der­stand the mech­a­nism, is the best news of all. Just this week­end, I re­ceived two calls from prac­ti­tion­ers who tried this and both foals got bet­ter im­me­di­ately. I love get­ting those calls.”

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