A LETTER OF THANKS

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:

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.”