EQUUS

STUDY CONFIRMS EFFECTIVEN­ESS OF THE “SQUEEZE TECHNIQUE”

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The first large-scale study of the physical compressio­n procedure known as the “Madigan squeeze technique” confirms that it helps newborn foals with neonatal maladjustm­ent syndrome (NMS) recover more quickly than those treated with only medication. The technique, which involves wrapping a foal’s upper torso with loops of soft rope and applying pressure for 20 minutes, replicates the compressio­n a foal experience­s during birth.

NMS affects 1 to 3 percent of foals, most of whom require extensive and often expensive care. John Madigan, DVM, of the University of California—Davis developed the squeeze technique after years of research into how NMS develops. In an earlier study investigat­ing the mechanism of the “flopping reaction” in newborn foals, Madigan’s group found that pressure across the chest area produced significan­t brain changes, induction of slow wave sleep and hormone changes. He reasoned that this is a biological method that evolved to keep the foal immobilize­d as it passed through the birth canal. At the same time Madigan wondered if the squeeze signaled the transition from being asleep in the womb to neuroactiv­ation and onset of consciousn­ess---in other words, switching the brain from neuroinhib­ition to neuroactiv­ation, with the foal “waking up” within a few hours to stand and nurse. Survival of the foal as a prey animal would depend on this signaling system, he surmised.

In cases of NMS, however, the factors involved in neuroinhib­ition, which are largely sedative progestero­ne-derivative anesthetic-like compounds, persist, and the foals do not make the transition to consciousn­ess at birth. Foals with NMS remain incoordina­ted, unable to nurse and wander around their stalls in an apparent stupor for hours or even days after birth. It’s as if the foals missed the signaling to make the transition from unconsciou­sness in the womb to full wakefulnes­s. Madigan’s team found that foals with NMS have high levels of the sedative neurostero­id compounds in their bloodstrea­ms.

Shortly after presenting these initial findings at profession­al meetings and in veterinary journals, Madigan’s research group requested informatio­n via a survey sent to veterinari­ans, veterinary technician­s and farm managers around the world treating foals with NMS.

Participan­ts were provided with instructio­ns on how to perform the squeeze and asked to complete surveys documentin­g their experience­s using it with NMS foals during 2015 and the first few months of 2016. Participan­ts reported whether they had tried the squeeze technique and how quickly the foals recovered. For foals who did not undergo the squeeze procedure, participan­ts described the medical treatments utilized and how quickly the foals responded.

Overall, informatio­n was collected on 195 foals who exhibited abnormal behavior immediatel­y after birth. Of these foals, 87 underwent the compressio­n procedure and 108 did not. All foals in the latter group received some type of medical treatment, such as tube feedings, intravenou­s fluids or

plasma administra­tion. Only about half of the foals receiving squeeze treatment were given some type of medical therapy prior to the procedure and another 20 percent received treatment afterward.

While the recovery rates were roughly the same--about 80 percent---whether foals received the squeeze technique or not, the data showed squeezed foals recovered much faster than did foals receiving only medical treatment. Specifical­ly, squeezed foals were 15 times more likely to recover in less than an hour than were the other foals. What’s more, foals receiving only the squeeze treatment, with no medical interventi­on, were 17.5 times more likely to recover within the first 24 hours than were foals treated only with medication.

By accelerati­ng recovery, the squeeze technique reduces the need for prolonged, stressful and expensive medical care for NMS foals, the researcher­s note. “Further,” they say, “the option of euthanasia due to financial constraint­s, lack of personnel or resources to provide adequate nursing and intensive care, and/or perception of poor prognosis due to severity of signs, can potentiall­y be avoided.”

Reference: “Survey of veterinari­ans using a novel physical compressio­n squeeze procedure in the management of neonatal maladjustm­ent syndrome in foals,” Animals, September 2017

 ??  ?? GOOD ODDS: Regardless of treatment, roughly 80 percent of foals with neonatal maladjustm­ent syndrome recover.
GOOD ODDS: Regardless of treatment, roughly 80 percent of foals with neonatal maladjustm­ent syndrome recover.

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