04/04/2025
What is a dummy foal?
Neonatal maladjustment syndrome (NMS), often referred to as “dummy foal syndrome,” is a condition affecting newborn foals. These foals appear perfectly healthy at birth, but shortly after, they exhibit a range of neurological abnormalities. Instead of demonstrating the usual curiosity and alertness of a newborn, dummy foals become detached, disoriented, unresponsive, and confused. One of the most distressing signs is their difficulty or inability to nurse, which can rapidly lead to further complications. The condition is alarming for horse owners, but thankfully, with prompt diagnosis and appropriate intervention, many foals recover fully.
What are the causes of dummy foal syndrome?
The primary cause of dummy foal syndrome is believed to be decreased oxygen reaching the foal’s tissues during birth, a condition known as hypoxia. This oxygen deprivation can lead to varying degrees of damage to the central nervous system. The severity of the damage depends on several factors:
• Age of the fetus: A fetus closer to term may be more vulnerable to oxygen deprivation.
• Length of oxygen deprivation: The longer the foal is deprived of oxygen, the more severe the neurological damage is likely to be.
• Severity of oxygen deprivation: A complete lack of oxygen will cause greater damage than a partial reduction.
During a normal birth, the foal experiences a physiological “squeeze” as it passes through the birth canal. This squeeze, researchers now know, triggers a crucial biochemical shift in the foal’s brain, essentially flipping a switch that prepares it for life outside the womb. In cases of NMS, this transition may not happen properly, often due to birthing complications such as a prolonged or difficult labor, which can lead to reduced oxygen delivery.
The success rate for treating dummy foals to greater than 80% over the past decades in hospital treatment settings. We have also been able to translate many treatments to the field with good success.
Treatments
Traditionally, treatments for dummy foal syndrome have focused on supportive care like intravenous fluids, nutritional support, and in some cases, anti-seizure medication. However, recent breakthroughs, particularly the work of researchers like Dr. John Madigan, have introduced a revolutionary approach called the “Madigan Squeeze.”
This method mimics the pressure experienced during normal birth using a simple rope harness. When gentle pressure is applied with the rope around the foal’s chest, it appears to fall asleep. This seemingly paradoxical action re-activates the biochemical switch that was missed during the birthing process. The foal is often placed laying down, which appears to allow the necessary physiological changes to take place.
The Madigan squeeze is relatively easy to administer and doesn’t require complex or expensive equipment. Once the procedure is complete, many foals begin to show rapid improvement in their neurological status, often within hours. The technique is simple:
• An assistant holds the foal securely.
• The handler stands behind the foal.
• A rope is positioned around the foal’s chest.
• Gentle, steady pressure is applied using the rope until the foal lays down.
• If the foal doesn’t lie down, pressure should be increased gradually.
This method has demonstrated remarkable success, and the vast majority of foals treated in this way show improvement.
To achieve the best results the foal must be younger than 3 days old, and even better if the foal is younger than 24 hours old.
This is only used on foals that have stood up prior to showing signs of NMS. It is not to be used on a foal with respiratory distress, shock, sepsis, rib fracture, prematurity or congenital anomalies.
A practitioner should be skilled in the procedure, and it should be performed only after a thorough physical exam. Monitoring the foal after the procedure is important. The foal squeeze is performed in a softly bedded area.
Once the rope pressure is released, the dummy foal immediately converts into an aroused, nursing foal engaged with its surroundings. If done properly, the foal experiences no adverse effects from the procedure.
