Neonatal maladjustment syndrome in foals

Neonatal maladjustment syndrome is one of the most common neonatal foal diseases. This article discusses the aetiology, clinical signs and treatment of the condition.

Historically, the syndrome has been attributed to hypoxic–ischaemic injury at foaling and the condition is seen in foals that have experienced a prolonged delivery as a result of dystocia or premature placental separation. In these foals, hypoxia initiates a complex cascade of events that ultimately leads to primary and secondary cell death. The organs most commonly affected by hypoxia include the brain, kidneys and intestinal tract. Foals that have experienced significant hypoxia tend to show severe clinical signs and generally have a poorer prognosis for survival. Postmortem examination of these foals reveals evidence of hypoxic tissue injury and neuronal cell death (Rossdale and Leadon 1975; Aleman et al, 2019). This mirrors the situation in human medicine in which infants that have experienced significant birth hypoxia often have an increased mortality rate and are likely to suffer from long-term neurological dysfunction (Yildiz et al, 2017).