Survey of Veterinarians Using a Novel Physical Compression Squeeze Procedure in the Management of Neonatal Maladjustment Syndrome in Foals

Neonatal foals must pass key milestones for survival such as standing and sucking from the mare shortly after birth. A condition known as neonatal maladjustment syndrome (NMS), or “dummy foal syndrome”, is characterized by failure to stand, suck, and follow their mare, putting them at risk of malnourishment, infection, and death. NMS had been presumed to be exclusively caused by low oxygen in the foal during the perinatal period. More recently, however, our group demonstrated the presence of neuroactive steroids in foals that exhibited the altered behavior and consciousness characteristic of the disorder. It has been hypothesized that signaling the transition from the in utero unconscious state to extrauterine consciousness may involve labor-induced physical compression (squeezing). During normal birth, foals experience such physical compression for approximately 20 min during stage-2 labor. Current medical treatments for NMS are symptomatic and supportive, which may require 2–7 days of veterinary care. Anecdotal evidence demonstrated that a novel physical compression (squeeze method) that applies 20 min of sustained pressure to the chest of neonatal foals exhibiting this syndrome might rapidly hasten recovery. This survey compares reported outcomes of medical therapy alone to this squeeze procedure with or without medical therapy. The results revealed some foals that received the squeeze procedure recovered faster than those that received medical therapy only