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Madigan foal squeeze method

ISSN 2398-2977


Introduction

Rationale for technique

  • Applying a ‘thoracic squeeze’ to a foal, using a soft rope method, appears to induce a somnolent-type state. 
  • This is probably due to a reflexive inhibition of physical movement and electrocortical activity which causes a reduction in heart rate, response to pain and body temperature, whilst simultaneously being associated with increases in ACTH, androstenedione and dehydroepiandrosterone sulfate (DHEA). 
  • The ‘thoracic squeeze’ mimics the pressure which a foal is subjected to as it passes through the mare’s birth canal during stage 2 labor. 
  • This physiological pressure associated with passing through the birth canal normally serves to help subdue the activation of consciousness which would otherwise be caused by increases in fetal plasma concentrations of the neuroactive hormones (estradiol 17β and noradrenaline). 
  • In a normal foal, soon after birth these two neuroactivatory hormones override the neuroinhibitory hormones (including adenosine, progesterone, allopregnanolone, pregnanolone, prostaglandin D2 and a placental neuroinhibitory peptide) which normally keep the fetus in a state of unconsciousness during the last third of equine pregnancy. 
  • The physiological ‘purpose’ of the inhibitory effect of physical pressure as the foal passes through the birth canal is to maintain the foal in state of ‘unconsciousness’ and to ensure that the foal remains immobile as it passes through the birth canal. 
  • In a normal foal, (soon) after birth plasma levels of neuroinhibitory hormones decrease (by various mechanisms, and at different rates depending on the hormone and its source). 
  • Such declines in plasma levels of neuroinhibitory hormones coupled with the release of the inhibitory effects of the physical pressure caused by the foal passing through the birth canal allow the neuroactivatory hormones estradiol 17β and noradrenaline to become dominant, which causes post-partum consciousness to be established. 
  • In foals suffering from ‘neonatal maladjustment syndrome’ (also sometimes known as hypoxic-ischemic encephalomyelopathy (HIE) or as ‘dummy’, ‘barker’ or ‘wandering’ foals Foal: neonatal maladjustment syndrome), these usual mechanisms of switching from the pre-natal state of unconsciousness to the post-natal state of consciousness seems to get disrupted. 
  • The rationale for using the ‘thoracic squeeze’ in foals is therefore to return the foal to a state of somnolence by mimicking the reflexive inhibition of physical movement and electrocortical activity. 

Uses

  • As a method of non-chemical restraint Restraint methods in young foals for minor procedures.  

This method does not provide analgesia sufficient to perform a painful procedure.

  • As a non-pharmaceutical treatment for neonatal maladjustment syndrome Foal: neonatal maladjustment syndrome.  
  • Applying a ‘thoracic squeeze’ for 20 min seems to mimic the pressure which the foal is normally subjected to as it passes through the birth canal. Releasing the thoracic squeeze after 20 min then seems to mimic the physiological release of this pressure at the end of stage 2 labor, which normally contributes to enabling the consciousness-provoking effects of neuroactivatory hormones to become dominant. Thus, the combination of first applying and then releasing a thoracic squeeze seems to effectively ‘reset’ a foal which has not undergone the transition from pre-partum unconsciousness to post-partum consciousness normally. 
  • With reference to the mechanisms of this treatment, it is interesting to note that: 
    • It is often reported that foals suffering from neonatal maladjustment syndrome experienced a rapid stage 2 of parturition (sometimes due to intervention, eg correction of malpresentation or dystocia Reproduction: dystocia, in cases of placental separation, ie the normal physiological effects of thoracic pressure may have been attenuated.
    • These foals typically have elevated, persistent plasma levels of neuroinhibitory hormones in the post-partum period compared to normal foals. 

Advantages

Disadvantages

  • Contraindicated in cases of respiratory compromise, broken ribs Rib: fracture or neuromuscular disease. 

This method MUST not be used in foals with fractured ribs, respiratory compromise or other significant abnormalities.

Technical problems

  • Inappropriate application of the rope causes the technique to fail. 
  • Foal is injured due to incorrect application of the rope or as it falls/gets up. 

Time required

Preparation

  • A few minutes to catch mare and foal.  

Procedure

  • 20-30 min. 

Decision taking

Criteria for choosing test/procedure

Risk assessment

Mare may become distressed as foal is handled. Pay attention to the safety of mare, foal and personnel. Sedate mare if necessary. Safeguard foal as it lies down and gets up.

Wear hard hats.

Requirements

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Preparation

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Procedure

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Aftercare

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Outcomes

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource. 
  • Aleman M, Weich K M & Madigan J E (2017) Survey of veterinarians using a novel physical compression squeeze procedure in the management of neonatal maladjustment syndrome in foals. Animals (Basel) 7 (9), 69 PubMed. 
  • Diesch T J & Mellor D J (2013) Birth transitions: Pathophysiology, the onset of consciousness and possible implications for neonatal maladjustment syndrome in the foal.Equine Vet J 45 (6), 656-660 PubMed 
  • Toth B, Aleman M, Brosnan R J et al (2012) Evaluation of squeeze-induced somnolence in neonatal foals.Am J Vet Res 73 (12), 1881-1889 PubMed. 

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