INTRODUCTION

Question:
Why is it important for horse owners to understand foaling emergencies?

Answer:
Foaling is an exciting time, but it can also be unpredictable. Knowing what’s normal—and what’s not—can make the difference between a healthy mare and foal and a true emergency. At Conley and Koontz Equine Hospital, we want horse owners to feel prepared and to know when to call us.

DYSTOCIA (DIFFICULT BIRTH)

Question:
What is dystocia in horses?

Answer:
Dystocia means a difficult or abnormal foaling. In horses, dystocia is always considered an emergency because the mare and foal have very little margin for error. Unlike other species, a normal foaling in a mare happens quickly. Usually within 20 minutes. Delays can be deadly for the new foal and/or the mare.

Question:
What are signs of dystocia during foaling?

Answer:
Signs of dystocia include:

  • Strong contractions with no progress after 10–15 minutes
  • Every contraction the foal should come out a little further. When the uterus relaxes the foal will fall back in a little. With the next contraction, the foal should come out a little further. If the are repeated contractions over 10-15 minutes without progress, there is likely an issue.
  • Prolonged active labor, greater than 20 minutes
  • Only one foot, no feet, or the head without legs visible
  • The mare appearing extremely distressed or exhausted
  • The foal positioned abnormally

If you see anything that doesn’t look right, call Conley and Koontz Equine Hospital immediately.

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Question:
In the event of a dystocia, will I have to transport my mare to a hospital?

Answer:
In the event of a dystocia, it is very likely you will need to transport your mare to the hospital for resolution. Be prepared! You should arrange transportation ahead of time for this possibility. If you have your own trailer, be sure that the truck and trailer are hooked up before foaling. Make sure snow or other obstacles are cleared before foaling so that a quick exit is possible if necessary. Time is critical. In the event of a dystocia contact Conley and Koontz Equine Hospital and we will have our dystocia team awaiting your arrival.

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Question:
In the event of a dystocia, will my mare definitely need surgery?

Answer:
No. At Conley and Koontz Equine Hospital we will first attempt to deliver the foal via controlled vaginal delivery. This must occur at the hospital. The mare is put under general anesthesia. Using a powerful crane mounted to the ceiling we lift the mare’s hindquarters. This mechanical advantage often allows us to then manipulate the position of the foal and deliver it vaginally.

Question:
If controlled vaginal delivery does not resolve the dystocia, will surgery be necessary?

Answer:
Yes, if controlled vaginal delivery is not successful we immediately proceed to surgery for cesarean section delivery. As with all things related to dystocia, time is critical.

RETAINED PLACENTA

Question:
What is a retained placenta in a mare?

Answer:
A retained placenta occurs when the mare does not pass the placenta after foaling. This is a serious condition that can lead to life-threatening infection, laminitis, and systemic illness if not treated promptly.

Question:
How long should it take for a mare to pass the placenta?

Answer:
The 1-2-3 rule applies. A normal foal should be standing by 1 hour, nursing by 2 hours, and the mare should pass the placenta by 3 hours after birth. The placenta should pass within 3 hours after foaling.
If the placenta has not passed by 3 hours, this is an emergency and you should contact Conley and Koontz Equine Hospital right away.

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NEWBORN FOAL MILESTONES

Question:
How long should it take for a foal to stand?

Answer:
The 1-2-3 rule applies: A normal foal should be standing by 1 hour, nursing by 2 hours, and the mare should pass the placenta by 3 hours after birth. A healthy foal should attempt to stand within 30 minutes and be standing well by 1 hour after birth. Delays can indicate weakness, prematurity, or other underlying problems. Some larger breeds like draft horses or racing standardbreds may take longer to stand.

Question:
How long should it take for a foal to nurse?

Answer:
Number “2” of the 1-2-3 rule applies. A foal should nurse within 2 hours of birth. Nursing early is critical because the foal needs colostrum to receive antibodies that protect against infection. If a foal is not nursing by 2 hours, veterinary attention is needed. Again, some larger breeds may take longer to stand and nurse. If you have a larger breed that is known to take longer to stand and nurse, you should be prepared to milk out the mare and let the foal suckle from a bottle in the sternal position before actually being able to stand.

Question:
How long should it take for a foal to pass manure (meconium)?

Answer:
Foals should pass their first manure, called meconium, within 3 hours after starting to nurse. Signs of rectal impaction is a more important indicator for human intervention than a strict timeline. Signs of difficulty passing the meconium include tail flagging, straining, rolling, or abdominal discomfort. Meconium impaction is common and treatable—but only if caught early.

WHEN TO CALL THE VETERINARIAN

Question:
When should I call Conley and Koontz Equine Hospital during foaling?

Answer:
Call us immediately if:

  • Active foaling lasts longer than 20 minutes
  • The placenta has not passed within 3 hours
  • The foal has not stood by 1 hour
  • The foal has not nursed by 2 hours
  • The foal is showing symptoms of meconium impaction
  • Something simply doesn’t look right

Trust your instincts—early intervention saves lives

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CLOSING

Question:
What’s the most important takeaway for horse owners during foaling season?

Answer:
Foaling is fast, and emergencies develop quickly. Preparation and rapid response matter. Be prepared to transport the mare and foal if necessary. If you ever have concerns during foaling, don’t wait—contact Conley and Koontz Equine Hospital. Our team is here to support you and your horse every step of the way.

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