There's nothing that pleases a mare owner more than when a healthy foal is born.  It's a dream come true when that beautiful foal first stands and nurses.  That first day flies by, with the foal performing charming antics for a spellbound audience.   
 
Unfortunately, that is sometimes where the joy ends.
 
"Most 'dummy foals' go through a twilight period where everything seems fine and the foal seems healthy.  Then, between 24 and 48 hours, the foal slowly spirals downward," said Dr. Margo MacPherson, D.V.M., M.S., of the Equine Veterinary Hospital at the University of Florida.
 
Today, the most accurate clinical name for "Dummy Foal Syndrome" has been identified as Hypoxic Ischemic Encephalopathy (HIE), although it was also referred to as Maladjustment Foal Syndrome in the past.  According to the Rood and Riddle Veterinary Hospital, HIE is one of the most common diseases of the foal, and has been for years.
 
The cause of HIE is parturition induced, meaning it is caused through birth.  There are several occurrences that can cause a foal to acquire HIE during the pregnancy or birth.  Placental infection causes a majority of the known cases of HIE, but premature placental separation, an extremely slow delivery and septicemia are all causes.   
 
Other causes can be maternal anemia, lung or cardiovascular disease in the mare, low blood pressure in the mare or foal, placental insufficiency (which can be caused when a mare carries twins full-term), placental thickening or oxytocin induction of labor.
 
"Basically, Hypoxic Eschemic Encephalopathy occurs when the foal does not get enough oxygen to the brain during the latter part of the pregnancy or during birth," MacPherson explained.  "It is one of the most common conditions when speaking of abnormal foals, which is an uncommon thing.  HIE is also one of the most treatable conditions, unless Septicemia (blood poisoning) sets in."
 
According to MacPherson, there is no way to prevent HIE, but there are ways to catch it earlier, such as to be present at the birth of the foal.  Although there are some cases where nothing can be done to prevent the cause of HIE, notifying a vet of any abnormalities greatly increases your chance of saving the foal.  A good way to try to catch HIE before the foal is born is to know the history of the mare.  If the mare has had placental infections in the past, she should be regularly checked for such infections (and treated) during her pregnancy.  It should also be noted with the attending veterinarian if the mare has a history of premature placental separation.
 
"If the mare goes through a particularly long or difficult labor, the mare owner should call the vet immediately," MacPherson said.  "By notifying the vet right away, he or she can watch the foal very closely for any symptoms and can treat them right away.
 
"The problem is that many people think the foal is just sleepy.  They think it is cute that the foal sleeps the whole day and they don't realize that there is a problem and therefore do not call the vet.  If HIE is treated right away, it is a very controllable and treatable condition."
 
Foals with Hypoxic Eschemic Encephalopathy are treated symptomatically.  The most common symptoms of this condition are excessive sleepiness, not eating and head pressing.  Not all foals experience these exact symptoms, however.  Symptoms can range from mild depression to severe seizure activity.
 
While the symptoms may seem to only affect the attitude of the foal, HIE can also suggest severe internal problems as well.  A lack of oxygen at birth affects the entire body, so it is important to have foals with HIE completely checked for other disorders, such as intestinal problems, kidney failure or abnormal heart rhythms.
 
"One of the most basic and most effective ways to treat foals with HIE is to simply support the foal until they get over it," MacPherson said.  This involves getting the foal to stand up and move around regularly, feeding the foal if you cannot coax it to nurse and keeping your veterinarian constantly involved in the first few days to monitor any changes.
 
"If managed, the majority of foals with HIE will live through the disease with no permanent side effects.  I consider these foals the most treatable foals, as long as they are managed symptomatically by a veterinarian."