Retrospective five-year study of equine casuistry in a Colombian perinatology center.

This five-year review from a Colombian equine perinatology center describes which conditions were most common in foals and mares and how often patients survived. Neonatal survival was about 74%, neonatal maladjustment was the leading diagnosis, and outcomes improved over time alongside protocol and equipment upgrades.

What the study set out to answer and why it matters

• Objective: Identify the most frequent perinatal pathologies in a dedicated equine center, describe patient sex, age, and breed distributions, and quantify survival—especially among neonates.
• Rationale: Knowing the local “casuistry” (case mix and frequencies) supports better protocols, resource allocation, and counseling for breeders, and enables benchmarking against published survival rates in equine neonatology.

Study design and setting

• Design: Retrospective review of clinical records over 5 years and 8 months (October 2017–May 2023).
• Setting: Foal Care Equine Perinatology Center, Colombia; a specialized referral facility focused on mares in late gestation/parturition and neonatal foals.
• Data set: 945 clinical histories, of which 776 were perinatology cases (mares around foaling and neonatal foals).
• Analysis: Descriptive statistics with calculation of survival rates and trends over time.

Patient population overview

• Neonates: Overall survival 73.6%; females represented 57% of neonatal patients.
• Breeds: The Creole Colombian Horse predominated among mares and neonates, reflecting local breeding demographics.
• Mares: Most admissions were for pregnancy monitoring; a minority presented for dystocia or other reproductive problems.

Key neonatal findings

• Dominant diagnosis: Neonatal maladjustment syndrome (NMS) accounted for 39.34% of neonatal cases.
• System involvement: Multisystemic presentations were common (71.40%), indicating concurrent involvement of multiple organ systems (e.g., neurologic, cardiovascular, respiratory, gastrointestinal), which typically necessitates comprehensive supportive care.
• Survival context: The 73.6% neonatal survival aligns with previously reported rates from equine referral centers, supporting external validity.
• Sex distribution: A modest female predominance (57%) may reflect herd breeding composition, referral patterns, or random variation rather than a biological survival advantage.

Cloned versus non-cloned foals

• Cohort: 341 foals admitted for neonatal adaptation support included 72 clones and 269 non-clones.
• Outcomes: Survival was 76.39% in clones and 72.49% in non-clones—an absolute difference of roughly 3.9 percentage points.
• Interpretation: The small survival difference suggests broadly comparable outcomes when both groups receive specialized perinatal care; however, case selection, referral timing, and intensive monitoring for cloned foals may influence results.

Key mare findings

• Admission purpose: 202 mares (88.98%) were hospitalized for pregnancy monitoring; 25 mares (11.02%) for dystocia or other reproductive pathologies.
• Most frequent mare diagnosis: Placentitis (73.68%), a leading cause of late-gestation compromise, prematurity/dysmaturity, and neonatal sepsis risk.
• Clinical implication: Vigilant surveillance and timely treatment of placentitis can reduce perinatal morbidity and improve foal viability.

Trends over time and quality of care

• Improvement: Survival rates increased over the study period, attributed to protocol refinement and acquisition of new medical equipment.
• Plausible contributors (as commonly reported in equine neonatal care): Standardized triage and sepsis screening, earlier referral, enhanced respiratory support and oxygen delivery, improved fluid/vasopressor strategies, judicious antimicrobial use, point-of-care ultrasonography, and better nutritional support; the study specifically notes protocol and equipment upgrades but does not itemize them.
• Operational takeaway: Iterative protocol audits and investments in critical care tools can translate into measurable outcome gains in neonatal equine medicine.

Understanding neonatal maladjustment syndrome (NMS)

• Definition: A peripartum neurologic dysfunction often linked to hypoxic-ischemic injury and neurosteroid dysregulation; colloquially “dummy foal” syndrome.
• Typical features: Absent/delayed suckle, disorientation, abnormal mentation, recumbency, and variable respiratory or gastrointestinal compromise.
• Why it dominates the caseload: NMS is common in referral neonatology and frequently coexists with sepsis, prematurity, or placental disease, which explains the high multisystemic involvement observed.

Year-round foaling in a tropical context

• Observation: Foaling occurs across all months in Colombia due to the absence of distinct seasons.
• Implications: Continuous staffing and resource readiness are required; surveillance, vaccination, and breeding management protocols should be designed for steady, year-round demand rather than seasonal peaks.

How these findings fit with prior literature

• Concordant outcomes: Neonatal survival near 70–75% matches reported ranges from equine referral centers internationally.
• Common diagnoses: NMS and placental disorders (especially placentitis) are consistently among the leading perinatal problems in horses globally.
• Multisystem illness: High rates of comorbid organ dysfunction are typical in critically ill foals and predict the need for comprehensive, protocol-driven care.

Strengths and limitations

• Strengths: Large single-center perinatology cohort; explicit tracking of survival over time; inclusion of cloned foals provides a useful comparator subgroup.
• Limitations: Retrospective design, single-center referral bias, incomplete standardization of case definitions across years, and limited granularity on illness severity or causes of death.
• Generalizability: Strongest for similar referral settings and tropical breeding systems; applicability to field cases or non-referral populations may be limited.

Practical takeaways for clinicians and breeders

• Prioritize surveillance and early treatment for placentitis to improve foal outcomes.
• Expect NMS as a leading diagnosis; prepare multidisciplinary neonatal support (airway/oxygenation, glucose and fluid management, antimicrobials when indicated, nursing care, and controlled neurosteroid weaning strategies where appropriate).
• Plan staffing, supplies, and ICU capacity for steady, year-round foaling rather than seasonal surges.
• Standardize perinatal protocols and invest in critical care equipment; track outcomes to drive continuous quality improvement.

Future research directions

• Expand sample sizes via multicenter registries to refine survival benchmarks and risk-adjusted outcomes.
• Collect prospectively standardized data on illness severity, timing of referral, and specific treatments to identify modifiable mortality risks.
• Evaluate protocol components and equipment additions with before–after or stepped-wedge designs to quantify their independent impact on survival.
• Study long-term outcomes (growth, athletic performance) in survivors, including cloned versus non-cloned foals.