Use of alprazolam to facilitate mare-foal bonding in an aggressive postparturient mare.

The study presents a case where a mare displaying postparturient aggression was administered alprazolam, which successfully resulted in positive mare-foal bonding and allowed the foal to suckle without supervision or maternal restraint.

Background

• A healthy 11-year old Quarter Horse mare was observed showing aggression towards her 4-day old foal, inhibiting the foal’s ability to suckle.
• The foal was progressively growing weak due to inadequate nutrition and exhibited severe dehydration, undernourishment, unresponsiveness, and hypothermia among other health issues particularly related to deprived immunity and metabolic dysfunctions.
• The foal’s condition indicated failure of transfer of passive immunity and polymicrobial sepsis confirmed via blood culture yielding E. coli and Citrobacter sp.

Treatment and Progress

• The foal was administered 2 L of equine plasma to boost its immunity, and was given fluid resuscitation, antimicrobial treatment, regular nasoesophageal tube feedings, and supportive and nursing care to address its health condition.
• Domperidone was given to the mare to increase milk production.
• Even though the foal managed to suckle voluntarily by Day 6, the mare’s consistent aggressive behavior required the use of physical restraints and sedation to supervise the suckling process.

Use of Alprazolam

• As a novel approach to allowing the foal to suckle without maternal sedation or restraint, alprazolam was administered to the mare starting Day 7.
• A noticeable change in the mare’s behavior was observed within 24 hours of the initial dose, with the mare showing less aggression and allowing the foal to suckle regularly from Day 9.
• By Day 11, with the mare’s physical examination showing normal parameters and her exhibiting less aggression, physical restraints were removed and suckling process occurred without incident.
• The mare was discharged with a prescription of alprazolam to be given for another eight days following a decreasing dosage schedule.

Post-Treatment Observation and Blood Analysis

• One week post-treatment, the owner reported no signs of aggression from the mare towards the foal, and the mare and foal were found to be healthy six months after presentation.
• Serum alprazolam concentrations in the mare’s blood were analyzed at various time points using liquid chromatography-ion trap mass spectrometry in positive ion mode. This showed that alprazolam was detectable within 10 minutes, and its active metabolite, α-hydroxyalprazolam, by 30 minutes after the first dose.
• Maximum serum concentration of alprazolam and its metabolite were observed at 4 hours and 6 hours, respectively.
• Multiple dose administration every 8 hours showed apparent accumulation of the drug at 24, 36, and 48 hours.