The first large-scale study of the physical compression procedure known as the “Madigan squeeze technique” confirms that it helps newborn foals with neonatal maladjustment syndrome (NMS) recover more quickly than those treated with only medication. The technique, which involves wrapping a foal’s upper torso with loops of soft rope and applying pressure for 20 minutes, replicates the compression a foal experiences during birth.

NMS affects 1 to 3 percent of foals, most of whom require extensive and often expensive care. John Madigan, DVM, of the University of California—Davis developed the squeeze technique after years of research into how NMS develops. In an earlier study investigating the mechanism of the “flopping reaction” in newborn foals, Madigan’s group found that pressure across the chest area produced significant brain changes, induction of slow wave sleep and hormone changes. He reasoned that this is a biological method that evolved to keep the foal immobilized as it passed through the birth canal. At the same time Madigan wondered if the squeeze signaled the transition from being asleep in the womb to neuroactivation and onset of consciousness—in other words, switching the brain from neuroinhibition to neuroactivation, with the foal “waking up” within a few hours to stand and nurse. Survival of the foal as a prey animal would depend on this signaling system, he surmised.

In cases of NMS, however, the factors involved in neuroinhibition, which are largely sedative progesterone- derivative anesthetic-like compounds, persist, and the foals do not make the transition to consciousness at birth. Foals with NMS remain incoordinated, unable to nurse and wander around their stalls in an apparent stupor for hours or even days after birth. It’s as if the foals missed the signaling to make the transition from unconsciousness in the womb to full wakefulness. Madigan’s team found that foals with NMS have high levels of the sedative neurosteroid compounds in their bloodstreams.

Shortly after presenting these initial findings at professional meetings and in veterinary journals, Madigan’s research group requested information via a survey sent to veterinarians, veterinary technicians and farm managers around the world treating foals with NMS.

Participants were provided with instructions on how to perform the squeeze and asked to complete surveys documenting their experiences using it with NMS foals during 2015 and the first few months of 2016. Participants reported whether they had tried the squeeze technique and how quickly the foals recovered. For foals who did not undergo the squeeze procedure, participants described the medical treatments utilized and how quickly the foals responded.

Overall, information was collected on 195 foals who exhibited abnormal behavior immediately after birth. Of these foals, 87 underwent the compression procedure and 108 did not. All foals in the latter group received some type of medical treatment, such as tube feedings, intravenous fluids or plasma administration. Only about half of the foals receiving squeeze treatment were given some type of medical therapy prior to the procedure and another 20 percent received treatment afterward.

While the recovery rates were roughly the same—about 80 percent—whether foals received the squeeze technique or not, the data showed squeezed foals recovered much faster than did foals receiving only medical treatment. Specifically, squeezed foals were 15 times more likely to recover in less than an hour than were the other foals. What’s more, foals receiving only the squeeze treatment, with no medical intervention, were 17.5 times more likely to recover within the first 24 hours than were foals treated only with medication.

By accelerating recovery, the squeeze technique reduces the need for prolonged, stressful and expensive medical care for NMS foals, the researchers note. “Further,” they say, “the option of euthanasia due to financial constraints, lack of personnel or resources to provide adequate nursing and intensive care, and/or perception of poor prognosis due to severity of signs, can potentially be avoided.”

Reference: “Survey of veterinarians using a novel physical compression squeeze procedure in the management of neonatal maladjustment syndrome in foals,” Animals, September 2017 

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