Neonatal Encephalopathy (Foals) Average Cost

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What is Neonatal Encephalopathy (Foals)?

Neonatal encephalopathy is also known by the other names of maladjustment syndrome and hypoxic ischemic encephalopathy. It is a condition caused by some type of fetal, maternal, or placental abnormality that leads to lack of oxygen to the foal while in utero. Lack of oxygen to the brain causes CNS symptoms such as head tilt, circling, mental depression, lethargy, seizures, and related symptoms. It can also cause other organ systems within the body to develop complications as well.  In many cases, diagnosis can be done by clinical symptoms with a rule out process of other probable conditions. Treatment of NE is purely supportive with fluids, oxygen, nutritional support, and any other type of helpful therapies. In uncomplicated cases, prognosis of a recovery is good. However, in more severe cases where the foal does not respond much in his first few days of life, prognosis of recovery greatly declines and is very poor.

Neonatal encephalopathy (NE) is a disorder affecting the central nervous system (CNS) of some neonatal foals. It can be caused by maternal, fetal, and placental abnormalities. If your foal is displaying any type of lethargy or acting inappropriately, contact your veterinarian.

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Symptoms of Neonatal Encephalopathy (Foals) in Horses

Symptoms may include:

CNS Symptoms 

  • Head tilt
  • Circling 
  • Asymmetric papillary reflexes
  • Lethargy 
  • Weakness 
  • Mental depression 
  • Seizures
  • Tremors 
  • Hypertonia 

Renal Symptoms 

  • Anuria
  • Oliguria

GI Symptoms 

  • Colic
  • Gastric ulcers
  • Gastric reflux
  • Transient ileus
  • Impaction
  • Bloat
  • Diarrhea
  • Necrotic enterocolitis 

Other Symptoms 

  • Inability to find udder
  • Dysphagia
  • Persistent tongue protrusion
  • Blindness
  • Respiratory issues 
  • Proprioceptive deficits 
  • Accidental self trauma


Neonatal encephalopathy is associated with perinatal asphyxia syndrome. Asphyxia is caused by lack of oxygen delivered to cells causing decreased blood oxygen content and decreased blood perfusion. It can lead to damage of multiple organ systems including the brain.

Causes of Neonatal Encephalopathy (Foals) in Horses

Causes of neonatal encephalopathy include maternal, fetal, and placental factors. Placental causes can occur when chronic placental separation happens and can lead to fetus hypoxia. Red bag delivery is another cause. Maternal and fetal factors can include hypotension and decreased tissue oxygenation.

Diagnosis of Neonatal Encephalopathy (Foals) in Horses

The clinical symptoms your foal is experiencing may be enough to diagnose his condition or to at least help the veterinarian rule out other probable conditions. She will also want to collect a history of your mare’s previous pregnancies and how the birthing process went. In cases with history of dystocia, placentitis, or premature placental separation, neonatal encephalopathy is a common result. 

Blood work will be recommended to look for anything remarkable. A complete blood count (CBC) will show if your foal is suffering from any type of infection or anemia. A chemistry panel will be beneficial to show if any organs are failing. 

The veterinarian may need to run other diagnostics in order to rule out other possible illnesses such as bacterial meningitis, equine herpesvirus, brain trauma, congenital defects, and more.

Treatment of Neonatal Encephalopathy (Foals) in Horses

Unfortunately, there is no specific treatment for neonatal encephalopathy. The best thing the veterinarian can offer for your foal is supportive care. Monitoring blood pressure and perfusion is key to ensuring cerebral blood flow is maintained to prevent further injury. Intravenous fluid therapy is recommended to prevent dehydration and to encourage the continual flow of blood. Glucose may need to be given via IV as well to maintain normal blood glucose levels. If your foal is unable to nurse, a feeding tube may need to be placed to enable him to receive the nutritional support he needs.

Medications will be administered according to your foal’s needs. Anticonvulsant medications will be administered to stop seizures and to increase cerebral oxygen consumption. Vitamins may be administered along with the fluid therapy to provide needed antioxidants and to give his immune systems the boost it needs. 

If any accidental self trauma occurs while seizuring or due to proprioceptive deficits, the veterinarian will administer treatment as she sees fit. She will do everything she can to prevent the condition from worsening and to offer your foal every supportive therapy he may possibly need in order to recover.

Recovery of Neonatal Encephalopathy (Foals) in Horses

In uncomplicated cases, foals with neonatal encephalopathy have a good prognosis of recovery. However, if sepsis develops or other complications arise, prognosis will decrease. If your foal’s condition is poor and remains so, such as he is comatose and difficult to arouse with poor neurologic function during the first few days of life, he has a very guarded to poor prognosis.