Meconium Impaction

Does your newborn foal need an enema?

Meconium is the first feces passed by the newborn foal and is made up of digested placental fluid, gastrointestinal secretions and cellular debris. It is usually dark greenish brown or black in color, firm pellets to pasty in consistency and is generally passed within the first three to four hours after birth. Failure to pass meconium results in significant abdominal pain for the foal. A foal is considered to have retained meconium or a meconium impaction if frequent unsuccessful attempts to pass meconium occur within the first 12 to 36 hours of life. It has been estimated that 1.5 percent of all foals are affected by meconium impactions. Colts reportedly have a higher incidence of meconium impactions than fillies.

Mild clinical signs are usually apparent within six to 24 hours after birth and include failure to completely pass meconium, a progressive increase in abdominal pain, and frequent posturing and straining to defecate. Affected foals may also be depressed and reluctant to nurse. The standard treatment for foals with a routine meconium impaction is administration of an enema. Two types of enemas are routinely used for foals. Perhaps the most common is a commercial sodium phosphate enema (Fleet brand or generic equivalent). An effective alternative is to administer an enema of about a pint of warm soapy water by gravity flow through a soft, flexible catheter.

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Breeding farms may choose to routinely give all newborn foals an enema within the first one to two  hours after birth or may selectively administer enemas only to foals that do not pass meconium on their own. Either management strategy is acceptable. Foals that do not successfully pass meconium in the first few hours of life should be treated because of the potential for significant complications, including colic, failure to nurse adequately and inflammation of the colon and rectum. If enemas don’t resolve a meconium impaction, your American Association of Equine Practitioners veterinarian should be contacted. Administration of a commercially available acetylcysteine enema might be more successful. Acetylcysteine solution is slowly infused into the rectum through a soft, flexible catheter. The catheter is clamped shut and the solution allowed to remain in the rectum for 15 to 30 minutes before the clamp is opened and the catheter removed. The foal should then be monitored for complete passage of the retained meconium and observations continued for the next 24 to 36 hours. The presence of yellow “milk stool” indicates meconium has passed completely. Additional therapy may be important in the management of foals with meconium impactions. Colostrum intake should be monitored, as it is a valuable source of antibodies required for passive transfer and has a strong laxative effect. Foals with colic associated with meconium impactions might not nurse as vigorously and could be at risk of failure of passive transfer. Your veterinarian might also administer intravenous fluids, medications to provide pain relief or other treatments as needed. Rarely, but occasionally, a severe refractory case of meconium impaction can require surgical intervention.

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As with many medical conditions, early recognition and treatment is important in the successful management of meconium impactions.