With the arrival of each healthy foal, we as breeders sense a great relief that once again nature has tended to all the details. As we let down from the intensity of foal watching and the inherent concerns of parturition, we can find ourselves spending hours hanging about the stall or paddock with our new arrival, becoming intimate with its qualities and enjoying all the newborn antics. Quite simply, we begin to relax into the enjoyment of a successful venture and the prospect of the relationship before us. Not to break the mood completely, but as marvelous as this experience can be, this is not a time to relax!

Now, instead of monitoring the mare, we begin the ongoing job of monitoring the foal's health and its orthopedic development. The orthopedic development of the young foal is as critical to its ultimate abilities as an athlete as is its safe arrival. Our management techniques to secure this safe development must be concrete and reliable, for as often as we look at something, we can easily overlook aspects of it at the same time. In this article, I will offer guidelines and suggestions to help optimize the management of pediatric orthopedic development, though space allows to only touch on the basics.

An important part of our monitoring efforts is good record keeping. At Hilltop, we do weekly orthopedic evaluations of our foals that include height and weight measurements, body condition assessment, and careful scrutiny of every limb and joint. Detailed notes are taken to help track, on a weekly basis, the degree of concern for any joint, tendon, or alignment issue. Therapeutic measures are established to address any concerns that might benefit from simple non-surgical management techniques. This type of evaluation is best accomplished with an experienced veterinarian, and requires good follow-up with the farrier. Often slight, but frequent raspings of the foal's hooves is required to maintain hoof shape and subsequently reduce joint stress. At times, lateral or medial extensions (usually glue-on shoes) are required to provide hoof support to minimize a joint problem. Good records track the progression of both a problem and its solution.

As we monitor each foal's growth rate and note any and all concerns regarding its joints or limb alignment, we begin to see patterns. During phases of rapid growth we can see an increase in orthopedic problems that might be associated with a growth spurt--physitis is a good example. Oral vitamin/mineral drenches can be useful in supporting the foal through these times. Our management efforts should aim to make transitions of exercise and nutrition as smooth and gradual as possible, not to evoke any sudden growth spurts that bring on orthopedic crises. These management efforts must address the mare's contribution to the foal's growth patterns as well and strategies applied to minimize sudden changes overall (ie. The lush grass of spring is tempting and great for milk production, but can also provoke massive growth spurts in babies of hungry mammas!). As we evaluate the foal from an orthopedic point of view, we must continually strive to identify areas of concern that might predispose the foal to joint stress and create a strategic management plan day by day, week to week, to safely meet the growing foal's exercise and nutrition needs.

Some joints "close" at earlier stages of development than others and therefore require earlier intervention to secure straight, healthy development if nature has not presented the foal perfectly correct. Angular limb deformities must be addressed with nature's schedule in mind. The distal radius closes at 24-30 months (affecting the knee); the distal tibia closes at 17-24 months (affecting the hock); the proximal P1 and P2 close at 6-9 months (affecting the fetlock); and the distal metacarpal and metatarsal close at 8-12 months (affecting the fetlock, too). Time may not allow for non-surgical measures to be exhausted before surgical measures must be used to correct a joint or leg that is going the wrong way. These considerations clearly are left to the veterinarian, but the prudent breeder remains wide eyed to this information and to the daily/weekly orthopedic changes in each foal. Like I said, definitely not the time to "relax" but definitely a time to still enjoy!