EQUINE VETERINARY EDUCATION
Equine vet. Educ. (2022) 34 (1) e1-e10
doi: 10.1111/eve.13448
Case Report
Successful induction of lactation, foal grafting and maintenance of
pregnancy in a nonparturient Thoroughbred mare
G. Podico , A. C. Migliorisi, P. A. Wilkins and I. F. Canisso*
Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois Urbana-
Champaign, Urbana, Illinois, USA
*Corresponding author email: canisso@illinois.edu
Keywords: horse; orphan foal; sulpiride; nurse mare; adoption
Abstract
An 8-year-old mare was presented for induction of lactation
and adoption of a 30-day-old twin filly. In each of the two
seasons prior to presentation, the mare had delivered a foal
that died shortly after birth. The mare had been bred by live
cover ~25 days prior to presentation to the Illinois Veterinary
Teaching Hospital, but no pregnancy diagnosis was yet
performed. Upon arrival at the hospital, pregnancy diagnosis
confirmed a viable singleton gestational vesicle. Lactation
was induced with dopamine D2 agonists. Immediately before
grafting, the mare was started on altrenogest to provide
exogenous hormonal support for the pregnancy. After two
consecutive days of PGF2a administration on Day 30 of
gestation, the mare began to accept the foal, but by the next
day, the mare had insufficient milk production and began to
show signs of foal rejection. The mare was treated with
acepromazine for sedation and stimulation of lactation, with
concurrent analgesic support provided by flunixin meglumine
and butorphanol. One ovulation was confirmed on Day 40,
and a second ovulation was confirmed on Day 45 of
gestation. On Day 47 of gestation, 11 days after adoption,
serum progesterone concentration was 13.2 ng/mL. As this
value was above the minimum level (≥4 ng/mL) deemed
necessary to maintain pregnancy in the mare, altrenogest
administration was tapered and ultimately discontinued on
Day 50 of gestation. The pair remained at the hospital for
treatment of leucopenia in the filly. On Day 61 of gestation,
25 days after adoption, continued maintenance of
pregnancy was confirmed in the mare, full lactation had
been achieved, and strong bonding between mare and foal
was apparent. The pair was discharged from the hospital to
the care of the owner.
Introduction
Maternal death, foal rejection, insufficient milk production or
inability to produce milk due to maternal illness is a common
problem seen in broodmare practice. Under these conditions,
foals may be bottle- or bucket-fed, transferred to a nurse
mare or weaned sooner than intended if older (Naylor and
Bell 1985; Cymbaluk et al. 1993; Paradis 2012; Stoneham et al.
2017). Despite the availability of commercial equine milk
replacers, there are concerns that these products can lead
to diarrhoea or constipation (Paradis 2012). Additionally,
feeding an orphan with milk replacers is relatively expensive,
given the cost of quality milk replacers, and a laborious task
requiring frequent attention (e.g. q. 2–4 h up to 60 days)
(Paradis 2012). In some farm settings, personnel limitations
e1
may mean that the foal is not fed throughout the night.
Prematurely weaning a foal is thought to have both
behavioural and developmental consequences (Houpt 2000).
Hand-raised foals may become adult horses with behavioural
problems due to the lack of socialisation with other horses
(Houpt 2000). Thus, placement of the foal with a nurse mare
can circumvent the issues related to hand-raised and
prematurely weaned foals. Typically, sources of nurse mares
include periparturient mares who had recently lost a foal;
lactating mares prematurely weaned from their own foal
(commercial nurse mare farms); mares with exceptional
maternal behaviour that would adopt a second foal; or
mares not bred displaying inappropriate lactation or that had
a hormonally induced lactation (Daels 2006; Steiner 2006).
Reported induction of lactation protocols in nonpregnant
multiparous mares involves administration of steroid hormones
(oestrogen and progestins), dopamine D2 receptor
antagonists (domperidone and sulpiride) and PGF2a which
can be administered at the end of steroid treatment to
induce luteolysis (Porter et al. 2002; Daels et al. 2002;
Chavatte-Palmer et al. 2002; Daels 2006). An increase and
decrease in oestrogen, followed by a rise and decline in
progesterone, coupled with a stimulus for prolactin
concentration increase, are thought to be important in the
successful induction of lactation in mares (Chavatte-Palmer
et al. 2002).
Ideally, foal grafting is done when a mare is in full
lactation, whether induced or spontaneous. Described foal
grafting protocols include vagino-cervical stimulation,
exposure of a lactating mare and foal to a perceived threat
such as another horse or dog, and hormonal manipulation
(Daels et al. 2002; Porter et al. 2002; Daels 2006). Other
described ancillary methods include wrapping the mare’s
placenta on a foal to be grafted, rubbing a foal with the
mare’s faeces or using the halter from the nurse mare’s
biological foal on the new foal to be adopted (Houpt and
Mills 2006). Additionally, some practitioners advocate
collecting mare’s sweat with a towel after administering large
doses of PGF2a and rubbing the towel on the foal being
adopted.
Vagino-cervical stimulation consists of restraining the mare
in stocks, performing vigorous stimulations in the birth canal to
emulate parturition, eliciting the Ferguson reflex and then
supervising suckling with the mare restrained in stocks for
several days until the full maternal–foal bond is attained
(Porter et al. 2002). Pharmacological protocols entail
administering oxytocin and/or extremely high doses of PGF2a
or its analogs; the latter is presumably given to stimulate the
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e2 Induction of lactation, foal grafting, and maintenance of pregnancy in a mare
release of oxytocin in the central nervous system (Fuchs
1987). Administration of oxytocin alone to induce foal grafting
should be discouraged as it is thought to be ineffective, as
oxytocin does not cross the blood–brain barrier in several
species such as sheep, rat, guinea pig and humans
(Meisenberg and Simmons 1983; Ermisch et al. 1985).
While PGF2a and its analogs are thought to be effective in
promoting foal grafting, they are known to be abortifacient in
mares during the first trimester of pregnancy, particularly
when given up to 35 days of gestation (Ginther 1985; Daels
et al. 1996; Podico et al. 2020). For this reason, induction of
lactation and subsequent foal grafting is typically performed
in nonpregnant mares. However, while not ideal, in some
specific situations, using a pregnant mare for foal grafting
could be both practical and financially beneficial when the
foal on the ground is prioritised over the pregnancy in utero.
This report aimed to describe the successful induction of
lactation in a pregnant mare starting at ~25 days of gestation
with subsequent foal grafting at ~35 days of gestation. This is
the first report of successful induction of lactation and foal
grafting in a pregnant mare to the authors’ knowledge.
Case history
An 8-year-old multiparous Thoroughbred broodmare was
presented to the Illinois Veterinary Teaching Hospital for
induction of lactation and subsequent adoption of a 30-day-
old orphan Thoroughbred filly owned by the same breeder.
The filly and its twin colt had been delivered in the field by
the referring veterinarian via terminal caesarean section
necessitated by dystocia. The twin colt died after 12 h of
hospitalisation; the filly required 4 weeks of intensive care
before withstanding the adoption procedure. The mare had
been bred by live cover ~25 days prior to presentation to the
Illinois Veterinary Teaching Hospital (IVTH) but had not yet
been examined to diagnose pregnancy. The mare delivered
two live foals in consecutive pregnancies, but both foals died
shortly after birth due to unknown causes. Acquisition of a
lactating mare from a specialised nursing mare farm or
induction of lactation in a different mare and then
performing a foal adoption were offered but declined by the
owner. Instead, the owner wanted to use one of his
nonparturient broodmares for the induction of lactation and
foal grafting. The owner was informed about potential risks for
abortion after the administration of PGF2a in the presence of
pregnancy but elected to pursue the adoption with this
particular mare.
Clinical findings
The mare weighed 636 kg and was bright, alert and
responsive. Physical examination was performed at admission,
and findings were unremarkable. The reproductive
examination revealed poor perineal conformation (vulva
slightly tilted horizontally with the majority of the vulva
located above the pelvic brim), and there was no Caslick’s
vulvoplasty in place. Transrectal palpation and
ultrasonography revealed a singleton gestational vesicle
(30 mm 9 35 mm) with an embryo displaying apparently
normal heartbeats. In addition, one corpus luteum was
visualised on each ovary associated with multiple small
follicles (<20 mm). Based on the clinical findings, the
gestational age was determined as approximately 23–
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25 days, consistent with the breeding history provided by the
owner. Visual examination and manual palpation of the
udder were performed. There was no mammary gland
development, nor were secretions, signs of mastitis or fibrosis
present.
Diagnosis
Apparently healthy mare carrying a singleton ~25-day-old
pregnancy.
Treatments
Induction of lactation
The mare was started on a course of a labelled dose of
domperidone (Equidoneâ, 1.1 mg/kg bwt, per os, q. 24 h)1
treatment for 4 days (Table 1). Milk stripping was started on
the second day of domperidone and continued two times a
day for the first 5 days, with average milk production of 45 mL
per day (Table 2). On Day 5, the domperidone treatment
was discontinued, and sulpiride treatment was initiated with
compounded injectable sulpiride (50 mg/mL, dissolved in 85%
cottonseed oil and 10% benzyl alcohol, 1 mg/kg bwt, i.m., q.
12 h)2. At the IVTH and elsewhere (Daels et al. 2002; Porter
et al. 2002), sulpiride is the preferred benzamide over
domperidone for induction of lactation in mares. It has been
suggested by other authors (Chavatte-Palmer et al. 2002;
Daels 2006), and it is the authors’ clinical impression that
sulpiride results in a more consistent clinical response when
compared to domperidone. However, herein the treatment
with sulpiride was delayed due to a nationwide shortage
immediately prior to the initiation of treatment of the present
case. On Day 9, after 5 days of sulpiride treatment initiation,
milk production progressively increased in volume (Table 2).
The mare was then milked more frequently (q. 4 h).
Foal adoption
On the day of adoption, the orphan filly was 30 days old,
weighed 32 kg and had a withers height of 76 cm. The
adoption was carried out at this age because the filly had
been intensively treated for immature bone and lung
development until this point. Until this time, the filly had been
unable to stand for an extended period of time and required
intensive treatments, which precluded grafting efforts. Prior to
the onset of adoption, the filly was being fed from a pan with
500 mL of equine milk replacer (Mare’s Match foal milk
replacer)3 every 3 h. To facilitate the adoption, the milk
replacer was withheld for 4 h before the onset of the grafting.
Right before the procedure, transrectal palpation and
ultrasonographic examination of the mare revealed a
singleton gestational vesicle with an embryo displaying
apparently normal heartbeats, staged as ~35 days old, and a
corpus luteum in each ovary (Fig 1, Table 3).
To prevent pregnancy loss, the mare was administered
altrenogest (Regu-Mateâ, 0.088 mg/kg bwt, per os., q. 24 h)4
beginning 6 h before the first grafting attempt. Dinoprost
tromethamine (Lutalyseâ, 25 mg, 5 mL, i.m.)5 was
administered, and the introduction of the orphan filly was
attempted, after ~20 min, when the mare was showing signs
of discomfort, which included mild sweating, restlessness and
soft manure due to hyperperistalsis (Coffman and Pinto 2016).
The filly was carefully restrained when presented to the mare;
an experienced handler held the mare to allow a controlled
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G. Podico et al. e3

TABLE 1: Summary of drugs used to induce and maintain lactation, to perform foal adoption and maintain pregnancy

Gestation Duration
days (d) Drugs and dosing Reason(s) for performing

26–29 4 Domperidone (1.1 mg/kg bwt, per os, q. 24 h) Induction of lactation

30–35 7 Sulpiride (1 mg/kg bwt, i.m., q. 12 h) Induction of lactation
35–41 5 Sulpiride (1 mg/kg bwt, i.m., q. 12 h) Support lactation
42–50 9 Domperidone (1.1 mg/kg bwt, per os, q. 24 h) Support lactation
35 1 Dinoprost tromethamine (25 mg, 5 mL i.m.), cloprostenol sodium Foal adoption
(500 lg, 2 mL i.m.)
35 1 Butorphanol tartrate (10 mg, 1 mL, i.v.) Analgesia, sedative and support foal
adoption
36 1 Dinoprost tromethamine (25 mg, 5 mL i.m.), cloprostenol sodium Foal adoption
(500 lg, 2 mL i.m.)
36 1 Butorphanol tartrate (10 mg, 1 mL, i.v.,) Analgesia, sedative and support foal
adoption
37–38 2 Butorphanol tartrate (10 mg, 1 mL, i.m., q. 8 h) Analgesia, sedative and support foal
adoption
35–38 4 Flunixin meglumine (1.1 mg/kg bwt, i.v., q. 24 h) Analgesia
37–39 3 Acepromazine (30 mg, 3 mL, i.m., q. 8 h) Tranquilliser, support lactation
35–38 16 Altrenogest (0.088 mg/kg per os, q. 24 h) for 4 days and then single Maintain pregnancy
39–50 dose (0.044 mg/kg per os, q. 24 h) for 8 days, then gradual
decrease until none in 4 days
38 1 Deslorelin acetate (1.8 mg, 1 mL, i.m.) Induce ovulation to enhance
progesterone for pregnancy
maintenance

TABLE 2: Milk production of an early pregnant Thoroughbred related to the high dose of PGF2a analogs and to mimic the
mare treated with domperidone (1.1 mg/kg bwt, per os, q. 24 h)
physiological release of opioids occurring during suckling.
(Days 1–4) and sulpiride (1 mg/kg bwt, i.m., q. 12 h) (Days 5–10)
Overnight, the pair was kept in the same stall, divided by
Milking Estimated production in a built-in pen. The filly was exposed to the mare overnight
Days frequency 24 h (mL) and encouraged to nurse at 4-h intervals. When no successful
latching was achieved, the filly was fed 500 mL equine milk
Domperidone 1 0 0 replacer (Mare’s Match Foal Milk Replacer) in a pan held
2 q. 12 h 40
under the mare. The mare was handheld during all the pan
3 q. 12 h 40
feedings. While she did not display aggressive behaviour,
4 q. 12 h 40
Sulpiride 5 q. 12 h 60 interest for the foal progressively declined throughout the
6 q. 8h 100 night. The next day, the mare showed no maternal
7 q. 8h 300 behaviour, and the procedure was repeated as previously;
8 q. 8h 600 the filly had feeding withheld for 4 h before the procedure.
9 q. 4h 1500 The mare did not show any maternal behaviour after 15–
10 q. 4h 2400 20 min from the injection of dinoprost (25mg, 5mL, i.m.)5;
therefore, she received an injection of cloprostenol sodium
(500 lg, 2 mL, i.m.)4. Within 5–10 min from the second
injection, the mare began to display excellent maternal
behaviour, and the filly was encouraged to nurse (Fig 2a).
and safe interaction. The filly’s nose, ribs, flank and perineal The mare started vocalising and licking the foal; she did not
area were presented to the mare. After 10–15 min of react at any attempt of the filly to nurse; indeed, she was
exposure, the mare did not show overt signs of aggression gently stimulating the filly to nurse while touching her back.
towards the filly, but did not display maternal behaviour like In contrast with the previous day, the filly had a strong
nickering, licking or sniffing the foal. The mare was then sucking reflex, which greatly facilitated grafting. Each
administered cloprostenol sodium (Estrumateâ, 500 lg, 2 mL, latching lasted for 2–5 min, whereas the filly would not fully
i.m.)4. The mare started showing stronger maternal behaviour latch in the previous day and only kept her mouth on the
after 10 min, such as licking, sniffing and nickering to the foal. udder for a few seconds. The mare was administered
The filly was assisted while trying to nurse; unfortunately, butorphanol tartrate (10 mg, 1 mL, i.v.)5 to alleviate pain and
her sucking reflex was not vigorous enough to fully latch on to further mimic the physiological release of endogenous
the udder. In addition, the filly seemed intimidated by the opioids during suckling. Thereafter, the filly was allowed to
mare as this was her first close exposure to another horse. nurse on the mare every 2 h under close supervision: one
After four unsuccessful attempts to assist the filly in nursing person holding the mare and a second person holding the
over approximately 2 h, with breaks of 20 min between foal with care to not allow the foal to cross beyond the
attempts, the nursing assistance was discontinued until the mare’s flank. After 6 h of successful foal–mare interaction,
next day. A dose of butorphanol tartrate (Torbugesicâ, 10 mL, they were kept together and monitored by having a person
1 mL, i.v.)5 was administered to the mare to alleviate the pain standing in front of the stall and watching on a wall-mounted

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e4 Induction of lactation, foal grafting, and maintenance of pregnancy in a mare

D 35 D 36 D 37 D 40 D 47

* * *
* * * * * *
* * *
*

a) b) c) d) e)
Fig 1: Representative images of ovarian structures and pregnancy development of a pregnant mare before a) and after b-e) the foal
grafting with PGF2a analogs. Images were obtained with a 5 MHz linear transducer. * denotes luteal structure; ▲ denotes the embryo a-
d) or fetus e).

TABLE 3: Ultrasonographic findings from 25 to 61 days of pregnancy in a Thoroughbred mare submitted to induction of lactation and
foal grafting with PGF2a at ~ 35 days of gestation

Left ovary Right ovary

Gestational age Follicles Luteal structures (no, size Follicles Luteal structures (no, size Fetal heart rate (beats/
(days) (mm) mm) (mm) mm) min)

25 20 1 20 1 n/a
35 40 1 (27.4 9 34.0) 15 1 (31.9 9 33.0) 128
36 40 1 (27.8 9 26.5) 15 1 (26.0 9 26.7) 124
37 40 1 (25.1 9 26.5) 30 1 (23.0 9 25.4) 118
40 15 1 40 2 120
47 15 2 15 2 112
61 15 2 15 2 120

camera. After no signs of rejection, they were left
unsupervised. Administration of the equine milk replacer to
the filly was discontinued that night. Flunixin meglumine
(PrevailTM, 1.1 mg/kg bwt, i.v., q. 24 h)6 was administered for 4
days to prevent and treat pain derived from a potentially
sore udder due to the now vigorous nursing behaviour of the
foal.
Approximately 18–24 h after the filly’s apparently
successful introduction, the mare demonstrated mild to
moderate signs of foal rejection, including stall walking, not
standing for the foal to nurse and minimal interest in the filly.
This behaviour was thought to be due to insufficient milk
production and subsequent discomfort caused by vigorous
suckling attempts in the absence of sufficient milk by the
mare. The filly was then offered 500 mL of the same brand of
equine milk replacer fed previously every 8 h to decrease the
burden on the mare. In addition, the mare received
acepromazine maleate (AceproJectâ, 30 mg, 3 mL, i.m., q. 8
h for 2 days)7 for its tranquilising properties and its ability to
stimulate prolactin production to promote lactation for 2 days
(Bryant et al. 1968). In addition, butorphanol tartrate (10 mg,
1 mL, i.m., q. 8 h for 2 days)4 was also administered for its
analgesic and sedative properties and its potential ability to
also stimulate prolactin release (Knight et al. 1986; Baumann
and Rabii, 1991). The filly gained 2.5 kg over the next 2 days,
considered appropriate weight gain, and milk replacer was
then offered at 12-h intervals (Knight and Tyznik 1985). After 4
days of continued weight gain, milk replacer was
discontinued, and there were no further signs of rejection.
Ultrasound examinations were performed daily for the first
6 days, then every 48 h for four more days and then weekly
until discharge (35–41, 43, 45, 47, 55 and 61 days of
gestation). The ultrasound examinations on the mare were
carried out with a linear probe 5 MHz coupled with an
ultrasound machine (IBEX EVO II)8 using the manufacturer’s
settings for equine reproduction. During each examination,
ovarian structures (number and size of follicles and corpora
lutea) and pregnancy features (size of the gestational

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G. Podico et al.
a) b) c)
Fig 2: Representative images of excellent maternal behaviour of the broodmare during a-b) and after c) the grafting procedure.
vesicle, stage of development, embryonic/fetal heart rates)
were assessed (Fig 1, Table 3). The follicles and corpora lutea
were measured at two of the major diameters of each
structure and reported in Table 3. One clinician manually
counted the embryonic/fetal heart rates, and the mean value
of two assessments was reported (Table 3). The pregnancy
continued developing after the treatments with PGF2a; the
chorioallantoic cavity increased in size. No abnormalities were
noted in the pregnancy fluids, embryonic and fetal structures,
or embryonic and fetal heart rates. The two primary corpora
lutea decreased in size after PGF2a administration (Table 3).
Two large follicles developed on Days 38 and 40 of gestation;
one dose of deslorelin acetate (SucroMateTM, 1.8 mg, 1 mL, i.
m.)9 was administered on Day 38 of gestation to induce
ovulation. Two new corpora lutea were visualised on Days 40
and 45 of gestation. The peripheral progesterone
concentrations were assessed in serum samples at 35, 36, 37,
40 and 47 days of gestation (Fig 3). After a rapid decline,
progesterone’s serum concentration increased after the
detection of one corpus luteum on Day 40 and another one on
Day 45 of gestation (Fig 3). The administration of altrenogest
(0.044–0.088 mg/kg, per os, q. 24 h) was adjusted based on the
serum progesterone concentrations and perceived proximity
of abortifacient side effects of PGF2a. The mare received a
supratherapeutic dose of altrenogest (0.088 mg/kg, per os, q.
24 h) for 4 days (35–38 days of gestation), then a standard
therapeutic dose (0.044 mg/kg, per os, q. 24 h) from 39 to
46 days of gestation. The concentration of progesterone at
47 days of gestation was 13.2 ng/mL, and the altrenogest dose
was tapered off by 2–3 mL/day until none was administered at
50 days of gestation. The minimum threshold of serum
progesterone concentration for maintenance of pregnancy in
the first trimester has been suggested as ≥4 ng/mL (Shideler
et al. 1982). Once it became clear that the mare was
maintaining the pregnancy, Caslick’s vulvoplasty was
performed at 45 days of gestation to correct the poor vulvar
conformation. The client declined to have it performed initially
as the mare could have experienced early pregnancy loss
during the foal grafting with the PGF2a administrations. An early
pregnancy loss would have implied transvaginal procedures
and the removal the Caslick’s procedure; therefore, the client
elected to postpone it to not incur additional costs.
Outcome
The pair was kept in the hospital for 26 days after the foal
grafting onset due to the foal’s concurrent leucopenia. A
definitive diagnosis of the cause of leucopenia was not
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e5
d)
achieved. The filly was treated with chloramphenicol
(Vicetonâ, 1 g/tablet, 20 mg/kg bwt, per os, q. 6 h)10 until
the white blood cell count returned to within normal limits. At
the time of discharge from the hospital, the mare was
confirmed pregnant at 61 days of gestation (Fig 4a-b), and
the foal was apparently healthy. The pair was reported to be
clinically well 3 months after discharge; they were successfully
reintroduced into their herd, and the filly appeared in good
general systemic health (Fig 5). No objective follow-up (e.g.
physical examination, bloodwork) was performed. Per
communication with the referring veterinarian and farm
manager, 6 months after discharge from the hospital, the filly
(weighing 180 kg) and mare were reported to be apparently
healthy (Fig 6), and the mare remained pregnant. The stud
farm planned to wean off the filly within days after our last
communication.
Discussion
The present report described a clinical case in which the
induction of lactation and foal grafting were successfully
carried out in a nonparturient early pregnant mare. Induction
of lactation has been successfully carried out in mares and
other species involving a combination of ovarian steroids,
PGF2a and benzamide dopamine D2 antagonists (Chakriyarat
et al. 1978; Head et al. 1980, 1982; Daels et al. 2002; Porter
et al. 2002; Chavatte-Palmer et al. 2002). The combination of
these hormones provides satisfactory induction of lactation in
multiparous mares but unsatisfactory lactation in nulliparous
mares (Chavatte-Palmer et al. 2002). In the present case, the
mare was a multiparous Thoroughbred mare that had never
raised foals for a full lactation, so while her udder was
developed enough up to delivery, she never came into the
peak of an entire lactation. This history implies that,
potentially, the udder was never fully developed before this
case. This may explain the relatively slow response of the
mare to produce milk in response to ten days of benzamide
dopamine D2 antagonists and milking.
Widely used protocols for induction of lactation involve
administration of oestrogen, progesterone and PGF2a; this last
hormone is typically given at the end, after a few days of
ovarian steroid administration (Daels et al. 2002; Daels 2006).
Due to progesterone’s negative feedback on prolactin
secretions, it is desirable to induce luteolysis early in the
protocol for induction of lactation (Shand et al. 2000;
Chavatte-Palmer et al. 2002; Guillaume et al. 2003). A
retrospective study found that Arabian mares, a breed
known for having a high incidence of abnormal maternal
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e6 Induction of lactation, foal grafting, and maintenance of pregnancy in a mare

14
PGF2α Ovulation
*
12
Ovulation
10 *
Progesterone (ng/mL)

0
35 36 37 38 39 40 41 42 43 44 45 46 47
Day of gestation

Fig 3: Serum progesterone concentrations before and after the administration of PGF2a. The mare was administered 0.088 mg/kg, per
os of altrenogest at 35–38 days, and then 0.044 mg/kg, per os from 39 to 50 days of gestation.

D 61

*
*

* *

a) b)

Fig 4: Representative images of the accessory corpora lutea a) and fetal appearance b) of a 61-day pregnancy of a mare after
induction of lactation and adoption of an orphan foal. Images were obtained with a 5 MHz transrectal sectorial convex transducer.
*denotes luteal structure; ▲denotes fetus.

behaviour (Juarbe-Diaz et al. 1998), had high peripheral
concentrations of progesterone and low prolactin the day
after parturition when rejecting their foals (Berlin et al. 2018).
This finding, coupled with the present clinical case, suggests
that progesterone may play an important role in maternal
behaviour in mares.
In the authors’ experience, mares displaying regular
ovarian cyclic activity during the breeding season have no
need for exogenous ovarian steroid administration as oestrus
and dioestrus produce physiological changes in oestrogen
(oestrus) progesterone (dioestrus and luteolysis)
concentrations. In the present case, the mare was pregnant,
and the administration of PGF2a alone could have resulted in
pregnancy loss (Ginther 1985; Podico et al. 2020). It is possible
that high progesterone concentrations from double
ovulations between 25 and 35 days of gestation, followed by
altrenogest supplementation from 35 to 47 days of gestation,
and coupled with the fact that the mare had never fully
lactated slowed the initial milk production. In other
domesticated animals, progesterone is known to have a
direct inhibitory effect on prolactin release (Chamley et al.
1973; Erb et al. 1976). Interestingly, a study involving dioestrous
mares receiving PGF2a demonstrated that prolactin pulses
frequency and amplitude peaked at the nadir of
progesterone concentrations following luteolysis (Shand et al.
2000). However, the relationship between progesterone and
prolactin concentrations and maternal behaviour remains to
be better studied in horses.
It has been recommended that mares are producing 3–5 L
of milk in 24 h before foal adoption (Daels et al. 2002),
however, as this mare was not progressing as typical in our
practice (1.5 L and 2.4 L in 24 h, 2 days before and the day
before adoption). The authors elected to carry on with the
adoption and supplement the foal as needed. The presence
of offspring (visual, tactile and olfactory stimuli) is thought to
play a role in stimulating lactation in sheep (Kendrick et al.
1986; Poindron et al. 1988); a similar mechanism likely occurs
in horses (Wolski et al. 1980). In addition, foals are more

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G. Podico et al.
Fig 5: Mare and foal 3 months after adoption.
Fig 6: Filly at 6 months of age immediately before weaning.
efficient in harvesting milk than manual human extraction; it
has been proposed to use weaned foals from leased nurse
mare as an alternative to manual milking starting from the first
day of hormonal treatment (Steiner 2006). In retrospect, the
adoption could have been delayed two or more days to see
whether the mare would have enhanced milk production,
but it is possible that it could have caused further delay in the
full onset of lactation in this mare.
After the induction of lactation and foal adoption, it has
been advised to continue dopamine D2 antagonists for at
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e7
least 3 days to support lactation (Daels et al. 2002; Porter
et al. 2002). In the present case, the administration of sulpiride
was continued for 6 days after induction of lactation. In
periparturient mares, prolactin is the primary hormone that
initiates lactation after a drastic increase in the last week of
gestation. In barren mares, prolactin level increases after
administration of D2 antagonist (Worthy et al. 1986; Daels
et al. 2002). Once lactation is fully initiated, the role of
prolactin is limited, and its concentration could decline
without affecting milk production (Neuschaefer et al. 1991).
However, in hormonally induced lactation, the foal adoption
is typically performed while the mare is still going into peak
lactation; thus, the recommendation is to continue to
administer D2 antagonist after foal grafting for at least 3 days
(Daels et al. 2002; Porter et al. 2002). Once lactation was
apparently fully achieved, the dopamine D2 antagonist was
discontinued.
After 18–24 h post-adoption, the mare started to show
mild to moderate signs of rejection that could have been
missed by inexperienced eyes. Milk replacer was
supplemented not fully to replace the mare’s milk but rather
to keep the foal fed but hungry enough to continue to nurse
from the mare. In addition, acepromazine maleate, a
phenothiazine tranquiliser shown to stimulate prolactin release
in sheep and humans, was also administered to the mare
(Bryant et al. 1968). Acepromazine maleate causes muscle
relaxation, vasodilation and an increase of prolactin
concentrations in a dose-dependent manner. This drug
blocks pre- and post-synaptic dopamine D2 receptors,
decreasing circulating cAMP, adenylate cyclase activity,
alteration of potassium and calcium concentrations, and
potassium conductance and decrease of dopamine
concentrations (Rankin 2015). In the present case, stall
walking immediately decreased after the administration of
low doses of acepromazine. Benefits of acepromazine
maleate include the long-lasting effect and the anecdotal
lack of interference with the horse’s ability to eat while
tranquilised at low doses (0.01–0.05 mg/kg bwt, i.v./i.m./per
os). As adequate food intake is paramount for lactation, this
was a desirable effect. In hindsight, acepromazine maleate
administration could have been started earlier in the
lactation induction/foal grafting process and have been of
benefit. It was ultimately decided to postpone the
commencement of acepromazine administration to avoid
the risk that the tranquilising effects could have masked signs
of rejection. Another questionable point about the present
case is the use of a Thoroughbred mare to induce lactation
and foal adoption. The use of Thoroughbred mares has been
questioned by some authors, with the use of calmer breeds,
such as Quarter Horses, preferred (Korosue et al. 2012).
However, the use of a nursing mare coming from the same
farm as the foal offers a cost advantage in not having to
acquire a nursing mare and could also prevent the
introduction of diseases to the farm (Korosue et al. 2012).
Small farm owners are also reluctant to introduce new horses
to their property, which was the case for the present mare
owner. In the present case, the Thoroughbred mare used
came from the same farm as the foal, similar to Korosue et al.
(2012). However, in the present case, the provided
nonparturient Thoroughbred mare was also pregnant during
the induction of lactation and foal adoption.
Before 35 days of gestation, equine pregnancy is more
vulnerable to the abortifacient action of PGF2a as the
© 2021 EVJ Ltd

e8 Induction of lactation, foal grafting, and maintenance of pregnancy in a mare
maintenance of pregnancy is entirely dependent on the
progesterone produced by the primary corpus luteum and
abrupt luteolysis induced by PGF2a administration generally
leads to pregnancy loss (Ginther 1985). If the mare in the
present case had lost her pregnancy between foal grafting
(35 days of gestation) and discharge (61 days of gestation)
from the hospital, it would have been difficult to differentiate
between an expected pregnancy loss of 6% between 15 and
42 days of gestation in Thoroughbreds for various causes not
related to exogenous PGF2a administration (Rose et al. 2018).
Due to the high odds for pregnancy loss in mares receiving
exogenous PGF2a analogs (Daels et al. 1995; Daels et al.
1996), the use of pregnant mares for foal grafting should be
restricted to select cases where the orphan foal is prioritised
over the ongoing pregnancy in utero. Luteolysis was
documented to occur shortly after initial PGF2a administration.
Progesterone concentrations were 10.2 ng/mL on Day 35 and
then 2.76 ng/mL on Day 36 of gestation, and it was 0.54 ng/
mL on Day 39 of gestation. Interestingly, since the mare had
two large pre-ovulatory follicles on Days 39 and 44, ovulation
was induced on Day 39, and two corpora lutea were
identified on Days 40 and 45 of gestation. These two
ovulations raised progesterone concentrations to 13.2 ng/mL,
which was deemed enough (≥4 ng/mL) to maintain
pregnancy in this mare (Shideler et al. 1982).
Once exogenous PGF2a is administered, the mare
responds by producing more endogenous PGF2a, as
evidenced by an increase in PGFM, an inactive metabolite
of PGF2a (Daels et al. 1996). Interestingly, PGFM was reduced
in pregnant mares challenged with the administration of
cloprostenol sodium (250 lg, i.m., q. 24 h) but also
supplemented with altrenogest (0.044 mg/kg per os q. 24 h)
when compared to mares treated with cloprostenol but not
treated with altrenogest (Daels et al. 1996). In addition, none
of the mares (8/8) treated with cloprostenol and altrenogest
aborted, whereas all mares aborted (6/7) when treated with
cloprostenol alone, with one out of seven not aborting when
treated with cloprostenol and flunixin meglumine (500 mg i.v.
q. 8 h) (Daels et al. 1995, 1996). While the concentration of
PGFM was not assessed in the present case report, the
amount of PGF2a administered was certainly enough to
cause abortion should this mare have not been
supplemented with altrenogest.
Sulpiride is preferred over domperidone to induce
lactation in mares. While one study reported similar total milk
production in mares treated with either product, studies
overwhelmingly recommend using sulpiride over
domperidone (Daels et al. 2002; Chavatte-Palmer et al. 2002;
Guillaume et al. 2003). One huge disadvantage is that the
oral product has low bioavailability (~20%), thus requiring
parenteral administration (Giorgi et al. 2013). Each injection
involves a large volume of product (i.e. 14 mL twice a day, in
the present case), which is administered intramuscularly. The
half-life (~9 h) of sulpiride is rather short, requiring
administration twice a day to maintain adequate blood
concentrations (Giorgi et al. 2013). Commonly, serial
injections of large volume of compounded medication cause
local swelling and tenderness. In the authors’ experience,
mares could become sensitised to repeated injections after
initial treatments. Surprisingly, the mare of the present case
did not develop an excessive local reaction or display
behavioural changes.
© 2021 EVJ Ltd
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The adoption protocol used here has been commonly
used at the University of Illinois for the past 5 years (>30 mares
treated). After 15–20 min of dinoprost, if the mare does not
show signs of maternal behaviour, cloprostenol is added to
the protocol. The authors have tried administering a larger
dose of dinoprost, and mares become extremely
uncomfortable, and the adoption protocol does not seem
effective. The authors also have attempted to use large
doses of cloprostenol, such as 1000–1250 lg, and mares do
not respond satisfactorily to it, and foal adoption is not
successful. Vagino-cervical stimulation is routinely performed
if the mare fails to respond to the combination of dinoprost
and cloprostenol. Oxytocin is not administered to the mare
unless it needs to be used as an ecbolic to treat intrauterine
fluid accumulation.
The authors routinely administer butorphanol tartrate once
the foal latches on the mare. This drug is included for its
analgesic properties and for presumably mimicking
endogenous release of opioids in the brain during suckling.
Studies in rodents and sheep have shown that endogenous
and exogenous opioids cause hyperprolactinaemia (Knight
et al. 1986; Baumann and Rabii 1991). Specifically, in
mammals, suckling results in a release of endogenous opioids,
which bind to mu and kappa receptors, causing a release of
prolactin and inhibition of LH secretion (Baumann and Rabii
1991). While single doses of butorphanol were shown to
increase prolactin concentrations in humans (Franceschini
et al. 1989), it is unknown whether butorphanol increases
prolactin in horses. Opioid receptors (mu, kappa and delta)
are G-protein-coupled receptors that are once activated by
an agonist or a competitive antagonist, resulting in
decreased cAMP production and downregulation of
adenylate cyclase (Kukanich and Wiese 2015). The analgesic
effect is produced by reduced excitatory molecules of
nociceptors and elevation of the activation threshold.
Specifically, butorphanol interacts with mu receptors, as a
competitive antagonist and partial agonist, and with kappa
receptors as an agonist (Kukanich and Wiese 2015). Its
analgesic properties are somewhat dose-dependent and do
not increase after a specific dose (Kukanich and Wiese 2015).
In the present case, the pain level was low, and the need for
both sedation and mild analgesia led us to use butorphanol
(Kukanich and Wiese 2015). Antagonist properties of
butorphanol with mu receptors prevent the hyperexcitement
associated with the opioid administration in horses (Gozalo-
Marcilla et al. 2015). This represented a desirable feature for
the present case (Gozalo-Marcilla et al. 2015).
If the mare fails to accept the foal or does not display
fully satisfactory maternal behaviour, the authors elect to
repeat PGF2a administrations 2–3 days in a row. In our clinic,
mare and foal are only put together after adoption if the
mare shows strong maternal behaviour over 6–12 h of careful
observation. The mare in the present case could have given
the false idea that it was safe to house the foal with her after
the first attempt. While the mare showed positive maternal
behaviour after the first round, the foal’s lack of a strong suck
reflex resulted in the mare losing interest in the foal overnight.
Though the maternal behaviour after the first round of
dinoprost could have discouraged some practitioners, a
second round was necessary. It is possible that altrenogest
supplementation given to prevent pregnancy loss could have
been the reason for the need for a second treatment. It

G. Podico et al.
remains to be determined whether altrenogest interferes with
maternal–foal bounding.
Flunixin meglumine is typically included as part of our foal
grafting protocol for its analgesic properties. Nursing foals
tend to be aggressive while suckling, some can be
compulsive such as suckling every 5 min and maybe
relatively old when adoption is performed. Under
physiological conditions, when the foal is delivered, it has a
small mouth and is gentle at suckling and then gradually
stimulates lactation and gives time for the mare’s udder to
adjust to lactation. Conversely, mares with induced lactation
and adoption may have older foals that bypass the initial
lactation phase. It is not uncommon for mares to start
displaying signs of rejection (e.g. stall walking and lifting a
hindleg) despite remaining deeply interested and bonded to
the foal. The authors interpret this as a sign of discomfort, not
necessarily full rejection. Thus, flunixin meglumine and, at
times, butorphanol are used to manage those cases. In the
present case, even though the filly had a small frame, her
appetite and oral development was past the newborn’s
state.
Conclusion
In conclusion, the present report described a unique case in
which lactation was induced poorly at the beginning, and
then, foal adoption and additional drugs administered
helped the mare come into full lactation and accepting the
foal. Administration of PGF2a fully induced luteolysis, and
altrenogest administration prevented pregnancy loss.
Practitioners facing similar cases in the field can use the
description of the present case as a foundation to establish a
successful therapeutic plan to induce lactation in a pregnant
mare.
Acknowledgements
The authors are thankful to one anonymous reviewer for the
providential critiques and suggestions.
Authors’ declaration of interests
No conflicts of interest have been declared.
Authorship
All authors contributed to the management of the case.
Ethical animal research
Not applicable.
Manufacturers’ addresses
1
Dechra Veterinary Products, Overland Park, Kansas, USA.
2
Hagyard Pharmacy, Lexington, Kentucky, USA.
3
Land O’ Lakes Animal Milk Products Company, Arden Hills,
Minnesota, USA.
4
Merck Animal Health, Kenilworth, New Jersey, USA.
5
Zoetis Animal Health, Parsippani, New Jersey, USA.
6
MWI Animal Health, Boise, Idaho, USA.
7
Covetrus, Dublin, Idaho, USA.
8
E.I. Medical Imaging, Loveland, Colorado, USA.
9
Thorn BioScience LCC, Louisville, Kentucky, USA.
10
Bimeda US, Oakbrook Terrace, Illinois, USA.
20423292, 2022, 1, Downloaded from https://beva.onlinelibrary.wiley.com/doi/10.1111/eve.13448 by University Of Illinois At, Wiley Online Library on [08/04/2024]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License
e9
References
Baumann, M.H. and Rabii, J. (1991) Inhibition of suckling-induced
prolactin release by mu and kappa-opioid antagonists. Brain Res.
567, 224-230.
Berlin, D., Steinman, A. and Raz, T. (2018) Post-partum concentrations
of serum progesterone, oestradiol and prolactin in Arabian mares
demonstrating normal maternal behaviour and Arabian mares
demonstrating foal rejection behaviour. Vet. J. 232, 40-45.
Bryant, G.D., Connan, R.M. and Greenwood, F.C. (1968) Changes in
plasma prolactin-induced by acepromazine in sheep. J.
Endocrinol. 41, 613-614.
Chakriyarat, S., Head, H.H., Thatcher, W.W., Neal, F.C. and Wilcox, C.J.
(1978) Induction of lactation: lactational, physiological, and
hormonal responses in the bovine. J. Dairy Sci. 61, 1715-1724.
Chamley, W.A., Buckmaster, J.M., Cerini, M.E., Cumming, I.A., Goding, J.
R., Obst, J.M., Williams, A. and Winfield, C. (1973) Changes in the
levels of progesterone, corticosteroids, estrone, estradiol-17beta,
luteinizing hormone, and prolactin in the peripheral plasma of the
ewe during late pregnancy and at parturition. Biol. Reprod. 1, 30-35.
Chavatte-Palmer, P., Arnaud, G., Duvaux-Ponter, C., Brosse, L., Bougel,
S., Daels, P., Guillaume, D.,  ment, F. and Palmer, E. (2002)
Cle
Quantitative and qualitative assessment of milk production after
pharmaceutical induction of lactation in the mare. J. Vet. Intern.
Med. 16, 472-477.
Coffman, E.A. and Pinto, C.R. (2016) A review on the use of
prostaglandin F2a for controlling the estrous cycle in mares. J.
Equine Vet. Sci. 40, 34-40.
Cymbaluk, N., Smart, M., Bristol, F. and Pouteaux, V. (1993)
Importance of milk replacer intake and composition in rearing
orphan foals. Can. Vet. J. 34, 479-486.
Daels, P.F. (2006) Induction of lactation and adoption of the orphan
foal. Proc. Am. Assoc. Equine Practnrs. 42, 1-6.
Daels, P.F., Besognet, B., Hansen, B., Mohammed, H., Odensvik, K. and
Kindahl, H. (1996) Effect of progesterone on prostaglandin F2a
secretion and outcome of pregnancy during cloprostenol-induced
abortion in mares. Am. J. Vet. Res. 57, 1331-1337.
Daels, P.F., Duchamp, G. and Porter, D. (2002) Induction of lactation
and adoption of foals by non-parturient mares. Proc. Am. Assoc.
Equine Practnrs. 48, 68-71.
Daels, P.F., Mohammed, H.O., Odensvik, K. and Kindahl, H. (1995)
Effects of flunixin meglumine on endogenous prostaglandin F2
alpha secretion during cloprostenol-induced abortion in mares.
Am. J. Vet. Res. 56, 1603-1610.
Erb, R.E., Monk, E.L., Mollett, T.A., Malven, P.V. and Callahan, C.J.
(1976) Estrogen, progesterone, prolactin and other changes
associated with bovine lactation induced with estradiol-17b and
progesterone. J. Anim. Sci. 42, 644-654.
Ermisch, A., Ruhle, H.J., Landgraf, R. and Hess, J. (1985) Blood-brain
barriers and peptides. J. Cereb. Blood Flow Metab. 5, 350-357.
Franceschini, R., Venturini, P.L., Cataldi, A., Barreca, T., Ragni, N. and
Rolandi, E. (1989) Plasma beta-endorphin concentrations during
sucklings in lactating women. Br. J. Obst. Gynaecol. 6, 711-713.
Fuchs, A. (1987) Prostaglandin F2alpha and oxytocin interactions in
ovarian and uterine function. J. Steroid Biochem. 27, 1073-1080.
Ginther, O.J. (1985) Embryonic loss in mares: nature of loss after
experimental induction by ovariectomy or prostaglandin F2alpha.
Theriogenology 24, 87-98.
Giorgi, M., Ozdemir, M., Camillo, F. and Panzani, D. (2013)
Pharmacokinetics of sulpiride after intravenous, intramuscular, and
oral single-dose administration in nurse mares. J. Equine Vet. Sci.
33, 533-538.
Gozalo-Marcilla, M., Gasthuys, F. and Schauvliege, S. (2015) Partial
intravenous anaesthesia in the horse: a review of intravenous
agents used to supplement equine inhalation anaesthesia. Part 2:
opioids and alpha-2 adrenoceptor agonists. Vet. Anaesth. Analg.
42, 1-16.
Guillaume, D., Chavatte-Palmer, P., Combarnous, Y., Duchamp, G.,
Martinat, N., Nagy, P. and Daels, P.F. (2003) Induced lactation with
© 2021 EVJ Ltd

e10 Induction of lactation, foal grafting, and maintenance of pregnancy in a mare
a dopamine antagonist in mares: different responses between
ovariectomized and intact mares. Reprod. Domest. Anim. 38, 394-
400.
Head, H.H., Chakriyarat, S., Thatcher, W.W., Wilcox, C.J. and Becker, H.
N. (1982) Induction of lactation: comparison of injections of
estradiol—17b and progesterone for 7 or 21 days on prolactin
response to thyrotropin releasing hormone and milk yield in dairy
cattle. J. Dairy Sci. 65, 927-936.
Head, H.H., Delouis, C., Terqui, M., Kann, G. and Djiane, J. (1980)
Effects of various hormone treatments on induction of lactation in
the ewe. J. Anim. Sci. 50, 706-712.
Houpt, K.A. (2000) Equine maternal behavior and its aberrations. In:
Recent Advances in Companion Animal Behavior Problems, Ed: K.
A. Houpt, International Veterinary Information Service, New York.
Houpt, K.A. and Mills, D.S. (2006) Why horse behaviour is important to
the equine clinician. Equine Vet. J. 38, 386-387.
Juarbe-Diaz, S.V., Houpt, K.A. and Kusunose, R. (1998) Prevalence and
characteristics of foal rejection in Arabian mares. Equine Vet. J. 30,
424-428.
Kendrick, K.M., Keverne, E.B., Baldwin, B.A. and Sharman, D.F. (1986)
Cerebrospinal fluid levels of acetylcholinesterase, monoamines
and oxytocin during labour, parturition, vaginocervical stimulation,
lamb separation and suckling in sheep. Neuroendocrinology 44,
149-156.
Knight, P.G., Howles, C.M. and Cunningham, F.J. (1986) Evidence that
opioid peptides and dopamine participate in suckling-induced
release of prolactin in the ewe. Neuroendocrinology 44, 29-35.
Knight, D.A. and Tyznik, W.J. (1985) The effect of artificial rearing on
the growth of foals. J. Anim. Sci. 60, 1-5.
Korosue, K., Murase, H., Sato, F., Ishimaru, M., Harada, T., Watanabe,
G., Taya, K. and Nambo, Y. (2012) Successful induction of lactation
in a barren thoroughbred mare: Growth of a foal raised on
induced lactation and the corresponding maternal hormone
profiles. J. Vet. Med. Sci. 74, 995-1002.
Kukanich, B. and Wiese, A.J. (2015) Opioids. In: Veterinary Anesthesia
and Analgesia: The Fifth Edition of Lumb and Jones. Eds: K.A.
Grimm, L.A. Lamont, W.J. Tranquilli, S.A. Greene and S.A.
Robertson, Wiley-Blackwell, Ames. pp 207-226.
Meisenberg, G. and Simmons, W.H. (1983) Minireview. Peptides and
the blood-brain barrier. Life Sci. 32, 2611-2623.
Naylor, J.M. and Bell, R. (1985) Raising the orphan foal. Vet. Clin. North
Am. Equine Pract. 1, 169-178.
© 2021 EVJ Ltd
20423292, 2022, 1, Downloaded from https://beva.onlinelibrary.wiley.com/doi/10.1111/eve.13448 by University Of Illinois At, Wiley Online Library on [08/04/2024]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License
Neuschaefer, A., Bracher, V. and Allen, W.R. (1991) Prolactin secretion
in lactating mares before and after treatment with bromocriptine.
J. Reprod. Fertil. Suppl. 44, 551-559.
Paradis, M.R. (2012) Feeding the orphan foal. Proc. Am. Assoc. Equine
Practnrs. 48, 402-406.
Podico, G., Canisso, I.F., Ellerbrock, R.E., Dias, N.W., Mercadante, V.R.
G. and Lima, F.S. (2020) Assessment of peripheral markers and
ultrasonographic parameters in pregnant mares receiving
intramuscular or intrauterine cloprostenol. Theriogenology 142, 77-
84.
 vy, F. and Krehbiel, D. (1988) Genital, olfactory, and
Poindron, P., Le
endocrine interactions in the development of maternal behaviour
in the parturient ewe. Psychoneuroendocrinology 13, 99-125.
Porter, R.H., Duchamp, G., Nowak, R. and Daels, P.F. (2002) Induction
of maternal behavior in non-parturient adoptive mares. Physiol.
Behav. 77, 151-154.
Rankin, D.C. (2015) Sedatives and tranquilizers. In: Veterinary
Anesthesia and Analgesia: The Fifth Edition of Lumb and Jones.
Eds: K.A. Grimm, L.A. Lamont, W.J. Tranquilli, S.A. Greene and S.A.
Robertson, Wiley-Blackwell, Ames. pp 196-206.
Rose, B.V., Firth, M., Morris, B., Roach, J.M., Wathes, D.C., Verheyen, K.
L.P. and de Mestre, A.M. (2018) Descriptive study of current
therapeutic practices, clinical reproductive findings and incidence
of pregnancy loss in intensively managed thoroughbred mares.
Anim. Reprod. Sci. 188, 74-84.
Shand, N., Irvine, C.H., Turner, J.E. and Alexander, S.L. (2000) A
detailed study of hormonal profiles in mares at luteolysis. J. Reprod.
Fertil. Suppl. 56, 271-279.
Shideler, R., Squires, E., Voss, J., Eikenberry, D. and Pickett, B.W. (1982)
Progestagen therapy of ovariectomized pregnant mares. J.
Reprod. Fertil. Suppl. 32, 459-464.
Steiner, J. (2006) How to induce lactation in nonpregnant mares. Proc.
Am. Assoc. Equine Practnrs. 52, 259-260.
Stoneham, S.J., Morresey, P. and Ousey, J. (2017) Nutritional
management and practical feeding of the orphan foal. Equine
Vet. Educ. 29, 165-173.
Wolski, T., Houpt, K. and Aronson, R. (1980) The role of the senses in
mare-foal recognition. Appl. Anim. Ethol. 6, 121-138.
Worthy, K., Escreet, R., Renton, J.P., Eckersall, P.D., Douglas, T.A. and
Flint, D.J. (1986) Plasma prolactin concentrations and cyclic
activity in pony mares during parturition and early lactation. J.
Reprod. Fert. Suppl. 569-574.