Researched by
Dr. Jenna Thebeau
Verified by
Dr. Jo Myers
Published on
Last updated on
4 min read

Key takeaways

Sepsis, or septicemia, is an infection of the blood caused by bacteria or bacterial toxins (endotoxins). Foals become infected with harmful bacteria in utero or after birth from environmental bacteria.

  • Septicemia is the most common cause of death in neonatal foals and is commonly diagnosed in foals under 4 weeks of age
  • Symptoms associated with septicemia include lethargy, inability to stand unassisted, a poor suckling response, red or pale gums, cold extremities, rapid breathing, and reduced temperature or fever
  • A diagnosis of septicemia requires blood tests to confirm inflammation and bacterial infection
  • Treatment is intensive, lasting 1-4 weeks, consisting of both therapeutic treatment and supportive care
  • Foal septicemia is an emergency, and a favorable prognosis is dependent on rapid diagnosis and treatment
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A closer look: Sepsis (Septicemia) in Foals

Foals are highly vulnerable to infection in the weeks immediately after birth as their immune system is developing. Without careful monitoring and effective nursing, infection may develop from multiple sources of bacteria.

Septicemia is commonly diagnosed in foals less than 4 weeks of age and is the most common cause of neonatal death. The severity of infection depends on how quickly the condition is diagnosed, the aggressiveness and response to treatment, and the organs affected.

Risk factors

Certain factors increase the risk of developing septicemia.

Foal septicemia is an emergency, and a good prognosis depends on an early diagnosis and aggressive treatment.

A variety of symptoms are possible with sepsis as many tissues and organs can be impacted. Advanced cases of sepsis can lead to infection and failure of several organs (termed multiple organ dysfunction syndrome).

Possible causes

Common routes of exposure to bacteria include:

  • Ingestion
  • Inhalation
  • Contamination of the umbilical cord leading to omphalophlebitis
  • Bacterial placentitis causing infection of the foal while in the womb

Main symptoms

Testing and diagnosis

The diagnosis of septicemia requires:

  • Physical examination
  • Blood work
  • Blood culture (to identify the causative bacterial agent)
  • Plasma immunoglobulin concentration (to determine if there was failure of passive transfer)
  • Diagnostic imaging such as ultrasound or x-rays to identify affected tissues

Steps to Recovery

Treating foals with septicemia is extremely labor intensive, requiring both medical treatment and supportive care.

Treatment may include:

  • Antibiotics
  • Anti-inflammatories
  • Plasma transfusion
  • Nutritional support such as placement of a feeding tube
  • Fluid therapy
  • Oxygen therapy
  • Warming of the foal to raise body temperature

The average length of treatment is 1-4 weeks. Although septicemia is the most common cause of death in neonatal foals, most foals that recover can have successful athletic careers. Foals that develop infections of the joints have a poorer prognosis for athletic performance later in life. Foals that are treated at specialty hospitals have the best outcome.


Foal septicemia can be prevented by:

  • Supervising labor and foaling
  • Having a clean foaling area
  • Cleaning the mare before and after foaling
  • Ensuring the foal ingests good quality colostrum soon after birth
  • Checking plasma immunoglobulin levels in the foal and in colostrum
  • Dipping the umbilicus in diluted chlorhexidine or povidone-iodine solution

Is Sepsis (Septicemia) in Foals common?

This is a common condition in neonatal foals.

Typical Treatment

Veterinary treatment may include:

  • Antibiotics
  • Anti-inflammatories
  • Plasma transfusions
  • Fluid therapy
  • Supportive care


No Author - Writing for MSD Animal Health
Daniela Bedenice , DVM, DACVIM, DACVECC - Writing for Merck Veterinary Manual
Daniela Bedenice , DVM, DACVIM, DACVECC - Writing for Merck Veterinary Manual
No Author - Writing for Zuku Review
Amanda Martabano House, DVM, Dipl. ACVIM - Writing for The Horse
Erica Larson - Writing for The Horse
Allison Stewart, BVSc (hons), MS, DACVIM-LAIM, DACVECC - Writing for dvm360®
Allison Stewart, BVSc (hons), MS, DACVIM-LAIM, DACVECC - Writing for dvm360®

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