History repeats itself: A mare, her filly, and a clinician who treated them both in their first days of life
Continentalcongres arrived at the Marion duPont Scott Equine Medical Center in Leesburg on a chilly February evening, accompanying her distressed newborn filly.
The emergency team, led by Megan Marchitello, clinical instructor of equine medicine, started their initial evaluation on the foal – and then Marchitello recognized the mare.
Similarly to her filly, Continentalcongres was born on the coldest day seven years earlier in February 2019 and required urgent veterinary care within the first hours of her life, her emergency team also led by Marchitello.
After unexpected complications during her foaling, Continentalcongres suffered from severe hypoxic ischemic encephalopathy, also known as Neonatal Maladjustment Syndrome (NMS) or “dummy foal syndrome.” It is a brain injury caused by reduced oxygen and blood flow during birth, sepsis, and frostbite.
Upon arrival at the center in 2019, Continentalcongres was unresponsive and severely hypothermic with a body temperature of 92.6 degrees. The team spent two weeks nursing her back to health, one tube feeding at a time. A small scar – a remnant of frostbite - remained on her hind quarters which made her easily recognizable to Marchitello.
“Dr. Megan slept in the stall with Continentalcongres for five nights when she was born and hospitalized,” said Tracy Mulroy, “Incredibly special and definitely above and beyond what most vets do; she is a special vet!”
Since her discharge from the hospital as a neonate, Continentalcongres competed successfully as a racehorse and now had a filly of her own, in need of the same medical team.
A foal in trouble
The new foal, Continentalcongres 26, owned by Tracy Mulroy and Kelly Caraballo of Legacy Farm in Bluemont, Virginia, had been born without obvious complication. But at three days of age, she was sent to the Equine Medical Center for signs of lethargy and decreased nursing.
Ultrasound quickly found that she had fractured six ribs, with four showing displacements toward her heart.
The fractures were likely sustained during birth. Even when foaling appears uneventful, the forces through the pelvic canal can cause serious injury. The clinical team, led by Marchitello, stabilized the filly with intravenous fluids, multimodal analgesia, and broad-spectrum antibiotics and monitored her through the night. Serial ultrasounds showed progressive fracture displacement, with her ribs moving closer to critical internal structures.
It was decided by the following morning that surgical repair would be the best option for the foal.
“We identify non-displaced or minimally displaced rib fractures via ultrasound with relative frequency on our neonatal patients here at the center," said Marchitello. "Most foals are minimally symptomatic, experiencing high respiratory rates or slight swelling on one side of the chest. While most of these cases respond well to conservative management and close veterinary supervision, rib displacement poses a risk for trauma of adjacent structures like the heart, the lungs, or the diaphragm. In these cases, surgical correction is recommended. Surgical fixation of rib fractures, though it sounds daunting, provides a good prognosis not just for survival, but for athleticism.”
The surgical team, led by Elsa Ludwig, clinical assistant professor of equine surgery, assisted by surgery resident Bruno Malacarne, stabilized ribs three through six with heavy-gauge suture and closed the overlying skin with absorbable sutures. A compressive bandage was wrapped circumferentially around the filly's thorax. She recovered well, and by that afternoon, she was nursing freely and cantering circles around her dam.
Post-operative thoracic imaging and blood work were performed and showed no signs of internal injury or infection. Four days after arriving, the filly was discharged home with a retrofitted small animal recovery jacket to protect her sutures.
What the Equine Medical Center offers
This filly's case illustrates the value of around-the-clock monitoring and rapid surgical capability at a referral center. Rib fractures in neonatal foals can escalate quickly displaced bone near the heart, or lungs creates risk of arrhythmia, hemothorax, and lung contusion. The window for intervention is narrow, and the decisions require continuous imaging, experienced clinical judgment, and surgical readiness.
The Marion duPont Scott Equine Medical Center, one of three teaching hospitals and animal healthcare facilities of the Virginia-Maryland College of Veterinary Medicine, is one of the region's premier equine referral hospitals, offering intensive care for neonatal foals, emergency surgery, and advanced diagnostic imaging. The center sees complex cases from across Virginia, Maryland, and beyond.
A circle of care
For Marchitello, the 2026 admission carried a particular weight.
The foal she helped save seven years earlier had grown up, carried pregnancy to term, and returned to the same building where her own life had begun in crisis. The filly born in 2019 — who once required tube feedings every two hours and continuous IV drips to maintain normal respirations and blood pressures — had become a healthy broodmare.
Her daughter, now recovering at home in Bluemont, Virginia, is expected to heal fully. The bony callus that forms at the fracture sites may be palpable for years, but it should not affect her use or athletic future.
Owners of mares and foals who have concerns following foaling are encouraged to contact their primary care veterinarian promptly. Early evaluation of a foal that is slow to stand, reluctant to nurse, or showing signs of discomfort can make a significant difference in outcome.
