Disorder of Gravid Uterus Flashcards
What are 3 complications that can be seen during pregnancy in a mare?
- Early embryonic death (EED)
- Abortion
- Twins
What are the 3 layers of fetal membranes associated with the embryo?
- Amnion
- Allantoamnion
- Allantochorion
Death in the absence of bacterial infection causes what?
Mummification
What are 3 things associated with mummification in the mare?
- Loss of fetal fluid
- Uterus contracted around fetus
- Secondary to twins
A dead fetus with bacterial contamination is referred to as what?
Maceration
Which bacteria is the most common cause of maceration in mares?
Strep zooepidemicus
Is the mare usually systemically ill when maceration occurs?
No
What should be done when a macerated fetus is present?
Remove the fetus then lavage the uterus and give antibiotics.
Normal amniotic fluid depth should not exceed what in the mare?
7.9 +/- 3.5 cm
Normal allantoic fluid depth should not exceed what in the mare?
13.4 +/- 4.4 cm
What is the most reliable parameter to indicate fetal well-being?
How is this obtained?
- Fetal heart rate (FHR)
- M-mode echocardiography
What are 5 possibilities of clinical signs that can be seen with placentitis in the mare?
- Purulent vulval discharge (often not present)
- Udder development
- Premature lactation
- Cervical dilation
- No clinical signs
What are the 2 most common bacteria seen with placentitis in the mare?
- Strep zooepidemicus
- E. coli
What are 3 types of drugs that can be given when treating ascending placentitis?
- Antibiotics
- NSAIDs
- Uterine relaxants
What are 2 antibiotics that can be used when treating ascending placentitis?
- TMS
- Gentocin
What is an NSAID that can be used when treating ascending placentitis?
Flunixin meglumine
What is a uterine relaxant that can be used when treating ascending placentitis?
Regumate
What is the most common hydropic condition seen in mares?
Hydro-allantois
What are 2 clinical signs that can be see with hydropic conditions with mares?
- Sudden onset of abdominal distention
- Mare can be slightly painful
What are 2 hydropic conditions that can be seen in mares?
Which one is more common?
- Hydro-allantois (more common)
- Hydro-amnion
What are 2 possible findings on a rectal examination of a mare with a hydropic condition?
- Difficult to ID foal due to excessive fluid
- Defective foal, small for gestational age
What needs to be done for a mare with a hydropic condition?
Need to induce abortion
Is hydrops allantois common or rare?
Rare
How quickly does distention develop with hydrops allantois?
Fast: over 10-14 days
What are 3 clinical signs that can be seen with hydrops allantois?
- Reluctance to move
- Altered gait
- Dyspnea
Hydrops allantois usually presents when in a mare during the pregnancy?
After the 7th month
How much fluid can be expelled with hydrops allantois?
120-200 L of fluid
What are 3 possible causes of hydrops allantois?
- Genetic
- Placentitis
- Torsion of amnion and umbilicus
Can the fetus be palpated with hydrops allantois?
Difficult/impossible to palpate fetus
What is the treatment for hydrops allantois?
Induce abortion
What are 3 steps for inducing abortion in a mare with hydrops allantois?
- Manually dilate cervix slowly and puncture membrane
- Try to get slow release of fluids (about 30 minutes)
- Give oxytocin (10-20 IU) every 30 minutes until delivery occurs
What may follow delivery after abortion has been induced with hydrops allantois?
Hypovolemic shock
What are 4 possible complications that can be seen with hydrops allantois?
- Prepubic tendon rupture
- Herniation
- abdominal muscle rupture
- Uterine rupture
What are 3 things that should be closely monitored for after treatment for hydrops allantois?
- Retained placenta
- Metritis
- Laminitis
Should a mare just treated for hydrops allantois be rebred on her foal heat?
Why?
- No
- Uterine involution is delayed
Is hydrops amnii rare or common in horses?
Rare (3 reported cases in literature)
What might hydrops amnii be associated with?
Fetal abnormalities
Is the fetus easy or difficult to see and feel with hydrops amnii?
Difficult
How quickly does fluid accumulate with hydrops amnii?
Slow: over weeks to months
Will a mare that has hydrops amnii have a predisposition to reoccurrence of the condition?
No
Prepubic tendon rupture is most commonly seen in what type of horses?
Heavy draft breeds
Prepubic tendon rupture can be sen with what 3 conditions?
- Hydrallantois
- Large fetus
- Twins
What can be seen with prepubic tendon rupture?
10-20 cm thick plaque on ventral abdomen
T/F: Prepubic tendon rupture may occur suddenly.
True
What happens to the udder of a mare with prepubic tendon rupture?
Looses support, becomes swollen and congested
What diagnostic tool can be used to look at the muscle/tendon to evaluate integrity with a prepubic tendon rupture?
US
What type of examination can be used with a prepubic tendon rupture and what does it demonstrate?
- Rectal exam
- Demonstrates abdominal floor falling away from pelvis
If the object is the save a foal that is near term with a prepubic tendon rupture, what should be done?
Support with sling or heavy canvas
If the object is to save the mare with a prepubic tendon rupture, then what should be done?
Induce parturition (will need assistance with delivery)
What usually happens to the mare if the prepubic tendon rupture is a full rupture?
Euthanized
If the prepubic tendon rupture is a partial tear, can the mare be rebred?
No, do not rebreed
What are 3 forms of supportive care that can be used with a prepubic tendon rupture?
- Support abdomen
- Medicate for pain as needed
- Give anti-inflammatories
Is uterine torsion common or rare in a mare?
Why?
- Relatively rare
- Due to dorsal uterine attachment of broad ligament
When are uterine torsions most commonly seen in the mare?
Mid-late term (5-10 months)
Most uterine torsions in the mare are limited to what degree of rotation?
180 degree rotation
Pain may not be seen if the uterine torsion is less than what degree?
Less than 180 degrees
Uterine torsions greater than what degree are usually painful, creating low grade colic that doesn’t respond well to analgesics?
Greater than 180 degrees
Uterine torsion might lead to what condition?
Uterine rupture or hemorrhage
How is diagnosis of uterine torsion confirmed?
Palpation per rectum
Does a uterine torsion in a mare usually involve the vagina and cervix?
No
Chronic uterine torsion may cause what?
Necrosis of broad ligaments and difficulty in using palpation for diagnosis.
What are 2 forms of treatment for uterine torsion?
- Left flank laparotomy
- Rolling mare with a plank on her flank
Even if a uterine torsion is corrected, what might still happen?
Fetus may still be aborted within the next few weeks.
Rolling to correct uterine torsion can be done at what point during gestation?
Early stages of last trimester
If the foal is dead in a torsed uterus, what type of approach can be used?
Ventral midline
What are 5 clinical signs that may be seen with chronic uterine torsion?
- Pyrexia
- Anemia
- Tachycardia
- Anorexia
- Depression
What are 3 differentials for colic in the late-term mare?
- Gastrointestinal
- Fetal movements
- Uterine torsion
What might be the cause of colic in a late-term mare experiencing moderate to severe pain that is difficult to examine rectally?
Gastrointestinal
What might be the cause of colic in a late-term mare that appears to be temporary with acute onset?
Fetal movements
What might be the cause of colic in a later-term mare with low grade pain of prolonged duration that is refractory to painkillers?
Uterine torsion
T/F: Signs of colic in a pregnant mare is considered to be an emergency.
True
Vaginal varicose veins are more common in what age mare?
Older multiparous mares near the end of gestation.
What are 3 treatments for vaginal varicose veins?
- Ligation
- Cautery
- Laser ablation
What is a clinical sign that might be seen with vaginal varicose veins?
Slight recurrent vaginal bleeding
When are 2 times uterine rupture can be seen?
- Pre-foaling
- During parturition
What are 3 possible causes of uterine rupture?
- Mutation and fetotomy
- Violent intrapartum movements
- Hydrops
Will uterine ruptures always present right away clinically?
No, may show no signs initially.
What are 4 ways to diagnose uterine rupture?
- Palpation
- US
- Abdominocentesis
- Exploratory surgery
What are 2 options for treatment of uterine rupture?
- Surgical
- Medical
Gestation in a mare is considered prolonged after what time period?
Greater than 360-380 days
Does a prolonged gestation usually result in an oversized fetus with horses?
No
It is normal for gestation in a mare to be about 10 days longer during what time of year?
Why?
- Early spring
- Relationship to photoperiod
What can occur during early pregnancy that can lead to a 3-5 week prolonged gestation?
Arrest of embryonic/fetal development at 3-6 weeks of gestation.
What is recommended with prolonged gestation?
Try to wait for normal parturition if there are no inciting causes.
Premature placental separation is also known as what?
Red Bag delivery
What are 4 possible causes of premature placental separation (red bag delivery)?
- Prolonged labor
- Meconium release
- Foal anoxia/asphyxia
- Dummy foal
T/F: A retained placenta is a common problem seen with premature placental separation (red bag delivery).
False - Retained placenta is NOT a common problem.
What is seen with a premature placental separation (red bag delivery)?
“Cervical star”
What is the fungus associated with fescue that can cause problems in the pregnant mare?
Acremonium coenophialum
What are 5 problems that Acremonium coenophialum can cause in pregnant mares?
- Decreased milk (low prolactin)
- Prolonged gestation
- Abortion
- Weak/dead foals
- Dystocia
What should be done with a pregnant mare on fescue if worried about fungal toxicity?
Remove from source of fescue 30-45 days before parturition.
What are 2 drugs that can be used with fungal toxicity associated with fescue?
- Low progesterone form day 300 to foaling
- Domperidone
With fungal toxicity associated with fescue, the placenta does not become thickened until when?
Within 48 hours of parturition.
