Dystocia and surgery of the female repro tract

Question 1

Give examples of confirmation problems that can lead to poor repro performance

Answer 1

Pneumo/urovagina
Cervical incompetency/lacerations
Delayed uterine clearance
Oviduct blockage

Question 2

Urovagina is often seen in older pleurioparous mares with pneumoviagina (rule out ectopic ureters in fillies). How is it diagnosed?

Answer 2

Cytology

Question 3

How is urovagina treated?

Answer 3

Improve BCS if thin

Surgery

Question 4

Following cervical tears, when should surgery be performed?

Answer 4

Dioestrus

3-4 weeks post-foaling

Question 5

How can delayed uterine clearance (persistent endometritis) be treated?

Answer 5

Uterine suspension

Restore normal orientation of uterus

Question 6

Mares that ovuate but do not have an oocyte in the uterus may have a blocked oviduct. How can this be treated? (2 ways)

Answer 6

Prostaglandin

Oviduct lavage

Question 7

What is the purpose of Caslick’s procedure?

Answer 7

Improve vaginal conformation to prevent pneumovagina

Question 8

How much mucosa is removed from each side of the vagina with a Caslick’s procedure?

Answer 8

3-4mm

Question 9

Are the sutures used in Caslick’s procedure absorbable or non-absorbable? What happens if you oversuture?

Answer 9

Non-absorbable - remove 10-14d post-op

Oversuturing can cause urovagina

Question 10

What are the 3 degrees of perineal lacerations?

Answer 10

1st degree - mucosal damage
2nd degree - mucosal, submucosal and perineal damage
3rd degree - complete disruption of rectovestibular shelf and anus

Question 11

How are 1st degree perineal lacerations treated?

Answer 11

May not require surery

If do - Caslick’s procedure

Question 12

How are 2nd degree perineal lacerations treated?

Answer 12

Caslick’s procedure and reconstruction of perineum

Question 13

How are 3rd degree perineal lacerations treated?

Answer 13

Delayed surgical repair - 4-6 weeks after injury once granulation tissue formed
2 stage procedure

Question 14

Granulosa cell tumours are common and can cause anoestrus, continued oestrus or stallion like behaviour. How can they be diagnosed?

Answer 14

Ultrasound
Rectal exam - enlarged ovary
Anti-Muellarian hormone

Question 15

What are the 3 surgical options for unilateral or bilateral ovary removal?

Answer 15

Laparoscopy - standing or under GA
Laparotomy - GA
Colpotomy - incision through vaginal wall

Question 16

An owner of a foaling mare says that there has been a ‘red bag’ delivery. What does this mean?

Answer 16

Placenta prematurely detached from uterus and is being expelled

Question 17

What sedative can be used for a foaling mare?

Answer 17

Xylazine

Question 18

What is the difference between assisted and controlled vaginal delivery?

Answer 18

Assisted - mare conscious

Controlled - mare anaesthetised with HLs elevated

Question 19

What is the treatment for pyometra in horses? (Rare)

Answer 19

Ovariohysterectomy

Laparotomy or laparoscopy

Question 20

The vulva and clitoris can get SCCs. What is the prognosis?

Answer 20

Poor - even with radical resection

Question 21

Varicose veins of the vagina are worse at oestrus. They do not usually require treatment, but if they are large or the owner is insistent, what can you do?

Answer 21

Ligate or cauterise vessels
Astringent topical creams
Laser photocoagulation of vessels