equine 3

Question 1

tell me about the cervical mucus plug

Answer 1

thick, viscous mucus plug that helps prevent bac t from passing

often passed just prior to foaling

Question 2

the cervix remains closed throughout pregnancy due to what hormone?

Answer 2

progesterone

Question 3

placentitis is usually _____ in origin

Answer 3

bacterial

Question 4

placentitis is a common cause of ____ term abortion and/or poor doing foals. how is mare fertility affected on subsequent cycles?

Answer 4

late
reduced

Question 5

what are the risk factors for ascending placentitis?

Answer 5

• hx of fetoplacental compromise
• poor vulvar conformation
• cervical dysfunction
• aged mare/immune compromise

Question 6

tell me about the pathophys of ascending placentitis in the mare

Answer 6

• bacteria migrate through cervix to cervical star [requires failure of mucus plug]
• infection spreads through chorioallantois from cervical star [necrotizing inflammation of chorioallantois]
• inflammation, impedes placental function, can spread to fetus

Question 7

what are the C/S of ascending placentitis

Answer 7

• late term pregnancy (8-10 months)
• udder development and premature lactation
• ± vag discharge

if in doubt, assume placentitis –> need to detect and tx early to fix!

Question 8

how do you dx ascending placentitis?

Answer 8

• C/S
• US (transrectal more accurate, but can also do trans abdominal)
• combined thickness of uterus and placenta (CUPT)
• vag speculum exam (be careful not to disrupt mucus seal if it’s intact!) - test is “how easy is it to pass the speculum?”
• fetal HR (decreases initially, but typically elevated) [120-130bpm]
• plasma progestogens (high levels = fetal stress)

Question 9

how do you perform a combined thickness of uterus and placenta (CUPT)?

Answer 9

• taken at cervical placental junction for most accurate info
• transrectal US
• if trans abdominal US, take avg of 4 measurements

Question 10

how do you tx placentitis?

Answer 10

• ABs [use C&S] (potentiated sulfas to start, can use penicillin) (don’t use gentamicin or ceftiofur)
• anti-inflammatories (flunixin, phenylbutazone)
• progesterone therapy (altrenogest/regumate)
• pentoxyphylline (improves bloodflow, reduces viscosity)

multi-modal approach is imperative, must talk to O’s abut cost, tx schedule

Question 11

what are the C/S / hx of ventral ruptures?

Answer 11

• rapidly enlarging abdomen
• sudden alteration in the contour of ventral abdomen
• painful edema along ventral abdomen
• rupture of the abdominal musculature or rupture of the rectus abdominus or rupture of prepubic tendonw

Question 12

what are some predisposing factors for ventral ruptures in mares?

Answer 12

• hydros of the fetal membranes
• twin preg
• trauma in late preg

Question 13

what is the prognosis of ventral rupture?

Answer 13

if true rupture, then poor :(

Question 14

what is the tx for ventral rupture

Answer 14

• palliative
• abdominal bandage
• restrict movement
• close monitoring for onset of parturition
• foal IgG monitoring (excessive udder edema)
• after foaling, sx approach

Question 15

what are the C/S of uterine torsion?

Answer 15

• low grade colic
• colic non-responsive to medical tx

Question 16

how do you dx uterine torsion?

Answer 16

trans-rectal palp –> broad ligament

you feel a sheet of broad ligament that extends across caudal abdomen = pathognomonic for torsion!

blood supply not cut off to placenta, so foal is stressed but not dead if you catch it early

Question 17

how do you tx uterine torsion?

Answer 17

sx, manual correction when at term

Question 18

when does uterine torsion usually happen in the mare?

Answer 18

beginning of 3rd trimester (7-9 months)

differ from cow, when it’s intra-partum

Question 19

colic in the preg mare:
- what do we need to know?
- what drugs are safe?

Answer 19

need to know:
- how bad it is, is she foaling?
- colic workup (palpation, US, NG tube)
- always ask the question “what is the goal? mare or foal safety?”

drugs:
- sedatives: xylazine, alpha 2 (know that you will likely sedate foal too)
- NSAID
- antispasmodics are not ideal coz they risk cervix laxity - but they can be used

Question 20

what is hydrops? is it common?

Answer 20

accumulation of allantoic or amniotic fluid

very rare in the mare

Question 21

what is premature placental separation?

Answer 21

normally, chorioallantois should rupture at cervical star, and amnion pulls through to vag canal - you have blood supply to fetus bc chorioallantois is still interdigitated to endometrium

but! if there is premature separation of the chorioallantois without rupture of the amniotic sac, there is a loss of blood supply to the foal

Question 22

what are the causes of premature placental separation

Answer 22

• fescue tox
• placentitis
• stress

Question 23

what is the consequence of premature placental separation?

Answer 23

dead foal! unless someone is there to step in and intervene EMERGENCY!!! CUT IT OPEN ASAP

Question 24

if you have retained fetal membranes, you should tell owner to tie up placental tissue to keep it intact until it is passed. why?

Answer 24

if it gets ripped out, some is still in there!

rips out = hemorrhage

Question 25

true or false: retained fetal membranes are an emergency!

Answer 25

false. it is urgent, so you need to get there same day, but you don’t have to drop everything and get there RIGHT NOW

Question 26

what are the sequelae of retained fetal membranes?

Answer 26

• metritis
• septicemia
• endotoxemia
• laminitis
• death

Question 27

how do you tx retained fetal membranes?

Answer 27

• remove fetal membranes –> oxytocin, CAREFUL manual removal
• dilute/remove inflammatory mediators from uterus
• control systemic inflammation/endotoxemia
• reduce risk of laminitis
• sedation/stocks/tail tie
• oxytocin
• float placenta (stomach pump + warm water, stimulate uterine contraction) = Burn’s technique
• Ca via IV fluids
• manual traction
• can do placental artery infusion –> infuse water into placental artery –> promotes expansion of vessel and detachment from endometrium (can take up to 6 hours)

Question 28

what is dystocia?

Answer 28

normal process of giving birth (eutocia) is disrupted

Question 29

tell me about dystocia origins

Answer 29

maternal:
- uterine inertia
- obstruction

fetal:
- posture abnormalities
- malformations

Question 30

true or false: dystocia is considered an emergency in the horse

Answer 30

true

Question 31

when do you intervene during dystocia?

Answer 31

not longer than 15 mins after stage 2 started

Question 32

how do you tx dystocia?

Answer 32

• C-section

Question 33

it is important to check all postpartum mares for ?

Answer 33

rectovaginal fistulas

Question 34

mares are most prone to colon torsion ________.

Answer 34

in first 3 months post foaling

Question 35

what are the C/S of post-foaling colon torsion?

Answer 35

• rapid onset of severe intestinal discomfort
• unrelenting and unresponsive to on farm tx

this is an emergency!