Equine Parturition, Dystocia and Postpartum Flashcards

1
Q

What stage of gestation dows waxing up occour?

A

d340

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2
Q

Outline 1st stage labour

A
  • restless, nest building, digging
  • variable duration
  • signs of colic
  • frequently passing urine nad feaces
  • several attempts to lie down
  • > 8 rolls indicates potential problem
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3
Q

What is the “waters breaking”?

A
  • Chorioallantois rupturing
  • point of no return
  • labour should be over within an hour from this point
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4
Q

What procedure may need to be carried out in some mares at the point when the waters break?

A

Episiotomy if have previously been Caslicked
(stud grooms can do this)
- some people may ask for Caslicks to be removed early but not helpful (though better than leaving too long and tearing!)

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5
Q

Outline 2nd stage labour

A
  • pale coloured, smooth amnion appears (will remain intact around foal as begins to be born, should rupture as foal is coming out)
  • allantoic fluid expelled
  • contractions increase
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6
Q

Which direction should the foals be pulled if assistance is needed?

A
  • towards hocks

- can be rotated

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7
Q

What antiseptics should be used on the umbilicus?

A
  • chlorhexidine best

- NOT iodine

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8
Q

When should the umbilicus be broken?

A

Try not to

  • allow blood to flow into foal
  • only pull cord if worried about tear
  • hold foal abdomen
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9
Q

Which mares are liekly to foal standing up?

A

1st time foalers or if stressed or disturbed

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10
Q

Should a new foal be warmed?

A
  • not unless in ICU

- shivering encourages breathing

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11
Q

What is the 3rd stage of labour?

A
  • stud groom ties up amnion into ball to prevent mare standing on it
  • placental release should occour iwthin an hour of birth
    (chorioallantois still inside, microcotyledons must separate)
  • > 4hrs retained placenta: call vet
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12
Q

What should be checked after the placenta has been released?

A
  • complete (tips havent been retained)
  • posterior (cervical) pole
  • amnion
  • umbilical cord
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13
Q

Why is transfer of colostral immunity important in foals?

A
  • Born agammaglobulinaemic (unlike other spp) as no in utero transfer
  • colostrum required within 12hours
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14
Q

When should mare and foal be turned out?

A

Morning after birth providing weather good

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15
Q

What position should the foal be born in?

A
  • head first, ventral ‘recumbency’

- before birth lies in dorsal recumbancy then spins in utero so if upside down may still spin!

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16
Q

What is a red bag delivery? What disease may this be seen in assocation with?

A

if waters do not vreak, placenta can be seen (thick, red chorioallantois instead of white/clear amnion)

  • if expelled with foal, foal is at risk of asphyxiation
  • placenta should be opened manually and O2 provided to foal
  • seen with tall fescue toxicosis in N America and Scandanavia (pathological thickening of the post uric pole)
  • seen with induction (induction = bad idea)
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17
Q

What blood biochem is assocaited with uterine inertia in mares? Tx of inertia?

A
  • low blood calcium
  • Oxytocin
  • Ca borogluconate Tx
  • Manual assistance
  • Induction ONLY IF: >340d, udder developed, cervix relaxed
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18
Q

What is a potential rare complication during parturition? Tx?

A

Vaginal evisceration

  • euthanise mare w barbiturates (peritonitis would be too severe to survive)
  • emergency C-sec
  • O2 to foal to counteract barbiturates
19
Q

What may occour due to posterior presentation? Tx?

A
  • impaction half way out
  • impedes umbilical blood flow
  • asphyxia
    > Tx
  • deliver rapdily
  • give O2
  • monitor foal for NMS
20
Q

What is the most common mis-presentation? Tx?

A

FOreleg back

  • Keep mare standing and walking
  • Pull foal tongue out
  • Epidural analgesia (6” spinal needle, 7-10ml 2% lidocaine or 7.5ml 1% xylazine, 1st intercoccygeal space)
  • Lube
  • repel foetus and deliver in NORMAL posture
21
Q

How should head and neck back presentation be treated?

A

As foreleg back, put rope round head and pull forward

22
Q

How should breech presenation be treated?

A
  • C section if foal alive

- Foetotomy if dead

23
Q

How should anaesthesia be managed for an assisted delivery?

A

keep them light

hoist hindquarters

24
Q

Where is a C sec incision made?

A

Midline or flank, surgeons preference

25
Q

C sec post op complications?

A
  • Adhesions

- Normal Sx (bleeding etc. esp haemostasis of uterus)

26
Q

Are foetotomies common?

A

Not common - do not attempt unless very experienced with cattle
- care of cervix, do not damage!!

27
Q

How can twins be distinguished from malpresentation?

A

Feel for knees/hocks rather than feet

28
Q

Is pain after foaling normal? Tx?

A
  • normal uterine cramps immediately after foaling resolve spontaneously and do not need Tx
  • uterine a. hamorrhage, uterine rupture or colonic/caecal rupture may present soon after foaling
  • 24hrs - months later: colon torsion
29
Q

What 2 forms of uterine artery haemorrhage are possible?

A

> fatal haemorrhage
- severe, colic, pale mm, shock
contained haematoma
- less severe colic, normal mm, mass on rectal

30
Q

How does uterine rupture present? Tx? Prognosis?

A
  • relatively low grade colic
  • progresses to shock and peritonitis
  • urgent emergency surgery
  • usually fatal
31
Q

How does ceacocolic rupture present? Tx? Prognosis?

A
  • relatively low grade colic
  • progresses to shock and peritonitis
  • urgent emergency surgery (rarely indicated)
  • basically always fatal
32
Q

When would uterine prolapse be seen? Signs? Tx?

A
  • after or with placentas release (do not mistake for placenta!!)
  • mare may collapse with shock
  • protect uterus with warm wet towels
33
Q

Prognosis of rectal prolapse

A

Usually fatal

34
Q

What may retained placenta lead to?

A
  • septic metritis
  • laminitis
  • death
    (+ lots of court cases!!)
35
Q

Tx of retained placenta?

A
  • Oxytocin drips (0.5IU in 500ml saline / 2hrs)
  • Abx
  • NSAIDs
  • Anti-endotoxic doses flunixin meglamine
  • Do not be impatient and pull, will tear microcotyledons [excpet >4hrs later, may be only option]
  • Reassure owner
  • Collect chorioallantois
  • Pump in ]
  • Daily large volume uterine flushes (2 stomach tubes in/out, not mamby pamby little saline flushes!)
  • lillypad or some kind of frog support to minimise laminitis risk
36
Q

Tx of obturator paralysis

A
  • leg hobbles for marginal cases

- slings if tolerated

37
Q

Colon torsion Tx?

A
  • emergency surgery

- colopexy

38
Q

What is foal heat?

A

The mares first heat after parturition - around 7-10d

  • excercise after foaling to encourage
  • vet exams for injury to vulva, cervix; size and fluid fill of uterus, smears (inflam) and swabs (infect); ovarian follicles
39
Q

Is fostering advocated?

A

YES! Alwys better than orphan

  • non TB mares best
  • be patient
  • tranquilisers?
40
Q

What are the 4 main cervical injuries sustained during parturition? Tx? Prognosis for future preg?

A
  1. Mucosal splits (heal spontaneously)
  2. Trans-os adhesions (fucidin/hydrocortisone ointment)
  3. Lacerations (Sx sometimes necessary)
  4. Incompetence (allyl-tranbolone “regumate”)
    - > all give guarded/poor prognosis for pregnancy maintainence
41
Q

What are the classifications of perineal, vulval and vestibular laceration?

A

> 1st (small tears of mm, heal spontaneously with minimal interference eg. caslick)
2nd (deeper structures eg. constrictor vulvae mm, perineal body, Sx indicated - immediate or next day)
3rd degree (tearing of vestibular and vaginal walls, perineal body ,anal sphincter or rectal wall -> cloaca, require Sx [@4-6 weeks and then 2nd stage 4-6 weeks later] and regular cleaning until mucosal healing d10)
Rectovestibular fistula (most will require Sx [if caudal and small leave to heal, if cranial or large convert to 3rd degree laceration and reconstruct], examine @ 4-6 weeks, initially first aid and cleaning)

42
Q

What minor injuries may be seen around foaling?

A
  • vulval splits
  • caslick tears
  • vaginal haematomas
    > No vulva, no broodmare!
43
Q

Do perineal lacerations have an effect of fertility?

A

No if surgical repair is good, no predisposition to reoccour at future foaling either

44
Q

See lecture notes for 3rd degree laceration repair

A