Equine Parturition, Dystocia and Postpartum Flashcards
What stage of gestation dows waxing up occour?
d340
Outline 1st stage labour
- restless, nest building, digging
- variable duration
- signs of colic
- frequently passing urine nad feaces
- several attempts to lie down
- > 8 rolls indicates potential problem
What is the “waters breaking”?
- Chorioallantois rupturing
- point of no return
- labour should be over within an hour from this point
What procedure may need to be carried out in some mares at the point when the waters break?
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!)
Outline 2nd stage labour
- 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
Which direction should the foals be pulled if assistance is needed?
- towards hocks
- can be rotated
What antiseptics should be used on the umbilicus?
- chlorhexidine best
- NOT iodine
When should the umbilicus be broken?
Try not to
- allow blood to flow into foal
- only pull cord if worried about tear
- hold foal abdomen
Which mares are liekly to foal standing up?
1st time foalers or if stressed or disturbed
Should a new foal be warmed?
- not unless in ICU
- shivering encourages breathing
What is the 3rd stage of labour?
- 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
What should be checked after the placenta has been released?
- complete (tips havent been retained)
- posterior (cervical) pole
- amnion
- umbilical cord
Why is transfer of colostral immunity important in foals?
- Born agammaglobulinaemic (unlike other spp) as no in utero transfer
- colostrum required within 12hours
When should mare and foal be turned out?
Morning after birth providing weather good
What position should the foal be born in?
- head first, ventral ‘recumbency’
- before birth lies in dorsal recumbancy then spins in utero so if upside down may still spin!
What is a red bag delivery? What disease may this be seen in assocation with?
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)
What blood biochem is assocaited with uterine inertia in mares? Tx of inertia?
- low blood calcium
- Oxytocin
- Ca borogluconate Tx
- Manual assistance
- Induction ONLY IF: >340d, udder developed, cervix relaxed
What is a potential rare complication during parturition? Tx?
Vaginal evisceration
- euthanise mare w barbiturates (peritonitis would be too severe to survive)
- emergency C-sec
- O2 to foal to counteract barbiturates
What may occour due to posterior presentation? Tx?
- impaction half way out
- impedes umbilical blood flow
- asphyxia
> Tx - deliver rapdily
- give O2
- monitor foal for NMS
What is the most common mis-presentation? Tx?
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
How should head and neck back presentation be treated?
As foreleg back, put rope round head and pull forward
How should breech presenation be treated?
- C section if foal alive
- Foetotomy if dead
How should anaesthesia be managed for an assisted delivery?
keep them light
hoist hindquarters
Where is a C sec incision made?
Midline or flank, surgeons preference
C sec post op complications?
- Adhesions
- Normal Sx (bleeding etc. esp haemostasis of uterus)
Are foetotomies common?
Not common - do not attempt unless very experienced with cattle
- care of cervix, do not damage!!
How can twins be distinguished from malpresentation?
Feel for knees/hocks rather than feet
Is pain after foaling normal? Tx?
- 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
What 2 forms of uterine artery haemorrhage are possible?
> fatal haemorrhage
- severe, colic, pale mm, shock
contained haematoma
- less severe colic, normal mm, mass on rectal
How does uterine rupture present? Tx? Prognosis?
- relatively low grade colic
- progresses to shock and peritonitis
- urgent emergency surgery
- usually fatal
How does ceacocolic rupture present? Tx? Prognosis?
- relatively low grade colic
- progresses to shock and peritonitis
- urgent emergency surgery (rarely indicated)
- basically always fatal
When would uterine prolapse be seen? Signs? Tx?
- after or with placentas release (do not mistake for placenta!!)
- mare may collapse with shock
- protect uterus with warm wet towels
Prognosis of rectal prolapse
Usually fatal
What may retained placenta lead to?
- septic metritis
- laminitis
- death
(+ lots of court cases!!)
Tx of retained placenta?
- 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
Tx of obturator paralysis
- leg hobbles for marginal cases
- slings if tolerated
Colon torsion Tx?
- emergency surgery
- colopexy
What is foal heat?
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
Is fostering advocated?
YES! Alwys better than orphan
- non TB mares best
- be patient
- tranquilisers?
What are the 4 main cervical injuries sustained during parturition? Tx? Prognosis for future preg?
- Mucosal splits (heal spontaneously)
- Trans-os adhesions (fucidin/hydrocortisone ointment)
- Lacerations (Sx sometimes necessary)
- Incompetence (allyl-tranbolone “regumate”)
- > all give guarded/poor prognosis for pregnancy maintainence
What are the classifications of perineal, vulval and vestibular laceration?
> 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)
What minor injuries may be seen around foaling?
- vulval splits
- caslick tears
- vaginal haematomas
> No vulva, no broodmare!
Do perineal lacerations have an effect of fertility?
No if surgical repair is good, no predisposition to reoccour at future foaling either
See lecture notes for 3rd degree laceration repair
