Equine Reproduction Flashcards
1
Q
What are the signs of oestrous in the mare?
A
Clitoral winking
Vocalisation
Raising tail in wind to spread pheromones
2
Q
What are the routine pre-breeding laboratory samples taken?
A
Swabs – PCR and culture. Taylorella equigenitalis, Pseudomonas, Klebsiella
Serum assays - Equine viral arteritis (EVA) is notifiable, Equine infectious anaemia (EIA) is notifiable, Streptococcus equi subspecies equi
3
Q
What are the clinical signs for all 3 bacterial CEM agents?
A
- Active state – vulval discharge, very mild to profuse
- Carrier state – no overt signs of infection.
- Can cause breeding problems, no mare will get in foal when an endometritis. Abortion
4
Q
Which mares are at the highest risk of CEM?
A
Mares previously positive/exposed for/to disease or those travelling from/stallion from/covered outside of UK
5
Q
Which pre-breeding swabs are done for low risk AI mares to identify CEMO?
A
- Clitoral swab
- Endometrial swab at home or at stud
6
Q
Which pre-breeding swabs are done for low risk walk in mares to identify CEMO?
A
- Clitoral swabs
- Endometrial swab at home or at stud
- Endometrial swab repeated for subsequent seasons
7
Q
Which pre-breeding swabs are done for low risk live in mares to identify CEMO?
A
- Clitoral swabs
- Endometrial swab at home or at stud
- Endometrial swab repeated for subsequent seasons
8
Q
Which pre-breeding swabs are done for high risk mares to identify CEMO?
A
- 2 clitoral swabs 7 days apart
- Endometrial swab at home or at stud
- Endometrial swab repeated for subsequent seasons
9
Q
How should you manage any positive CEM results?
A
Swab in contacts
Disinfect
Inform
Treat
Test
Foal in isolation, test foals
10
Q
What could a seropositive EVA mean?
A
Previously vaccinated, historical infection, active infection. Unable to determine between these
11
Q
What is assessed in breeding soundness examinations of the mare?
A
- Perineal conformation
- Mammary glands
- Trans-rectal palpation
- Trans-rectal ultrasound
- If (history of) problems – hysterocopy, biopsy
12
Q
What is the ideal perineal conformation?
A
- ¾ vulva ventral to pelvic brim
- Vulva 0-10 degrees from vertical
- Vulval seal – no air entry, check seal, listen when walk, check for bubbles in vagina. No faecal contamination. Free draining urine
13
Q
What should you observe for using a speculum and pen torch?
A
Faecal contamination
Urine pooling
Bubbles/foam
Cervical appearance
14
Q
What is the appearance of the equine cervix during oestrous?
A
Flaccid
Red
Oedematous
Engorged
15
Q
What is the appearance of the equine cervix during dioestrous?
A
Erect position
Tight
Pale pink
Best to check for scars now
16
Q
What is the appearance of the equine cervix when pregnant?
A
Small
Tight
Similar to dioestrous
17
Q
What is the appearance of the equine cervix when there is cervicitis?
A
Red
Haemorrhagic
18
Q
What is equine ovarian palpation and ultrasound useful for?
A
- Confirmation of normality
- Detection of cyclicity = CL present
- Estimation of the stage of the cycle
- Prediction of ovulation
- Detection of pathology
19
Q
What are the advantages of deep intrauterine insemination?
A
- Lower semen dose required
- Less post breeding reaction
- Increases fertility rate
20
Q
How can you use the equine ovary to predict ovulation in early oestrous?
A
- (Alternate ovary per cycle)
- (Require no active CL to ovulate)
- Follicle grows spherically but not high pressure initially so does not collapse neighbours initially
21
Q
How can you use the equine uterus to predict ovulation in early oestrous?
A
Oedema pattern of oedema increases
22
Q
How can you use the equine cervix to predict ovulation in early oestrous?
A
Flattening, softening
23
Q
How can equine ovaries predict ovulation in mid-late oestrous?
A
- Follicle points to ovulation fossa
- Follicle tone decreases
- Oedematous margin
- Hyperechoic flecks
- Thicker wall
24
Q
How can the equine uterus predict ovulation in mid-late oestrous?
A
Uterine oedema max 24hrs prior – reducing at ovulation
25
How can the equine cervix predict ovulation in mid-late oestrous?
Soft and flaccid
26
How do you confirm that ovulation has occurred in the mare?
- Hypoechoic follicle collapses and fills with blood clot to form Corpus haemorrhagicum
- Then the density increases as it becomes a corpus luteum
- Always check for 2 CL which come with a double ovulation
27
What are the durations of cycle lengths in the mare?
Cycle length = 21 days +/- 2 days
Oestrous 3-7 days
Interoestrous 14-16 days
28
How can you bring forward transitional oestrous in the mare?
- Artificial lights
- Plane of nutrition
- Altrenogest (Regumate)
- Administer progestagens then withdraw them may cause a rebound in FSH triggering cyclicity
29
How can you shorten the luteal phase in the mare?
- Synthetic naturally occurring PG
- Synthetic PG analogues
- Need a mature CL to be effective – mare ovulates 2-7d after injection
30
What are problem mares?
Abnormal cycling
- Erratic oestrus
- Anovulatory follicle
- Granulosa cell tumour
- Non-functional ovaries
Failure to conceive
- Endometritis – post mating, chronic, infective, pyometra
- Uterine cysts
- Early embryonic death low in horses
31
What is the aetiology of post-mating endometritis?
- Poor uterine drainage – cervical lesions, dependent uterus, impaired uterine contractility
- Direct response to semen/extender
32
What is the treatment for post-mating endometritis in the mare?
Lavage - commonly performed routinely as preventative, sterile saline and ecbolics (oxytocin/PG) 4-6 hours post cover/insemination
Uteropexy for high value mares
33
How is infectious endometritis treated?
Lavage and ecbolics. Appropriate local antimicrobials
34
How is chronic endometritis treated?
Possible irritation – dilute povidone iodine lavage. Hypertonic saline lavage
35
How is hysterscopy treated?
Laser ablations
Topicals to oviduct ostia
36
How are uterine cysts treated?
- Benign neglect
- Laser ablation
- Deflate and ethanol injection
37
What is the outcome of erratic oestrous?
Persistent CLs leading to prolonged dioestrus
38
How is erratic oestrous treated?
PG administration, often need multiple treatments
Altrenogest
39
What is a anovulatory/haemorrhagic follicle?
- Abnormally large follicle later in breeding season, may be sequential
- Maintaining spherical shape beyond expected ovulation point
- Fail to rupture to form a CL
40
What are the causes of small, non-functional ovaries in the mare?
- PPID – equine Cushing’s disease
- Chromosomal abnormalities – turners XO intersex
41
How is oestrous prevented in the mare?
- Oral altrenogest long term
- GnRH vaccine
- Double dose ovuplant
- Manual disruption early pregnancy
Until 120 days
42
When can transrectal ultrasound be used to pregnancy diagnose a mare?
From day 12 (15 common)
43
When can elevated plasma progesterone be used to pregnancy diagnose a mare?
Day 18-20
44
When can failure to return to oestrous be used to pregnancy diagnose a mare?
Day 18-21
45
When can transrectal palpation be used to pregnancy diagnose a mare?
Day 21
46
When can plasma eCG be used to pregnancy diagnose a mare?
Equine chorionic gonadotropin from day 60-120
47
When can transrectal ballottement be used to pregnancy diagnose a mare?
Day 80
48
When can oestrone sulphate be used to pregnancy diagnose a mare?
Day 100-150
49
When can urine oestrogen be used to pregnancy diagnose a mare?
Day 120-150
50
How long is the equine gestation?
11 months 11 days
51
What can be felt from day 21 from transrectal palpation of the pregnant mare?
The conceptual swelling protrudes at the base of 1 horn and usually bulges ventrally
52
What can be felt from day 40 from transrectal palpation of the pregnant mare?
Extensive ovarian activity under eCG results in ovarian enlargement, uterine swelling continues to increase in size and is spherical
53
What can be felt from day 60 from transrectal palpation of the pregnant mare?
Swelling is approximately 12cm in diameter and fills the pregnant horn and may involve the uterine body
54
What can be felt from day 90 from transrectal palpation of the pregnant mare?
The whole uterus is filled with fluid and more ventral in position, distinction between the body and horns is difficult, the uterus may be difficult to palpate and the foetus may not be balloted
55
What can be felt from day 120 from transrectal palpation of the pregnant mare?
Follicular activity ceases and ovaries become progressively smaller. Significant tension is present in the ovarian ligament and the utero-ovarian ligaments. The ovaries move more ventrally and medially.
56
What can be seen from day 12 on transrectal ultrasound?
First visible at day 12 – sphere of 1cm diameter
57
What can be seen from day 18 on transrectal ultrasound?
Implanted – sphere 3cm diameter
58
What can be seen from day 20 on transrectal ultrasound?
Irregular shape
59
What can be seen from day 24 on transrectal ultrasound?
Heart beat visible
60
What can be seen from day 30 on transrectal ultrasound?
Allantois is equal size to the yolk sac
61
What can be seen from day 36 on transrectal ultrasound?
Allantois is greater than the yolk sac
62
What can be seen from day 40 on transrectal ultrasound?
The yolk sac is gone
63
What can be seen from day 50 on transrectal ultrasound?
Foetal limb buds
64
What can be seen from day 55-65 on transrectal ultrasound?
Genital tubercle
65
What can be seen from day 60 on transrectal ultrasound?
Foetal eyes
66
What can be seen from day 85 on transrectal ultrasound?
Foetus out of reach
67
Why must twins be reduced to a single foal?
If not reduced to single foetus likely to abort both at 8-9 months (80%)
68
What are the management options when it comes to twin foals?
- Manual rupture “pinch” one
- Risk killing both with altrenogest. If not implanted then separate, which gets harder as they get larger
- Inflammation alone may be enough
- Abort both with PG
- Later options TUGA /Cervical luxation
69
Describe a grade 1 rectal tear.
- Mucosa and submucosa damaged
- Treated medically or with blind suture repair
70
Describe a grade 2 rectal tear.
- Muscular layer only damaged
- Treated medically
71
Describe a grade 3a rectal tear.
- Mucosa, submucosa and muscular ruptured with serosa intact
- Medical or surgical repair or euthanasia
72
Describe a grade 3b rectal tear.
- Mucosa, submucosa and muscular layers with mesocolon and intact dorsally damaged
- Medically or surgically repaired or euthanaia
73
Describe a grade 4 rectal tear.
- Full thickness with exposure to peritoneum damaged
- Surgically treated or euthanasia
74
How are rectal tears diagnosed?
- Visualisation – endoscopy, speculum
- Palpation – un-gloved hand?
- Abdominocentesis
75
How is the length of a rectal tear associated with its cause?
Repro exam 6cm
GI exam 4cm
Dystocia 25cm
76
What is the first aid required to manage rectal tears in a horse?
Antibodies, NSAIDs, absorbent packing
77
Describe how progesterone levels change throughout the mare's cycle.
- Primary and secondary CLs produce progesterone
- Progesterone initially declines but is then supported by equine chorionic gonadotrophin (eCG) from endometrial cups
- Progesterone still declines from mid pregnancy onwards
78
How is oestrone sulphate used to diagnose pregnancy in the mare?
- Peak levels at 150 days can measure until 300 days
- Serum oestrone SO4 more accurate than PMSG from 100 days
- Urine oestrone SO4 from 120 days
- Demonstrates foal is alive
79
When is oestrous next seen in a mare that loses the embryo at 0-5 days?
Normal oestrous interval
80
When is oestrous next seen in a mare that loses the embryo at 5-15 days?
Early return to oestrous
81
When is oestrous next seen in a mare that loses the embryo at 16-36 days?
Approximately 6 weeks after luteolysis of primary CL
82
When is oestrous next seen in a mare that loses the embryo at 36-140 days?
Approximately 5 months after luteolysis of secondary CL
83
When is oestrous next seen in a mare that loses the embryo at 140 days?
Variable time dependent upon season and why foal was lost
84
What are the clinical signs of bacterial placentitis?
Vulval discharge
Lactation
Abortion
85
How is bacterial placentitis diagnosed?
Measure combined thickness of uterus and placenta, swab cervix - culture and sensitivity
86
How is bacterial placentitis treated?
NSAIDs, atrenogest (uterine quiescence), vitamin E (antioxidant), oxygen delivery to the mare, antibiotics appropriate to culture and sensitivity (care over Abs crossing the placenta).
87
Distinguish equine herpes virus 1 and 4.
EHV-1 – respiratory disease, abortion including storms, neurological form
EHV-4 – mainly respiratory disease, occasional abortion
88
When is abortion from equine herpes virus seen?
Abortion seen usually in late pregnancy 7 days after viral contact
89
How is equine herpes virus controlled?
- Vaccination does not wholly protect from abortion forms
- Aborted foetus highly contagious other mares so dispose
90
How is equine herpes virus diagnosed?
- Virus isolation on nasopharyngeal swabs
- Serology – rising AB titre CF
- Endometrial swab – PCR
- PM – virus isolation/PCR – histopathology
91
How is equine viral arteritis transmitted?
Venereal and respiratory routes
92
What are the clinical signs of equine viral arteritis?
Abortion
Conjunctivitis
Scrotal swelling
93
How is equine viral arteritis diagnosed?
Clinical signs
Placental autolysis
PM VI/PCR
Semen VI/PCR
Nasopharyngeal swab – PCR
Serology ELISA/VN rising titre
94
What are the non-infectious causes of pregnancy loss in the mare?
- Vascular compromise from umbilical cord (twisted)
- Twins (not identified earlier)
- Premature placental separation
- Uterine torsion
- Ruptured pre-pubic tendon
- Hydrops
- Pseudopregnancy
- Prolonged gestation
95
What does uterine torsion in the mare present as?
- Mid-late term mare
- Presents with colic
- Diagnosis by palpation
96
What are the treatment options for uterine torsion in the mare?
Caesarian section
Flank laparotomy
Rolling under GA
97
What is uterine dorsoretroflexion in the mare?
- Late pregnancy mare
- Moderate to severe colic
- Palpation of foetus very painful
98
How is uterine dorsoretroflexion treated?
Clenbuterol and gentle exercise
99
What happens when the pre-pubic tendon ruptures in the mare?
- Aged heavy breed mares
- Presents with – massive ventral swelling, pitting oedema
100
How is ruptured pre-pubic tendon treated in mares?
Support abdomen (belly bandage), assisted foaling
101
What is hydrops uteri in the pregnant mare?
- Mid-late pregnancy (>7m)
- Presents with distended abdomen
- Allantois>> Amnion
- Foetus usually non-viable
102
How is hydrops uteri treated in the pregnant mare?
Induce abortion, care with shock after fluid
103
What are the factors predisposing prolonged gestation in the mare?
- Wrong dates
- Sex (males slightly longer)
- Individual variation
- Placental lesions
- Death of 1 twin
370 days
104
What is a urethral vent?
Aetiology unknown, present as blood in the urine and pain during ejaculation or erection
105
How are uroliths removed surgically?
Cystotomy – various approaches: caudal midline ventral, paramedian, parainguinal, perineal
106
What is the normal anatomy of the equine prepuce?
- External lamina continuous with the skin of the abdominal wall
- Internal lamina
- Different from other species in that it is formed by a double fold of preputial skin
- Opening of the prepuce is termed the preputial ring
- At birth, the internal and external laminae are fused and separation occurs after 1 month of age
107
Distinguish CCP and CSP of the equine penis.
CCP is a closed system during erection
CSP is an open system during erection
108
What sedative should not be used in tact stallions?
Acepromazine – will give intact male priapism which will cause trauma and then paraphimosis, so use detomidine. In geldings, ACP is good.
109
What are the diagnostic tools for the equine penis and prepuce?
Urinalysis
Semen evaluation
Biopsy of mucosal lesions
Catheterisation
Endoscopy
Ultrasound
110
How is urinalysis done in horses?
Normal horse urine is cloudy due to mucus and calcium carbonate crystals, so do not worry about protein on urine dipstick in horses
111
Distinguish management of penile lacerations if fresh and if contaminated?
If fresh: debridement and primary closure
If Infected: daily cleaning and topical and/or systemic antimicrobials
112
What are the possible complications of equine penile lacerations?
- Urethral lacerations that heal as either fistulas or by cicatrix
- A shunt forming between the CCP and superficial penile vasculature
- Extensive tissue trauma, may require phallectomy
113
Why may a penile haematoma develop in a horse?
- Rapid development post trauma
- Most likely superficial vessel ruptured
- Occasionally from corporeal vessel
114
What is the first aid required for equine penile haematomas?
Cold compression
Compressive bandage
Hydrotherapy/cold hosing
Box rest 5-6 days, followed by light exercise to minimise sheath swelling
Keep away from sexual stimuli
115
What are the possible complications of equine penile haematomas?
- Urethral obstruction – catheterise
- Paraphimosis/phimosis – acute due to swelling and cellulitis, chronic due to scar tissue formation
116
What is the aetiology of paraphimosis in horses?
- Preputial or penile oedema – trauma
- Damage to penile innervation – spinal disease, trauma, infectious (EHV1)
- Debilitation
- Phenothiazine tranquilizers – idiosyncratic reaction, will wear off but need support initially
117
What does prolonged protrusion of the penis cause?
Oedema
Swelling
Stretching of nerves and retractor penis muscles
118
How is paraphimosis managed in the male horse?
- Goals are to control oedema, prevent trauma and reduce weight on muscle and nerves
- Options are to retain penis in sheath via purse string suture, towel clamps and reefing surgery, or support in a sling
119
What is the most common cause of priapism in the male horse?
ACP
120
Distinguish high and low flow priapism in the male horse.
High flow – increased arterial flow
Low flow – reduced venous outflow
121
How can priapism be managed medically in the horse?
Phenylephrine/adrenaline into CCP, massage, support, compression, cold therapy
122
How can priapism in the horse be surgically managed?
Irrigate CCP with heparinised saline, create shunt between CCP-CSP. Cannot get erection, care in case selection, not breeding stallion
123
What is reefing?
Segmental posthectomy - resection of circumferential segment of internal preputial lamina with/without preputial ring
124
When is reefing indicated?
Neoplasia, granuloma, phimosis, paraphimosis
125
What are the possible complications with a phallectomy in male horses?
- Haemorrhage – expect mild bleeding from stump for several days during urination. More in stallions than geldings
- Haematoma
- Dehiscence
- Infection
- Oedema
- Urethral obstruction
- Pain
- Regrowth of neoplasia
126
What does phimosis cause?
Urine scalding within the sheath
127
What are the treatment options for phimosis in horses?
- Constriction preputial orifice – wedge resection external preputial lamina
- Constriction preputial ring – wedge resection internal preputial lamina to expose penis, followed by segmental posthectomy ‘reefing’
128
How does a urethral vent present in horses?
Haemospermia (infertility)
Haematouria (end of micturition)
Multiple mounting attempts due to pain during erection/ejaculation
129
How can urethral vents be diagnosed in horses?
Urethroscopy usually at level of ischial arch or semen cytology (differential diagnoses septic seminal vesiculitis, WBC on semen cytology)
130
How can urethral vents be treated in horses?
- Surgery – perineal urethrotomy or perineal opening of CSP – approach as PU then divert around urethra into CSP, as this decreases pressure in CSP
- Pain relief (if when urinating)
- May heal spontaneously
- Sexual rest
131
How do uroliths present in male horses?
Behaviour changes
Haematuria (esp post exercise)
Bleeding from urethra
Dysuria/stranguria/ pollakiuria
Urine scalding
Colic
Hindlimbs gait changes
132
How are uroliths diagnosed in male horses?
- Catheter obstructed
- Urethroscopy
- Urine cytology – increased WBC and RBC
- Rectal examination with/without ultrasound
133
Distinguish calcium and phosphate uroliths in male horses.
Calcium carbonate – spiculated, common
Phosphate – smooth, rare
134
How are uroliths in male horses managed?
- Standing perineal urethrotomy with crushing of the stone and flushing
- Ultrasound the kidneys to check for more
135
What are the indications for epistioplasty/Caslick's procedure in mares?
- Poor perineal conformation
- Previous foaling trauma
- Pneumovagina
- Faecovagina
- With/without urovagina, secondary to pneumovagina
136
What are the goals of epistioplasty/Caslick's procedure?
- To improve vulval seal:
- To improve vaginal and endometrial environment pre/post covering
- Allow subsequent cover attempts
- Breeding stitch – bottom suture is large and can be tightened or loosened
137
How is an epistioplasty/Caslick's procedure done?
1. Assess pubic brim level, aim to extend repair beyond this
2. Inject local anaesthetic into proximal part of vulval lips
3. Remove narrow margin (few mm) of tissue from vulval lips
4. Suture or staple closed
138
What is the goal of an epitiotomy?
- Goal is to remove obstruction caused by vulval lips at birth
- Done post Caslicks, 2 weeks before foaling date
- Can be done at foaling if dystocia and insufficient space to deliver foal.
139
What is the presentation of urovagina in mares?
Often thin multiparous mare
Sloping vaginal floor
Consequences of urovagina are vaginitis, cervicitis and endometritis
140
How is urovagina diagnosed in the mare?
- Examination with speculum
- Rectal US – NB endometritis – this is a differential diagnoses and sequelae
- Perform cytology on fluid – differential diagnoses discharge from uterine infection
141
How is urovagina treated surgically?
To extend urethra so urine exist more caudally
1. Catheterise bladder
2. Incise vaginal floor mucosa and blunt dissect
3. Pull together over catheter
4. Inverting closure
142
What is the goal of a uteropexy in the mare?
To elevate a dependant uterus so allowing fluid to drain out via the cervix rather than pooling
143
How is a uteropexy done?
- Standing laparoscopy surgery
- Fix the uterine horns to the dorsolateral abdominal walls
144
What is the most common approach to an equine caesarean section in UK?
Ventral midline GA. Faster, less bleeding, easier to extend, familiar than low oblique left flank
145
What are the indications of a caesarean section in the mare?
- Emergency – dystocia, uterine tear, uterine torsion, ruptured prepubic ligament
- Elective – terminal (mare), pelvic injury, gnotobiotic foal
146
Why is the mare in dorsal recumbency during a caesarean section?
Slight skew improves venous return
147
Outline the approach to a ventral midline caesarean section in the mare.
1. Identify and exteriorise gravid horn
2. Isolate with swabs
3. Incise uterus
4. Incise placenta with scissors or scalpel
5. Ropes on foal limbs and elevate foal
7. If foal alive – lay beside mare for a little while, until umbilical artery stops pulsing and foal breathing. Or deliver straight to team medicine, clamp navel x2 and cut umbilical cord between clamps. If foal dead – cut umbilical cord, may need to suture if still bleeding mare side
8. Remove fluid (lochia)
9. Remove placenta
10. Sterile lavage
11. Haemostatic suture
12. Inverting closure x2 uterus, then oxytocin
148
What are the possible complications of dystocia?
Reproductive tract trauma
Retained foetal membranes
Delayed uterine involution
Bladder prolapse
Metritis
Arterial haemorrhage
Neuropraxia
Pressure necrosis
149
What are the 4 grades of perineal lacerations in mares?
1st degree – damage to vulva lips or vaginal mucosa
2nd degree – vaginal submucosa with/without perineal muscles
3rd degree – complete disruption rectovestibular shelf – common opening
Recto-vaginal fistula – penetration from vagina into rectum – anal sphincter intact
150
What is the goal when repairing 3rd degree perineal lacerations?
To recreate separate rectal/anal and vaginal/vulval structures
151
How should 3rd degree perineal lacerations be managed post operatively?
- Ensure soft faeces to allow healing with grass diet
- Provide time to heal before overing again – likely faecovagina will cause endometritis so AI rather than natural covering
152
What are recto-vaginal fistulas caused by?
- Forceful kick from foal during birth; through vagina wall through rectum then retracts. If no retraction, causes 3rd degree perineal laceration
- Partial dehiscence of 3rd degree repair. Less likely if do a 2 staged repair
153
How are recto-vaginal fistulas managed?
Create into 3rd degree laceration
154
What are the consequences of cervical lacerations?
Endometritis, failure to conceive, abortion
155
What is done if uterine lacerations are identified before birth?
- Perform C-section
- If foal known to be dead and laceration to uterine body, especially near cervix, consider repair 1st before delivering foal
- If foal alive, deliver foal but may repair laceration before incision
156
What is done if uterine lacerations are identified after birth?
Consider location – GA midline ventral, laparoscopic
157
How are uterine lacerations managed?
Antibiotics, NSAIDs, antiendotoxins, lavage
158
What are the indications for ovariectomies in mares?
Behavioural changes
Large ovary
- Granulosa Cell Tumour
- Melanoma
- Terratoma
- Adenocarcinoma
- Haematoma/abscess
Stud use for AI collection
159
What are the approaches for ovariectomies for mares?
- Laparoscopic – flank
- Laparotomy – GA ventral midline, paramedian, median or flank
- Colpotomy – going into abdomen from the vagina, done in US
160
What is the presentation of granulosas in mares?
- Aggressive mare with stallion like tendencies
- Nymphomania
- Persistent oestrous behaviour
161
What are the characteristics of granulosa cell tumours in mares?
Benign neoplasia – rarely spread, hormonally active
162
How are granulosa cell tumours diagnosed in mares?
- Rectal ultrasound examination – 1 large and 1 small ovary
- Serology – antimullerian hormone, inhibin, testosterone
163
What are the advantages of laparoscopic ovariectomies in mares?
Standing sedation
Minimally invasive
Good visualisation and manipulation in site
Good haemostasis
Minimal complications
Quicker return to work
164
What are the disadvantages of laparoscopic ovariectomies in mares?
- Flank incisions for large ovaries
- Expensive due to equipment and experience
165
Why are horses routinely castrated?
- Reduces aggression/more docile
- Group turnout now possible
- Inappropriate erection avoided
- Improves focus
- If behaviour is already learnt then removing hormonal driver will not change this. 20% of geldings may express stallion like behaviour.
- Gene pool
- Orchitis, neoplasia, inguinal hernia, trauma
166
When should horses be castrated?
- When both testicles are present
- Generally done between 6 and 24 months
- Avoid fly/mud season
167
Describe the 3 possible approaches to castration in equine.
Open – vaginal tunic incised and left open, use in all locations/positions, not in mature stallions, donkeys or mules
Semi-closed – vaginal tunic incised, contents check then closed, only under GA, care with field use due to sterility
Closed – testicle removed in vaginal tunic which is ligated then removed, only under GA, care with field use due to sterility
168
Why may closed castration be chosen in equine?
When other options are contraindicated, such as for mature stallions, large inguinal rings, donkeys, mules
169
What are the advantages of closed castration?
Reduces risk of peritonitis, herniation and evisceration
170
Briefly outline the approach to a closed castration in horses.
1. GA dorsal recumbency
2. Incise skin and dartos
3. Strip skin and dartos form vaginal tunic using blunt dissection
4. Palpate testicle
5. Clamp and ligate twice then excise or ligate and emasculate proximal to the testicle
6. Can remove an ellipse of scrotal skin ablation
171
Briefly outline the approach to a semi-closed castration in equine.
1. Strip tunic to exteriorise testicle in vaginal tunic
2. Incise tunic
3. If large, apply emasculators to vasculature, release stump and then to tunic. If small, apply emasculators across all on abdominal side of incision
172
What are the advantages of henderson devices for equine castration?
- Reduces post op haemorrhage
- Reduces scrotal swelling
- Reduces surgery time
- Reduces anaesthetic time
173
What are the disadvantages of henderson device for equine castration?
- Requires GA
- Greater risk of herniation/evisceration – GIT and connection tissue
174
Outline the approach to an open equine castration.
1. Sterile prep
2. LA over incision site
3. 2nd prep
4. Incise away from hand
5. Push caudal pole of testes down through incision first
6. Testicle in dartos exposed
7. Pull testicle down from within vaginal tunic
8. Apply the emasculators to the caudal vaginal tunic first or tear the ligament of the tail of the epididymis.
9. Apply the emasculators to the pampiniform plexus for 3-5 mins
10. Hold the stump as you remove the emasculators, then watch it for haemorrhage
175
What are the acute non-life threatening complications of equine castration?
- Mild haemorrhage – clamp, pack or ligate
- Herniation of omentum – resect
- Prolapsed tissue – resect
- Respiratory signs – NSAIDs with/without antibiotics
- Fever – NSAIDs
- Swelling – exercise, NSAIDs with/without antibiotics
- Seroma – re-establish drainage, exercise, NSAIDs with/without antibiotics
- Infection/abscess – re-establish drainage, exercise, NSAIDs with/without antibiotics
176
What are the acute life threatening complications of equine castration?
- Arterial haemorrhage - ligate, likely need to re-sedate or GA
- Evisceration - hold intestines up in towel to avoid self-trauma. Refer for GA, replace into abdomen, possible resection and anastomosis depending on damage.
- GA associated risks, such as cardiac event, fracture, myopathy – euthanasia? Fluids if myopathy
- Penile damage, paraphimosis - catheterise if difficulty urinating, refer for repair of CCP
177
What are the chronic complications of equine castration?
Septic funiculitis - infected spermatic cord. Presents as hindlimb stiffness/reluctance. More likely with open castration. Surgical excision under GA
Hydrocoele - peritoneal lining produces fluid leaving a pocket in scrotum (cosmetic)
178
What are the abdominal to inguinal ratios for different cryptorchid positions in equine?
Left abdominal:inguinal is 75:25
Right abdominal:inguinal is 42:58
179
How does cryptorchidism affect functionality of the stallion?
Unilateral 90% - fertile
Bilateral 10% - sterile (thermal)
All hormonally active – Leydig cells create testosterone, stallion like behaviour
180
When do the testicles normally descend in equine?
- Testicle in abomasum hypertrophies at 5 months old and epididymis descends into vaginal process
- Testicle into vaginal process by 10 months with large gubernaculum in scrotum
- At birth testicle in inguinal canal with full descent by 2 weeks
181
How does the development of the inguinal ring contribute to cryptorchidism in horses?
- Growth of the horse continues and but the inguinal ring does not expand proportionately and the inguinal canal relatively narrows
- If testes are abdominal they may become trapped there
182
How can hormone assays determine cryptorchidism in horses?
- At puberty, Sertoli cell maturation is accompanied with reduced AMH
- Greater in cryptorchids, then mature stallions and least in geldings
183
What are the advantages of laparoscopic surgery for cryptorchid castration?
- Definitive diagnosis and treatment
- May avoid GA if required
- Short convalescence
- Cosmetic results excellent
- Low incidence of complications
184
What are the disadvantages of laparoscopic surgery for cryptorchid castration?
- Cost
- Surgical experience
- Only if quiet demeanour
- More challenging if inguinal
185
Name the possible approaches for cryptorchid castration.
Inguinal approach
Para-inguinal approach
Midline abdominal approach
Laparoscopic
Midline/parainguinal approach
186
How is parturition predicted in the mare?
- Date conception
- Estimate foetal age by orbit size, limb length, head position
- Relaxation pelvic ligament
- Examination mammary glands
- Mammary secretions
- Foaling alarms – recumbency or sweat
187
How can milk electrolyte changes be used to predict parturition?
- Increased calcium, increased potassium, decreased sodium, decreased pH
- Calcium has steep incline in 12-24 hours before foaling
- 200ppm/40mg/dl then 84% of foaling within 48 hours
188
Describe stage 1 of labour in the mare.
- Duration 1-4 hours
- Onset uterine contractions
- Mild colic signs
- Foal enters pelvis
- Cervix will be opening
189
How can you prepare for foaling?
Bandage tail, wash perineum, reverse caslicks
190
Describe stage 2 of parturition in the mare.
- Duration 5-25 mins
- Abdominal contractions are explosive, powerful
- Chorioallantoic membranes rupture at cervical star
- Amnion is exteriorized
- Foal delivered
191
Describe stage 3 of labour in the mare.
- Duration 3 hours
- Expulsion of foetal membranes – allantochorion, lochia
- Mild uterine pain
192
What happens to the mare post-parturition?
- Uterine involution rapid within a week
- Vulval discharge 3-4 days
- Turnout helps express lochia
193
What has happened if stage 3 of labour takes over 3 hours in the mare?
Retained foetal membranes
194
When would foaling be induced?
- Rupture pre-pubic tendon
- Hydrops uteri
- Overdue and small foal
- Uncomfortable and open cervix
195
How would foaling be induced?
Low dose oxytocin
PG cervix
196
What is the risk of inducing foaling?
Risk to foal of peri-natal asphyxia syndrome greater than in mare
197
What are red bag deliveries in mares?
- Premature placental separation
- Predisposed by induced labour
- Emergency – get foal out asap
- Foal supplemental O2
- High risk perinatal asphyxia syndrome
198
Distinguish the effects of dystocia on the mare and foal.
Maternal – uterine torsion, pelvic fracture
Foetal – size, malpresentation, deformities such as hydrocephalus and limbs
199
What is the definition of equine dystocia?
No amnion or foal at vulva within 5 minutes or no strong contractions within 10 minutes
200
What are the alternative options for delivery of dystocia case in equine?
Vaginal assisted delivery
Controlled vaginal delivery
Caesarean section
201
What does controlled vaginal delivery allow?
Allows repositioning without contractions impairing your progress
202
When should the foal be standing and suckling?
Foal should be standing up within 1 hour and suckling within 2 hours
203
In a dystocia case, what must the mare be monitored for after parturition?
DUDE
Lactation – treatment Domperidone
Pain – treatment NSAIDs
Passing placenta within 3h
Laminitis
Endotoxic shock
Peritonitis
204
What are the possible post-partum problems?
- Retained Foetal Membranes (RFM)
- Trauma- vulva, vestibule, vagina, cervix, perineum, uterus, rectum, anus
- Uterine rupture/haematoma/prolapse
- Rupture utero-ovarian artery
- Hypocalcaemia
- Metritis
- Mammary gland issues
205
Why must the placenta be checked post parturition in mares?
Placenta check to ensue all passed in entirely for all mares – non-pregnant horn remains in situ if torn most commonly. Can check if this is still intact bit inverting to right way round and filling with water to check for tears
206
How are retained foetal membranes in the mare treated?
- Oxytocin drip/bolus
- Manual traction with care
- Post removal – lavage large volume and oxytocin bolus
207
What can happen if retained feotal membranes are left untreated?
Endometritis, laminitis, shock, death
208
When is the best stage of the oestrous cycle to recognise cervical abnormalities?
Dioestrous
209
How are uterine haematomas diagnosed?
- Presents as post-partum colic
- Diagnosis made using rectal palpation and ultrasound – blood looks like black area with speckled white dots in this fluid on US
210
How is ruptured ovario-uterine artery diagnosed?
- Severe colic
- Clinical signs
- Ultrasound scan – abdominal paracentesis
211
How is ruptured ovario-uterine artery treated in the mare?
- Autotransfusion/blood transfusion
- Formalin IV as an anticoagulant
- Antifibrinolytics
212
How is uterine prolapse in the mare managed?
- Lavage thoroughly
- Feed in gently and lavage large volume fluid
- Antibiotics
- NSAIDs
- Calcium, no oxytocin
213
How does hypocalcaemia in the mare present?
- Hyperaesthesia and dry faeces
- Spontaneous diaphragmatic flutter (thumps)
- Recumbency and tetanic spasms
214
How is hypocalcaemia in the mare treated?
Infuse calcium borogluconate
215
How is post-partum metritis treated in the mare?
Copious lavage
Topical and/or systemic antibiotics
NSAIDs
Polymyxin B
216
When is pasture breeding in horses done?
- In lower value males and stallions and in semi-feral populations
- Less knowledge of exact dates
- Less disease control/monitoring
- Stallion turned out with group or single mares
- Serves those in oestrous twice daily
217
What are the disadvantages of pasture breeding in horses?
- Bringing in new mares is difficult
- Shifts herd dynamic
- Limited numbers of mares per season
- May have preferred mares
218
What vaccination statuses are checking at stallion breeding soundness exams?
Influenza
Tetanus
EHV 1,4
EVA? – no DIVA
Strangles?
219
What is assessed on testicular palpation on stallion breeding soundness exams?
- Thin skinned scrotum
- Symmetrical – can rotate 90˚
- Firm
- Tail of epididymis is caudal
- Non painful
- Appropriate size -10x6x5cm
220
What is assessed on general examination of the penis at stallion breeding soundness exams?
Straight
Capable of erection
No masses
221
Distinguish bacteriology screening in low and high risk stallions.
'Low Risk’ Stallion – 2 negative sets of swabs >7 days apart
‘High Risk’ Stallion – 2 negative sets of swabs >7 days apart, plus screen 4 mares post mating
222
What are the clinical signs of equine viral arteritis in stallions?
- Predilection for mucus membranes – conjunctivitis
- Malaise, diarrhoea and colic, cough and dyspnoea
- Urticarial rashes, oedema (scrotum, eyelids, ventral oedema)
- Abortion in mares
223
How is equine viral arteritis transmitted?
- Droplet infection through respiratory tract
- Virus present in nasal secretion, urine, blood, faeces, semen
224
What is done with shedder stallions of equine viral arteritis?
30% of stallions shed virus in semen for life – castrate these, shedder semen not permitted
225
Where is pyospermia located?
Positive CEMO can cause pyospermia which will live in the accessory sex glands
226
How is semen collection in stallions managed?
- Avoid toxic lubricants
- Avoid contamination with water
- Avoid allowing sample to become cold
- Keep out of light
- Store at room temperature
- Extend semen before chilling
227
Why is the gel fraction removed in AI?
- Gel reduces sperm motility
- Reduces longevity
- Interferes with staining
- Makes pipetting of semen difficult
228
What are the factors affecting sperm?
Age
Season
Frequency of ejaculation and testicle size
229
How is semen assessed?
- Gross morphology
- Number – concentration, volume
- Motility – progressively motile %, objective, subjective
230
What must be done before cooling semen in cooled semen?
- Extend before cooling
- 1:1 -1:3 ratio semen:extender
- Once cool keep cool until inseminate
231
What must be done before cooling semen in frozen semen?
- Cushion then centrifuge
- Dilute into cryoprotective solution
- Cool to 5˚C
- Freeze in liquid nitrogen
232
What must be done before insemination with cooled semen?
Allow to warm in mare
233
What must be done before insemination with frozen semen?
Fast thaw 30 sec at 37˚C , cut crimped end, place in insemination device cut end first, depress stylet, pushes bung along straw, repeat
234
What should equipment in contact with semen be?
Rubber free, warmed to 37˚C, dry, dark
235
If semen quality is poor, what next?
- Semen evaluation
- Ultrasonography
- Urethroscopy
- Further tests – testicular biopsy, testicular FNA cytology, cytology
236
How does illness impact sperm production?
- Any cause of fever will reduce sperm production
- It can take a few months for fertility to increase, as spermatogenesis takes 57 days
237
What are the findings of ultrasound of normal testes?
- Echogenic capsule
- Hypoechoic parenchyma – bright echogenic stippling, central vein
238
What are the findings of ultrasound of abnormal testes?
- Generalised changes in testicular echotexture
- Often representing cellular infiltration – fibrosis (testicular degeneration), haemorrhage, oedema, inflammation/infection
- Focal changes in testicular echotexture – neoplasia, cysts, spermatocele
239
What are the possible complications of testicular biopsies in stallions?
Sperm count for weeks-months
Inflammation
Haematoma
Adhesions
Increased testicular pressure
Immune reaction against sperm
Decreased testicle size
Dangerous
240
What is haemospermia?
Reduced sperm motility due to sperm agglutinating with RBCs
241
What is the aetiology of haemospermia?
- Urethritis
- Bacterial
- Urolith
- Accessory gland infection
- Penile laceration/trauma with urethral rent
242
How is haemospermia treated in stallions?
Systemic antibiotics and NSAIDs for primary condition. Rest – no covering/collection
243
What is the aetiology of urospermia?
Cystitis, cauda equine syndrome
244
How is urospermia diagnosed?
- Obvious colour and smell, pH 9 (normal pH 7.7)
- Urea and creatinine
- Microscopically – Ca2Co3 crystals
- Sperm motility drastically affected
245
What is the effect of pyospermia?
Reduces sperm longevity
246
What are fractioned ejaculates?
1st jet – bulbourethral gland secretions
1st-3rd jets – sperm rich fraction, fluids from testes, epididymides and ampullae
247
How are urethroscopy and cytoscopy done in the stallion?
- Standing sedation
- Using standard endoscope designed for equine upper respiratory tract
248
What is the normal appearance of urethroscopy and cystoscopy?
Pale pink mucosa, longitudinal folds
249
What is the purpose of urethroscopy and cystoscopy?
Use to identify source of blood (haemospermia or haematuria), pus and visualise uroliths
250
What are some common problems of the dam that can result in abnormal foals?
- Previous/current disease
- Poor perineal conformation
- Poor nutritional condition
- History of previous abnormal foals, placental abnormalities and twins
251
How can you evaluate the foetus and placenta prepartum?
- If pregnancy identified as high-risk – evaluate foetus for viability by patting head and seeing if it bounces back (crude test and foal must be quite big)
- Movement on rectal
- Ultrasound – foetal fluids, placental thickness (increases with placentitis), heart beat
- Foetal ECG
- Normal foetal heart rate in the last months gestation is 65-115 bpm
252
How can altrenogest be used to manage high risk pregnancies in foaling?
- Provide exogenous progesterone to support the pregnancy
- Some evidence
- Should commit to continuing treatment until after about 180 days gestation
- Cost can add up
- Risk dummy foals?
253
What are the clinical signs of placentitis?
- Running milk – commonest sign
- Some have vulval discharge
- Often thick placental wall on ultrasound
254
How is placentitis in the mare managed?
Altrenogest plus TMPS
255
What is the protocol for a mare ran milk in high risk pregnancy?
- Give colostrum from another mare or hyperimmune plasma
- Then give 1 or if possible, 2l total of either, 250ml every hour
- Then check IgG at 12 to 24h, give IV plasma if required, then re-check IgG
256
How do cardiovascular and respiratory systems change in the foal?
- Spontaneous breathing within 1st minute
- Up to 80bpm in 1st hour
- Then 30-40bpm
- At least 60bpm in 1st hour
- By 1 day old, 70-100bpm
- Investigate any murmur persisting beyond 1 week old
257
What should be investigated in the foal?
Heart rate
Respiratory rate
Mmbs
Temperature - 37.5-39˚C for first 7 days
Standing in 1 hour
Nursing 1 – 3 hours
Urine usually 5 – 10 hours
Any limb deformities
258
What are the most common causes of respiratory arrest in foals?
- Premature placental separation
- Early severance or twisting of the umbilical cord
- Dystocia
- Airway obstruction by foetal membranes
- Failure to spontaneously breathe (unknown cause)
259
What are the possible causes of cardio-pulmonary arrest in foals not associated with birth?
Primary lung disease
Sepsis
Hypovolaemia
Metabolic acidosis
Hyperkalaemia
Hypoglycaemia
Hypothermia
260
What are the success rates of CPR in foals?
- If resuscitation is begun before a non-perfusing rhythm develops, likelihood of revival is good (~ 50%)
- If there is a delay until after asystole, survival is less than 10%
261
When should equine neonates be resuscitated?
- Heart rate is less than 60 bpm or irregular
- Slow/irregular respiration
- In lateral, some muscle tone
- One nasal mucosal stimulation, grimace
- Stimulate intranasal oxygen
- Heart rate or respiration is undetectable
- Muscle tone limp/absent
- Unresponsive to nasal mucosal stimulation
262
How is ventilation done in resuscitation?
1. Clear the airway
2. Place naso or endotracheal tube is the in the birth canal
3. Ventilate (many response to ventilation alone)
263
If the foal does not respond to ventilation alone, how are foals resuscitated?
- Mouth to tube, ambu-bag to mask or mouth to nose, close opposition nostril
- Room air is fine, you just want to get air into them
- Look for chest excursion to make sure tidal volume is sufficient
- Short, infrequent breaths – 10bpm is enough
- Do 6 breaths and re-assess
264
What is the consequence of aerophagia and how is it eliminated?
If no cuffed tube in place, make sure the head is extended to reduce aerophagia – distended stomach with air can reduce thoracic capacity.
265
Describe how to administer CPR in foals.
1. Reassess 30 seconds after starting ventilation
2. If HR 40bom or less than 50bpm and not increasing, decide to do CPR
3. Check for rib fractures
4. Place fractured rib side down
5. If bilaterally fractured, place the side with more of the cranial ribs fractured down
6. Chest compressions
7. If remains bradycardic – epinephrine
266
How should chest compressions be done in foal CPR?
- Ideally 1 person to compress and 1 to ventilate with no pauses
- Compression to ventilation ratio of 5:1
- Compression 100-120 per minute
267
What supportive care is given to the foal post resuscitation?
- Keep warm - bandages, blankets, keep off the floor. If low temp, warm slowly
- 5% glucose - do not warm before giving glucose if hypoglycaemic
- Hydration
268
How is dehydration in foals different to equine adults?
- Rapid deterioration to life threatening severity
- USG >1.010
- Often hypoglycaemic
- 50kg bolus – 1l bolus Hartmann’s then reassess
269
How should acidaemia in foals be managed?
- Measure pH, base excess
- Treat fluid deficit
- Oxygen is appropriate
- Always correct hypokalaemia
270
How is failure of passive transfer categorised in foals?
Partial FPT 400-800mg/dl
Total FPT is under 400mmg/dl
271
What is failure of passive transfer a risk factor of?
Sepsis – 87.5%
272
Which at risk foals should be tested for failure of passive transfer?
Maternal disease
Dystocia
Slow to suck
Meconium impaction
Any other problems with foal
Mare leaked milk
273
How are foals tested for failure of passive transfer?
SNAP ELISA
274
How should a septic foal due to failure of passive transfer be managed?
- Hyperimmune plasma transfusion
- Blood – giving set
- Re-test after each bag
275
What is the usual entry point of bacteria causing sepsis in foals?
Usually the gut and can go and sit into the blood/septicaemia and go sit in places – septic umbilicus, septic joint
276
What are the clinical signs of sepsis in foals?
- Pyrexia
- Depression
- Recumbency
- Injected mucous membranes
- May have joint effusion with/without lameness
- May be totally non-responsive
277
What tests can diagnose sepsis in foals?
- Blood culture (sterile sample)
- White cell count
- SAA
- SNAP test
- Creatinine – risk anuric renal failure
- Urine specific gravity best indicator of hydration
- Glucose
- Lactate
- Culture from umbilicus
- Joint sample for cytology and culture
278
How is sepsis in foals treated?
- Broad spectrum antibiotics, then based on culture. Cephalosporin/ampicillin and amikacin – avoid gentamycin
- Plasma – even if no FPT
- Joint lavage
- Remove umbilicus
- Nursing vital – sternal, warm, dry
279
What are the characteristics of seizures in foals?
Subtle signs
Generalised convulsions – get seizures with less obvious signs like the head being repeated turned back, differentiate from behaviour whether you can distract them out of it
280
What are the possible causes of seizures in foals?
- Hypoxia
- Cranial trauma
- Electrolyte abnormalities
- Hypoglycaemia
- Sepsis
- Neonatal maladjustment syndrome
- Idiopathic epilepsy of Arabians
- Congenital anomalies
281
How are seizures managed in foals?
- Correct primary cause if possible
- Maintain airway
- Administer oxygen
- Anticonvulsant therapy - Diazepam v. Midazolam, all 5 mins
282
What are dummy foals?
- Hypoxic ischaemic encephalopathy (HIE), perinatal asphyxia syndrome (PAS), maladjustment syndrome, but are all likely the separate syndromes in the same foal
- Waves of neuronal cell death over several days
- Typically normal at birth
- Signs of CNS abnormalities at a few hours old
- Worst at 48h old
283
What are the possible causes of dummy foals?
Hypoxia at birth
Hypoxia in utero – maternal illness, placentitis, cytokinaemia
284
What are the varying signs of dummy foals?
- Slow to swallow
- Not sucking
- Not following mare
- Ataxic
- Forgetting to breathe
- Seizure
- Can have damage to other organs – GI tract may result in ileus, renal compromise
285
How are dummy foals treated?
- Nursing
- Maintain cerebral perfusion – careful iv fluid support
- Correct metabolic imbalances
- PPN/slow enteral feeding
- Madagan squeeze technique – tie them up and squeeze through a tube to imitate being born to stimulate switch off of inhibitory neurotransmitters that are present in utero (being sleepy in utero)
286
How is prematurity of the foal categorised?
>320d unusual to be premature
< 305 days need ICU. Less likely to survive if placenta normal
<280 days is very unlikely to survive
287
Distinguish dysmaturity and postmaturity in foals.
Dysmaturity = look premature despite normal or often longer gestation
Postmaturity = long gestation, normal size but emaciated
288
How is prematurity and dysmaturity characterised?
- Smaller than expected
- Silky short hair
- Floppy ears
- Domed head
- Weak
- Abnormal RR (low or high)
- Organs immature
- Incomplete ossification carpal and tarsal bones
289
How is flexural deformity managed in foals?
- Physiotherapy
- Walk on hard ground
- Oxytetracycline – antibiotic that is given as it has a side effect of binding calcium
- Toe extensions
- Splint
- Half limb cast
- Full limb cast
- Check ligament desmotomy
- Tenotomy
290
How is meconium retention in foals managed?
1. Soapy water enema/phosphate enema
2. Acetylcysteine retention enema – breaks down mucus
3. Analgesia – buscopan
4. Surgery – rare
291
How are gastric ulcers prevented in foals?
- Reduction in blood supply to stomach wall
- Pg** encourage blood supply to stomach wall
- Sucralfate encourages Pg**
- Use sucralfate prophylactically in compromised foal
- Raising pH may be contraindicated for prevention - more sepsis and may not work anyway, avoid NSAIDs
292
How are hernias in foals managed?
- Umbilical/scrotal
- Ultrasound to assess size, risk for strangulation of SI
- Surgery at 3 months if not resolved, and does not require surgery earlier
293
What are the risks of pneumonia in foals?
Aspiration – beware of owners bottle feeding
FPT risk
294
What are the clinical signs of pneumonia in foals?
- Increased respiratory rate and effort
- Pyrexia
- If severe, often fatal
295
When do foals show clinical signs of rhodococcus equi?
6 weeks
296
What are the possible clinical signs of rhodococcus equi in foals?
Pneumonia
Septic/immune mediated joint effusion
Diarrhoea
297
What are the diagnostic tests of rhodococcus equi in foals?
- Thoracic radiograph – abscesses
- Tracheal wash, cytology, culture and sensitivity
- Joint fluid sample if effusion
- Very high WCC and fibrinogen
298
How is rhodococcus equi in foals treated?
- Clarithromycin (or other macrolides) – do not give to hindgut fermenters but baby foals are not yet hindgut fermenters
- Plus rifampicin – beware (fatal) diarrhoea in adult, discuss precautions so that mare does not clean baby of faeces containing this drug
- Treat until radiographs and blood normal
- Joint lavage
299
What are the clinical signs of neonatal isoerythrolysis in foals?
Anaemia
Icterus
Weak
300
How is neonatal isoerythrolysis treated in foals?
- Transfusion at PCV < 12%
- Washed red cells v. donor
- Withdraw colostrum
- Prevent future foals from drinking colostrum
- Blood type dam and sire
