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CVSOH1 Clinical Repro > Is She In Foal? > Flashcards

Is She In Foal? Flashcards

1
Q

Methods of PD and times at which they can be used?

A
  • Transrectal ultrasound – from d12 (15 common).
  • Elevated plasma progesterone – d18-20.
  • Failure to return to oestrus – d18-21.
  • Transrectal palpation – from d21.
  • Plasma equine chorionic gonadotrophin d60-120.
  • Transrectal ballottment of foetus – d80.
  • Oestrone sulphate (plasma) – d100-150.
  • Urine oestrogen – d120-150.
  • Birth – 11m11d (ish).
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2
Q

Transrectal palpation…
1. What does normal luteal phase feel like?
2. What does it feel like from d21 preg?
3. What does it feel like from d40 preg?
4. What does it feel like from d60 preg?

A
  1. Uterus becomes more tonic, cervix closed (hard).
  2. Conceptual swelling protrudes at base of one horn and usually bulges ventrally.
  3. Extensive ovarian activity (under eCG) results in ovarian enlargement.
    Uterine swelling continues to increase in size and is spherical.
  4. Swelling is approx. 12cm diameter and fills pregnant horn and may involve uterine body.
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3
Q

Transrectal palpation…
1. What does it feel like from d90?
2. What does it feel like from d120?

A
    • Whole uterus filled w/ fluid and more ventral in position.
      - Distinction between b body and horns difficult.
      - Uterus may be difficult to palpate and foetus may not be balloted.
    • Follicular activity ceases and ovaries become progressively smaller.
      - Significant tension is present in ovarian ligament and the utero-ovarian ligaments.
      - Ovaries move more ventrally and medially.
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4
Q
  1. What can be seen at first on transrectal ultrasound when pregnancy positive?
  2. What can be seen at d18 when implantation has happened?
  3. From d20?
A
  1. Sphere (anechoic) of 1cm diameter.
  2. Sphere (anechoic) of 3cm diameter.
  3. Takes an irregular shape.
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5
Q
  1. Time of foetal motility?
    – What does it stimulate?
    – What happens in this time?
  2. What then needs to happen and why?
A
  1. 11d-16d.
    – Maternal recognition of pregnancy.
    – Increased tone, foetus come to rest in horn.
    – Foetus gains O2 by diffusion.
    – Nutrients mostly from yolk sac.
  2. Embryo needs to implant to gain O2 and nutrients.
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6
Q
  1. From what point of pregnancy are foetal heart beat and allantoic membranes visible?
  2. From what point of pregnancy is allantois and yolk sac sizes equal?
  3. From what point of pregnancy is allantois larger than yolk sac?
A
  1. day 24.
  2. day 30.
  3. day 36 (3cm+ daily growth from here).
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7
Q
  1. d40 transrectal ultrasound?
  2. d50 transrectal ultrasound?
  3. d55-65 transrectal ultrasound?
  4. d60 transrectal ultrasound?
  5. d85 transrectal ultrasound?
A
  1. Yolk sac gone.
  2. Foetal limb buds.
  3. Genital tubercle.
  4. Foetal eyes.
  5. Foetus out of reach.
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8
Q
  1. What do you want to look for in mare 12-15d pregnant?
  2. 24-28d pregnant?
  3. 35d pregnant?
  4. 65-80d pregnant?
A
  1. Twins.
  2. Heartbeat.
  3. Just before endometrial cups form.
  4. Foetal sexing.
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9
Q

Consideration when ultrasound scanning?

A

Preg v cyst.
- Preg typically spherical at <20d and has characteristic specular reflections (artefacts).
- Cysts usually irregular.
- Pregnancies grow.
Twins (one can hide!)
- Check for 1 or 2 CL.
- Careful if scanning early.
- Be systematic.

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10
Q
  1. DDx for twins?
  2. How does a twin pregnancy usually occur?
  3. Incidence of twins in same horn?
  4. What % naturally reduce to single?
  5. What is likely to happen if not reduced to single?
A
  1. Uterine cysts.
  2. 2 follicles (up to 1/3 of ovulations) whch can be days apart (count CLs).
  3. Approx. 50%.
    - manual palpation poor accuracy.
    - US can still be tricky to spot.
  4. 83%.
  5. Abort at 8-9mths - uterine SA no longer efficient to sustain.
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11
Q
  1. Early options for twin management?
  2. Later options for twin management?
A
  1. Manual rupture, where you pinch one.
    Abort both w/ PG.
    *must check for effect afterwards.
  2. TUGA/Cervical luxation.
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12
Q

Rectal tears as complication of rectal exam…
1. Presentation.
2. DDx.

A
  1. Blood on rectal glove.
    Sudden loss of rectal tone.
  2. Blood from ulceration/proctitis.
    Loss of tone w/ gas movement.
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13
Q

Rectal tear grading,

A
  • Grade 1 = mucosa + submucosa damaged, medically treat or blindly suture.
  • Grade 2 = only muscular layer damaged, medically treat.
  • Grade 3a = Mucosa, submucosa and muscular rupture w/ serosa intact, treat w/ euthanasia, surgically or medically.
  • Grade 3b = Mucosa, submucosa and muscular layers (full thickness) w/ mesocolon intact dorsally, treat w/ euthanasia, surgically or medically.
  • Grade 4 = Full thickness w/ exposure to peritoneum, treat w/ euthanasia or surgically.
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14
Q

Rectal tear dx confirmation.

A
  • Visualisation.
    – endoscopy.
    – speculum.
  • Palpation.
    – un-gloved hand?
  • Abdominocentesis.
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15
Q
  1. Positioning of most rectal tears.
  2. Lengths of tears and associated causes.
A
  1. Dorsal-dorsolateral.
  2. 6cm repro exam.
    4cm GI exam.
    25cm dystocia.
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16
Q
  1. In what instances is rectal tearing a risk?
  2. How can this risk be reduced?
A
  1. Rectal exam (repro, GI, general medical).
    Dystocia.
    Sex – female.
    Age – older.
    Breed – Arab, American miniature ponies.
  2. sedation and relaxants (Buscopan).
17
Q

What to do when rectal tearing occurs.

A
  • Be reassured this is a known risk.
  • Don’t hide the fact that it has happened.
  • Offer 2nd opinion / referral.
  • Administer appropriate first aid:
    – ABX, NSAIDs, absorbent packing.
18
Q

Mare hormonal changes of pregnancy?

A
  • Primary and secondary CLs produce progesterone.
  • Progesterone initially declines but is then supported by eCG from endometrial cups.
  • Progesterone still declines from mid pregnancy onwards.
19
Q

What are the options for serology if unable to rectal?

A
  • Progesterone (>1ng/ml at 18-20 d post ovulation (false -ve).
  • eCG/Pregnant Mare Serum Gonadotrophin (PMSG):
    – 95% reliable 60-80d.
  • Oestrone Sulphate:
    – foeto-placental oestrogens from foetal gonads.
    –> peak levels at 150d, can measure until 300d.
    –> More accurate than PMSG from 100d.
    –> Urine measure from 120d.
    –> DEMONSTRATES LIVE FOAL!
20
Q

Causes of pregnancy loss.

A
  • Early embryonic death.
  • Infectious.
  • Non-infectious causes.
  • Intended abortion by vet:
    – <~35d.
    –> until endometrial cups form.
    –> use prostaglandins to abort.
21
Q
  1. Oestrus next seen after embryo loss at 0-5d.
  2. Oestrus next seen after embryo loss at 5-15d.
  3. Oestrus next seen after embryo loss at 16-36d.
  4. Oestrus next seen after embryo loss at 36-140d.
  5. Oestrus next seen after embryo loss at or after 140d.
A
  1. Normal oestrus interval.
  2. Early return to oestrus.
  3. Approx. 6wks after luteolysis of primary CL.
  4. Approx. 5mths after luteolysis of secondary CL.
  5. Variable time dept. on season and why foal lost.
22
Q
  1. What percentage pregnancy loss cause by infection?
  2. Infections that cause pregnancy loss.
A
  1. Approx. 60%.
    • Bacterial placentitis.
      - EHV.
      - Equine Viral Arteritis notifiable.
23
Q
  1. Bacterial placentitis clinical signs.
  2. Dx of bacterial placentitis?
A
    • Vulval discharge.
      - Lactation.
      - Abortion.
    • Culture and sensitivity.
      - Mostly Streptococcus zooepidemicus in UK.
      - Ascending infection.
      - If culture -ve, consider false -ve.
24
Q

Treatment of bacterial placentitis?

A

ABX appropriate C+S.
- Care over ABX crossing placenta.
- TMPS/Pen/Ceftiofur/Gentomycin.
NSAIDs.
Altrenogest - uterine quiescence.
Vit E - antioxidant.
O2 delivery mare.

25
Q
  1. EHV-1.
  2. EHV-4.
  3. When is abortion due to EHV usually seen?
  4. EHV vac?
  5. What to check for if late abortion cause suspected to be due to EHV?
A
    • Respiratory disease.
      - Abortion (incl. storms).
      - Neuro form.
    • Mainly respiratory disease.
      - Occasional abortion.
  3. Late pregnancy - ~7d after viral contact (5,7,9mths pregnancy).
  4. Does not wholly protect from abortion forms.
  5. Check others (youngstock) for respiratory signs.
26
Q

Dx of EHV.

A
  • Virus isolation on nasopharyngeal swabs.
  • Serology – rising Ab titre CF.
  • Endometrial swab – PCR.
  • PM – VI/PCR. –> histopathology.
27
Q
  1. EVA notifiable?
  2. Transmission of EVA?
  3. Clinical signs of EVA?
A
  1. Yes.
  2. Venereal and respiratory routes.
    • Abortion.
      - Conjunctivitis.
      - Scrotal swelling.
28
Q

Dx of EVA?

A
  • Clinical signs.
  • Placental signs.
  • PM – VI/PCR.
  • Semen – VI/PCR.
  • Nasopharyngeal swab – PCR.
  • Serology – ELISA/VN rising titre.
29
Q

Infectious causes abortion not usually seen in UK.

A
  • Leptospirosis.
  • EIA notifiable (Coggins test AGID).
  • Piroplasmosis.
  • Dourine notifiable.
  • Mycotic – occasionally Aspergillus UK.
  • Mare Reproductive Loss Syndrome.
    – Kentucky and Australia.
30
Q

Non-infectious causes of pregnancy loss.

A
  • Vascular compromise from umbilical cord (twisted) (long cords prone to this).
  • Twins (not identified earlier).
  • Premature placental separation.
  • Uterine torsion.
  • Ruptured pre-pubic tendon.
  • Hydrops.
  • Pseudopregnancy.
  • Prolonged gestation.
31
Q

Abortion of twins.

A

Survival dept. on location.
- determines endometrial surface area.
– one dies early, it mummifies, the other may survive.
– one dies late, inflammation aborts both @ 5-8mths.
– 50:50 share of endometrium, 2 small foals.

32
Q

Premature placental separation.

A
  • Usually in periparturient mare.
  • “Red bag delivery”.
    – endometrial surface of allantochorion.
    – velvet-like red protrusion appears at vulval lips.
  • Incise this to deliver foal.
    EMERGENCY
33
Q

Uterine torsion.

A
  • Mid-late term mare.
  • Presents w/ colic.
  • Dx by palpation.
  • Treatment = caesarean section, flank laparotomy, rolling UGA?
34
Q

Uterine dorsoretroflexion.

A

Late pregnancy mare.
Moderate to severe colic.
Palpation of foetus v painful.
Treatment = Clenbuterol and gentle exercise.
Can resolve.

35
Q

Ruptured pre-pubic tendon.

A
  • Aged heavy breed mares.
  • Presents w/:
    – massive ventral swelling.
    – pitting oedema.
  • Treatment = support abdomen w/ belly bandage and assisted foaling.
36
Q

Hydrops uteri.

A
  • Mid-late pregnancy (>7m)
  • Presents with distended abdomen
  • Allantois» Amnion
  • Foetus usually non viable
  • Treatment:
  • Induce abortion
  • Care with shock after fluid loss.
37
Q

Pseudopregnancy.

A
  • EED not recognised and O is expecting a foal…
  • PD by Progesterone early, eCG, rectal palpation
  • v not by US (visualise)/ oestrone sulphate (live foal)
  • Weight gain due to overfeeding by owner
  • Not physiological
  • May lactate
  • Due to nutrition plane.
38
Q

Prolonged gestation.

A

May be <370d (330-345 normal).
Factors:
- Wrong dates.
- Sex (males slightly longer).
- Individual variation.
- Placental lesions.
- Death of 1 twin.

CVSOH1 Clinical Repro (36 decks)

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