Mare Dystocia

Question 1

Rapid resolution of dystocia
corresponds to ? (3)

Answer 1

– Improved fetal outcome
– Improved mare survival
– Improved mare fertility

Question 2

what is included in initial eval (6)

Answer 2

-History
-What are client’s financial limitations
-Fetus alive? Or dead…
-Presentation, position, posture
-Assess trauma; Affects decision making from the start!
-Make a plan - which optionwill resolve the dystocia rapidly

Question 3

Obstetrical Principles (4)

Answer 3

-Cleanliness
-Lubrication
-Care and caution
-Have a plan and
timelines (Avoid large number
of in-and-out movements)

Question 4

sedation options / epidural options

Answer 4

-Xylazine or detomidine, plus
butorphanol

+/- Epidural
-Lidocaine alone OR
-Xylazine 0.17 mg/kg with 3 ml
lidocaine for longer duration of
action

Question 5

what can you give to reduce contractions

Answer 5

Clenbuterol

Question 6

Assisted Vaginal Delivery
in Mares; indications

Answer 6

• Temperament will allow
• Draft mares where GA is less than ideal
• Minimum manipulations expected to resolve dystocia

Question 7

Controlled Vaginal Delivery In
Mares; indications

Answer 7

• Failure of AVD
• Temperament won’t allow AVD

Question 8

Controlled Vaginal Delivery In
Mares; positioning

Answer 8

• Anesthetized
• Dorsal recumbancy with hindend elevated is preferred

Question 9

when should we refer the case (5)

Answer 9

-Discuss from the beginning with client; If not an option, best to know right away
-Transverse presentation – C Section
-Live foal and difficult, prolonged manipulation expected
-Fetotomy is indicated and you don’t have the proper equipment
-Discuss that euthanasia of mare is a possible outcome

Question 10

Coordinated Dystocia Management
Protocol (CDMP); uses

Answer 10

-CDMP reduces time to resolution was adopted
-Increases mare survival
-More foals discharged alive if delivered by AVD than by CVD

Question 11

what to do if after 15 minutes the dystocia isnt resolved when doing CDMP

Answer 11

– Fetotomy
– C – section/Terminal C-Section

Question 12

Frequently Encountered Fetal
Malalignments in Mares

Answer 12

• Dog-sitting
• Breech
• Head /neck deviations
• Carpal / shoulder flexion
• Contracted tendons

Question 13

what can complicate foal corrections

Answer 13

The length of foal limbs can complicate corrections

Question 14

dog sitting; options to fix position

Answer 14

-Repel hindlimbs; Often revert
-C section if alive
-Fetotomy or
-C- section if foal dead

Question 15

what is a fetotomy

Answer 15

-Definition: fetal dismemberment to allow extraction
-Preferred option in some cases over difficult repositioning

Question 16

what is needed to do a fetotomy

Answer 16

Proper equipment is essential

Question 17

how many cuts can you make for a fetotomy and why

Answer 17

-Mares more sensitive to prolonged manipulations per vaginum – severe
trauma….infertility
-Therefore limit to max. 2-3 cuts in mares

Question 18

When might fetotomy be preferred
in a mare?

Answer 18

-You asses fetus is dead and 1-2 cuts will allow you to remove it
-Breech presentation; with limited space to reposition
-Bilateral carpal flexion with contracted tendons
-Lateral deviation of head and you cannot reach nose
-Dog-sitting
-Shoulder flexion

Question 19

how do deal with a breech position

Answer 19

-CVD; hips up, fill uterus with lube
-Convert hip flexion to hock flexion
-Then extend limbs; Distal limb comes medial, joint laterally
-Fetotomy –split pelvis of foal
-C-Section

Question 20

how to deal with deviations of head and neck

Answer 20

-If alive, repel to allow room
-Grasp lower jaw and bring head around into pelvis
-Use of a rope

Question 21

how to deal with Bilateral Carpal or Shoulder
Flexion

Answer 21

If fetus alive
-Repel and reposition
-Intranasal Oxygen to foal
-C-section

-Warn owner of possible contracted tendons that may result in euthanasia of foal

-Fetotomy if dead

Question 22

how to deal with Transverse position

Answer 22

-Extremely difficult fetotomy
-Turning fetus around usually results in large uterine tear
-C-Section indicated

Question 23

when to do c section in mares (3)

Answer 23

-Immediate preferred option in some cases
-Live foal where resolution is expected to be long and difficult
-Dead foal where mare’s future fertility is of utmost concern

Question 24

Complications After C-Section in Mares (5)

Answer 24

-Retained Fetal Membranes common
-Stormy anesthetic recoveries (Tends to occur in mares with prolonged dystocia)
-Fractures in recovery
-Incisional problems following C section
-Long recovery with abdominal incision

Question 25

Complications of Dystocia in Mares (7)

Answer 25

-Perineal Lacerations
-Uterine tears
-Uterine prolapse
-Cervical tears
-Vaginal/cervical adhesions
-Retained membranes
-Infertility