Mare Dystocia Flashcards
Rapid resolution of dystocia
corresponds to ? (3)
– Improved fetal outcome
– Improved mare survival
– Improved mare fertility
what is included in initial eval (6)
-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
Obstetrical Principles (4)
-Cleanliness
-Lubrication
-Care and caution
-Have a plan and
timelines (Avoid large number
of in-and-out movements)
sedation options / epidural options
-Xylazine or detomidine, plus
butorphanol
+/- Epidural
-Lidocaine alone OR
-Xylazine 0.17 mg/kg with 3 ml
lidocaine for longer duration of
action
what can you give to reduce contractions
Clenbuterol
Assisted Vaginal Delivery
in Mares; indications
- Temperament will allow
- Draft mares where GA is less than ideal
- Minimum manipulations expected to resolve dystocia
Controlled Vaginal Delivery In
Mares; indications
- Failure of AVD
- Temperament won’t allow AVD
Controlled Vaginal Delivery In
Mares; positioning
- Anesthetized
- Dorsal recumbancy with hindend elevated is preferred
when should we refer the case (5)
-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
Coordinated Dystocia Management
Protocol (CDMP); uses
-CDMP reduces time to resolution was adopted
-Increases mare survival
-More foals discharged alive if delivered by AVD than by CVD
what to do if after 15 minutes the dystocia isnt resolved when doing CDMP
– Fetotomy
– C – section/Terminal C-Section
Frequently Encountered Fetal
Malalignments in Mares
- Dog-sitting
- Breech
- Head /neck deviations
- Carpal / shoulder flexion
- Contracted tendons
what can complicate foal corrections
The length of foal limbs can complicate corrections
dog sitting; options to fix position
-Repel hindlimbs; Often revert
-C section if alive
-Fetotomy or
-C- section if foal dead
what is a fetotomy
-Definition: fetal dismemberment to allow extraction
-Preferred option in some cases over difficult repositioning
what is needed to do a fetotomy
Proper equipment is essential
how many cuts can you make for a fetotomy and why
-Mares more sensitive to prolonged manipulations per vaginum – severe
trauma….infertility
-Therefore limit to max. 2-3 cuts in mares
When might fetotomy be preferred
in a mare?
-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
how do deal with a breech position
-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
how to deal with deviations of head and neck
-If alive, repel to allow room
-Grasp lower jaw and bring head around into pelvis
-Use of a rope
how to deal with Bilateral Carpal or Shoulder
Flexion
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
how to deal with Transverse position
-Extremely difficult fetotomy
-Turning fetus around usually results in large uterine tear
-C-Section indicated
when to do c section in mares (3)
-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
Complications After C-Section in Mares (5)
-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
Complications of Dystocia in Mares (7)
-Perineal Lacerations
-Uterine tears
-Uterine prolapse
-Cervical tears
-Vaginal/cervical adhesions
-Retained membranes
-Infertility
