Parturition, dystocia, post-partum events and reproductive surgery

Question 1

Decsribe rupture pre-pubic tendon or abdominal wall rupture

Answer 1

mainly heavy horses
Characterised by massive ventral swelling and oedema, abdominal pain and often recumbency

Question 2

Describe how to manage abdominal wall rupture in pregnant mare

Answer 2

Use of belly band in late pregnancy?
Prognosis is poor because mare cannot generate expulsive abdominal effort
Parturition normally need to be induced- assistance with delivery

Question 3

How to induce parturition in the mare

Answer 3

PG (higher dose than luteolytic)
Oxytocin- if close to due date

Question 4

List 3 indications for induction of parturition of mare

Answer 4

1. mares with dystocia or premature placental separation in previous deliveries
2. Mares with abnormalities such as rupture of the prepubic tendon
3. Mares that are very uncomfortable with marked ventral oedema and are running milk and have an open cervix

Question 5

List 3 criteria for induction of parturition

Answer 5

adequate gestation length- at least 330days
adequate mammary development and milk/colostrum production
suitable softening of the cervix

Question 6

List 5 things that can be used to predict parturition

Answer 6

Date of conception
Estimation of fetal age using ultrasound
Relaxation of pelvic ligaments
Waxing up of the teats
Change in mammary secretion

Question 7

What is the most common cause of dystocia in mares

Answer 7

fetal disposition

Question 8

How to treat perineal tears

Answer 8

Usually best to delay repair as heal well without treatment- Except third degree laceration
NSAIDs + topical treatments (lavage etc)
Don’t forget tetanus status

Question 9

how long till placenta delivered in mares

Answer 9

within 3 hours of foaling- after this considered abnormal

Question 10

How to treat retained fetal membranes in mare

Answer 10

1. Separate allanto-chorion from uterus at vulva
2. Twist allanto-chorion so force evenly applied
3. Insert hand between uterus and allanto-chorion
4. If haemorrhage or not easily separating – STOP
5. Either attempt oxytocin treatment or preventative treatments and revisit in 8 hours
6. Daily Abs and anti-inflam and lavage

Question 10

Philomena foaled at grass 7 days ago. It has been very cold and the ground is frozen and she has been quite hungry. The foal is sucking well.
This morning she did not seem able to nibble at the grass, and what she did pull up fell out of her mouth. This afternoon she has developed some kind of fasiculations

what metabolic condition is this

Answer 10

hypocalcaemia

Question 11

signs of hypocalcaemia in mares

Answer 11

Mild cases appear to be hyperaesthesia and dry faeces
This is followed by inability to prehend food (which worsens the condition)
Subsequently there is diaphragmatic asynchrony (‘thumps’)

Question 12

How to treat hypocalcaemia in mare

Answer 12

Treatment is slow infusion of calcium borogluconate to effect whilst continuously monitoring cardiac activity

Question 13

what does Caslick’s Vulvoplasty aim to do

Answer 13

Aims to close the dorsal commissure of the vulva and so improve the vulval seal

Question 14

3 Indications for a caslick vulvoplasty

Answer 14

Correction of mild conformational abnormalities which cause pneumovagina
Sunken anus
Sloping of the vulva

Question 15

List 2 complications of caslicks vulvoplasty

Answer 15

faecal accumulation on sutures
wound breakdown

Question 16

what is the aim of a episioplasty

Answer 16

Aims to produce some reduction in diameter of the vestibule- decreasing potential for contamination

Question 17

2 indications of episiopasty

Answer 17

Correction of moderate conformational abnormalities which lead to pneumovagina
Elevated vulva in relation to pelvic floor

Question 18

what are the aims of Perineal Body Transection (Pouret’s Operation

Answer 18

Aims to increase the distance between the anus and the vulva- restores anatomy and function

Question 19

indications of Perineal Body Transection (Pouret’s Operation)

Answer 19

Correction of severe conformational abnormalities which lead to pneumovagina

Question 20

what do you need to advise owner regarding 3rd degree perineal laceration

Answer 20

No use for that breeding season
Anus may never function again
May require more than one attempt at surgical repair

Question 21

what are the aims of clitoral sinusectomy

Answer 21

To remove the sinus areas to ensure that CEMO (contagious equine metritis organism) cannot be harboured prior to export

Question 22

Describe first degree laceration

Answer 22

small tears with significant reddening and bleeding - will settle with general nursing care

Question 23

Describe a second degree laceration

Answer 23

laceration through the vulval lips
hole may seal on its own but if not can be sutured after sloughing has occured

Question 24

Describe a 3rd degree laceration

Answer 24

extends through the anal sphincter muscle- anus and vestibule become one opening

Question 25

Describe a recto-vaginal fistula

Answer 25

hole through the vestibule wall into the anus - doesn’t extend to the edge of the anus - will need to be turned into a third degree laceration to be fixed