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y4 eq - reproduction > Peri –Parturient Problems in the Mare > Flashcards

Peri –Parturient Problems in the Mare Flashcards

1
Q

List the pre-parturient problems seen in mares

A
  • Colic
  • The over-large mare: ventral oedema, pre-pubis tendon rupture
  • Placentitis
  • Varicose veins
  • Orthopaedic disease
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2
Q

List the parturient problems seen in mares

A

Dystocia
Uterine rupture
Uterine tears
Cervical tears
Perineal tears

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3
Q

List the post-parturient problems seen in mares

A

Colic
Uterine prolapse
Rectal prolapse
Retained placenta
Metritis
Hypocalcaemia
Tetanus

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4
Q

Describe pre-parturient colic

A
  • Treating colic in the pre-parturient mare can be diagnostically and therapeutically challenging.
  • Colic is not uncommon in late-term mares
  • As well as all the “normal” types of colic, there are colics specific for pregnancy.
  • Some pregnancy-specific colics have a poor (or worse) prognosis
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5
Q

Why is investigation of colic harder when it presents pre-parturiently?

A
  • Investigation is hampered by the presence of a large foal – this makes rectal examination, abdominal ultrasound and abdominocentesis more difficult and less useful.
  • Heavily pregnant mares are poor candidates for general anaesthesia
  • Exploratory laparotomy hampered by presence of foal
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6
Q

List the different pregnancy specific colic seen in mares

A
  • ‘Foal movement’
  • GI colic
  • Actually foaling or aborting
  • Ischaemia/necrosis/rupture of caecum and colon
  • Uterine torsion
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7
Q

Describe ‘foal movement colic’

A
  • Mild-moderate medical colics –caused by intra-uterine movement of the foal?
  • Common
  • Should respond to mild/moderate analgesia (buscopan or phenylbutazone)
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8
Q

How can you tell apart colic from actually foaling or aborting?

A

Vaginal exam - is the cervix open?

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9
Q

Describe colic due to ischaemia/necrosis/rupture of caecum and colon in mares

A
  • Syndrome of ischaemic necrosis of colon/caecum potentially ending in rupture.
  • Due to weight of foal applying pressure to viscera or stretching visceral blood vessels
  • Difficult to diagnose definitely – look for signs peritonitis/endotoxaemia
  • Even more difficult to manage – lesions maybe inaccessible at exploratory laparotomy
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10
Q

How is colic due to uterine torsion diagnosed?

A

Rectal palpation – palpate one tight broad ligament
Vaginal exam not helpful – unlike cattle, twist cranial to cervix

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11
Q

How is colic due to uterine torsion treated?

A

Surgery
Standing flank laparotomy
GA and midline laparotomy (± caesarean?)
Rolling under GA – not recommended

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12
Q

Describe ventral oedema seen in pre-parturient mares

A
  • Some mares develop a large plaque of ventral oedema near term.
  • This maybe due to compression of lymphatic drainage by foal.
  • If mare is well and oedema uniform and non-painful – then no treatment required – will resolve post foaling.
  • Important to differentiate this from other causes of abdominal enlargement.
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13
Q

Describe the signs of pre-pubic tendon rupture in mares

A
  • Large plaque of painful oedema, continuous with udder (“dropped” udder).
  • Maybe bloody discharge in milk
  • Often gives colic signs
  • Mare often spends more time recumbent.
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14
Q

How is pre-pubic tendon rupture in mares treated?

A
  • Analgesia = bute
  • Will need assistance with foaling – cannot use abdominal press. Caesarean?
  • Will resolve if mare nursed through to foaling, however often progressively becomes more painful and results in euthanasia.
  • If survives – do not breed from again!
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15
Q

Describe Hydrops amnion/Hydrops allantois in the pre-parturient mare

A

Excessive fluid in allantoic/amniotic space
Up to 200 litres have been recorded

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16
Q

What are the signs of Hydrops amnion/Hydrops allantois in the pre-parturient mare?

A

May eventually cause colic, dyspnoea, recumbency, circulatory collapse.
Foals usually deformed. Heritable?

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17
Q

How is Hydrops amnion/Hydrops allantois in the pre-parturient mare diagnosed?

A

Rectal exam – huge fluid filled uterus but foal out of reach

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18
Q

How is Hydrops amnion/Hydrops allantois in the pre-parturient mare treated?

A

Induce foaling or abortion
Dilate cervix, drain fluid off slowly
Manually remove foal
IV fluids to maintain systemic blood pressure?

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19
Q

What is the main consequence of placentitis?

A

Eventually leads to abortion

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20
Q

What is the cause of placentitis?

A

Ascending infection from cervix
Strep. spp., E.coli, Aspergillus.

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21
Q

How does placentitis present?

A

Premature udder development and lactation ± vaginal discharge

22
Q

How is placentitis diagnosed?

A

Clinical signs
Ultrasonographic demonstration of placental thickening
Cervical swabs if discharging

23
Q

How is placentitis treated?

A

Potentiated sulphonamides
Bute

24
Q

What is the most common cause of vaginal bleeding in the horse?

A

Varicose veins

25
Q

How are varicose veins managed?

A

Usually no treatment required – tend to be of more concern to owner than mare

26
Q

Describe orthopaedic disease in pre-parturient mares

A
  • Extra weight/ bulk of late pregnancy can substantially exacerbate the effects of orthopaedic disease – arthritis, laminitis etc.
  • Despite frequent owner concerns over of use of Nsaids in pregnant mares, use of daily phenylbutazone maybe necessary to keep some mares going.
27
Q

What equipment should be prepared when going to a dystocia case?

A
  • Sedation (and ketamine?)
  • Clenbuterol or buscopan
  • Local anaesthesia (epidural)
  • Doxapram
  • Foaling ropes
  • Lubricant
  • Hibiscrub
  • Needles/syringes
  • Waterproofs
28
Q

Once at the place with the foaling mare with dystocia describe the steps to take to handle this case

A
  1. Warn owner – guarded prognosis – may lose both mare and foal
  2. Restrain mare (sedation? Twitch? Clenbuterol?)
  3. Quickly check mare not in shock /haemorrhaging.
  4. Clean perineum/arms
  5. Vaginal exam – with plenty of lubricant
  6. Ascertain presentation/posture/position
    7.Decide if vaginal delivery possible – if not refer for caesarean or euthanase
29
Q

If a foaling mare makes no progress after … reassess the situation?

A

15 minutes

30
Q

Describe uterine tears/ruptures during parturition

A
  • In complete ruptures the foal may fall into the abdomen and not be palpable in the birth canal.
  • In these cases the mare may fatally haemorrhage, or will develop fulminating peritonitis and fatal endotoxaemia .
  • Extract the foal and consider euthanatising the mare.
  • Smaller tears may not be noticed and only suspected when the mare shows sign of peritonitis after foaling. These have a better, but still guarded prognosis.
31
Q

How are uterine ruptures/tears during parturition diagnosed?

A

Clinical signs
Rectal/vaginal examination
Ultrasonography
Peritoneal tap

32
Q

Describe perineal lacerations during parturition

A
  • Minor perineal lacerations are common during foaling.
  • Many will heal without intervention.
  • Lacerations which substantially disrupt the perineal anatomy should be repaired, especially if natural healing will alter perineal conformation.
  • This maybe done immediately, or delayed for a few days if bruising is severe.
  • Administer antibiotics/Nsaids/tetanus cover
33
Q

What is a third degree perineal laceration?

A

Where foals foot has penetrated rectum and torn through anus.
Rectum, vulva and vagina all communicate

34
Q

How is a third degree perineal laceration treated/managed?

A
  • Do not repair immediately – will break down
  • Administer antibiotics/Nsaids/tetanus cover
  • Repair required if mare to conceive again!
  • Delay surgery for 4-6 weeks until granulated in.
  • Surgery difficult, several attempts often needed before complete repair occurs.
35
Q

List the types of post-partum colic seen

A
  • ‘Uterine cramps’
  • GI colic
  • Ischaemia/necrosis/rupture of caecum and colon
  • Inversion of uterine horn
  • Colonic torsion
  • Rupture of uterine artery
36
Q

Describe post-partum colic due to ‘uterine cramps’

A

Many colics soon after foaling are put down to post-partum uterine contractions.
Mild to moderate colics, no sign endotoxaemia.
Should resolve with buscopan or phenylbutazone.

37
Q

Describe post-partum colic due to inversion of the uterine horn

A
  • After forceful foaling or too forceful removal of retained membranes
  • Colic which reoccurs despite analgesia
  • If mare continues to strain may proceed to uterine prolapse
  • Diagnosis by vaginal and rectal exam
  • Treat with analgesia, smooth muscle relaxants (buscopan/clenbuterol), manual replacement, uterine lavage.
38
Q

Describe post-partum colic due to colonic torsion

A

Post-partum mares prone to colonic torsion
Due to sudden increase of space in abdomen post foaling?
A surgical colic and rapidly fatal unless quickly corrected

39
Q

Describe post-partum colic due to rupture of the uterine artery

A
  • More common in older mares.
  • Haemorrhage may occur into broad ligament or into abdomen
  • Mild to moderate colic signs, which may progress to signs of haemorrhagic shock.
  • May not respond well to Nsaids – painful?
  • May be contained within broad ligament, but if this ruptures or mare is haemorrhaging directly into abdomen then is likely to be rapidly fatal.
40
Q

How is post-partum colic due to rupture of the uterine artery diagnosed?

A

Gentle palpation of broad ligament per rectum
Abdominal and rectal ultrasonography.

41
Q

How is post-partum colic due to rupture of the uterine artery treated?

A

Keep quiet – sedate?
Analgesia
IV fluids – judiciously
Blood transfusions

42
Q

Describe post-partum uterine prolapse in mares

A
  • Uncommon.
  • After excessive traction on foal or retained membranes.
  • After difficult foaling or if mare exhausted
  • May rupture uterine vessels and cause fatal internal haemorrhage.
  • Even after replacement, death from metritis/endotoxaemia not uncommon.
43
Q

How is post-partum uterine prolapse in mares treated?

A
  • Clean uterus.
  • Replace under epidural anaesthesia.
  • Give oxytocin once replaced
  • Treat with broad spectrum antibiotics and Nsaids for anti-endotoxic effects
44
Q

When are foetal membranes classed at retained?

A
  • On average mares pass the foetal membranes within 2 hours post foaling.
  • Over 4 hours is considered abnormal.
  • When intervention should take place is controversial – if still retained 4-6 hours post foaling then most stud vets advise treatment.
45
Q

What are the consequences of retained foetal membranes?

A

If left in place the membranes decompose rapidly, produce a metritis which induces endotoxaemia, which may lead to severe laminitis and death.

46
Q

Describe how to treat retained foetal membranes

A
  • Administer oxytocin, broad spectrum antibiotics, flunixin for anti-endotoxic effects and check tetanus cover.
  • Oxytocin alone maybe enough to quickly stimulate passage of the membranes (If this does not work then further treatments are highly controversial)
  • Manual removal controversial
    -If a retained fragment exists and cannot be located and removed then the uterus should be lavaged until the recovered fluid is running fairly clear. Use clean tap water initially.
47
Q

Describe post-partum metritis in mares

A
  • Maybe due to unnoticed partial retention of placenta or due to contamination of uterus during foaling
  • May cause fatal endotoxaemia ± laminitis if untreated
  • Treat as by antibiotics, Nsaids, oxytocin and lavage exactly as described for RFM
48
Q

Describe post-partum hypocalcaemia in mares

A
  • Uncommon (c.f. cattle)
  • Muscle fasciculations, recumbency, tetany, Diaphragmatic flutter “thumps”
  • Give calcium diluted in saline
49
Q

How are orphaned foals managed?

A

You will need (before the orphan appears):
- Foster mare ( Newmarket Foster mares Ltd)
- A source of colostrum
- A milk replacer
- Bottle/teat
- Feeding protocol

50
Q

Describe the main considerations of orphaned foals

A
  • Hand-rearing foals is not recommended
  • Expensive
  • Hugely time consuming
  • Growth problems common
  • Socialisation and behavioural problems
  • Adult hand-reared horses can be exceptionally dangerous

y4 eq - reproduction (7 decks)

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