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Y4 - Equine > Peri-parturient problems in the mare > Flashcards

Peri-parturient problems in the mare Flashcards

1
Q

What are pre-parturient problems in the mare?

A

Colic
*“foal moving”
*Normal gastrointestinal colic
*Colonic infarctions/necrosis
*Uterine torsion

The Over-large Mare
*Ventral oedema
*Pre-pubic tendon rupture
*Hydrops =
- hydrallantois
- hydramnios

*Placentitis
*Varicose veins
*Orthopaedic disease

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2
Q

What are intrapartum problems in the mare?

A

*Dystocia
*Uterine Rupture
*Uterine tear
*Cervical tear
*Perineal tears

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3
Q

What are post-parturient problems in the mare?

A

Colic
*Uterine cramps
*Normal gastrointestinal colic
*Uterine haemorrhage
*Colonic torsion
*Uterine horn inversion
*Colonic infarctions/necrosis

Prolapse
*Uterus
*Rectum

*Retained placenta
*Metritis
*Hypocalcaemia
*Tetanus

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4
Q

What is ‘foal movement’ colic?
What should be done?

A
  • Mild / moderate medical colics - caused by intra-uterine movement of foal
  • Tx = mild/moderate analgesia = buscopan or phenylbutazone
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5
Q

What is ischaemia/necrosis/rupture of caecum + colon due to?

A
  • Due to weight of foal applying pressure of viscera or stretching visceral blood vessels
  • Difficult to diagnose + to treat
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6
Q

When does uterine torsion occur? What is seen?
Dx? Tx?

A
  • Occurs in last third of pregnancy
  • Low grade chronic / intermittent colic
  • Dx = rectal palpation - one tight broad ligament
  • Tx = Surgery, standing flank laparotomy, GA + midline laparotomy
  • Rolling under GA
    (50% of live foal + 70% of live mare)
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7
Q

Where is the uterine torsion usually?

A
  • Usually cranial to cervix in mares - vaginal exam not helpful
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8
Q

Why do mares get ventral oedema?

A

*This maybe due to compression of lymphatic
drainage by foal
- no Tx if non-painful + uniform
* differentiate from other causes of abdominal enlargement

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9
Q

What is pre-pubic tendon rupture?
What is seen?

A
  • Due to weight of foetus – more common in older mares
    *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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10
Q

What is Tx of pre-pubic tendon rupture?

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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11
Q

What is hydrops aminion / hydrops allantois?

A

*Excessive fluid in allantoic/aminotic space
*Up to 200 litres have been recorded
*May eventually cause colic, dyspnoea, recumbency, circulatory collapse.
*Foals usually deformed

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12
Q

How is hydrops aminion / allantois diagnosed / treated?

A
  • Dx = Rectal exam - huge fluid filled uterus but foal out of reach
  • Tx = induce foaling / abortion, dilate cervix + drain fluid off slowly, IV fluids to maintain BP
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13
Q

What is the last thing that may cause an over-large mare?

A
  • FAT - sometimes mare = very large near term
  • Some mares just Fat and not in foal
  • Do rectal to confirm if foal present
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14
Q

What does placentitis lead to?
What are the causes and signs?

A
  • Leads to abortion
  • Causes = ascending infection - Strep, E.coli, Aspergillus
  • Signs = premature udder development + lactation +/- vaginal discharge
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15
Q

How do you Dx + Tx placentitis?

A
  • Dx =
  • Clinical signs
  • Ultrasonographic demonstration of placental
    thickening
  • Cervical swabs if discharging
  • Treatment =
  • Potentiated sulphonamides
  • Bute
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16
Q

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

A
  • Varicose veins - No Tx needed
17
Q

How are pregnant mares more prone to orthopaedic disease?

A
  • More weight = arthritis / laminitis
  • daily use of NSAIDs may be necessary
18
Q

What would you want with you if you were to go to a dystocia?

A
  • Sedation (and ketamine?)
  • Clenbuterol or buscopan
  • Local anaesthesia (epidural)
  • Doxapram
  • Foaling ropes
  • Lubricant
  • Hibiscrub
  • Needles/syringes
  • Waterproofs
19
Q

What would be your approach to dystocia?

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. (MM)
  4. Clean perineum/arms
  5. Vaginal exam – with plenty of lubricant
  6. Ascertain presentation/posture/position
    9.Decide if vaginal delivery possible
    – if not refer for caesarean or euthanise
    - if foaling possible – check time
    - apply ropes/start traction
  7. If no clear progress within 15minutes
    – reassess situation
    - consider caesarean
    - or controlled vaginal delivery under GA
    - Terminal caesarean – GA mare, cut foal out, then euthanise mare
20
Q

What is a controlled vaginal delivery with dystocia?

A
  • Vaginal delivery under GA
  • Hindquarters hoisted
  • Can proceed to caesar, terminal caesar or euthanasia
21
Q

How are uterine ruptures/ tears diagnosed?

A
  • CS
  • Rectal / vaginal examination
  • Ultrasonography
  • Peritoneal tap
22
Q

What is the Tx of uterine ruptures/tears?

A
  • Medical treat as for peritonitis
  • Exploratory laparotomy and repair for full thickness tears
23
Q

What happens with uterine ruptures?

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.
  • Some may not be full thickness
24
Q

What happens with perineal lacerations? What should be done?

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
25
Q

What is third degree perineal lacerations?
What should be done?

A

*Where foals foot has penetrated rectum and torn through anus.
*Rectum, vulva and vagina all communicate
*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.
*Recto-vaginal fistulas – treat in same manner- delayed repair

26
Q

Until when would you delay repair of cervical lacerations?

A
  • Until uterus involuted + inflammation subsided
    (1 month post partum)
27
Q

What can cause post-partum colic?

A
  • Uterine cramps - post partum uterine contractions (mild/moderate, no endotoxaemia, resolve with bute/buscopan)
  • Gastrointestinal colics
  • Ischaemia/necrosis/rupture of caecum + colon - expulsive forces
  • Inversion of uterine horn - may proceed to uterine prolapse - analgesia + smooth muscle relaxant
28
Q

What are post partum mares prone to?

A
  • Colonic torsion - sudden increase in abdomen
    SURGICAL + rapidly fatal if not treated
29
Q

What happens with rupture of 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

30
Q

How is rupture of uterine artery diagnosed + treated?

A

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

Treatment:
*Keep quiet – sedate?
*Analgesia
*IV fluids – judiciously
*Blood transfusions
*Clotting agents – amino caprionic acid?, 10ml 10% formalin in 1 litre saline

31
Q

How does uterine prolapse occur?

A

*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

32
Q

How are uterine prolapses treated?

A

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

33
Q

What occurs with 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.
  • However not all mares succumb to the endotoxaemia – some may tolerate RFM very well, whilst others become very sick, very quickly.
  • Heavy horses traditionally are considered very susceptible to the effects of RFM
34
Q

How is retained foetal membranes treated?

A

*Administer oxytocin (1-2mls =10-20iu), 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 if oxytocin doesn’t work
  • Twist placenta if pulling doesn’t work
  • If part retained / broke off after checking = LAVAGE + administer more oxytocin
  • If signs of endotoxaemia = lavage again in 24hrs
  • Maintain Antibiotics / NSAIDs
  • Keep lavaging until problem gone
35
Q

How would you treat metritis?

A
  • Same as RFM - oxytocin, lavage, Ab + NSAIDs
36
Q

What are signs of hypocalcaemia in mares?

A

*Muscle fasciculations, recumbency, tetany, Diaphragmatic flutter “thumps”

37
Q

What is needed straight away with orphan foals?

A
  • A source of colostrum
  • A milk replacer
  • Bottle/teat
  • Feeding protocol
  • Foster mare
  • FOAL NEEDS A LOT OF MILK - EXPENSIVE
38
Q
A

Y4 - Equine (46 decks)

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