Peri-parturient problems in the mare Flashcards
(38 cards)
What are pre-parturient problems in the mare?
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
What are intrapartum problems in the mare?
*Dystocia
*Uterine Rupture
*Uterine tear
*Cervical tear
*Perineal tears
What are post-parturient problems in the mare?
Colic
*Uterine cramps
*Normal gastrointestinal colic
*Uterine haemorrhage
*Colonic torsion
*Uterine horn inversion
*Colonic infarctions/necrosis
Prolapse
*Uterus
*Rectum
*Retained placenta
*Metritis
*Hypocalcaemia
*Tetanus
What is ‘foal movement’ colic?
What should be done?
- Mild / moderate medical colics - caused by intra-uterine movement of foal
- Tx = mild/moderate analgesia = buscopan or phenylbutazone
What is ischaemia/necrosis/rupture of caecum + colon due to?
- Due to weight of foal applying pressure of viscera or stretching visceral blood vessels
- Difficult to diagnose + to treat
When does uterine torsion occur? What is seen?
Dx? Tx?
- 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)
Where is the uterine torsion usually?
- Usually cranial to cervix in mares - vaginal exam not helpful
Why do mares get ventral oedema?
*This maybe due to compression of lymphatic
drainage by foal
- no Tx if non-painful + uniform
* differentiate from other causes of abdominal enlargement
What is pre-pubic tendon rupture?
What is seen?
- 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
What is Tx of pre-pubic tendon rupture?
*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
What is hydrops aminion / hydrops allantois?
*Excessive fluid in allantoic/aminotic space
*Up to 200 litres have been recorded
*May eventually cause colic, dyspnoea, recumbency, circulatory collapse.
*Foals usually deformed
How is hydrops aminion / allantois diagnosed / treated?
- 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
What is the last thing that may cause an over-large mare?
- FAT - sometimes mare = very large near term
- Some mares just Fat and not in foal
- Do rectal to confirm if foal present
What does placentitis lead to?
What are the causes and signs?
- Leads to abortion
- Causes = ascending infection - Strep, E.coli, Aspergillus
- Signs = premature udder development + lactation +/- vaginal discharge
How do you Dx + Tx placentitis?
- Dx =
- Clinical signs
- Ultrasonographic demonstration of placental
thickening - Cervical swabs if discharging
- Treatment =
- Potentiated sulphonamides
- Bute
What is the most common cause of vaginal bleeding in horses?
- Varicose veins - No Tx needed
How are pregnant mares more prone to orthopaedic disease?
- More weight = arthritis / laminitis
- daily use of NSAIDs may be necessary
What would you want with you if you were to go to a dystocia?
- Sedation (and ketamine?)
- Clenbuterol or buscopan
- Local anaesthesia (epidural)
- Doxapram
- Foaling ropes
- Lubricant
- Hibiscrub
- Needles/syringes
- Waterproofs
What would be your approach to dystocia?
- Warn owner – guarded prognosis – may lose both mare and foal
- Restrain mare (sedation? Twitch? Clenbuterol?)
- Quickly check mare not in shock /haemorrhaging. (MM)
- Clean perineum/arms
- Vaginal exam – with plenty of lubricant
- 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 - 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
What is a controlled vaginal delivery with dystocia?
- Vaginal delivery under GA
- Hindquarters hoisted
- Can proceed to caesar, terminal caesar or euthanasia
How are uterine ruptures/ tears diagnosed?
- CS
- Rectal / vaginal examination
- Ultrasonography
- Peritoneal tap
What is the Tx of uterine ruptures/tears?
- Medical treat as for peritonitis
- Exploratory laparotomy and repair for full thickness tears
What happens with uterine ruptures?
- 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
What happens with perineal lacerations? What should be done?
- 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
