Peri-parturient problems of mare

Question 1

what are some pre-parturient issues seen in the mare?

Answer 1

colic

Question 2

what colics can mares get pre-parturition?

Answer 2

all the normal colics
specific colics -

Question 3

what is the prognosis of pre-parturient colics?

Answer 3

often guarded/poor (worse than normal colics)

Question 4

why is examination of colic in the pre-parturient mare difficult?

Answer 4

rectal exam difficult due to foal
ultrasound/abdominocentesis more difficult and less useful
exploratory laparoscopy hampered by foal

Question 5

what are some colics specific to the pre-parturient mare?

Answer 5

“foal movement”
foaling/aborting
ischaemia/necrosis/rupture of caecum or colon
uterine torsion

Question 6

how severe is the colic seen due to “foal movement”?

Answer 6

mild/moderate

Question 7

how is “foal movement” colic treated?

Answer 7

buscopan and phenylbutazone

Question 8

why do pre-parturient mares get colic due to ischaemia/necrosis/rupture of caecum and colon?

Answer 8

weight of foal applies pressure to viscera or stretches the vessels

Question 9

why are ruptures/necrosis of the caecum or colon in the pre-parturient mare difficult to treat and manage?

Answer 9

often rupture at the base of caecum which is very inaccessible especially with foal in the abdomen

Question 10

when does uterine torsion usually occur?

Answer 10

last third of pregnancy

Question 11

how severe is the colic caused by uterine torsion?

Answer 11

usually low grade but can be severe

Question 12

how are uterine torsions diagnosed?

Answer 12

rectal palpation - one of the broad ligaments will be tight

Question 13

why can vaginal examination be used to diagnose uterine torsions on the mare?

Answer 13

usually twists cranial to the cervix

Question 14

how can uterine torsions be treated?

Answer 14

surgery (standing flank or midline)

Question 15

what is the prognosis for uterine torsions?

Answer 15

50/50 for foal
70% of mares live

Question 16

what is often seen in mares near term when they get very large?

Answer 16

ventral oedema (no treatment required)

Question 17

what are some differentials for ventral oedema in the late gestation mare?

Answer 17

pre-pubic tendon rupture
hydrops amnion/allantois
just fat

Question 18

what is pre-pubic tendon rupture?

Answer 18

the weight of foetus causes a rupture leading to a painful oedema continuous with the udder, bloody discharge in milk may be seen and mare often colics

Question 19

how is pre-pubic tendon rupture treated and managed?

Answer 19

analgesia (phenylbutazone)
will need assistance foaling (can’t use abdomen)
don’t breed again

Question 20

what is the prognosis for pre-pubic tendon rupture?

Answer 20

can resolve after foaling but often progresses and ends with euthanasia

Question 21

what is hydrops amnion/allantois?

Answer 21

excessive fluid in amniotic/allantoic space eventually leading to colic, recumbency and circulatory collapse

Question 22

how can hydrops amnion/allantois be diagnosed?

Answer 22

rectal exam (lots of fluid and foal out of reach)

Question 23

how is hydrops amnion/allantois treated?

Answer 23

induce foaling/abortion
dilate cervix and drain fluid slowly
IV fluids

Question 24

what is the prognosis for the foal from a mare with hydrops amnion/allantois?

Answer 24

foal often deformed

Question 25

what are some clinical signs of placentitis?

Answer 25

premature udder development and lactation vaginal discharge

Question 26

how is placentitis treated?

Answer 26

potentiated sulphonamides and phenylbutazone

Question 27

what is the usual outcome for placentitis?

Answer 27

abortion

Question 28

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

Answer 28

varicose veins

Question 29

how is varicose veins treated?

Answer 29

usually not required (more of a concern to owner than mare)

Question 30

what can be used to relax the uterus in dystocia cases?

Answer 30

clenbuterol or buscopan

Question 31

what is controlled vaginal delivery in dystocia cases?

Answer 31

vaginal delivery under GA, preferably with the hindquarters lifted

Question 32

what can happen in uterine rupture/tear cases?

Answer 32

foal can fall into abdomen and not be palpable in the birth canal

Question 33

how should full thickness uterine tears be treated?

Answer 33

extract the foal and consider euthanasia

Question 34

what is the prognosis for full thickness uterine tears?

Answer 34

fatal haemorrhage or development of peritonitis and endotoxaemia is often fatal

Question 35

how do partial thickness smaller uterine tears present?

Answer 35

mare shows peritonitis signs after foaling

Question 36

how can most perineal lacerations be treated?

Answer 36

many will heal on their own

Question 37

what is a third degree perineal laceration?

Answer 37

full thickness tear into the rectum/anus so the rectum, vulva and vaginal all communicate

Question 38

how should third degree perineal lacerations be treated?

Answer 38

antibiotics, NSAIDs, tetanus delay surgery for 4-6 weeks as the wound will breakdown if you repair immediately

Question 39

should cervical lacerations be treated immediately?

Answer 39

no wait until uterus has involuted a d inflammation subsides (about a month)

Question 40

what are some possible postpartum colics?

Answer 40

uterine cramps gastrointestinal ischaemia/necrosis/rupture of caecum and colon inversion of uterine horns colonic torsions rupture of uterine artery

Question 41

how severe is colic due to uterine cramps postpartum?

Answer 41

mild/moderate (no endotoxaemia)

Question 42

how is postpartum uterine cramp colic treated?

Answer 42

buscopan and phenylbutazone

Question 43

what can cause ischaemia/necrosis/rupture of caecum or colon causing postpartum colic?

Answer 43

expulsive forces from the foaling

Question 44

why may the uterine hors invert postpartum?

Answer 44

too forceful foaling or removal or retained membranes

Question 45

how is inversion of the uterine horns postpartum treated?

Answer 45

analgesia, buscopan, manual replacement and uterine lavage

Question 46

why are postpartum mares prone to colonic torsions?

Answer 46

because of the sudden increase in space in the abdomen post foaling

Question 47

how are colonic torsions treated?

Answer 47

surgery (rapidly fatal if not treated)

Question 48

how severe if the colic caused by a ruptured uterine artery postpartum?

Answer 48

mild/moderate

Question 49

how does a colic from a ruptured uterine artery progress from a mild/moderate colic?

Answer 49

can show signs of haemorrhagic shock

Question 50

what is the prognosis for uterine artery ruptures in postpartum mares?

Answer 50

guarded - if it ruptures into the abdomen it is often rapidly fatal

Question 51

where can the uterine artery rupture into?

Answer 51

abdomen or broad ligament

Question 52

how is uterine artery rupture treated?

Answer 52

keep quiet (sedate) analgesia, IV fluids blood transfusion, clotting agents

Question 53

what is a possible complication that can occur due to uterine prolapse?

Answer 53

rupture of uterine vessels

Question 54

how are uterine prolapses treated?

Answer 54

clean uterus and replace under an epidural give oxytocin once replaced NSAIDs and broad spectrum antibiotics

Question 55

how long should it take for mares to pass the foetal membranes?

Answer 55

roughly 2 hours

Question 56

how long is it considered abnormal for a mare to not pass the foetal membranes?

Answer 56

4 hours

Question 57

why are retained foetal membranes so problematic?

Answer 57

rapidly breakdown leading to metritis which induces an endotoxaemia causing severe laminitis and death

Question 58

how are retained foetal membranes treated?

Answer 58

oxytocin, broad spectrum antibiotics, flunixin manual removal if oxytocin doesn't work

Question 59

how should the foetal membranes appear when checking them?

Answer 59

F shaped

Question 60

if there is part of the foetal membrane missing after expulsion/removal, what should be done?

Answer 60

if the fragment can't be located lavage uterus until fluid runs clear then administer oxytocin should be examined and repeated after 12-24 hours