Postpartum Conditions of the Mare Flashcards by Kendra Broadfoot

what are some PP conditions? (9)

-Uterine prolapse
-Retained placenta/ Metritis
-Uterine tear
-Hernias/ Ruptured PPT
-Rectovaginal fistula
-Perineal Lacerations
-Cervical tear
-Vaginal tear
-Hemorrhage of uterine artery

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when is mare endometrium is histologically normal

Mare endometrium is histologically normal by 14‐15 days postpartum

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what is foal heat

-“Foal Heat” –first postpartum estrus ‐ at 9 days PP – can conceive and carry!
-Next heat occurs 21 days later – “30 day heat”

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when does mare uterus return to pre-pregnancy size

Mare and cow uterus returns to pregravid size by 25 to 32 days postpartum

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what is the voluntary waiting period for cows and why is it important

-Voluntary waiting period 50‐60 days
-allows repair to occur to increase chance of successful next pregnancy

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Selection of mares that are good candidates + which one is most important (4)

-Normal parturition and postpartum period
-No intrauterine fluid by day 9
-Good uterine involution – 9 cm diameter or less by day 9
-Ovulating after day 10

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when will mares have higher early embryonic death rates

Mares bred at foal heat have higher early embryonic death rates

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when are pregnancy rates higher in mares

-Pregnancy rates are higher for mares ovulating after day 10 postpartum
-Embryo enters uterus at day 6 post ovulation

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when is a PP exam done

-Frequently requested by owner (Mare and Foal)
-Anytime a problem is suspected
-Usually within 24 hours of birth

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what are some questions to ask in PP exam history? (7)

-Due date
-Past foalings – how many, any history of problems
-When did she foal?
-Problems?
-Pass Placenta?
-Attitude, appetite?
-Is Foal Nursing?

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what is part of the visual inspection of the PP exam

Obvious
-Retained Placenta
-Uterine Prolapse
-Vaginal Discharge – lochia vs. abnormal?
-Perineal Lacerations
-Udder

-Attitude, Appetite, painful?

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what three things are included in the reproductive exam

-Rectal exam
-Vaginoscopy
-Vaginal Exam

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what are some common PP conditions after foaling that you should look for in PP physical exam

GI colic, trauma to repro tract, RFM with metritis in mares

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why do you need to check digital pulses in mares PP

Digital pulses in mares, mucous membranes

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what are some abnormalities you may come across in PP rectal exam (4)

-RV fistulas
-Broad Ligaments
-Uterine fluid
-GI tract

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what do you need to do in the recal exam (3)

-Examine perineal area first (Tears, discharge, frank blood?)
-Rectal exam
-Assess uterine involution

whats to look for in Postpartum Exam ‐ Vaginoscopy and Vaginal Exam (6)

-Always check for another fetus!!!
-Vaginal tears or bruising
-Cervical tears
-Perineal lacerations
-Assessment of retained placenta
-Discharge – Odour? Character?

what must you suspect in any mare with frank bloody discharge post partum

uterine tear

prognosis of uterine tears in mares

-If recognized early surgical repair carries a good prognosis for survival and future breeding
-If found later, and peritonitis present, prognosis is guarded to poor

where is a common location for uterine tear

-Ventral uterine body
-Often tip of pregnant horn – cannot reach on vaginal exam

is uterine prolapse common in mares and cows? when does it occur?

-Common in cows
-Rare in mares
-Usually immediately postpartum

Contributing factors of uterine prolapse in mares (6)

-Dystocia, forced extraction, fetotomy
-Manual removal of placenta
-Uterine intertia
-Twins
-Following abortion
-Rarely‐ assoc. with straining due to GI colic

Uterine Prolapse Treatment in mares

-Sedation and Epidural
-Clean well and replace
-NO vulvar retention sutures (Severe swelling and necrosis of vulva, Cross‐tie in stall for 1‐2 days instead)
-Systemic antibiotics
-Anti‐inflammatories
-Prognosis good (if she survives) for future breeding

risk factors for Retained Fetal Membranes in Mares (4)

-Dystocia, twins, abortion
-Draft mares (also at high risk for laminitis with RFM)
-? Low Vit E and Selenium
-Genetics? – high prevalence in Friesian breed

what can retained placenta in mares lead to

-potential for serious complications is high -Rapid onset of toxic metritis, laminitis and death

when do you consider at placenta retained in mares

-Retained if not passed within 3 hours -Diagnosis – obvious (hanging from vulva) – or NOT

what happens if you forcibly remove a RP from a mare (5)

-Severe hemorrhage – even death -Inversion of a uterine horn -Uterine prolapse -Leave a piece behind – toxemia and death -Scarring and infertility with microscopic remnants

what do you need to evaluate when you suscept RFM in mares?

-Physical examination – ? Presence of complications -Increased digital pulses?, mucous membranes, dehydration, toxemia, pyrexia, anorexia -Perform vaginal exam using aseptic technique -Evaluate how tightly adhered (Can just be hung‐up in cervix, Gently twist membranes ‐ ? If Loosen – ok to keep twisting)

treatment for RFM in mares (4)

Low dose oxytocin – 10 ‐ 20 I.U. repeated -Uterine contractions ‐‐‐ expulsion -Mild signs of colic common -Note – high doses over 60 I.U. associated with tetanic spasm of uterus Uterine lavage -Distension of uterus ‐‐‐‐ uterine contractions ‐‐‐‐expulsion of membranes -Removal of potentially toxic debris/bacteria Systemic therapy if indicated or if a draft mare -Antibiotics, Anti‐inflammatories -Fluid therapy Monitor for complications

burns technique; what is it and when does it work

-Distend the intact chorioallantois with fluid – 20‐30 mins -Stretches membranes and uterus -Separation – detachment -Can only be done when membranes are completely intact (no holes)

Infusion of Umbilical Vessels with Water for RFM in Mares; when can you use it

-Seems to work well in uncomplicated cases -Risky if it does not work immediately -Particularly if the integrity of the abdominal wall is compromised (eg. with hydrops cases, or post C‐section) -Or if you suspect uterine artery rupture/broad ligament hematoma

what do you look for when you palpate the broad ligament

Palpate broad ligament for hematoma

Broad Ligament Hematoma in Mares; when is it common, treatment, prognosis

-More common in older, pluriparous mares Treatment -Keep quiet – consider low dose acepromazine if mare is anxious -Supportive care – fluid therapy, blood transfusion -+/‐ oxytocin; -N‐butyl alcohol; aminocaproic acid; IV Formalin?, naloxone and other shock therapies -Monitor PCV and MM colour -If hemorrhage into abdomen ‐ prognosis is grave -Usually live if hemorrhage limited to broad ligament -Prognosis for future breeding; low risk for future bleed

differentials for Sick Postpartum Mare (6)

-Uterine tear -RFM -Anterior vaginal/ Cervical tear into abdomen -GI Accident/Colic -Broad ligament hematoma -Ruptured bladder

Differentials for Bloody Discharge PP ‐differentiate from lochia or pus (4)

-Uterine tear -Uterine artery rupture/hematoma(+/‐) -Uterine wall hematoma -Uterine prolapse