Postpartum Conditions of the Mare Flashcards
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
when is mare endometrium is histologically normal
Mare endometrium is histologically normal by 14‐15 days postpartum
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”
when does mare uterus return to pre-pregnancy size
Mare and cow uterus returns to pregravid size by 25 to 32 days postpartum
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
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
when will mares have higher early embryonic death rates
Mares bred at foal heat have higher early embryonic death rates
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
when is a PP exam done
-Frequently requested by owner (Mare and Foal)
-Anytime a problem is suspected
-Usually within 24 hours of birth
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?
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?
what three things are included in the reproductive exam
-Rectal exam
-Vaginoscopy
-Vaginal Exam
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
why do you need to check digital pulses in mares PP
Digital pulses in mares, mucous membranes
what are some abnormalities you may come across in PP rectal exam (4)
-RV fistulas
-Broad Ligaments
-Uterine fluid
-GI tract
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
