The Post-Partum Mare Flashcards
what are the goals of a breeding operation?
- produce one foal per mare per year
- produce early foals
-given length of gestation, you have about 25 days to get the mare pregnant (2 chances to breed)
what is puerperium?
period from parturition to reinitiation of normal repro activity; includes:
- uterine involution
- restoration of hypothalamic-pituitary function
- reinitiation of ovarian activity
describe anatomic involution
uterine contractions mediate
1. decrease in uterine size:
-uterus back to palpable in 3d
-pregravid size in 23-32 days
- expulsion of loquia:
-vaginal discharge for 6 days
-brownish-bloody
histologic involution: more important than size; determines normal function of endometrium!
1. <24 hours post-partum: irregular ednometrium of crypts interdigitating with embryonic villi, enlarged glands, lots of PMNs and macrophages
- 14 days post partum should be normal:
-endometrial glands decrease in size 4 day post foaling
-epithelium restored by 7 days post foaling
describe restoration of hypothalamic-pituitary function
- FSH peak at foaling causes follicular recruitment
- estrus 5-12d post foaling/foal heat
- can breed in foal heat if:
-normal parturition
-normal puerperium
-normal uterine involution
describe post-partum emergencies
- colic
- depression, inappetance
- abnormal vulvar discharge
- +/- endotoxemia
- +/- cardiovascular shock
usually occur immediately following or within 1st week following parturition
what are genital versus non-genital postpartum emergencies?
genital:
retained placenta, metritis, uterine rupture or prolapse, intussusception of uterine horn, hemorrhage, lacerations, necrotic vaginitis, vaginal evisceration
nongenital:
-colon torsion, intestinal ileus, bladder prolapse, eversion, or rupture, intestinal or msesnteric rupture, rectal prolapse, diaphragmatic rupture
describe retained fetal membranes
- failure to expel within 3 hours; occurs in 2-10% of mares
-is an EMERGENCY!!! - risk factors:
- >15 yrs, draft breed, history, dystocia, placentitis, fescue toxicosis - pathophysiology:
-adhesions, edema, hormones, weakness, inbreeding - diagnosis:
-total retention: don’t see at all or just full thing hanging out
-partial retention: if pass some, have to evaluate entire placenta to check for any bits left behind
describe treatment goals of retained placenta
- non-traumatic expulsion of placenta: want chorionic villi to detach from crypts, not rip
-oxytocin: small bolus, slow IV drip +/- calcium to help with contractions, repeat every 2-6 hours until expulsion
-redistention of the allantoic cavity (Burn’s technique: pass NG tube into allantoic cavity, someone pump fluids, distention causes uterine contractions and placental detachment
-uterine lavage
-manual extraction not recommended (likely to rupture chorionic villi)
-exercise: increase intra-abdominal pressure and stimulate uterine contractions
- prevent complications
- tetanus prophylaxis
describe toxic metritis
bacterial contamination of uterus can cause metritis (endo and myometrium), which can lead to septicemia
since usually a mixed growth (gram negatives present to release endotoxins), can lead to endotoxemia, which means risk for laminitis and death
describe clinical signs of toxic metritis
- fever
- depression
- anorexia
- tachycardia, tachypnea (associated with septicemia)
- injected mucous membranes
- nasty smelling brown-yellow vulvar discharge
- fluid filled, enlarged, flaccid uterus on ultrasound
what are the goals of treatment of toxic metritis?
- control bacterial growth
- evacuate uterine contents
- prevent complications
describe treatment of toxic metritis
- treat with systemic antibiotics (gram neg and positive coverage)
-penicillin and gentamicin or
-penicillin and enrofloxacin or
-oral TMS if in field - uterine lavage to remove toxic contents
-8-10 liters at a time until clear - treat with flunixin meglumine, pentoxyfylline, and polymixin B for septicemia and endotoxemia (anti-inflam, anti-oxidant)
- ice boots and soft rides to prevent laminitis
describe post-partum hemorrhage
- arterial rupture of:
-middle uterine
-utero-ovarian
-external iliac
-vaginal or
-adrenal arteries
leads to
- bleeding into:
-broad ligament, uterine wall, uterine lumen, and/or peritoneal cavity
-if in uterine lumen or peritoneal cavity = worst prognosis - responsible for 40% of deaths in peri-partum mares, esp older multiparous mares
-not common occurence, but when it happens tends to be deadly
describe diagnosis of post-partum hemorrhage
- very pale MM
- in shock: violent colic, hitting walls, throwing themselves on ground
- bleeding from vulva
- trauma in birth canal
- ultrasound:
-may see hematoma within broad ligament or uterine wall
-may see hemoperitoneum
describe treatment of postpartum hemorrhage
- restore cardiovascular volume: fluids, blood transfusion
-be careful if not actively bleeding, if suddenly increase BP may restart bleeding - provide hemostasis:
-aminocaproic acid: antifibrinolytic, stops dissolution of blood clot
-10% formalin IV: scary
-yunnan bayao: herbal oral supplement, MOA unknown, but helps with bleeding - provide analgesia and sedation:
-flunixin, butorphenol, xylazine, detomidine
-acepromazine: some love some hate; decreases BP (Ferrer does not use) - provide antimicrobial prophylaxis
