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Dystocia Difficulties Foaling

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					 Dystocia: Difficulties Foaling




Imogen Silhan-Sutton
  BVetMed MRCVS
 Cliffe Equine Clinic
                   Dystocia
Difficult/abnormal labour
Incidence?
  TB 4% - Draught 10%
  >Primiparous mare
EMERGENCY!
Delay: compromised foal
Foetal / maternal dystocia
Inappropriate intervention
Be prepared
  Foaling box: 5m2; CCTV
  Foaling kit
               Foaling Kit
Mare headcollar & rope
Towels
Bucket
Hibiscrub
Cotton wool
Lubricant (Lubrel)
Sharp knife / scalpel
Heat lamp
Feeding bottles
Access to warm water
(Frozen colostrum)
Light
               Foetal Dystocia
Malpostures: presentation of body, head & limbs
  Body presentations: Ant 98.9%; Post 1.0%, Transverse 0.1%
  Head posture: twisted back; flexed
  Limb posture: knee/shoulder/hock/hip flexion; leg over head;
  dog sitting
Foetal abnormalities
  “Contracted foal”; hydrocephalus (ponies); shistosomes
Anterior Presentation, Leg Back




             See: Nose & one leg only
Feel: Knee flexion – knee; shoulder flexion - no leg
   Correction: Repel foal, find second leg, pull
Anterior presentation, head only




                See: Head only
      Feel: Head only; possibly knee(s)
   Correction: Repel foal; find both legs; pull
Anterior presentation; head back




                  See: Two legs
     Feel: Two legs; no head; side of neck
   Correction: If can feel eye/mouth pull head
     round while repelling foal. If not, refer.
Anterior presentation, head down




          See: Two feet; possibly ears
   Feel: Two feet; ears; forehead; no muzzle
Correction: Repel foal, feel for muzzle and lift up
                   nose, pull
Anterior presentation, dog sit




             See: Head & two legs
 Feel: Head & two legs; possibly 1-2 other feet
     BUT: straining / traction has no effect
Correction: Repel foetus to try and dislodge feet
Posterior presentation; two legs




          See: CARE!!! Two back legs
     Feel: No head; two legs (flex fetlocks)
             Correction: Pull gently
 Thorax compresses umbilicus – foetal hypoxia
 Cord rupture while head in uterus – foetal death
Posterior presentation, no legs




       See: No head or legs; possibly tail
               Feel: Possibly tail
Correction: Get hocks into flexion if possible, pull
           Usually caesarean section
   Transverse
   presentation

 See: Nothing OR 4 feet
Feel: Back/spine OR 4 feet
  Correction: Caesarean
          section
         Foetal Abnormalities




Hydrocephalus

Flexural Limb Deformities
            Maternal Dystocia
Factors related to mare causing problems foaling
  Premature placental separation (red bag)
  Prepubic tendon rupture
  Small pelvis
  Uterine inertia
  Uterine torsion

Other postpartum problems
  Retained placenta
  Rectovaginal tears
  No colostrum
  Uterine prolapse/rupture
  Middle uterine artery rupture
  Bladder prolapse/rupture
Premature Placental Separation
          “Red Bag”
                    EMERGENCY
                Separation of intact
                placenta from uterus.
                Allantochorion fails to
                rupture – foal trapped
                MUST CUT THROUGH
                Foaling may proceed
                normally
                Bladder prolapse?
Prepubic Tendon Rupture
           Tendon / muscle rupture
           Uterus drops
           Painful ventral oedema
           Causes dystocia
           Rare: older / draft horses
           Restrict activity
           Monitor: blood loss, pain &
           constipation
           Belly wrap?
           Poor prognosis
Dystocia: Management Options
Assessment – quick!
Manipulate: 10-15 minutes
No change?
Move to other options…
Controlled vaginal delivery
Foetotomy
Caesarean section
  High risk to mare & foal; GA
  If done promptly foal mortality rate ~10%
Retained Placenta
        Retained: >6hrs postpartum
        Incidence: 2-10% mares
        NEEDS VET ATTENTION
        Serious consequences:
          Endometritis / (metritis)
          Laminitis
          Septicaemia
          Death
        Tx: Oxytocin; Abs; NSAIDs;
        manipulation; warm lavage
        Px: Good if treated early
Expelled Placenta
       Rectovaginal Tears
Second Degree Perineal
     Laceration




                         Third Degree Perineal
                             Laceration
        Uterine Prolapse

Usually postpartum
Rare
Older mares
Sedation/epidural
Cleaning
Manual replacement
Abs; NSAIDs
Final Note on the Mare….
            Repeat breeding: consider
            foaling-conception interval
            Need to average 25d
            Aggressive management
            Breed at earliest time
            providing optimal chance
            for conception
            Thorough examination;
            prompt dx & tx of disease

				
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posted:9/27/2011
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