dystocia in mare:--by: dr. dhiren bhoi

PERIPARTURIENT PROBLEMS IN

MARE

PRESENTED BY:

Dr. DHIREN B. BHOI

M. V. Sc., (Gynaecology)

E. Mail:-drdhirenvet@gmail.com

A

CLINICAL STUDY

ON

DYSTOCIA IN MARE PRESENTED TO COLLEGE

CLINICAL COMLPLEX

Anatomy of MareAnatomy of Mare

VulvaVulva VaginaVagina CervixCervix UterusUterus OviductsOviducts OvariesOvaries

Left Ovary

Oviduct

Left UterineHorn

Uterine Body

Cervix Vagina

Normal DeliveryNormal DeliveryPresentationPresentation: Anterior Longitudinal: Anterior Longitudinal

The foal’s head is presented towards the The foal’s head is presented towards the mare’s vulva. mare’s vulva.

PositionPosition: Dorsal Sacral: Dorsal Sacral

Describes the relationship between the foal’s back and Describes the relationship between the foal’s back and the mare’s spine.the mare’s spine.

PosturePosture: Extended extremities: Extended extremitiesHead, neck & forelimbsHead, neck & forelimbs

Stages of ParturitionStages of ParturitionStages of Parturition

First StageFirst Stage • • Lasts Lasts 11 to to 44 hours hours

CharacteristicsCharacteristics

Rotation of the fetus into Rotation of the fetus into normal position normal position

Uterine contractionUterine contraction

Cervical relaxationCervical relaxation

Appear anxiousAppear anxious

SweatSweat

Look and kick at her Look and kick at her sidessides

May lie down May lie down intermittentlyintermittently

RollingRolling

May look like a colicMay look like a colic

Second StageSecond Stage Most critical stage!!!Most critical stage!!!

It is completed in It is completed in 1010 to to 30 30 minmin

Rupture of the placentaRupture of the placenta

Release of allantoic fluidRelease of allantoic fluid

Protrusion of the amniotic sac through the vulva several minutes after rupture of placenta.

Forelegs appear extended

Extended head between carpal joints

The foal is expelled

Third Stage

Expulsion of the placenta

It occurs within the first 3 hours after birth

A retained placenta for more than 3hrs is an emergency itself.

DystociaDystocia

Calving or birthing difficultyCalving or birthing difficulty

Common form in mare

•Abnormal posture of head and neck is one of the most common form.

•Transverse ventral presentation is not uncommon

•Wryneck is seen most commonly in equine foetus

“The abnormal positions and postures, together with violent labor contractions, frequently result in impaction of foetus in the pelvis.”

(Roberts, 1971)

Causes of Dystocia

1.Maternal

2.Foetal

3.Mechanical

1. Maternal

Uterine inertia due to systemic disease

Narrow pelvic canal

Pelvic fractures

Dislocated pelvis (sacroiliac luxation)

Tumors

2. Fetal

Improper positioned

Malformation

Oversized

Twins

3. Mechanical

Feto-pelvic disproportion

Uterine torsion

Narrowing of the cervix & vagina

Congenital abnormalities

HISTORY HISTORY ► Animal aged about 7 yearsAnimal aged about 7 years

► Animal was on its first parityAnimal was on its first parity

► Animal was in full termAnimal was in full term

► Animal shows the straining for parturition 3 days Animal shows the straining for parturition 3 days beforebefore

► Consulted to local veterinarian who referred the Consulted to local veterinarian who referred the case to college hospitalcase to college hospital

Animal was healthy.Animal was healthy.

Animal showed severe straining.Animal showed severe straining.

Animal showed normal alertness.Animal showed normal alertness.

Mucus membrane was congested.Mucus membrane was congested.

General Examination

External ExaminationExternal Examination

No edematous swelling of vulva.No edematous swelling of vulva.

Dorsal vulvar commisure was slightly Dorsal vulvar commisure was slightly

lacerated.lacerated.

No fetal part seen out side to genital tract.No fetal part seen out side to genital tract.

No discharge from vulva.No discharge from vulva.

Little bit foul smell observed. Little bit foul smell observed.

Specific Examination :Specific Examination :

► During pervaginal examination animal During pervaginal examination animal strained severely & showed eversion of the strained severely & showed eversion of the floor of vagina.floor of vagina.

► Epidural anesthesia Epidural anesthesia 5ml5ml (2% lignocaine) was (2% lignocaine) was administered to the animal.administered to the animal.

► Pervaginal examination has been carried Pervaginal examination has been carried out.out.

► No part of fetus felt in vagina & cervix.No part of fetus felt in vagina & cervix.

► Foetus palpated within the uterus.Foetus palpated within the uterus.

►Presentation Presentation :: Anterior longitudinal Anterior longitudinal

►Position Position : : Dorso - sacral Dorso - sacral

►PosturePosture : : Bilateral carpal flexion with Bilateral carpal flexion with

downward deviation of downward deviation of

head (Nape)head (Nape)

Procedures Used to Resolve Procedures Used to Resolve Dystocia in the MareDystocia in the Mare

Enough space was not available.Enough space was not available.

Repulsion of the foetus failed.Repulsion of the foetus failed.

Repulsion of right carpal joint was tried to Repulsion of right carpal joint was tried to reach up to the hoof. reach up to the hoof.

Right hoof of fore limb was captured.Right hoof of fore limb was captured.

Hoof moved laterally and anteriorly.Hoof moved laterally and anteriorly.

Right fore limb was extended out to Right fore limb was extended out to vagina.vagina.

The animal lies down & keep in left lateral The animal lies down & keep in left lateral

recumbence.recumbence.

The effort was made to extend the left fore The effort was made to extend the left fore

limb.limb.

Less space & uterine contraction prevent Less space & uterine contraction prevent

it.it.

After lot of effort left carpal joint was After lot of effort left carpal joint was

reachable.reachable.

It was decided to amputate the left fore It was decided to amputate the left fore limb from carpal joint.limb from carpal joint.

Amputation was performed.Amputation was performed.

Performing Fetotomy

Again effort was made to correct the Again effort was made to correct the

deviation of head but failed.deviation of head but failed.

The case was proceeded for cesarean The case was proceeded for cesarean

section. section.

Cesarean Section

Site :Site :

Oblique abdominal incision in the Oblique abdominal incision in the lower right flank region on a line lower right flank region on a line between the stifle and the between the stifle and the umbilicus, parallel to ventral umbilicus, parallel to ventral borders of the ribs.borders of the ribs.

Anesthesia:

General anesthesia with local infiltration

SITE OF INCISION

Shaving and scrubbing was done by antiseptic soap in Shaving and scrubbing was done by antiseptic soap in standing position.standing position.

General anesthesia was carried out by intravenous General anesthesia was carried out by intravenous 10ml10ml Xylazine (0.5-1.1 mg/kg body wt.) + Xylazine (0.5-1.1 mg/kg body wt.) + 15ml 15ml Ketamine (2.2 Ketamine (2.2 mg/kg body wt.).mg/kg body wt.).

The mare was restrained in left lateral recumbence .The mare was restrained in left lateral recumbence .

► The fluid therapy and antibiotic treatment was started.The fluid therapy and antibiotic treatment was started.

►60 ml lignocaine (2%) was infiltrated 60 ml lignocaine (2%) was infiltrated locally on incision site.locally on incision site.

►With antiseptic precaution 30cm long With antiseptic precaution 30cm long Incision was taken.Incision was taken.

►After incising the skin, muscle and After incising the skin, muscle and peritoneum, incision of the uterus was peritoneum, incision of the uterus was made over the fetal prominence.made over the fetal prominence.

►Foetus was removed with great difficulty.Foetus was removed with great difficulty.

►Placenta also removed after the fetus.Placenta also removed after the fetus.

►Fetus was completely emphysematous Fetus was completely emphysematous without any abnormality.without any abnormality.

►Cephalaxine (Lixen) powder sprinkled in Cephalaxine (Lixen) powder sprinkled in the uterus before closing. the uterus before closing.

REMOVING THE FOETUS

►Then after uterus was sutured with double Then after uterus was sutured with double row Cushing suture pattern by Chromic row Cushing suture pattern by Chromic catgut No # 2.catgut No # 2.

►Then peritoneum and two layer of muscles Then peritoneum and two layer of muscles was sutured with continuous lockstitch was sutured with continuous lockstitch suture pattern by Chromic catgut No # 2.suture pattern by Chromic catgut No # 2.

►Skin was sutured with Horizontal mattress Skin was sutured with Horizontal mattress suture pattern by nonabsobable cotton suture pattern by nonabsobable cotton thread.thread.

SUTURING

►During operation,During operation,

- 7 lit. DNS (5%), - 7 lit. DNS (5%),

- 4gm Intamox, - 4gm Intamox,

- 10ml Dexamethasone, - 10ml Dexamethasone,

- 15ml Analgin was given intravenously.- 15ml Analgin was given intravenously.

•Incision line was sealed with tincture

benzoin seal

Difference of the caesarian Difference of the caesarian section in bovine and equine.section in bovine and equine.

►Anesthesia:Anesthesia:

►Site of incision on abdomen.Site of incision on abdomen.

►Site of incision over uterus.Site of incision over uterus.

►Suturing.Suturing.

Post operative complications in Post operative complications in mare.mare.

►Shock and Toxemia (1Shock and Toxemia (1stst day). day).

► Peritonitis (within 2-5 days).Peritonitis (within 2-5 days).

►Adhesion and strangulation (1-3 Adhesion and strangulation (1-3 weeks)weeks)

Post operative care.Post operative care.

► Stall confinement.Stall confinement.► Injection of Tetanus toxoid.Injection of Tetanus toxoid.► Limited amount of laxative food.Limited amount of laxative food.► Broad spectrum antibiotic systemically.Broad spectrum antibiotic systemically.► Anti-inflammatory drugsAnti-inflammatory drugs► Anti histaminicAnti histaminic► Fluid therapy Fluid therapy ( continue for 5-7 days) ( continue for 5-7 days)