Page 476 - Equine Clinical Medicine, Surgery and Reproduction, 2nd Edition

Reproductive system: 2.1 The female reproductive tr act 451

VetBooks.ir 2.59 2.60

Fig. 2.59 Post-mortem view of a broodmare that was
euthanased after a post-foaling peritonitis. Note the
rupture in the caecum.

Fig. 2.60 ‘Dog-sitting’ behaviour in a broodmare
with abdominal pain a few days post foaling.

Mares that rupture the caecum or large colon early in to impacted small colon, painful foci in the abdo-
parturition may present with difficulty in foaling due men or roughened, inflamed serosal surfaces.
to weak straining. Delivery of the foal with assistance Transabdominal ultrasonography or laparoscopy may
is usually possible with/without complication, but the be helpful in further differentiation of the diagnosis.
mare does not recover from the foaling as would be
normally expected and rapidly develops signs of septic Management
peritonitis and endotoxic shock. Should any intestine In many cases of rupture the opportunity for
prolapse, contamination and trauma to the intestine treatment is minimal and euthanasia is indicated.
will occur. Death can occur in 4–6 hours. Where Surgical intervention by midline ventral laparotomy
the bowel is damaged but not ruptured, a slower, less may establish the site and severity of damage, but
marked clinical picture evolves with low-grade abdom- the inaccessibility of some lesions, particularly in the
inal pain, sometimes several days after parturition. small colon and rectum, and the extent of mesenteric
The delivery may or may not have been complicated. damage make many lesions inoperable. Resection of
The colic is accompanied by fever and depression, with damaged bowel and mesentery followed by anasto-
poor milk production and abdominal guarding if peri- mosis is particularly challenging in the small colon
tonitis becomes established. Bowel damage can lead to or cranial rectum. Treatment of the peritonitis by
progressive leakage of bacteria and bacterial toxins and peritoneal lavage, peritoneal drainage and antibiot-
result in endotoxic shock, septicaemia and death. ics, followed by high levels of systemic antibiotics,
fluid therapy and intensive care is indicated
Diagnosis
Peritoneal fluid collection and analysis are essential Prognosis
for diagnosis of peritonitis (neutrophilia and leuko- The prognosis is poor to grave depending on the
cytosis) and bowel rupture (food material). Rectal degree, site and extent of damage to the bowel, and
palpation reveals variable findings from nothing the amount of peritoneal contamination.