Page 485 - Equine Clinical Medicine, Surgery and Reproduction, 2nd Edition

460 CHAPTER 2

VetBooks.ir instruct the attendant to rupture the membranes examination. Sedation is necessary in some cases to
and deliver the foal as soon as possible.
allow examination or correction of the dystocia, with
• Foals that are stuck at the shoulders or hips should
commonly used. Romifidine can also be used, but it
be pulled carefully while rotating the foal slightly. low-dose detomidine, with or without butorphanol,
This aligns the widest part of the foal to the widest is recommended to always use it in conjunction with
part of the pelvis and can reduce the circumference butorphanol to minimise the possibility of ‘defensive
of soft-tissue areas such as the abdomen. movements such as kicking’. All α2 agonists cause
• If the foal is upside down, then allow the mare to uterine myometrial contraction to some degree, but
get up and down before trying again to deliver the advantages of sedation appear to outweigh the
the foal. disadvantages. A short general anaesthesia is very
• Posterior presentations should have traction useful to allow correction of the dystocia in some
applied immediately to deliver the foal as soon as circumstances.
possible.
• Lacerations can be repaired after the foaling is Preparation
over. Wrap the tail in a bandage and have it held to one
• Have plenty of clean warm water and help available. side by an assistant. Clean the perineum with dilute
warm povidone–iodine solution before examination.
PREPARATION OF MARE Preferably use clean rectal examination gloves or arms
PRIOR TO EXAMINATION cleaned with dilute povidone–iodine. Fresh, clean
obstetric lubricant should be used. Most mares tolerate
Post-parturient uterine infection after assisted foal- examination very well, but initially stand to one side
ing is common and potentially serious. Every care while examining to gauge the mare’s response.
should be taken with cleanliness and hygiene to
minimise contamination. Other medications/procedures
for use in the field
Restraint Clenbuterol (empirical dose of 12–15 ml i/v for a 500
An experienced handler is essential to control the kg horse), although not licensed for horses in some
mare in a clean, dry foaling box. A twitch can be a countries, is mainly used when a mare has to be trans-
useful way to quickly restrain the mare for the initial ported to a hospital facility. It helps reduce strain-
ing and possible pelvic impaction of the foal. In the
post-foaling mare, multiple doses of oxytocin (10–15
2.70
IU i/m q8 h) should be given for 2 days post partum
to ensure that involution of the uterus has not been
affected by the administration of clenbuterol. If this
dose produces colic, a smaller dose is given.

Epidural anaesthesia
This provides perineal and caudal reproductive tract
analgesia but has no effect on abdominal straining.
It takes time to administer, is not as easy to do as in
cattle, and so is not routinely used in foaling mares,
It is, however, very useful in some cases at parturi-
tion. Give 4–7 ml lidocaine or mepivicaine (2%) via
Fig. 2.70 Epidural analgesia of the mare is a useful aid an 18G 1.25 cm needle. The injection is placed in a
in dealing with dystocia cases. A needle is being placed surgically prepared area between the first and sec-
between the first and second coccygeal spaces after ond coccygeal spaces after a subcutaneous bleb of
aseptic preparation and subcutaneous local anaesthesia. local anaesthetic (Fig. 2.70).