Page 486 - Equine Clinical Medicine, Surgery and Reproduction, 2nd Edition

Reproductive system: 2.1 The female reproductive tr act 461

VetBooks.ir General anaesthesia malpostures. Invariably the mare will need
transporting to a surgical facility, and this must
General anaesthesia is indicated if difficult and pro-
longed manipulation is required. The mare’s hind-
quarters should be raised using a slope in a field, a be done safely and quickly for the welfare of
mare and foal. In-utero oxygen provision to the
winch from a ceiling or a front loader on a tractor. foal is possible by a cuffed intranasal tube, and
If it is suspected that the mare will require a caesar- this supports the foal during transport when the
ean section, it should be referred immediately rather placenta is likely to be ineffective.
than trying a general anaesthetic in the stable first. 4 If the foal is already dead, perform a ‘quick
partial fetotomy’ (2–3 cuts) to correct a postural
INITIAL VETERINARY EXAMINATION abnormality by sectioning the foal into smaller
sections that can then be delivered. Full fetotomies
The clinician should ascertain any relevant history are performed, but these nearly always damage the
such as length of gestation, length of second stage of relatively short cervix of the mare and therefore
parturition, past problems with pregnancy or partu- seriously compromise the mare’s future breeding
rition, prior interventions and other medical prob- prospects. Specialised equipment, including a
lems. A careful and thorough obstetric examination fetotome, hooks and an introducer, and technical
needs to be carried out to establish the cause of the skills are necessary to minimise damage to the mare.
problem. The presentation, position, posture and
health of the foal should be carefully assessed, plus SUMMARY
the state of the mare’s reproductive tract (i.e. fore-
limbs/hindlimbs; alive/dead; malposture/deformity; • Apply limb and head ropes as soon as possible
room for manipulation/delivery; one/two foals). before the birth canal gets dry and swollen.
The normal presentation is anterior longitudinal, • Use plenty of clean lubricant and use a stomach
the normal position dorsosacral and the normal pos- pump and stomach tube to infuse the uterus
ture extended head resting on carpi of extended fore- • Apply traction in rotation so that the foal
limbs. Once all this information is established, a plan presents the least possible circumference.
can be formulated as to how to rectify the problem. • A maximum of 2–3 people should apply traction
at any one time.
FOALING TECHNIQUE • Consider general anaesthesia if a malposture
is not easily correctable in a standing position.
After the initial assessment there are four broad Some malpostures can be delivered safely
courses of action. A decision should be made quickly, (e.g. hindlimb up alongside the chest).
following a full discussion with the owner, as delays • Consider referral for caesarean section early if a
may have consequences for the chances of survival prolonged manual delivery is anticipated.
for the mare and/or foal:
SOME SPECIFIC CAUSES OF DYSTOCIA
1 Deliver the foal after a simple and speedy AND RECOMMENDED ACTION
manipulation.
2 Deliver the foal alive or dead after a relatively • Incomplete elbow extension. Should be easily
prolonged manipulation, using sedation, epidural correctable, but will require the trunk to be
anaesthesia or general anaesthesia. An early repelled and the limbs extended.
decision to undertake this option is essential • ‘Dog sitting’. This presentation is very difficult
before the mare and the clinician/helpers to correct standing. Consider general anaesthesia
become exhausted, the mare’s birth canal swells or refer for caesarean section.
and the foal dies. • Partial dog sitter (one hindlimb back and
3 Caesarean section. This is the best option one hindlimb forward). May be deliverable as
in cases of gross deformity or complicated presented but may lead to cervical damage.