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Flashcards in Postpartum Disorders Deck (74):
1

What is one of the most common problems associated with dystocia?

Retained placenta

2

A placenta is considered retained if it has not been passed in what amount of time?

3 hours

3

Which species has a higher incidence of retained placenta, equine or bovine?

Bovine

4

Which species have more severe consequences associated with a retained placenta, equine or bovine?

Equine

5

What are 4 consequences that can be seen with a retained placenta in mares?

- Toxic metritis
- Septicemia
- Laminitis
- Delayed uterine involution

6

The likelihood of a retained placenta can increase with what 3 conditions?

- Dystocia
- Abortion
- Placentitis

7

What drug can be given with a retained placenta?

Oxytocin

8

Should a retained placenta be manually separated?

No

9

What are 6 aspects of handling a retained placenta?

- Manual assistance
- Antibiotics
- NSAIDs
- Tetanus prophylaxis
- Watch for metritis and laminitis
- Uterine lavage/infusion

10

How should manual assistance in removal of a retained placenta be performed?

Reach as far forward as possible and grab chorioallantois then add twisting, gentle traction to deliver

11

What can happen if part of the chorioallantois is retained within the uterus?

Torn retained placenta

12

What are 2 ways to confirm a torn retained placenta?

- US
- Manual examination

13

If a torn retained placenta is detected, what should be done with the mare?

Place mare on preventative therapies

14

What are 2 things that can be used to aid in removal of a torn retained placenta?

- Lavage
- Oxytocin

15

Does the mare eat the placenta?

No

16

Fetal monsters usually require what in a mare?

Fetotomy or cesarean section

17

What are 4 types of fetal monsters that can be seen with foals?

- Torticollis
- Contracted tendons
- Schistosomus reflexus
- Hydrocephalus

18

With partial duplication/double monsters, is it better to perform a c-section or a fetotomy?

C-section

19

The brain forms outside of the fetal skull in what condition?

Exencenphalus

20

What are 5 examples of trauma that can be seen postpartum in the mare?

- Recto-vestibular fistula
- Perineal lacerations
- Cervical trauma
- Vaginal trauma
- Vulvar trauma

21

When should cervical trauma be repaired?
With what?

- Repair during estrus
- Use long-handled instruments

22

What are 2 things to watch out for with vaginal trauma in the mare?

- fat/intestinal prolapse
- Vaginal adhesions

23

How can vulvar trauma be repaired?

Caslick

24

What degree of perineal laceration involves the skin and mucous membranes of the dorsal commissure of the vulva/vestibule?

First degree

25

What degree of perineal laceration involves deeper structures but does not involve the rectal sphincter?

Second degree

26

What degree of perineal laceration involves complete disruption of the recto-vestibular shelf?

Third degree

27

What is used to correct a first degree perineal laceration?

Caslick

28

What is used to correct a second degree perineal laceration?

Caslick plus reconstruction of perineal body

29

What is another term for a recto-vaginal fistula?

"Gill flirter"

30

What are 2 aspects of treatment for a third degree perineal laceration?

- Initial treatment with antibiotics, NSAIDs and debridement
- Surgical repair once healed in 6-8 weeks

31

Surgical repair of a third degree perineal laceration should be held off for how many weeks?

6-8 weeks

32

What type of suture pattern should be used on the vaginal mucosa with perineal laceration repair?

Inverted suture pattern

33

When assessing for a prolapse in a young animal, it is important to check for what?

Persistent hymen

34

What are 3 things that a vaginal prolapse can be secondary to?

- Irritation
- Coughing
- Tear

35

Since the urethra in a mare is short and wide, what is possible?

Bladder prolapse

36

Uterine prolapse can occur secondary to what?

Uterine inertia

37

Once the uterus has passively started to evert and has entered the vaginal canal, what can cause further eversion?

Ferguson's reflex

38

Why might a retained placenta exacerbate a prolapsed uterus?

Placenta pulls on the uterine horn, starting eversion.

39

What should be done with the tail during a uterine prolapse?
Why?

- Wrap the tail and move it out of the way.
- So it doesn't damage the endometrium of the uterus.

40

What are 4 things that should be done right away with a uterine prolapse?

- Restrain mare
- Support uterus with a clean plastic board
- Perform epidural
- Place tail wrap, clean perineum/uterus

41

How should the uterus be manipulated back into the body?

Using flat hands and working the edges in slowly.

42

What is something that can be done to the uterus to try and decrease edema?

Wrap towels around the uterus.

43

Once the uterus is placed back in the body, what needs to be done?

Uterine horns need to be extended

44

What are 4 types of treatments that can be administered after a uterine prolapse has been corrected?

- Oxytocin
- Systemic antibiotics
- NSAIDs (Banamine)
- Tetanus prophylaxis

45

What is done surgically after a prolapsed uterus is placed back in the body?

Use a Buhner needle to place a purse string around the vulvar opening.

46

How long is a purse string left in a mare after a uterine prolapse?

3-5 days

47

After a uterine prolapse, it is a good sign if a mare can do what right away?

Urinate

48

What is the cause of cervical hyperplasia?

Unknown

49

Does a mare have to be pregnant for cervical hyperplasia to occur?

No

50

What is the normal range for total protein in the foaling mare?
Total nucleated cell count?

- TP less than 2.5 g/dL
- Total nucleated cell count less than 500 cells/uL

51

What is the primary cell type seen in the peritoneal fluid of non-dystocia mares?
of post-dystocia mares?

- Non-dystocia: mononuclear
- Post-dystocia: neutrophils

52

Up the what percentage neutrophils is normal in the peritoneal fluid of postpartum mares?
When an acute inflammatory process exists?

- 70%
- 85-100%

53

What are 3 peritoneal fluid values that are suggestive of the mare becoming ill?

- TP greater than 3 g/dL
- Total NCC greater than 15,000 cells/uL
- Neutrophil count greater than 80%

54

Hemorrhage postpartum is more common in what age mares?

Older mares greater than 12 years

55

Which artery is more predisposed to rupture from parturition?
Why?

- Right middle uterine artery
- Cecum pushes uterus to left, possibly increasing tension on right artery

56

Postpartum hemorrhage can be secondary to what 4 events?

- Uterine torsion
- Uterine rupture
- Uterine trauma
- Normal foaling

57

Age related vessel changes can cause what?

Aneurismal dilation leading to rupture and hemorrhage.

58

What deficiency may predispose the mare to hemorrhage postpartum?
Why?

- Low copper
- Copper is responsible for increased elasticity of vessels

59

What are 3 aspects of treatment for uterine artery rupture?

- Keep mare quiet
- Monitor PCV
- US for fluid in abdomen

60

A mare with a uterine artery rupture may need what?

Transfusion

61

With a uterine artery rupture, be careful not to do what?
Why?

- Do not over-hydrate
- Increases blood pressure

62

Mares with a ruptured uterine artery often present with what?

Colic

63

Should a mare that has ruptured a uterine artery be re-bred?

No

64

What is the most common drug used for uterine artery rupture in mares?

Aminocaproic acid

65

A mare that is presenting post-foaling with an inability to defecate but appears to be bright and alert may be experiencing what?

Rectal mucosal sloughing

66

Damage to what artery during foaling can lead to loss of blood supply to the rectum and rectal mucosal slugging?

Mesocolic artery

67

What type of a prognosis does a mare with rectal mucosal sloughing have?

Poor outcome

68

A post-partum mare should always be checked for what?

Mastitis

69

A mare with mastitis may present with what?

Lameness

70

How should a sample be collected to test for mastitis in a mare?

- Wipe teat end with alcohol
- Strip small amount
- Wipe teat end again
- Collect sample into sterile container for C/S

71

What are 4 forms of treatment for mastitis in mares?

- Strip frequently, giving oxytocin just prior
- Systemic antibiotics and udder infusion
- NSAIDs (Banamine)
- Warm compress

72

Rejection of the foal is seen more commonly with what type of mare?

Maiden mare

73

What is a drug that can be given to a mare that treats agalactia and causes some sedation?

Reserpine

74

What is a technique that can be tried with mares that initially reject their foals?

Adoption technique