Management of hydrops amnion in a mare resulting in birth of a live foal

CASE DESCRIPTION: A 19-year-old Thoroughbred mare was evaluated at 265 days of gestation with a markedly distended abdomen and edema of the ventral portion of the abdomen. CLINICAL FINDINGS: The uterus was distended over the pelvic rim, making transrectal palpation of the fetus impossible. Transabdominal ultrasonography revealed excessive amounts of fetal fluid. Results of analysis of fluid obtained via amnio- and allantocentesis confirmed that the amniotic cavity was large. TREATMENT AND OUTCOME: The mare was monitored for signs of weakness of the prepubic tendon and abdominal wall. The fetus and placenta were monitored for signs of stress and pending abortion. Flunixin meglumine and altrenogest were administered to the mare. Parturition was attended and occurred at 321 days' gestation. Postpartum complications in the mare included hypovolemic shock and cardiac arrhythmias. Both conditions were treated, and the mare recovered. The foal was considered small, had bilateral angular limb deformities, and was unable to nurse. The foal was given plasma for failure of passive transfer of immunity. Ten months later, the foal underwent procedures to correct limb deformities. CONCLUSIONS AND CLINICAL RELEVANCE: Hydrops conditions are rare in horses, with hydrops allantois occurring more frequently than hydrops amnion; reportedly result in fetal or neonatal death; and may result in death of or injury to the mare. Close monitoring of maternal and fetal health in combination with supportive treatment of the mare can result in the safe progression of a hydrops pregnancy and the birth of a live foal.     

Abortion of a mummified fetus associated with short uterine body in a mare

A mummified fetus was aborted at 284 days of gestation from a Quarter Horse mare with a history of consecutive abortions. The abortion occurred 12 days after administration of supplemental progestogen had been discontinued. Results of a breeding soundness evaluation revealed that this mare had a short uterine body. Other abnormalities were not discovered. This condition may have been responsible for repeated abortions in this mare, and may represent a cause of fetal mummification other than twin pregnancy in mares.     

Surgical Removal of One Conceptus from Fifteen Mares with Twin Concepti

A surgical technique for removal of one conceptus from mares with twin concepti more than 35 days of gestational age was evaluated. One conceptus was removed surgically from each of 15 mares carrying twin concepti that were 41 to 65 days of gestational age. As determined by ultrasonography, eight mares had bicornuate and seven mares had unicornuate twin concepti. For maintenance of pregnancy if surgical trauma should cause prostaglandin release and luteolysis, progesterone was administered prophylactically. Flunixin meglumine was administered perioperatively to minimize prostaglandin release. Five mares with bicornuate twin concepti delivered a single viable foal; in one mare the fetus was alive 4 days after surgery when the mare was euthanatized because of a fractured femur. None of the remaining feti in the seven mares with unicornuate twin concepti survived. The poor survival rate of unicornuate twin concepti was attributed to disruption of the remaining chorioallantois during surgery. Thirteen mares have been rebred successfully.     

Cystic calculus in a mare due to a misplaced uterine glass marble

A 9-year-old Quarter Horse mare was referred for evaluation of continuous oestrus, polyuria and suspected pyometra after a glass marble was placed in the uterus by the owner. Palpation per rectum and transrectal ultrasonography confirmed the presence of a spherical object, but it was not possible to discern whether it was located within the lumen of the uterus or urinary bladder. Thus, an endoscopic examination of both uterus and bladder was carried out and a spherical, spiculated surface urolith was found on the floor of the bladder. The cystic urolith with suspected marble core was removed using a 12-mm specimen retrieval bag with endoscopic guidance. Follow-up with the owner one month after discharge revealed that the mare had not shown any signs of discomfort while urinating nor signs of oestrus.     

Reduction of Twin Pregnancy in the Mare by Transvaginal Ultrasound-Guided Aspiration

Diagnosis and management of twin pregnancies in the mare are an ongoing challenge in equine reproduction. Early detection of twin and manual crush of one vesicle are the main steps in the management of twins. Few studies were carried out about the use of transvaginal ultrasound-guided aspiration (TUGA) for reduction of twins in the mare. In this study, the efficiency of TUGA for management of twin pregnancies was investigated. Reduction of unicornuate twins between 16 and 25 days of gestation gave a success rate of 70.0% (14 viable foals/20 twin pregnancies); when reduction was performed after day 40 of gestation, all mares (one unicornuate; three bicornuate) lost both. For those cases in which the window for early crush of a twin vesicle has been missed, TUGA can be successfully used to reduce twin pregnancy between 16 and 25 days of gestation.     

Removal by laparoscopic partial ovariohysterectomy of a uterine leiomyoma assumed to have caused fetal death in a mare

A 13‐year‐old pluriparous Dutch Warmblood mare presented to Utrecht University's Department of Equine Sciences 4 weeks after suspected abortion at 3.5 months gestation, to investigate the nature of a uterine mass and persistent vulval discharge. Transrectal ultrasonographic examination revealed copious flocculent fluid and fetal remnants within the uterus and a 5–6 cm heterogenous mass in the uterine wall at the tip of the right horn. Expulsion of fetal parts and resolution of the coexisting endometritis were effected by a combination of repeated PGF_2a analogue injections to induce oestrus, application of PGE₂ gel to aid cervical relaxation, and daily uterine lavage and antibiotic instillation. The presence of the mass in the uterine wall was confirmed by hysteroscopy and the suspected tumour subsequently removed by partial laparoscopic ovariohysterectomy under standing sedation and local anaesthesia. The histological appearance of the tumour was consistent with a leiomyoma or moderately malignant leiomyosarcoma. Although a follow‐up examination 6 months post surgery revealed uncomplicated healing of the uterus, the owner decided to retire the mare from breeding. Uterine neoplasia is an extremely unusual cause of fetal death in the mare but, in the present case, laparoscopic partial ovariohysterectomy proved a promising, minimally invasive technique for salvaging sufficient uterus to make subsequent breeding a realistic proposition.     

Birth of a Live Foal after Transabdominal Ultrasound-guided Cardiac Injection of a 200-day Equine Twin Fetus

In horses, development of twins is often problematic and may represent a potential life-threatening condition for the mare and both of the embryos/fetuses. There have been many attempts at various stages of gestation to reduce twin fetuses to a singleton with variable success. Techniques have been described to perform transabdominal ultrasound-guided cardiac injection of a toxic substance into a twin fetus. The case discussed in this report is of a mare that presented at 200 days with twin fetuses. Procaine penicillin was injected directly into the heart of one fetus, using an ultrasound-guided approach. The ultimate outcome was birth of a live healthy filly, followed by the passage of a mummified fetus. This report is the first to describe the procedure in a mare at more than 168 days of gestation, leading to birth of a live foal that lived longer than 3 days.     

Fetal maceration and retention of fetal bones in a mare

A 19-year-old Quarter Horse mare was evaluated because of bloody vaginal discharge that was apparent immediately following breeding. On transrectal ultrasonography, it was evident that the uterus was filled with fluid containing echogenic particles; linear hyperechoic structures were also visible. Endoscopy was performed, which revealed a number of bones adhered to the cranial wall and floor of the right uterine horn as well as purulent fluid in both uterine horns. Bacterial endometritis and fetal maceration were diagnosed. The mare was treated with antibiotics, and the fetal bones were manually removed from the uterus. Fetal maceration with intrauterine retention of bones is rare in mares. Use of hysteroscopy supplements ultrasonography in the diagnosis of uncommon conditions of the uterus. Macerated bones may be adhered to the endometrium, thereby requiring manual removal.     

Haematic Mummification in a Mare With Twin Pregnancy

Mummification occurs when the fetus dies during the second or third trimester of gestation and remains in the uterine cavity because of the persistence of the corpus luteum or existence of another live fetus. Generally, the mummified fetus and fetal membranes undergo desiccation. The hematic process is similar, but the fetus appears like melted chocolate and becomes lodged between the uterus and chorion. This report describes the treatment of dystocia in a mare with twin pregnancy, with one fetus having undergone hematic mummification. Although difficult to diagnose, the possibility of a second fetus should be investigated in mares with dystocia.     

Hormone Profiles of Mares Affected by the Mare Reproductive Loss Syndrome

While searching for the cause of the Mare Reproductive Loss syndrome (MRLS), we postulated that 1 of 3 tissues in 40–120 D pregnant mares was the likely primary target of the noxious factor that caused early abortions: The corpora lutea (CL), the endometrium or the fetus and/or its membranes. At this stage of gestation, progesterone (P4) is solely produced by luteal tissue, eCG by endometrial cups in the endometrium and oestrogens by the feto‐placental unit. We determined whether concentrations of P4, eCG and/or total conjugated oestrogens (CE) would indicate which tissue was targeted during the MRLS. P4, eCG and CE were measured in single serum samples collected from 216 mares, 60–110 D after ovulation during the 2001 MRLS outbreak. All mares had previously been confirmed pregnant by ultrasonography. The following data was obtained from each mare: Interval from ovulation, pregnancy status and normalcy of fetal fluids at the time of sampling, and pregnancy status 3 weeks after sampling and at term. There were no meaningful differences in hormone concentrations between pregnant mares that had normal and excessively echogenic fetal fluids at the time of sampling. CE were lower (p < 0.05) in mares that aborted after sample collection than in mares the carried to term. In 8 mares from which multiple samples were obtained, CE consistently decreased prior to any decreases in P4 or eCG. Arguments are presented that lead to the hypothesis that the fetal trophoblast was the primary target of the MRLS agent.     

Uterus unicornis in two mares

Two American Paint Horses, a 3-year-old nulliparous mare and a 7-year-old primiparous mare, presented for recent infertility and a pre-breeding examination, respectively. Examination of the internal reproductive tract of both mares using transrectal palpation and ultrasonography revealed the presence of the cervix, uterine body, left uterine horn and bilateral ovaries. The right uterine horn could neither be palpated nor imaged. The clinical diagnosis of uterus unicornis in one mare was confirmed at necropsy, which revealed combined aplasia of the right uterine horn and oviduct.     

Anastomosis of the medial digital artery in a mare following traumatic laceration

A 7‐year‐old Warmblood mare presented with blood loss from a laceration of the medial digital artery sustained in the field. The mare was initially managed conservatively by pressure bandaging but the bleeding did not stop. After a blood transfusion the mare underwent arterial repair under general anaesthesia and was initially managed in a cast post operatively. Doppler ultrasonography 4 days post operatively confirmed effective blood flow distal to the arterial anastomosis and the mare was discharged from the hospital. At 6 months follow‐up the owner reported that the mare was sound at the trot with an excellent cosmetic outcome of the surgical site.     

Successful reduction of a monozygotic equine twin pregnancy via transabdominal ultrasound‐guided cardiac puncture

In horses, twin pregnancy is pathological and represents a potentially life‐threatening condition to the mare and foal. Twinning occurs in approximately 2% of pregnancies. Of these, the majority of cases are dizygotic twins, resulting from 2 ovulations and monozygotic twins are rare. A 12‐year‐old Quarter Horse mare was presented for breeding management with shipped cooled semen and embryo transfer. Seven days post ovulation, a single late morula/early blastocyst was recovered and transferred immediately to a recipient mare. Thirty‐six days after transfer, transrectal ultrasound examination revealed the presence of 2 embryos. A transcutaneous reduction of one of the fetuses was performed successfully at 128 days of gestation. This report is the first to describe a successful reduction of monozygotic twins by transcutaneous ultrasound‐guided cardiac puncture.     

Relationship between estrous behavior in pregnant mares and the presence of a female conceptus

Unsolicited reports of estrous behavior in mares thought to be pregnant were received from owners or caretakers of Arabian mares. Estrous behavior was confirmed and mares were examined for pregnancy. Gender of the conceptus was determined at foaling in 11 mares in which estrous behavior was confirmed while an apparently viable, ultrasonically normal-appearing conceptus was present. In 9 mares in which the day of ovulation was known (Day 0), the estrous behavior occurred on Day 12, 13 or 14 (5 mares), Day 18 or 20 (2 mares), Day 40 (1 mare) and Day 60 (1 mare). In another study, 55 pony mares were observed for estrous behavior every 3 days for 20 minutes during Days 11 to 40. Estrous behavior was observed in 1 mare (2%) on Day 24. Combined for the 2 studies, the incidence of a female conceptus (12/12) was greater (P<0.01) than the incidence of a male conceptus (0/12) in mares that exhibited estrous behavior.     

Monitoring of the mare during the perinatal period at the clinic and in the stable

Complications in late gestation are challenging problems for the equine clinician and are causes of considerable distress to owners. Health problems in a pregnant mare in each stage of gestation can adversely affect the pregnancy. It is important to obtain a thorough history and perform a detailed and systematic examination of the pregnant mare so that the mare may be classified as normal or high-risk. However, even after a thorough examination, practitioners may face problems with the interpretation and assessment of risk. Normal mares should foal in the stable or pasture. Mares classified as having a high-risk pregnancy need to be monitored precisely for signs of oncoming foaling with attendance of trained personnel when labour begins. A valuable method for monitoring of the high-risk mare is assessing fetoplacental well-being. Fetoplacental well-being is most accurately assessed with ultrasonography as well as several available hormone profiles. We are proposing our scoring system of the mare's health, which may be useful in the assessment of risk during pregnancy and help clinicians to decide whether sending the mare to the clinic is reasonable or unnecessary.     

Exercising the Pregnant Mare from Day 16 to Day 80 of Gestation

Our previous research has demonstrated moderate exercise can be detrimental to early pregnancy in the mare, but little work has examined exercise after pregnancy has been detected. We exercised mares (n = 8) 6 days a week for 45 min from Day 16 until Day 80 of gestation. Color Doppler ultrasonography was used to evaluate embryonic vesicle size, fetal length, and uterine blood flow. Blood was sampled every other day to analyze cortisol and progesterone concentrations. Results indicated that exercising pregnant mares (n = 4) led to greater (P < .01) cortisol concentrations 30 min after the exercise period. No overall treatment effect could be detected in progesterone concentrations; however, following Day 60 of gestation, progesterone concentrations were lower (P < .05) in exercised mares. Additionally, progesterone concentrations peaked earlier in exercised mares at Day 52 of gestation compared to peak levels at Day 68 of gestation for control mares. No significant effects were detected in embryonic vesicle size. Fetal length tended (P = .06) to be longer in the conceptus of exercised mares. Uterine blood flow did not differ between groups but increased as pregnancy progressed (P < .001) in both groups. All mares in this study went on to deliver healthy foals and suffered no difficulties during parturition. These results indicated that moderate exercise was not detrimental to mare pregnancy.     

The use of ultrasonography for pregnancy diagnosis in the bitch

Twenty-three Greyhound bitches housed at 3 breeding kennels were examined for pregnancy via transabdominal palpation and ultrasonography. Pregnancy was timed from the calculated day of ovulation (day of ovulation = day when first pup was whelped--63), and from a single breeding date (day 0). Starting on day 10 after ovulation, 9 bitches were monitored every 3 days by ultrasonography only, to determine gestational vesicle sizes during gestation and the time when fetal movements and heartbeats could be first detected. The other 14 bitches were examined by ultrasonography and transabdominal palpation on the same day every week, starting on postovulation day 19, to compare the effectiveness of the 2 methods of pregnancy determination. Parturition was the final determinant of pregnancy status. The earliest correct diagnosis of pregnancy was at 18 days after ovulation, but fetal movements and heartbeat could not be identified until days 28 and 35, respectively. Estimation of fetal numbers by ultrasound or palpation was not reliable when there were more than four in the litter. Pregnancy and nonpregnancy were correctly determined by both methods in an increasingly greater number of bitches as gestation progressed, but ultrasonography was more accurate at all stages; on days 19 to 22, 26 to 30, 34 to 38, and greater than 40 after ovulation, correct diagnoses were made in 33%, 42%, 50%, and 75% of the bitches by palpation and in 42%, 67%, 75%, and 83% of the bitches by ultrasonography. The most common error was failure to detect pregnancy by palpation or ultrasonography in bitches with small litters and tense abdominal muscles.(ABSTRACT TRUNCATED AT 250 WORDS)     

Current methods for the diagnosis and management of twin pregnancy in the mare

Historically, twin pregnancy has been one of the leading causes of pregnancy loss in the mare. Numerous studies have identified factors that increase the incidence of twinning. The identification and management of twins during the mobility phase remains the most effective method to control the potentially detrimental effects of twin pregnancy. Options exist for post fixation management of twins, although these methods are generally less successful than management during the mobility phase.     

Effects of ovulation rate and fetal number on fertility in twin-producing cattle

Effects of ovulation rate and of fetal number and distribution within the uterus on pregnancy rate and fetal survival were evaluated in nulliparous (n = 1,331) and parous (n = 3,517) cattle selected for twinning. Cattle were divided into a spring (70 d) and fall (60 d) breeding season and bred by a combination of AI and natural service. Ovulation rate, pregnancy status, and fetal number and distribution were determined by transrectal, real-time ultrasonography of the uterus and both ovaries at the end of the breeding season. Pregnancy was reconfirmed by rectal palpation at 75 to 135 d of gestation. For heifers and cows combined, ovulation rate increased (P < 0.01) from 1.46 +/- 0.4 in 1994 to 1.89 +/- 0.4 in 2004; number of calves per parturition increased (P < 0.01) from 1.34 +/- 0.3 to 1.56 +/- 0.3, respectively, which included an increase in triplet and quadruplet ovulations and triplet births. Bilateral twin ovulations yielded proportionately more (P < 0.01) twin births than unilateral twin ovulations. Ovulation rate was greater (P < 0.01) in the fall than spring breeding season. Pregnancy rate at ultrasound diagnosis did not differ among females with 1, 2, or 3 ovulations (89.1 +/- 0.7, 91.2 +/- 0.7, or 91.5 +/- 2.8%, respectively), but rates at calving decreased (P < 0.01) with increasing ovulation rate (85.1 +/- 0.6, 82.7 +/- 0.6, or 64.2 +/- 2.7%, respectively). Pregnancy rate was less (P < 0.01) after twin or triplet births than single births. For dams birthing twins or triplets, pregnancy rate was less in the fall vs. spring, but rates were similar between seasons for dams with a single birth (type of birth x season, P < 0.05). Cows 60 d, regardless of type of birth. Maintenance of pregnancy to term differed (P < 0.01) among females diagnosed with 1, 2, or 3 fetuses (95.7 +/- 0.6, 87.8 +/- 0.8, and 54.9 +/- 2.3%, respectively). The reduced survival of twin and triplet fetuses in heifers had occurred (P < 0.01) by d 75 to 135 of gestation, and fetal losses were greater (P < 0.01) for unilateral than bilateral twins or triplets, whereas loss of twin or triplet fetuses in cows occurred later in gestation, and losses were not affected by uterine location. Thus, increased calf production from selecting for increased ovulation rate in beef cattle is tempered by increased fetal mortality, partially associated with the crowding of 2 or 3 fetuses within 1 uterine horn, especially in heifers.     

Accuracy of early fetal sex determination by ultrasonic assessment in goats

The objective of this study was to determine the accuracy of early fetal sex determination by ultrasonic assessment of the relative location of the genital tubercle (GT) in goats at different stages of pregnancy as well as by the identification of fetal external genitalia. Pregnant animals were divided into three experimental groups (EI: n=21, EII: n=28, EIII: n=33). In EI, fetuses (n=27) were transrectally monitored daily from days 40 to 60 of pregnancy with a linear transducer (6.0 and 8.0MHz). In EII, fetuses (n=40) were examined once between days 45 and 70 of pregnancy by transrectal ultrasonography. In EIII fetuses (n=52) between days 100 and 120 of pregnancy, were submitted to a single transabdominal ultrasonography using a convex transducer (5.0 and 7.5MHz). Regardless of fetal sex diagnosis, 15/15 (EI), 13/16 (EII) and 9/14 (EIII) of single pregnancies and 10/12 (EI), 20/24 (EII) and 21/38 (EIII) of twin pregnancies were correctly identified. The accuracy of sex identification among EI (92.6%), EII (82.5%) and EIII (57.7%) was not statistically different (P>0.05). Identification of the GT in male fetuses was possible from day 45 onward. Changes in the GT position were not observed between days 53 and 60 of pregnancy. Accuracy of fetal sexing under field conditions is high in goats when ultrasound imaging is properly timed during pregnancy and when it is performed with proper equipment by experienced operators.