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, 15:50, 9 June 2011
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'''An 8-year-old multiparous mare is presented 4 hours post-partum like this:'''
<FlashCard questions="5">
|q1=What possible structures could be present?
|a1= (1) placenta; (2) uterus; (3) bladder; (4) small intestine or small colon; (5) blood clot within the prolapsed uterus.
|l1=
|q2= What restraint can be used for successful and safe treatment?
|a2= Care in selection of tranquillisers as the mare may already have low blood pressure; the use of stocks, hay bales and a low stable door must be assessed for prevention of injury to the operator and/or mare if an unexpected reaction by the mare occurs.
|l2=
|q3= How would you treat each condition?
|a3= (1) In some cases, the placenta can be removed manually by gentle massage; an inability to remove it without haemorrhage may indicate that both the placenta and uterus may have to be replaced into the abdominal cavity.
(2) Palpate the uterus for tears, presence of the bladder, small intestine, small colon or blood clot, which may prevent replacement of the prolapse.
|l3=
|q4= What complications can arise?
|a4= (1) A ruptured or torn uterus due to the mare kicking the prolapse;
(2) severe haemorrhage from the placenta being torn off or from the mare galloping and kicking at the prolapse;
(3) if the bladder is prolapsed, the mare may be unable to urinate and so may strain heavily; drain the bladder before it is returned;
(4) where bowel loops are suspected, these may be returned to the abdominal cavity without opening the dorsal portion of the prolapsed vagina; standing the mare with the hind quarters elevated greatly assists in the replacement of bowel loops if present, but more importantly, helps replacement of the prolapsed uterus.
|l4=
|q5= What is your prognosis for future breeding?
|a5= The prognosis is good for a simple prolapse with retained placenta. Severe prolapses can cause tearing of ovarian attachments, which may cause physical injury and blockage of oocyte transport from the ovary. Haemorrhage, tearing and scarring of the uterus and tearing of the cervix all contribute to a less favourable prognosis; careful treatment and nursing can reduce these factors substantially.
|l5=
</FlashCard>
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