There are a number of possible post foaling complications which require immediate veterinary attention. These include:
Retained Placenta
The placenta should be passed intact between 30 minutes and 3 hours after the foal is delivered. If the placenta has not been passed by 2-3 hours then it is retained and is classed as a true equine emergency. Please call your vet immediately. The incidence of retained placenta in the mare is reported to be 2-10%, but can commonly occur as a consequence of:
- Dystocia- difficulties delivering the foal
- Twins
- If the mare has a caesarian section
Treatment:
It is imperative that 100% of the placenta is removed. Even a small retained piece can result in serious complications. Bacterial multiplication within the uterus can quickly lead to septicaemia and endotoxaemia with a potentially fatal result. Severe laminitis is a possible sequel. Treatment is carried out by the vet. No attempt should be made to manually pull the placenta. This can result in serious complications such as uterine prolapse and tearing of the uterine arteries.
What the owner can do:
- tie the hanging placenta into a ball just above the hocks – this prevents them from becoming torn and contaminated
- gentle walking exercise may be helpful
What the vet will do:
- Oxytocin injections will be given – this stimulates uterine contractions
- the uterus can be infused with fluid – this often promotes expulsion of the membranes, together with any uterine contaminants
- manual removal may be attempted by a vet who will take great care not to tear the placenta and leave a piece inside the mare
If the mare retains her membranes longer than six hours, urgent veterinary treatment is required. If she develops a temperature and becomes obviously ill she may need to be hospitalised. The uterus is flushed at regular intervals, intravenous fluids are administered, oxytocin, antibiotics and anti-endotoxic drugs are given and prophylactic laminitis treatment may be given.
Remember to note the time that the mare foals. If the placenta is passed, lay it out on the floor and check it is fully intact- call the vet if you are at all unsure.
Prolapse of the uterus
This is uncommon but more likely to occur if the mare had problems giving birth, uterine trauma or if the membranes are retained. It tends to occur within the first few hours after birth. Uterine prolapse can be potentially life threatening if complicated by rupture of the large uterine arteries, if the prolapsed uterus becomes contaminated, infected and ischaemic leading to shock, septicaemia and death. This is a true equine emergency and your vet should be called immediately.
Treatment is focused on stopping the mare from straining with sedatives, epidural or sometimes general anaesthesia. The uterus is held up to prevent further traction, is cleaned, any bleeding vessels are clamped and any uterine tears are sutured. The uterus is then replaced if possible and fluid will be instilled into the uterus to ensure the tips of the horns are everted. Antibiotics and oxytocin will be given for a number of days.
Uterine tears
These are more likely to occur if there are foaling problems and the delivery has to be assisted. Occasionally they can occur during an apparently normal delivery due to a foetal foot perforating the uterus.
Rupture of a major vessel
The incidence of severe haemorrhage from rupture of a uterine artery increases with the age of the mare. Haemorrhage is usually internal so no evidence of bleeding from the vagina is seen. The mare often sweats and shows signs of extreme pain or colic. The mucous membranes quickly become pale and the condition is often fatal. Treatment can be attempted but if often unsuccessful.
Vaginal Haemorrhage
May be caused by vaginal or cervical tears, trauma, forceful removal of retained placenta or varicose veins. Mild bleeding does not usually require treatment.
Rupture of the caecum
This may occur due to the high abdominal pressures experienced during foaling.
Colon Torsion
The most common cause of colic in the first 2 months after foaling is a displaced and / or twisted large colon. This occurs as uterine involution is taken place and more room is suddenly available in the abdomen that the foal previously occupied. The large intestines float around in the new available space and often displace or twist. The mare will present with sudden onset, severe unrelenting colic which is not improved with painkillers.
Immediate veterinary attention, rapid diagnosis and immediate surgery are essential if the mare is to survive. Fatality is as high as 72%.
