I would need your input on my mareís case. Sheís a 6 y.o. sport horse broodmare.
I bought her pregnant in February 2009. She had been bred and took on 1 dose of frozen in 2008 (first year bred). She had a caslick and I was told by previous owner that her vet often performed them on most mares to prevent problems.
The caslick was opened early March and the mare foaled on March 24th. The foal was enormous and had a leg under him and his head on his shoulder. It took several hours, 2 vets and 2 technicians to get it out of there. Of course the foal was dead, but the mare survived. We were pretty sure to lose her at one point, so Iím glad sheís still alive.
My vet gave her oxitocyn and performed several flushes on the days following the disastrous foaling. She was clean and the vet said the uterus was recovering very well.
Fast forward to July 2009. I decided to try to breed her once this year, in case she would catch. She was in excellent health and my vet also thought she could be ready to be bred again, although we first thought of giving her a complete year off.
She doesnít show any signs of heat, and we missed 2 week-end ovulation. The 2 times, the ultrasound showed a good amount of air in the uterus. She told me that the air was coming in when she would put her arm in the mareís rectum.
We finally timed the ovulation with a shot (Iím sorry I canít remember the name of it!) to ease the process since Iím breeding fresh cooled and couldnít have the shipment on a week-end. The mare came into heat, and the vet could see some air into the uterus, but it appeared to be minor. We did the A.I., performed the caslick, and the vet gave her another shot to make sure she would ovulate in the next 24h (canít remember what it was either!).
Everything was done to make sure she would catch, but the 18 days ultrasound showed no pregnancy. When the vet removed the caslick, it appeared that the vulva didnít close at all. I didnít see any signs of infection or any liquid coming out of the suture the days after the caslick was done.
So Iím wondering what is the best protocol I should follow next spring when I try again? Do you think the 2009 dystocia could prevent her from catching again? Is there a way to have her expulse the air after she is bred? Would giving her oxitocyn help clearing the air as it does for fluid? Should we do a couple flushes?
Sorry for the long thread! Sheís a stunning mare and I really hope for a successful breeding next time. Thanks for your help.
The average rate of conception is about 60% per cycle, so in fact, your mare is pretty much statistically normal (obviously you can't have a mare almost being pregnant, so some will get pregnant the first cycle, and some the third). Not getting pregnant on the first cycle of breeding is not an immediate cause for alarm.
Having said that, the pneumouterus (uterine air) is more of a concern. Air is in itself a uterine irritant, and it also will potentially drag in pathogens with it when it's sucked in. That therefore is something to be conscious of, and likely a good breeding soundness examination (including a culture and cytology or possibly even better, a culture and biopsy) is called for. I would also have a careful evaluation of the cervix performed either manually or using a videoendoscope - cervical damage is a common sequela of dystocia, and could be a contributory factor to the pneumouterus. It is also of course likely that the mare will require a Caslick's procedure, and this should be put in before breeding, not after, in order to maintain a "clean" environment for the conceptus to inhabit. Putting it in after breeding with a confirmed windsucker is more likely to leave the door open (so to speak! ) to pathogenic presence prior to breeding.
Oxytocin will be beneficial in maintaining clearance of air, and we like the oxytocin protocol that we have laid out on our site. Note that commencement of treatment in a situation such as this would be at onset of estrus, with treatment every 6 hours until about 3 days after ovulation. That will be more likely to maintain an "air-free" environment.
So... good BSE, good breeding practices, and good luck!
I'm not panicing but want to do things correctly next time!
I will certainly have a culture and biopsy done on her.
What if there is indeed damages to the cervix? Is it permanent? Is there a way to correct it?
Sorry for my ignorance, but... I guess if the caslick is put in before breeding, it means that you need to leave enough space for an arm to go through it for A.I.? If I remember correctly, the space left unsutured when I bought her wasn't that big? Or do you open the caslick for breeding, and then suture again?
For Oxytocin, I should start the treatment as soon as she goes into estrus? Since she shows absolutely no signs of heat, I guess I will have to wait until the pre-breeding ultrasound to start the treatment? This summer I had no choice but to ultrasound her to know where she was in her cycle... .
The ability to repair damage to a cervix will depend entirely upon the nature, position and extent of the damage. Some may be surgically reperable, while others can be positioned in such a way, or extensive enough that they are not.
A Caslick's procedure is intended to prevent aspiration of air and foreign particles into the uterus and/or vaginal vault. Obviously such aspiration has the potential to be contraindicated for pregnancy establishment. It is therefore often considered good practice to place the closure prior to breeding in order to allow the mare to develop and/or maintain a clean environment. The degree of closure will depend to some extent upon the angulation involved (see the article on the Caslick procedure on our site for more details). Obviously if the degree of closure and the size of the inseminator's hand are disproportionate, opening prior to insemination may be required. Often however placement of a "breeder's stitch" to give a degree of durability to the bottom of the suture line may be adequate to allow insemination without opening. An alternative is to inseminate through a speculum or a videoendoscope (with biopsy channel). If none of those are possibilities, the opening and reclosing may be necessary.
Depending upon where you are located (and therefore availability), the use of P&E or one of the other progestin therapies to synchronize onset of estrus may be beneficial in allowing a better determination of onset.
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