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Journal of equine science2020; 31(4); 95-99; doi: 10.1294/jes.31.95

Abortion and uterine prolapse in a Thoroughbred mare with twin pregnancy: Clinical and laboratory findings and treatment approach.

Abstract: This report presents a case of uterine prolapse in a Thoroughbred mare. The uterine prolapse occurred after abortion of twins in the eighth month of gestation. The prolapsed uterus was bleeding and congested but not damaged. The placenta was still attached to the endometrium. Blood samples were collected for hematology and for estimation of calcium, progesterone and estrogen. The cervix and clitoris were swabbed for bacteriology. The mare showed a decrease in the number of lymphocytes. The concentrations of estrogen and progesterone seemed normal compared with mares that foaled. Pseudomonas aeruginosa was isolated. The prolapsed uterus was washed with warm normal saline, and the retained placenta was carefully removed. An antibiotic cream was spread on the prolapsed uterus before replacing it. Two-thirds of the upper vulva was transiently sutured. Systemic antibiotics and an anti-inflammatory were administrated for 5 days. After 24 hr, the sutures were removed, and uterine lavage was performed using warmed normal saline for three days. The mare received 20 IU of oxytocin twice a day for three days to aid uterine clearance. A local antibiotic was inserted into the uterus. After treatment, the mare did not show any health disorders. She entered estrus 9 days after abortion and again 10 days later. In conclusion, twin pregnancy in a mare is considered a critical condition that necessitates specific management during early and late pregnancy. Uterine prolapse is an emergency that should be treated in a skilled manner to protect the mare and her future fertility. Calcium deficiency might predispose mares to uterine prolapse.
©2020 The Japanese Society of Equine Science.
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Publication Date: 2020-12-18 PubMed ID: 33376446PubMed Central: PMC7750639DOI: 10.1294/jes.31.95Google Scholar: Lookup
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Summary

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This research article reports on a clinical case of a pregnant Thoroughbred mare that experienced an uterine prolapse after aborting twin foetuses in the eighth month of gestation. The successful treatment approach is outlined, highlighting both emergency management and future fertility considerations.

Clinical and Laboratory Findings

  • The mare in this case study experienced an uterine prolapse – a condition in which the uterus slips down into or protrudes out of the vagina, after the spontaneous abortion of her twin foetuses.
  • Upon examination, the prolapsed uterus was found to be bleeding and congested, although it was not damaged. The placenta was still attached to the endometrium, the inner lining of the uterus.
  • Blood samples and swabs were collected for laboratory investigation. General health indicators were analyzed through hematology, while reproductive hormone levels (calcium, progesterone, and estrogen) were estimated.
  • The mare’s lymphocyte count (a type of white blood cell) was found to be lower than normal – an indication of stress or possibly an immune reaction.
  • The levels of estrogen and progesterone were found to be in normal range when compared with healthy mares that had delivered foals.
  • A bacteriology swab from the cervix and clitoris led to the isolation of Pseudomonas aeruginosa – a bacterium that can cause infection particularly after a surgical procedure or in individuals with weak immune systems.

Treatment Approach

  • Emergency treatment began with cleaning the prolapsed uterus using warm normal saline solution, followed by careful removal of the still-attached placenta.
  • The cleaned uterus was coated with an antibiotic cream before being carefully replaced inside the body.
  • A temporary suture was placed in two-thirds of the upper vulva to support the replaced uterus positioning.
  • The mare was given systemic antibiotics and an anti-inflammatory medication for 5 days to combat any potential infection and reduce inflammation.
  • After 24 hours, the earlier placed sutures were removed, and a uterine lavage (a medical washing procedure) was performed using warm normal saline for three consecutive days.
  • In addition to these measures, the mare received oxytocin for three days to stimulate uterine contractions and aid with uterine clearance.
  • Finally, a local antibiotic was administered directly into the uterus to further prevent bacterial infection.

Post Treatment and Final Thoughts

  • After the extensive treatment, the mare did not show any negative health effects. She returned to estrus (the periodic state of sexual receptivity in female mammals) 9 days after the abortion, and again 10 days later, indicating continued fertility.
  • The report suggests that twin pregnancy in mares can predispose them to complicated health conditions like uterine prolapse, thus requiring special early and late pregnancy management.
  • Lastly, the authors suggest that calcium deficiency could be a potential risk factor in the development of uterine prolapse, although this might need further research for confirmation.

Cite This Article

APA
Alamaary M, Ali A. (2020). Abortion and uterine prolapse in a Thoroughbred mare with twin pregnancy: Clinical and laboratory findings and treatment approach. J Equine Sci, 31(4), 95-99. https://doi.org/10.1294/jes.31.95

Publication

Journal of equine science
ISSN: 1340-3516
NlmUniqueID: 9503751
Country: Japan
Language: English
Volume: 31
Issue: 4
Pages: 95-99

Researcher Affiliations

Alamaary, Mohammed
  • Horse Clinic, Ministry of Environment, Water and Agriculture, Al Qassim51911, Saudi Arabia.
Ali, Ahmad
  • Department of Veterinary Medicine, College of Agriculture and Veterinary Medicine, Qassim University, Buraidah 51452, Saudi Arabia.
  • Department of Theriogenology, Faculty of Veterinary Medicine, Assiut University, Assiut 71515, Egypt.

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Citations

This article has been cited 1 times.
  1. Li L, Li S, Ma H, Akhtar MF, Tan Y, Wang T, Liu W, Khan A, Khan MZ, Wang C. An Overview of Infectious and Non-Infectious Causes of Pregnancy Losses in Equine. Animals (Basel) 2024 Jul 2;14(13).
    doi: 10.3390/ani14131961pubmed: 38998073google scholar: lookup
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