In an ideal world, every broodmare would foal under veterinary supervision at a clinic with the latest technology at arm's length for correcting any potentially life threatening health emergencies. In reality equine practitioners often have to deal with dystocias--difficult births--in the field.
During a presentation at the 2011 American Association of Equine Practitioners convention, held Nov. 18-22 in San Antonio, Texas, Terry Blanchard, DVM, MS, Dipl. ACT, discussed approaches for managing dystocias in a farm setting. Blanchard, a professor of theriogenology in Texas A&M University's Department of Large Animal Clinical Sciences, also described when and how to manage referral care. "To be able to successfully intervene in equine dystocia in a farm setting first requires an adequate understanding of normal parturition and knowledge of the causes of dystocia," Blanchard explained.
The birthing process takes place in stages, he continued. Stage 1 (marked by the start of uterine contractions and cervical dilation), which can last anywhere from 30 minutes to four hours, is when the foal moves into birthing position prior to rupture of the chorioallantois, or the fetal membrane, ("breaking water") and the actual birth. Stage 2 ("active labor") often lasts only 20 to 30 minutes and is when the foal proceeds through the birth canal and into the world.
"Suspect dystocia if either Stage 1 or 2 is prolonged or interrupted," Blanchard said. "Call in a vet for assistance. Early intervention improves the chance of success."
Before the Vet Arrives
Blanchard suggested a few things you can do that will help the practitioner work optimally upon his or her arrival:
- Ensure there's a clean delivery area with good footing and--especially if it's at night--good lighting;
- Have a clean bucket with soap and water available;
- Ensure the mare's tail is wrapped or bagged;
- Have a lip twitch available; and
- In case to the veterinarian refers the dystocia case to a hospital, have a truck and trailer ready to go, and ensure the trailer has clean bedding.
While waiting for the veterinarian, it's advisable to keep the mare as quiet as possible to minimize fetal distress. In some cases, this might require hand walking to prevent her from lying down and straining or rolling. In the event of a "red bag" delivery (premature separation of the placenta, with the placenta coming out before the foal; this can cause the foal to suffocate if the birth is unattended), he said to carefully cut the bag to make it easier to reach the foal for delivery. Prompt handling of a red bag delivery will often allow sufficient oxygen to reach the foal (otherwise he runs the risk of suffocating or suffering complications such as dummy foal syndrome).
Examining the Mare
Once the veterinarian arrives, he or she should examine the mare quickly to determine the severity of the dystocia and begin treatment. Blanchard recommends examining the standing mare, if possible , but says to be careful when using stocks if the mare repeatedly tries to lie down. Additionally, use a lip twitch if the mare becomes agitated during examination.
Sometimes veterinarians can correct mild dystocias by manipulating the foal while the mare is walking. More severe dystocias will require correction in an alternate manner, he noted.
"Develop a plan of action" before intervening, he stressed to veterinarians. It's important--if possible--to determine whether the fetus is alive or dead before selecting a course of action, as this factor could affect the action taken. Also, "keep track of time and progress," in case a referral is indicated.
Complications
Blanchard explained that a host of complications can cause severe dystocias, including uterine or vaginal rupture, fetal impaction in the birth canal, posterior presentations (hindquarters present first), "dog sitting" posture of the fetus, and fetal abnormalities. Veterinarians can often correct positional abnormalities via manual manipulation, he added.
Traction (i.e., pulling the foal out) can be applied if needed, Blanchard noted, but it should only be used when the mare pushes. This typically takes more than one person to achieve, and often times the foal will need resuscitation upon birth.
Consider Referral
Finally, although veterinarians are able to resolve many dystocias without issue, some require the assistance of more advanced veterinary technology than is available on the truck. Blanchard said that typically, practitioners will recommend referral upon arrival if it's immediately apparent that the dystocia is unlikely to be resolved on the farm, or they'll refer if there's no progress after 15 to 20 minutes of treatment.
Take- Home Message
Veterinarians can correct many dystocias without incident. It's crucial for mare owners or caretakers to be prepared for emergencies when mares are scheduled to foal, and it's also important to understand what will help the veterinarian get to work upon arrival.
Blanchard stressed that it's important to call a veterinarian immediately if dystocia is suspected, as early intervention can improve the chances that mare and foal will survive and thrive.
Disclaimer: Seek the advice of a qualified veterinarian before proceeding with any diagnosis, treatment, or therapy.
