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1.
This article describes the surgical management of uterine torsion by midline celiotomy and cesarean section on 12 mares presented with signs of colic to a teaching veterinary hospital. The mares were either in full term of gestation (n = 7) or in advanced stage of pregnancy (n = 5). Six mares were in first parity. Uterine torsion was diagnosed by per rectal and per vaginal examinations. For surgical intervention, mares were anesthetized using a combination of xylazine (1.1 mg/kg) and ketamine (2.2 mg/kg), intravenously. After intubation, the animals were maintained on halothane (n = 4) or isoflurane (n = 8) inhalation anesthesia. Midline celiotomy was performed, and foals were delivered by cesarean section. In 11 mares, before closing the abdominal wound, the uterus was detorted manually and confirmed for its normal position. Both anesthetic protocols using halothane and isoflurane were found satisfactory for surgical correction of uterine torsion. After long-term follow-up, the study reported 75.0% (9/12) survival rate for mares. One mare was euthanized because of devitalized, necrosed, and adhered uterus to the abdominal wall. Of the nine surviving mares, seven were successfully bred. Three foals were born alive, and only one could survive on long-term basis. Of the nine dead foals, two had umbilical cord torsion.  相似文献   

2.
REASONS FOR PERFORMING STUDY: Ovariohysterectomy appears to have a low mortality rate in mares, but the procedure needs to be reviewed because of the high risk of life-threatening complications. HYPOTHESIS: That ovariohysterectomy can be effective treatment for a variety of uterine diseases in mares and carries a good prognosis. METHODS: Diagnosis, clinical data, surgical technique, post operative care, complications and outcome were recorded from medical records of 7 mares that underwent total (6) and partial (1) ovariohysterectomy at the University of Illinois from 1994 to 2001. RESULTS: The indications for ovariohysterectomy were chronic pyometra (4 mares), chronic uterine torsion (n = 2) and chronic intramural haematoma (n = 1). Surgical exposure was difficult but was improved by traction on stay sutures and right-angled clamps. In some cases, application of the TA-90 autosuture instrument as a right-angled clamp to the caudal part of the uterus improved access to the uterine stump. The most common post operative complications were decreased faecal output, decreased intestinal sounds (4 mares) and mild abdominal pain (2). Two mares had mild to moderate incisional infections. Other previously reported complications, such as haemorrhage, septic peritonitis, uterine stump infection or necrosis, and diarrhoea, did not occur. All mares survived over follow-up periods of 6 months to 5 years and were used for riding (6 mares) and embryo transfer (1 mare, after partial ovariohysterectomy). CONCLUSIONS AND POTENTIAL RELEVANCE: According to this study, the prognosis for mares after ovariohysterectomy appears to be good, despite the technical difficulties of the procedure. The prevalence of life-threatening complications can be lower than reported.  相似文献   

3.
OBJECTIVE: To report a technique for intra-partum ovariohysterectomy (OVH) in cows after severe uterine compromise after uterine torsion. STUDY DESIGN: Clinical case report. ANIMALS: Four cows with uterine torsion. METHODS: After a ventrolateral cesarean section, uterine closure, and uterine detorsion, the laparotomy incision was elongated (20 cm) caudally so that the uterus can be completely exteriorized. The uterus was separated from broad ligaments by transection between 2 rows of overlapping interrupted sutures placed in the broad ligaments to a point approximately 2 cm caudal to the external os of the cervix. The vagina was occluded with 2 clamps directly caudal to the external os of the cervix and closed with 5 single cruciate sutures that penetrated all layers, and then the vagina was transected between the suture line and external os to remove the uterus. The abdominal incision was closed in layers. Results- All cows survived the surgery; however, 1 died the next day from Escherichia coli sepsis and 1 was euthanatized at 8 days because of unresponsive E. coli mastitis. One cow, 28 days after surgery developed a 15 cm perivaginal abscess, which resolved after drainage. This cow and the fourth cow survived and lactated. CONCLUSIONS: Intra partum OVH is technically possible after cesarean section in cows with uterine compromise or necrosis after uterine torsion. CLINICAL RELEVANCE: Ovariohysterectomy should be considered in cows with severe uterine torsion that have uterine tissue compromise to improve survival.  相似文献   

4.
OBJECTIVE: To report on the outcome of surgical treatment of uterine torsion in preterm mares. DESIGN: Retrospective case series of pregnant mares with uterine torsion presented to the Clinic for Obstetrics, Gynaecology and Andrology of Large and Small Animals. METHODS: Hospital records of all pregnant mares that underwent ventral midline laparotomy for uterine torsion between 1998 and 2004 were reviewed. The signalment, history, clinical signs, results of diagnostic procedures, direction and degree of the uterine twist, treatment and outcome were retrieved from each case record. RESULTS: This study comprised 19 mares between months 5 and 11 of pregnancy (8.7 +/- 1.9) and suffering from uterine torsion. In all cases ventromedian laparotomy was carried out under general anaesthesia. Gastrointestinal disorders were also present in 52.6% of horses. Postoperative complications included subcutaneous seromas (five mares), peritonitis (one mare) and abortion (two mares). In four mares (21%) the operation was unsuccessful (i.e. these mares had to be euthanased intra- or postoperatively). Of the surviving 15 mares, 13 (86.6%) gave birth to viable foals at full term. The foals developed normally. Only two mares aborted. CONCLUSIONS: Because of its versatility the ventral midline approach should be considered for correction of uterine torsion. The approach has many advantages, including rapid and clear access to the abdominal cavity, safety, visual assessment of uterine wall viability, correction of concomitant gastrointestinal tract problems, and performance of hysterotomy or hysterectomy, if indicated. In this study, managing uterine torsion in this way resulted in a high percentage of cases (86.6%) in which pregnancy was maintained, with the birth of a viable, mature foal.  相似文献   

5.
Ovariohysterectomy in Six Mares   总被引：2，自引：0，他引：2  
Six mares had ovariohysterectomy performed for chronic pyometra associated with cervical abnormalities, uterine neoplasia, or removal of a macerated fetus. Ovariohysterectomy was performed through a ventral midline incision with access to the ovarian and uterine vessels aided by traction on the uterus and retraction of abdominal viscera. Abdominal pain, the most common complication after surgery, occurred in four mares but resolved within 36 hours. Peritonitis occurred in two mares; one mare was subsequently euthanatized. Other complications that resolved with treatment included infection of the uterine stump (two mares), abdominal hemorrhage (one mare), diarrhea (one mare), and incisional infection (one mare). Complications after surgery can be reduced by removing as much of the uterus as possible, minimizing peritoneal contamination with uterine contents, and providing a secure closure of the caudal reproductive tract.  相似文献   

6.
REASONS FOR PERFORMING STUDY: Anecdotal speculation suggests that prognosis for survival of mares and foals following correction of uterine torsion has improved over the past 30 years. OBJECTIVES: To determine statistically the outcome of uterine torsion according to duration of clinical signs, stage of gestation, parity, physical examination findings, method of correction, prognosis for survival and reproductive health of the mare, and prospects for the foal within the neonatal period. METHODS: This retrospective study combined cases from 4 equine referral hospitals. RESULTS: The stage of gestation at which uterine torsion occurred was a risk factor for survival of mare and foal. Overall mare survival was 53/63 (84%); when uterine torsion occurred at < 320 days gestation, 36/37 (97%) of mares survived compared to 17/26 (65%) survival rate when uterine torsion occurred at > or = 320 days gestation. Overall foal survival was 54% (29/54). When uterine torsion occurred at < 320 days gestation, 21/29 (72%) foals survived compared to 8/25 (32%) when uterine torsion occurred at > or = 320 days gestation. Thirty mares were discharged from the hospital carrying a viable fetus following uterine torsion correction and 25/30 (83%) of these mares delivered live foals that survived beyond the neonatal period. CONCLUSIONS: Prognosis for survival for mares and foals following uterine torsion is good and improves if torsion occurs < 320 days compared to > or = 320 days gestation. CLINICAL RELEVANCE: Gestational timing of uterine torsion should be considered when advising clients about the prognosis for survival of the mare and foal. The prognosis for a mare delivering a live foal is good if the mare is discharged from the hospital following uterine torsion correction with a viable fetus.  相似文献   

7.
Nonsurgical treatment of uterine torsion in seven mares   总被引：1，自引：0，他引：1  
Nonsurgical correction of uterine torsion was performed in 7 mares, and 6 foals were subsequently born alive. Uterine rupture necessitated euthanasia in 1 mare. Correction was achieved by rolling of the mares after general anesthesia had been induced. Previously, this technique was believed to be associated with a high prevalence of fetal and maternal mortality. Nonsurgical correction may be a satisfactory alternative to abdominal surgery in treating uterine torsion in mares.  相似文献   

8.
A case of uterine torsion in a mare with colic is described in which an early diagnosis was made and the torsion successfully reduced through a standing laparotomy with survival of both the mare and the foal. This case is used to stress the importance of thorough examination of all pregnant mares with colic in order to differentiate uterine torsion from other causes of abdominal pain, thereby avoiding delay in surgical correction and reducing the risk of fetal and/or maternal death. The advantages of the standing laparotomy are presented in support of this method of treatment of torsion of the gravid uterus.  相似文献   

9.
A case of uterine torsion in a mare with colic is described in which an early diagnosis was made and the torsion successfully reduced through a standing laparotomy with survival of both the mare and the foal. This case is used to stress the importance of thorough examination of all pregnant mares with colic in order to differentiate uterine torsion from other causes of abdominal pain, thereby avoiding delay in surgical correction and reducing the risk of fetal and/or maternal death. The advantages of the standing laparotomy are presented in support of this method of treatment of torsion of the gravid uterus.  相似文献   

10.
OBJECTIVE: To determine survival rate, complications, and short-term fertility rate after fetotomy in mares. DESIGN: Retrospective study. ANIMALS: 72 mares with severe dystocia. PROCEDURES: Records from 1991 to 2005 were searched for mares with dystocia in which a fetotomy was performed. Data relating to presentation and position of foals; survival rate, complications, and short-term fertility rate in mares; and 45-day pregnancy rate in mares bred 2 to 3 months after fetotomy were recorded. RESULTS: Anterior fetal presentation was detected for 54 of 72 (75%) mares, posterior presentation was detected for 13 (18.1%), and transverse presentation was detected for 5 (6.9%). One fetus in anterior presentation was hydrocephalic. Survival rate after fetotomy was 95.8%. Complications included retained fetal membranes (5.5%), laminitis (6.9%), vaginal and cervical lacerations (2.8%), and delayed uterine involution (2.8%). Mares bred 2 to 3 months after fetotomy had good short-term fertility, with a mean pregnancy rate of 79.4% at 45 days after breeding. CONCLUSIONS AND CLINICAL RELEVANCE: The survival rate was high, compared with rates reported after cesarean section, and short-term fertility rate was similar to those reported for mares that had a controlled vaginal delivery or cesarean section. Fetotomy performed by a skilled veterinarian on a nonviable fetus should be considered as a means of quick and safe correction of dystocia that does not necessarily impair short-term fertility in affected mares.  相似文献   

11.
A 9-year-old bitch was presented because of lethargy and abdominal distension. Abdominal ultrasound revealed an enlarged, fluid-filled uterus and associated mass. Subsequent exploratory laparotomy revealed unilateral uterine torsion involving the mass. Recovery following ovariohysterectomy was uneventful and the histopathological diagnosis was of a benign endometrial inflammatory polyp. Reports of uterine torsion in the English-language literature are reviewed to identify factors associated with the incidence of uterine torsion. The aetiology of the cystic endometrial hyperplasia/pyometra complex and its possible role in the development of inflammatory polypoid lesions in the bitch is also discussed.  相似文献   

12.
Three mares underwent diagnostic laparoscopy because of suspicion of post-partum uterine ruptures. All three horses showed clinical signs of a uterine rupture between 1 and 3 days after parturition and underwent diagnostic laparoscopy. In all cases a full thickness uterine rupture could be detected and was sutured laparoscopically. Availability of suture material and surgeon experience were responsible for the surgical methods chosen for repair. In the first case, a hand-assisted laparoscopic approach was chosen for suturing the ruptured uterus, whereas in the other cases the approach was entirely laparoscopic. In the second case, extracorporeal knots were used for the repair and in the last case described a barbed loop suture was available for closure of the uterus. Two of three mares were alive for at least 12 months after surgery without any abdominal problems. One of these mares delivered a healthy foal 2 years after surgery. The remaining mare died 3 months after surgery but no necropsy was done. Laparoscopy should be considered for post-partum mares with signs of peritonitis to access the uterus and repair a rupture if it is accessible. A laparoscopic approach using intracorporeal knots or barbed sutures for the repair of the uterine rupture as well as a hand-assisted laparoscopic approach are feasible. The use of the barbed suture for intracorporeal closure makes the minimal invasive laparoscopic technique easier to perform.  相似文献   

13.
The case records of 19 mares undergoing caudal ventral midline celiotomy for cesarean section were reviewed. Surgical exposure to the uterus was good, and the incisions healed by first intention in surviving mares. Seventeen mares (89%) survived to time of hospital discharge. Six foals (32%) were delivered alive, of which three were euthanatized because of severe deformity (1 died on day 6 and 2 survived to time of discharge). The most frequent postoperative complications were abdominal pain (13 mares), anemia (10 mares), and retained placenta (6 mares). Sixteen mares were bred during at least one season after the cesarean section and eight (50%) produced at least one foal. The collective foaling rate for these mares, bred a total of 25 seasons, was 36%. Only one mare bred during the same year as the surgery produced a live foal. The collective foaling rate for mares bred after the year of the surgery was 50%.  相似文献   

14.
In this article different possible treatments for problem mares are discussed. The therapeutic possibilities vary and can be classified into anatomical correction, anti-infectious therapy, and treatment to enhance the uterine defence mechanisms. Anatomical correction and treatment with antibiotics are valuable therapies and have been used for many years. In recent years, stimulation of the mechanical defence mechanism of the uterus, by flushing it with physiological solution combined with parenteral oxytocin, has been shown to increase the chance of getting problem mares in foal.  相似文献   

15.
A 5-year-old, sexually intact poodle bitch was presented with a 2-year history of inguinal mass. A tentative diagnosis of hydrometra/mucometra with inguinal herniation was made and ovariohysterectomy with hernia repair was performed. Both fluid-filled uterine horns, both broad ligaments, and the uterine body were observed to be herniated through the inguinal ring. On histopathology, marked edema and diffuse hemorrhage were diagnosed in the uterus.  相似文献   

16.
Reasons for performing study: There is a need for study of a method for restoring a ventrally positioned uterus to a horizontal position involving fertility of mares with delayed uterine clearance. Hypothesis: A ventrally‐angled uterus can be elevated to a horizontal position using a laparoscopic technique. Objective: To develop a laparoscopic technique of imbricating the mesometria to elevate the uterus to a horizontal position. Methods: The right and left mesometria of 5 pluriparous mares, all barren for 1–8 years (mean 3.8 years), with a pendulous, ventrally‐angled uterus were shortened laparoscopically, by imbrication, with the mares standing, to raise the uterine body and horns to a horizontal position. Sutures were placed through the dorsal aspect of the uterine body and uterine horn and the adjacent region of the mesometrium using a simple continuous suture pattern. Results: The uterus of all 5 mares was elevated successfully to a horizontal position. Three of the mares became pregnant the same year, without other treatment, after the procedure. Conclusions: A pendulous, ventrally‐angled uterus can be returned to a normal, horizontal position by imbricating the mesometria, using a laparoscopic technique. Potential relevance: Elevating a ventrally‐angled uterus to a horizontal position may improve egress of uterine debris, thereby improving fertility.  相似文献   

17.
After contagious equine metritis bacteria were inoculated into the uterus of mares, genital tract tissues were examined for presence of the organism by bacteriologic cultural technique and an indirect immunofluorescent staining technique. Up to 14 days after mares were inoculated, the organism was frequently in the lumen of the uterus and in the cervix and, less frequently, in the vagina, vestibule, clitoral fossa, clitoral sinus, and uterine tubes. After 21 to 116 days, the organism was occasionally found on the ovarian surface, in the uterine tubes, uterus, cervix, and vagina and more frequently in the clitoral sinus and clitoral fossa. The distribution of organisms in the remainder of the genital tract was not different in mares that had been clitorectomized.  相似文献   

18.
Two groups of 3 mares were inoculated with Haemophilus equigenitalis or Pseudomonas aeruginosa on the 1st day of estrus. Uterine flushing samples were recovered on day 3 of estrus and day 8 after ovulation for each cycle. Mares were killed 22, 25, and 30 days after inoculation with P aeruginosa and 45, 46, and 49 days after inoculation with H equigenitalis. Pseudomonas aeruginosa was recovered from the uterus of 2 mares 48 hours after inoculation. Although the initial flushing sample of 1 of these 2 mares had an increased total protein concentration, there appeared to be little difference between protein concentrations of other uterine flushing samples. Haemophilus equigenitalis was recovered from the uterus of each of the 3 mares at postmortem. One mare had a slight, purulent discharge from the vulva. Total protein values were not increased in flushing samples from this mare after inoculation with H equigenitalis. Total protein values decreased in the last flushing sample of each of the 2 remaining mares. Swabbing the uterus was more effective than was homogenizing the uterine mucosa in isolating H equigenitalis.  相似文献   

19.
This study was designed to evaluate the haemostatic suture as a means of preventing haemorrhage from the hysterotomy in mares after caesarean section. At 2 university hospitals 1982-1994, 48 mares had caesarean section for dystocia, 10 as an elective, and 8 mares concurrently with colic surgery. The haemostatic suture was used in 31 of 66 mares (47%) and surgery period was significantly (P<0.05) shorter when it was not applied. Anaemia (PCV<30%) was recorded in 13 (22%) of 58 mares, excluding the colic group, and the haemostatic suture did not after this proportion of mares that had anaemia. Anaemia was 5 times more probable following caesarean section than vaginal delivery, evidence that bleeding from the hysterotomy is a serious and common complication of caesarean section in mares. Severe uterine haemorrhage was recorded in 3 mares that had an haemostatic suture (10%) and in 2 mares that did not (6%). The latter two mares died of haemorrhage. The suture, therefore did not eliminate post operative anaemia and severe uterine haemorrhage. If omitted, the hysterotomy should be closed with a full thickness pattern that is sufficiently tight to compress vessels in the uterine wall.  相似文献   

20.
Twelve horse mares were used to investigate the effect of phenylbutazone or progesterone administration on uterine tubal motility, as reflected by embryo recovery from the uterus on day 5 after ovulation. Four treatment groups were used: group A (controls), in which uterine flush was performed 7 to 11 days after ovulation; group B (5-day controls), in which uterine flush was performed 5 days after ovulation; group C, in which uterine flush was performed 5 days after ovulation following administration of phenylbutazone (2 g, IV) on day 3; and group D, in which uterine flush was performed 5 days after ovulation following administration of progesterone in oil (250 mg, IM) on days 0, 1, and 2. Each mare was randomly assigned to each group once. Embryo recovery for each group was: group A, 13 embryos from 12 mares; group B, 3 embryos from 12 mares; group C, 4 embryos from 11 mares; and group D, 1 embryo from 11 mares. Recovery of embryos on day 5 in 3 of 12 nontreated mares indicated that equine embryos may enter the uterus before day 6. Neither treatment increased embryo recovery from the uterus on day 5 over that from the uterus of the 5-day controls.  相似文献   

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