EQUINE CARE - Foaling Problems

BY HEATHER SMITH THOMAS

Most pregnancies in mares are normal and everything goes smoothly at foaling time. There are a few situations, however, when a mare has a problem and you need to be aware of it so assistance can be given—with more chance to save the foal.

Dr. Ahmed Tibary, Professor of Theriogenology, Department of Veterinary Clinical Sciences, Washington State University, says breeders should be proactive and not leave anything to chance.

“The mare should be monitored throughout pregnancy and as she gets closer to foaling, we watch her more closely,” Tibary said. “For due date, however, all we can go by is pregnancy length, which can be variable with mares.”

If she might foal early or prematurely, you need to be watching her well ahead of her expected foaling date.

“In addition to regular observation, it pays to do a few tests that can help pinpoint when she might foal. Then you can monitor her continually, because once she starts, if anything goes wrong it is an emergency,” Tibary said.

Studies have shown (in normal mares) that testing the secretions of the mammary gland—regarding concentrations of calcium, and the pH—can tell us whether the mare will go into labor within the next 24 hours.

Barn cameras are helpful to monitor mares for any subtle changes in behavior.

“If you are monitoring the mare before foaling, checking mammary secretions to watch for a change in pH, you can let your veterinarian know that the mare may be foaling within 24 hours,” Tibary said. “Alerting the vet that the mare has started labor is easier than in the past. Today you can have a cell phone situated close to the mare’s stall, so that anyone who goes by the stall, noticing anything abnormal, could call the vet.” FOALING

The first stage of labor varies, but someone watching the mare will usually notice changes.

“The mare may be pacing around, perhaps sweating and yawning, or mildly colicky,” Tibary continued. “As we see more sweat-

ing and yawning, this is an indication that oxytocin has kicked in and the uterus is starting to contract.” The mare is feeling changes. Uterine contractions stimulate the foal to move, reposition and extend the front legs, aiming toward the cervix. The mare shows more signs of early labor, perhaps getting up and down a few times—which helps change the presentation of the foal to get in proper position for birth. This first stage of labor can last for many hours or just a few hours. “We need to observe her continually, to make sure everything is normal,” Tibary said. “If she seems to be in severe pain and rolling or starting to strain so much that her rectum is bulging out but the foal is not appearing, this is an emergency.” As soon as the water bag—allantochorion—breaks, there is a rush of water from the vulva. This looks different from urinating. Generally this water bag ruptures within the mare and you just see the fluid coming out. The mare is now straining and in second stage labor, and often lies down but with her head up. In a normal foaling, the amnion (a whitish-clear sac) will appear at the vulva with tips of one or both front feet and the nose within it. If a red bag is the first thing that appears (placenta coming first), this is an emergency because the placenta is detaching. Part of it is coming ahead of the foal—and his lifeline is detaching. In The amnion appears at the vulva n Tibary Photo that situation you need to immediately cut through that tissue with scissors and reach through it to the foal’s feet and help the foal come through the birth canal. “If there is no red bag showing, and the mare is progressing in labor, we expect her to show something at the vulva (hopefully the amnion) within 10 minutes of breaking her water, and the foal should be born quickly,” Tibary said. This second stage of labor is fast. A mare may foal within five to 30 minutes after breaking her water—usually between 10 to 20 minutes. If she goes beyond 30 minutes, this is a concern because the foal is at risk if it’s taking this long. “The reason it’s such a quick process in the mare is because the cervix is relatively soft and can dilate quickly. Once the fetus is bumping the cervix and starting to push through, this triggers an outpouring of more oxytocin, causing more and stronger con-

Dystocia-mare straining too hard and rectum bulging n Tibary Photo

Second stage labor - legs and head emerging n Tibary Photo tractions,” Tibary said. “It becomes an explosive phenomenon and the mare is straining very hard.

“If nothing is showing at the vulva within 10 minutes of the water breaking, this is when to start examining the mare to see if everything is ok and if the foal is aligned normally for birth. This is when to reach in (using a sterile OB glove) to see if you can feel the feet and head.

“A call should be made to the vet as soon as signs of second stage labor are seen, to announce that the mare is definitely foaling. If this does not progress normally, it is an emergency, particularly if the mare seems to be very uncomfortable,” he explains.

“Most of the problems we see during foaling, besides a red bag, would be during the 20 minutes of second stage labor. It is important to know what to look for. If we have a mare at our hospital for observation during foaling, we go by the 10-minute rule (though some people go by five minutes). When the first water bag breaks, by 10 minutes you should see feet and nose at the vulva, and in another 10 minutes you should see normal progression and then complete foaling within the next 10 minutes,” Tibary says.

“Things that are relatively simple to look for include whether feet are appearing or not, and whether the head is there. Are the feet/legs on top of the head or is the head positioned normally [resting on the legs]? If the feet are on top, this is dangerous because it often results in rectovaginal tears as the foal comes out.”

The feet in this position are not aimed properly and tend to scrape the birth canal or even poke through it and into the rectum, tearing the partitioning tissue as the foal comes on out.

“Many people rush to help deliver the foal, and this can sometimes be disastrous. The mare is straining and pushing, and they try to snatch that foal out. The mare needs a little time to dilate enough; if we pull too soon we may tear the cervix. I tell people that when the foal’s nose is at the vulva, they need to realize that the thorax (ribcage) is still behind the cervix.”

The cervix needs to stretch and dilate more, to allow the ribcage and hips to come through, since these are the largest parts of the foal.

“We must give the cervix time to fully dilate before we pull strongly, to avoid cervical tears. As long as we are still within that 20 minutes, we don’t have to rush to help the foal come through—as long as the mare is not in severe pain,” he says.

What help is given will depend largely on the experience of the person attending the birth.

“That person can be in phone contact with the veterinary clinic and let the veterinarian know, play by play, what is happening. The person helping the mare can take photos and text them to the veterinarian, if there are any questions about what is appearing at the vulva. We can look at the pictures and either assure the person that things are ok, or we can say this is an emergency or needs to be checked,” says Tibary.

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Equine Care Continued from page 46

“Once the mare is in second stage labor, we have to start considering how much delay there can be before the foal’s life is in danger. There are studies that show that the time between the rupture of the water bag (beginning of second stage labor) and the foal being born—with likelihood of losing the foal—is about 70 to 80 minutes. In mares that take an hour or longer after rupture of the water bag, we see a sharp decline in survival of their foals,” he says.

“In foaling mares here at the hospital, we have them under constant observation and we don’t let them go that long without assistance, but most of the mares we receive that are referred to us for help have gone too long because of the distance involved. We have poor chance of saving those foals because there isn’t time, by the time those mares arrive,” he says.

“The owner needs to work with the attending veterinarian and know the abilities of that veterinarian in terms of anesthesia and surgery. You need to make a plan with that clinic for possible referral to a place with more advanced handling of a dystocia. Trying to handle a serious dystocia on the farm can be done, and we can resolve many simple complications, but you should always keep in mind the possibility that we might need to resolve a serious problem with a more advanced technique,” he explains.

When dystocia is complicated and the veterinarian must do major repositioning of the foal within the uterus, the mare must be anesthetized to eliminate all straining. The veterinarian needs a window of time in which to work on repositioning and manipulating the foal without the mare crushing it or the veterinarian’s arm with strong contractions.

“When we deal with a serious foaling complication, danger for the mare and foal and danger for the operator must be considered. We need a spacious, well-lit and protected area to work with the mare. If there is no plan for dealing with potential problems, we can have serious trouble,” he says.

“These problems don’t occur often; severe dystocia in the mare is not as common as in cattle. Only about four percent of mares have some dystocia, but if it does happen, you need to be prepared because it is always an emergency,” he says. TFH