LA Sx, Q3, VII
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What is bimanual examination?
One hand in the rectum, one hand in the vagina
What can be a conformational problem in overly fat mares?
vulva may not meet correctly, therefore prone to infection
Older mares with multiple birthings often have a rectum pulled in which direction?
rectum pulled cranial and inward compared to tuber ischii
T or F: Poor general condition can cause pneumovagina?
true- correct the condition of the animal if this is the case
Racing Fillys commonly get what condition? Why is this a problem?
- problem= aesthetics, objectionable noises, contamination
What anesthesia do we use for a Caslicks on a mare?
local anesthesia to lips of vulva by injecting mucocutaneous jxn
What is the general procedure for a Caslicks?
- 1. local anesth.
- 2. remove small band of skin/mucosa at jxn
- 3. suture edges together
If I have a mare with a Caslick's in place but i want to breed her live cover, what must i do?
- open the sutures for breed and then resuture after
- or use breeding stitch
What is a breeding stitch?
heavy piece of suture at ventral end of Caslick's, prevents stallion from destroying the suture line
Why would we need to "suture a mare" the rest of her life after a Caslicks?
seal of vulva compromised
What are some complications from a Caslicks?
- 1. incomplete seal
- 2. urine pooling- if closed too far ventral
- 3. suture sinus- if you suture thru the vaginal mucosa
What is the 'variation of the Caslick's'?
same as Caslick's but only mucosa removed and stitches are more cranial inside vulva
What is the Gadd Technique? what are the basic steps? what is the end result?
- episioplasty or perineal body reconstruction
- 1. remove triangle of mucosa at dorsal vestibule
- 2. edges are approximated
- result= increased size of perineal body
What is a perineal body transection?
- frees attachments of rectum and repro tract
- then return vulva to more natural conformation (vertical)
Why do most perineal lacerations occur?
secondary to foaling
What is a first degree laceration? How does it heal?
- only skin and mucous membrane involved
- healing= not complicated, no special care
What is a second degree laceration? When is it best to repair these?
- perineal body involved but NOT rectum
- wait until inflamm/infxn reduced (5-10d)
What is a third degree laceration? How does this commonly occur in delivery?
- involves perineal body, dorsal vagina and rectum
- maiden mares where foot of foal forced thru dorsal vagina
Why would we wait to repair a 3rd degree perineal laceration if the mare has a live foal?
Dont want to bring foal into a hospital (high risk of infection), wait until foal 3 months old
What should be examined/on your mind in a 3rd degree perineal laceration?
- 1. look at extent of damage (evisceration possible)
- 2. debridement (even if sx delayed)
- 3. tetanus
- 4. parenteral Antibiotics for 4-5d
- 5. wound cleaning for several days
What are the 3 surgical techniques for closing a 3rd degree perineal laceration?
- 1. Modified Goetz
- 2. Annes Technique
- 3. Pull Back technique
What is the common cause of a rectovaginal fistula?
- foals foot goes thru vagina and thru rectum and then back out
- marked wound contraction but fistula remains
In vaginal lacerations what complication can result from persistant straining? and what is a differential dx?
- -pelvic abcess
- -DDX for abdominal straining = rabies
What is the controversy surrounding urine pooling in mares and what to do?
- -some say with good cleaning before breeding this doesnt matter
- -some say conception decreases with urine pooling mares
What mares most commonly have urine pooling?
older mares in poor condition
What is the best surgical technique to correct urine pooling in mares? what are some other options?
- best= McKinnon technique
- others= Monin, Brown and Shires technique
How can I tell a prolapsed bladder from a prolapsed vagina?
look for ureters openings on bladder
What are 2 things I can do to prevent straining in a mare with a prolapsed bladder?
- 1. continuous epidural
- 2. tracheotomy
What is the best way to control hemorrhage in a mare with a uterine prolapse?
- to quickly return the uterus to normal position
- (ligatures of vessels doesnt work well)
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