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High Risk Pregnancy in Mares

By: Dr. Mary Rose Paradis

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Treatment For Placentitis

  • Antibiotic administration
  • Anti-inflammatory drugs
  • Progesterone-type drugs
  • Stall rest

    Systemic antimicrobial therapy is important in the treatment of bacterial placentitis in mares. The effects of pregnancy on drug distribution are unknown in the mare. In pregnant women, drug levels can be reduced 10-50 percent due to various pharmacological reasons, such as an increase in volume of distribution and an increase in drug metabolism. The recommendations in humans are to increase the dose or dosing interval by 25-50 percent. This should not be done when using aminoglycosides due to their kidney toxicity. Penicillin, cephalosporin and trimethoprim sulfas would be the safest choices.

    Using an antimicrobial that crosses into the foal would also be important because septicemia occurs in 80 percent of the aborted fetuses with acute placental lesions. In one study, the investigator measured concentrations of penicillin, gentocin and trimethoprim sulfa in amniotic, allantoic and foal plasma/serum after administration to the mare and found that only trimethoprim sulfa was detectable. It is possible that placentitis may enhance the passage of other drugs through the placenta, but this is not known.

    Increases in prostaglandins (inflammatory products that induce birth) have been associated with early parturition in the pony mare. Flunixin meglumine (Banamine®) is a potent anti-inflammatory drug that inhibits the release of prostaglandin F2a. Its use in placentitis is an attempt to delay parturition. Altrenogest, a synthetic progestagen, can be added to the regime. Though its use is sometimes controversial, it is felt to maintain possibly low maternal progesterone levels and prevent abortion. Mares have been known to foal while on Altrenogest, so there was little fear that the pregnancy would be maintained beyond a safe time for the foal. Stall rest is important until clinical signs resolve.

    For the diagnosis of twinning, there is no specific treatment. Some veterinarians feel that anti-inflammatory drugs and progesterone-type drugs are helpful in maintaining the pregnancy to a more mature state. It is extremely important to attend the birth of twins so the mare should be monitored closely. It is difficult to predict the timing of birth of twins. Generally twins come early. If the foals are near term, they may have a dystocia (difficult delivery) due to their size or the possibility of both coming at the same time.

    Malpositioning of a foal often results in a dystocia. Normal foals are delivered front feet first with the foal's head resting on his knees (carpus). A malposition is any position other than this. The foal may come upside-down, hind legs or tail first or one leg or head bent back. It is sometimes hard to determine the exact orientation of a malpositioned foal because of the tight quarters in the uterus. Your veterinarian will attempt to palpate the foal and reposition him for a normal delivery. This is an emergency situation because the foal needs to be delivered within 30 minutes of the mare breaking water or the foal will die from lack of oxygen.

    If the foal is delivered and you notice that the amniotic fluid is yellow-tinged then you should suspect meconium aspiration. You should immediately wipe out the foal's nostrils and mouth. Suspending the foal from his hind legs and gently hitting him on the chest with a cupped hand (coupage) will help to expel more of the meconium-contaminated fluid from the lungs before he begins to breathe regularly.

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