Effusion of blood in the vaginal walls

Effusion of blood in the vaginal walls

Effusion of blood in the vaginal walls

Effusion of blood in the vaginal walls. This is common as a result of difficult parturition, but it may occur from local injury before that act, and may seriously interfere with it. This condition is easily recognized by the soft, doughy swelling so characteristic of blood clots, and by the dark-red color of the mucous membrane. I have laid open such swellings with the knife as late as 10 days before parturition, evacuated the clots, and dressed the wound daily with an astringent lotion (sulphate of zinc 1 dram, carbolic acid 1 dram, water 1 quart). A similar resort might be had, if necessary, during parturition.

Though the hand may be easily introduced

Though the hand may be easily introduced

Though the hand may be easily introduced

When the case is intractable, though the hand may be easily introduced, the instrument shown in Plate XIV, figure 7, may be used. Each hole at the small end of the instrument has passed through it a stout cord with a running noose, to be passed around two feet or other portion of the fetus which it may be possible to reach. The cords are then drawn tight and fixed around the handle of the instrument; then, by using the cross handle as a lever, the fetus and womb may be rotated in a direction opposite to that causing the obstruction. During this process the hand must be introduced to feel when the twist has been undone. This method may be supplemented, if necessary, by rolling the mare as described above.

The period and pains of parturition arrive

The period and pains of parturition arrive

The period and pains of parturition arrive

The period and pains of parturition arrive, but in spite of continued efforts no progress is made, neither water bags nor liquids appearing. The oiled hand introduced into the closed neck of the womb will readily detect the spiral direction of the folds on its inner surface.

The method of relief which I have successfully adopted in the cow may be equally effective in the mare. The dam is placed (with her head uphill) on her right side if the upper folds of the spiral turn toward the right, and on her left side if they turn toward the left, and the oiled hand is introduced through the neck of the womb and a limb or other part of the body of the fetus is seized and pressed against the wall of the womb, while two or three assistants turn the animal over on her back toward the other side. The object is to keep the womb stationary while the animal is rolling. If success attends the effort, the constriction around the arm is suddenly relaxed, the spiral folds are effaced, and the water bags and fetus press forward into the passage. If the first attempt does not succeed, it may be repeated again and again until success crowns the effort. Among my occasional causes of failure have been the prior death and decomposition of the fetus, with the extrication of gas and overdistention of the womb, and the supervention of inflammation and inflammatory exudation around the neck of the womb, which hinders untwisting. The first of these conditions occurs early in the horse from the detachment of the fetal membranes from the wall of the womb; and as the mare is more subject to fatal peritonitis than the cow, it may be concluded that both these sources of failure are more probable in the former subject.

Twisting of the neck of the womb

Twisting of the neck of the womb

Twisting of the neck of the womb

Twisting of the neck of the womb. This condition is very uncommon in the mare, though occasionally seen in the cow, owing to the greater laxity of the broad ligaments of the womb in that animal. It consists in a revolution of the womb on its own axis, so that its right or left side will be turned upward (quarter revolution), or the lower surface may be turned upward and the upper surface downward (half revolution). The effect is to throw the narrow neck of the womb into a series of spiral folds, turning in the direction in which the womb has revolved, closing the neck and rendering distention and dilatation impossible.

Yet it is very rarely seen in the mare

Yet it is very rarely seen in the mare

Yet it is very rarely seen in the mare

Hernia of the womb. The rupture of the musculo-fibrous floor of the belly and the escape of the gravid womb into a sac formed by the peritoneum and skin hanging toward the ground is described by all veterinary obstetricians, yet it is very rarely seen in the mare. The form of the fetus can be felt through the walls of the sac, so that it is easy to recognize the condition. Its cause is usually external violence, though it may start from an umbilical hernia. When the period of parturition arrives, the first effort should be to return the fetus within the proper abdominal cavity, and this can sometimes be accomplished with the aid of a stout blanket gradually tightened around the belly. This failing, the mare may be placed on her side or back and gravitation brought to the aid of manipulation in effecting the return. Even after the hernia has been reduced the relaxed state of the womb and abdominal walls may serve to hinder parturition, in which case the oiled hand must be introduced through the vagina, the fetus brought into position, and traction coincident with the labor pains employed to produce delivery.

Tumors in the vagina and pelvis

Tumors in the vagina and pelvis

Tumors in the vagina and pelvis

Tumors in the vagina and pelvis. Tumors of various kinds may form in the vagina or elsewhere within the pelvis, and when large enough will obstruct or prevent the passage of the fetus. Gray mares, which are so subject to black pigment tumors (melanosis) on the tail, anus, and vulva, are the most liable to suffer from this. Still more rarely the wall of the vagina becomes relaxed, and being pressed by a mass of intestines will protrude through the lips of the vulva as a hernial sac, containing a part of the bowels. If a tumor is small it may only retard and not absolutely prevent parturition. A hernial protrusion of the wall of the vagina may be pressed back and emptied, so that the body of the fetus engaging in the passage may find no further obstacle. When a tumor is too large to allow delivery the only resort is to remove it, but before proceeding it must be clearly made out that the obstruction is a mass of diseased tissue, and not a sac containing intestines. If the tumor hangs by a neck it can usually be most safely removed by the écraseur, the chain being passed around the pedicel and gradually tightened until that is torn through.

In all cases in which there has been

In all cases in which there has been

In all cases in which there has been

In all cases in which there has been injury to the bones of the pelvis the obvious precaution is to withhold the mare from breeding and to use her for work only.

If a mare with a pelvis thus narrowed has got in foal inadvertently, abortion may be induced in the early months of gestation by slowly introducing the oiled finger through the neck of the womb and following this by the other fingers until the whole hand has been introduced. Then the water bags may be broken, and with the escape of the liquid the womb will contract on the solid fetus and labor pains will ensue. The fetus being small will pass easily.

Fractured hip bones More commonly the obstruction

Fractured hip bones More commonly the obstruction

Fractured hip bones More commonly the obstruction

Fractured hip bones. More commonly the obstruction comes from distortion and narrowing of the pelvis as the result of fractures. (Plate XIII, fig. 2.) Fractures at any point of the lateral wall or floor of the pelvis are repaired with the formation of an extensive bony deposit bulging into the passage of the pelvis. The displacement of the ends of the broken bone is another cause of constriction, and between the two conditions the passage of the fetus may be rendered impossible without embryotomy. Fracture of the sacrum (the continuation of the backbone forming the croup) leads to the depression of the posterior part of that bone in the roof of the pelvis and the narrowing of the passage from above downward by a bony ridge presenting its sharp edge forward.

Difficult parturition from narrow pelvis

Difficult parturition from narrow pelvis

Difficult parturition from narrow pelvis

Difficult parturition from narrow pelvis. A disproportion between the fetus got by a large stallion and the pelvis of a small dam is a serious obstacle to parturition, sometimes seen in the mare. This is not the rule, however, as the foal up to birth usually accommodates itself to the size of the dam, as illustrated in the successful crossing of Percheron stallions on mustang mares. If the disproportion is too great the only resort is embryotomy.

Difficult Parturition.

Difficult Parturition.

With natural presentation this is a rare occurrence. The great length of the fore limbs and face entail, in the anterior presentation, the formation of a long cone, which dilates and glides through the passages with comparative ease. Even with the hind feet first a similar conical form is presented, and the process is rendered easy and quick. Difficulty and danger arise mainly from the act being brought on prematurely before the passages are sufficiently dilated, from narrowing of the pelvic bones or other mechanical obstruction in the passages, from monstrous distortions or duplications in the fetus, or from the turning back of one of the members so that the elongated conical or wedge-shaped outline is done away with. Prompt as is the normal parturition in the mare, however, difficult and delayed parturitions are surrounded by special dangers and require unusual precautions and skill. From the proclivity of the mare to unhealthy inflammations of the peritoneum and other abdominal organs, penetrating wounds of the womb or vagina are liable to prove fatal. The contractions of the womb and abdominal walls are so powerful as to exhaust and benumb the arm of the assistant and to endanger penetrating wounds of the genital organs. By reason of the looser connection of the fetal membranes with the womb, as compared with those of ruminants, the violent throes early detach these membranes throughout their whole extent, and the foal, being thus separated from the mother and thrown on its own resources, dies at an early stage of any protracted parturition. The foal rarely survives four hours after the onset of parturient throes. From the great length of the limbs and neck of the foal it is extremely difficult to secure and bring up limb or head which has been turned back when it should have been presented. When assistance must be rendered, the operator should don a thick woolen undershirt with the sleeves cut out at the shoulders. This protects the body and leaves the whole arm free for manipulation. Before inserting the arm it should be smeared with lard. This protects the skin against septic infection and favors the introduction of the hand and arm. The hand should be inserted with the thumb and fingers drawn together like a cone. Whether standing or lying, the mare should be turned with head downhill and hind parts raised as much as possible. The contents of the abdomen gravitating forward leave much more room for manipulation. Whatever part of the foal is presented (head, foot) should be secured with a cord and running noose before it is pushed back to search for the other missing parts. Even if a missing part is reached, no attempt should be made to bring it up during a labor pain. Pinching the back will sometimes check the pains and allow the operator to secure and bring up the missing member. In intractable cases a large dose of chloral hydrate (1 ounce in a quart of water) or the inhalation of chloroform and air (equal proportions) to insensibility may secure a respite, during which the missing members may be replaced. If the waters have been discharged and the mucus dried up, the genital passages and body of the fetus should be lubricated with lard or oil before any attempt at extraction is made. When the missing member has been brought up into position and presentation has been rendered natural, traction on the fetus must be made only during a labor pain. If a mare is inclined to kick, it may be necessary to apply hobbles to protect the operator.

The treatment consists in the separation of the mare

The treatment consists in the separation of the mare

The treatment consists in the separation of the mare

Treatment. The treatment consists in the separation of the mare, in a quiet, dark, secluded place, from all other animals, and the free use of antispasmodics and anodynes. Opium in dram doses every two hours, or laudanum in ounce doses at similar intervals, will often suffice. When the more urgent symptoms have subsided these doses may be repeated thrice a day till all excitement passes off or until the passages have become relaxed and prepared for parturition. Viburnum prunifolium (black haw), in ounce doses, may be added if necessary. Should parturition become inevitable, it may be favored and any necessary assistance furnished.

Besides the knowledge that parturition is not yet due

Besides the knowledge that parturition is not yet due

Besides the knowledge that parturition is not yet due

Besides the knowledge that parturition is not yet due, there will be less enlargement, redness, and swelling of the vulva, less mucous discharge, less filling of the udder, and fewer appearances of wax and probably none of milk from the ends of the teats. The oiled hand introduced into the vulva will not enter with the ease usual at full term, and the neck of the womb will be felt not only closed, but with its projecting papillae, through which it is perforated, not yet flattened down and effaced, as at full term. The symptoms are, indeed, those of threatened abortion, but at such an advanced stage of gestation as is compatible with the survival of the offspring.