Part 24

DROPSY OF THE AMNION.

This differs from simple dropsy of the womb in that the fluid collects in the inner of the two water bags (that in which the foal floats) and not in the otherwise void cavity of the womb. This affection can occur only in the pregnant animal, while dropsy of the womb occurs in the unimpregnated. The blood of the pregnant mare contains an excess of water and a smaller proportion of albumen and red globules, and when this condition is still further aggravated by poor feeding and other unhygienic conditions there is developed the tendency to liquid transudation from the vessels and dropsy. As the watery condition of the blood increases with advancing pregnancy, so dropsy of the amnion is a disease of the last four or five months of gestation. The abdomen is large and pendulous, and the swelling fluctuates under pressure, though the solid body of the fetus can still be felt to strike against the hand pressed into the swelling. If the hand is introduced into the vagina, the womb is found to be tense and round, with the projecting rounded neck effaced, while the hand in the rectum will detect the rounded, swollen mass of the womb so firm and tense that the body of the fetus can not be felt within it. The mare moves weakly and unsteadily on her limbs, having difficulty in supporting the great weight, and in bad cases there may be loss of appetite, stocking (dropsy) of the hind limbs, difficult breathing, and colicky pains. The tension may lead to abortion, or a slow, laborious parturition may occur at the usual time.

Treatment consists in relieving the tension and accumulation by puncturing the fetal membrane with a cannula and trocar introduced through the neck of the womb and the withdrawal of the trocar so as to leave the cannula in situ, or the membranes may be punctured with the finger and the excess of liquid allowed to escape. This may bring on abortion, or the womb may close and gestation continue to the full term. A course of tonics (gentian root 2 drams, sulphate of iron 2 drams, daily) will do much to fortify the system and counteract further excessive effusion.

DROPSY OF THE LIMBS, PERINEUM, AND ABDOMEN.

The disposition to dropsy often shows itself in the hind and even in the fore limbs, around and beneath the vulva (perineum), and beneath the abdomen and chest. The affected parts are swollen and pit on pressure, but are not especially tender, and subside more or less perfectly under exercise, hand rubbing, and bandages. In obstinate cases rubbing with the following liniment may be resorted to: Compound tincture of iodin, 2 ounces; tannic acid, one-half dram; water, 10 ounces. It does not last more than a day or two after parturition.

CRAMPS OF THE HIND LIMBS.

The pressure of the distended womb on the nerves and blood vessels of the pelvis, besides conducing to dropsy, occasionally causes cramps of the hind limbs. The limb is raised without flexing the joints, the front of the hoof being directed toward the ground, or, the spasms occurring intermittently, the foot is kicked violently against the ground several times in rapid succession. The muscles are felt to be firm and rigid. The cramp may be promptly relieved by active rubbing or by walking the animal about, and it does not reappear after parturition.

CONSTIPATION.

This may result from compression by gravid womb, and is best corrected by a graduated allowance of boiled flaxseed.

PARALYSIS.

The pressure on the nerves of the pelvis is liable to cause paralysis of the hind limbs or of the nerve of sight. These are obstinate until after parturition, when they recover spontaneously, or under a course of nux vomica and (local) stimulating liniments.

PROLONGED RETENTION OF THE FETUS (FOAL).

Though far less frequently than in the case of the cow, parturition may not be completed at term, and the mare, to her serious and even fatal injury, may carry the foal in the womb for a number of months. Hamon records one case in which the mare died after carrying the fetus for 17 months, and Caillier a similar result after it had been carried 22 months. In these cases the fetus retained its natural form, but in one reported by Gohier the bones only were left in the womb amid a mass of apparently purulent matter.

Cause.—The cause may be any effective obstruction to the act of parturition, such as lack of contractile power in the womb, unduly strong (inflammatory) adhesions between the womb and the fetal membranes, wrong presentation of the fetus, contracted pelvis (from fracture or disease of the bones), or disease and induration of the neck of the womb.

The mere prolongation of gestation does not necessarily entail the death of the foal; hence the latter has been born alive at the four hundredth day. Even when the foal has perished putrefaction does not set in unless the membranes (water bags) have been ruptured and septic bacteria have been admitted to the interior of the womb. In the latter case a fetid decomposition advances rapidly, and the mare usually perishes from poisoning with the putrid matters absorbed.

At the natural period of parturition preparations are apparently made for that act. The vulva swells and discharges much mucus, the udder enlarges, the belly becomes more pendent, and the animal strains more or less. No progress is made, however; there is not even opening of the neck of the womb, and after a time the symptoms subside. The mare usually refuses the male, yet there are exceptions to this rule. If the neck of the womb has been opened and putrefying changes in its contents have set in, the mare loses appetite and condition, pines, discharges an offensive matter from the generative passages, and dies of inflammation of the womb and putrid infection. In other cases there is a slow wearing out of the strength, and she finally dies of exhaustion.

The treatment is such as will facilitate the expulsion of the fetus and its membranes and the subsequent washing out of the womb with disinfectants. So long as the mouth of the womb is closed time should be allowed for its natural dilatation, but if this does not come about after a day or two of straining, the opening may be smeared with extract of belladonna, and the oiled hand, with the fingers and thumb drawn into the form of a cone, may be inserted by slow oscillating movements into the interior of the womb. The water bags may now be ruptured, any malpresentation rectified (see "Difficult parturition"), and delivery effected. After removal of the membranes wash out the womb first with tepid water and then with a solution of 2 ounces of borax in half a gallon of water.

This injection may have to be repeated if a discharge sets in. The same course may be pursued even after prolonged retention. If the soft parts of the fetus have been absorbed and the bones only left, these must be carefully sought for and removed, and subsequent daily injections will be required for some time. In such cases, too, a course of iron tonics (sulphate of iron, 2 drams daily) will be highly beneficial in restoring health and vigor.

ABORTION.

Abortion is, strictly speaking, the expulsion of the impregnated ovum at any period from the date of impregnation until the foal can survive out of the womb. If the foal is advanced enough to live, it is premature parturition, and in the mare this may occur as early as the tenth month (three hundredth day).

The mare may abort by reason of almost any cause that very profoundly disturbs the system; hence, very violent inflammations of important internal organs (bowels, kidneys, bladder, lungs) may induce abortion. Profuse diarrhea, whether occurring from the reckless use of purgatives, the consumption of irritants in the feed, or a simple indigestion, is an effective cause. No less so is acute indigestion with evolution of gas in the intestines (bloating). The presence of stone in the kidneys, uterus, bladder, or urethra may induce so much sympathetic disorder in the womb as to induce abortion. In exceptional cases wherein mares come in heat during gestation, service by the stallion may cause abortion. Blows or pressure on the abdomen, rapid driving or riding of the pregnant mare, especially if she is soft and out of condition from idleness, the brutal use of the spur or whip, and the jolting and straining of travel by rail or boat are prolific causes. Bleeding the pregnant mare, a painful surgical operation, and the throwing and constraint resorted to for an operation are other causes. Traveling on heavy, muddy roads, slips and falls on ice, and jumping must be added. The stimulation of the abdominal organs by a full drink of iced water may precipitate a miscarriage, as may exposure to a cold rainstorm or a very cold night after a warm day. Irritant poisons that act on the urinary or generative organs, such as Spanish flies, rue, savin, tansy, cotton-root bark, ergot of rye or other grasses, the smut of maize and other grain, and various fungi in musty fodder are additional causes. Frosted or indigestible feed, and, above all, green succulent vegetables in a frozen state, have proved effective factors, and filthy, stagnant water is dangerous. Low condition in the dam and plethora have in opposite ways caused abortion, and hot, relaxing stables and lack of exercise strongly conduce to it. The exhaustion of the sire by too frequent service, entailing debility of the offspring and disease of the fetus or of its envelopes, must be recognized as a further cause.

The symptoms vary mainly according as the abortion is early or late in pregnancy. In the first month or two of pregnancy the mare may miscarry without observable symptoms, and the fact appears only by her coming in heat. If more closely observed a small clot of blood may be found behind her, in which a careful search reveals the rudiments of the foal. If the occurrence is somewhat later in gestation, there will be some general disturbance, loss of appetite, neighing, and straining, and the small body of the fetus is expelled, enveloped in its membranes. Abortions during the later stages of pregnancy are attended with greater constitutional disturbance, and the process resembles normal parturition, with the aggravation that more effort and straining is requisite to force the fetus through the comparatively undilatable mouth of the womb. There is the swelling of the vulva, with mucus or even bloody discharge; the abdomen droops, the flanks fall in, the udder fills, the mare looks at her flanks, paws with the fore feet and kicks with the hind, switches the tail, moves around uneasily, lies down and rises, strains, and, as in natural foaling, expels first mucus and blood, then the waters, and finally the fetus. This may occupy an hour or two, or it may be prolonged for a day or more, the symptoms subsiding for a time, only to reappear with renewed energy. If there is malpresentation of the fetus it will hinder progress until rectified, as in difficult parturition. Abortion may also be followed by the same accidents, as flooding, retention of the placenta, and leucorrhea.

The most important object in an impending abortion is to recognize it at as early a stage as possible, so that it may, if possible, be cut short and prevented. Any general, indefinable illness in a pregnant mare should lead to a close examination of the vulva as regards swelling, vascularity of its mucous membrane, and profuse mucus secretion, and, above all, any streak or staining of blood; also the condition of the udder, if that is congested and swollen. Any such indication, with colicky pains, straining, however little, and active movement of the fetus or entire absence of movement, are suggestive symptoms and should be duly counteracted.

The changes in the vulva and udder, with a soiled and bloody condition of the tail, may suggest an abortion already accomplished, and the examination with the hand in the vagina may detect the mouth of the womb soft and dilatable and the interior of the organ slightly filled with a bloody liquid.

Treatment should be preventive if possible, and would embrace the avoidance of all causes mentioned, and particularly of such as may seem to be particularly operative in the particular case. If abortions have already occurred in a stud, the especial cause in the matter of feed, water, exposure to injuries, overwork, lack of exercise, etc., may often be identified and removed. A most important point is to avoid all causes of constipation, diarrhea, indigestion, bloating, violent purgatives, diuretics or other potent medicines, painful operations, and slippery roads, unless well frosted.

When abortion is imminent, the mare should be placed alone in a roomy, dark, quiet stall, and have the straining checked by some sedative. Laudanum is usually at hand and may be given in doses of 1 or 2 ounces, according to size, and repeated after two or three hours, and even daily if necessary. Chloroform or chloral hydrate, 3 drams, may be substituted if more convenient. These should be given in a pint or quart of water, to avoid burning the mouth and throat. Or Viburnum prunifolium (black haw), 1 ounce, may be given and repeated if necessary to prevent straining.

When all measures fail and miscarriage proceeds, all that can be done is to assist in the removal of the fetus and its membranes, as in ordinary parturition. As in the case of retention of the fetus, it may be necessary after delivery to employ antiseptic injections into the womb to counteract putrid fermentation. This, however, is less necessary in the mare than in the cow, in which the prevalent contagious abortion must be counteracted by the persistent local use of antiseptics. After abortion a careful hygiene is demanded, especially in the matter of pure air and easily digestible feed. The mare should not be served again for a month or longer, and in no case until after all discharge from the vulva has ceased.

INFECTIOUS ABORTION IN MARES.

This disease is discussed in the chapter on "Infectious Diseases."

PARTURITION.

SYMPTOMS OF PARTURITION.

As the period of parturition approaches, the swelling of the udder bespeaks the coming event, the engorgement in exceptional cases extending forward on the lower surface of the abdomen and even into the hind limbs. For about a week a serous fluid oozes from the teat and concretes as a yellow, waxlike mass around its orifice. About 24 hours before the birth this gives place to a whitish, milky liquid, which falls upon and mats the hairs on the inner sides of the legs. Another symptom is enlargement of the vulva, with redness of its lining membrane, and the escape of glairy mucus. The belly droops, the flanks fall in, and the loins may even become depressed. Finally the mare becomes uneasy, stops feeding, looks anxious, whisks her tail, and may lie down and rise again. In many mares this is not repeated, but they remain down; violent contractions of the abdominal muscles ensue; after two or three pains the water bags appear and burst, followed by the fore feet of the foal, with the nose between the knees, and by a few more throes the fetus is expelled. In other cases the act is accomplished standing. The whole act may not occupy more than 5 or 10 minutes. This, together with the disposition of the mare to avoid observation, renders the act one that is rarely seen by the attendants.

The navel string, which connects the foal to the membranes, is ruptured when the fetus falls to the ground, or when the mare rises, if she has been down, and the membranes are expelled a few minutes later.

NATURAL PRESENTATION.

When there is a single foal, the common and desirable presentation is with the fore feet first, the nose between the knees, and with the front of the hoofs and knees and the forehead directed upward toward the anus, tail, and croup. (Plate XII, fig. 1.) In this way the natural curvature of the body of the fetus corresponds to the curve of the womb and genital passages, and particularly of the bony pelvis, and the foal passes with much greater ease than if placed with its back downward toward the udder. When there is a twin birth the second foal usually comes with its hind feet first, and the backs of the legs, the points of the hocks, and the tail and croup are turned upward toward the anus and tail of the mare. (Plate XII, fig. 2.) In this way, even with a posterior presentation, the curvature of the body of the foal still corresponds to that of the passages, and its expulsion may be quite as easy as in anterior presentation. Any presentation aside from these two may be said to be abnormal and will be considered under "Difficult parturition."

PREMATURE LABOR PAINS.

These may be brought on by, any violent exertion, use under the saddle, or in heavy draft, or in rapid paces, or in travel by rail or sea, blows, kicks, crushing by other animals in a doorway or gate. Excessive action of purgative or diuretic agents, or of agents that irritate the bowels or kidneys, like arsenic, paris green, all caustic salts and acids, and acrid and narcotico-acrid vegetables, is equally injurious. Finally, the ingestion of agents that stimulate the action of the gravid womb (ergot of rye or of other grasses, smut, various fungi of fodders, rue, savin, cotton root, etc.) may bring on labor pains prematurely.

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.

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.

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.