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What is bimanual examination?
One hand in the rectum, one hand in the vagina
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What can be a conformational problem in overly fat mares?
vulva may not meet correctly, therefore prone to infection
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Older mares with multiple birthings often have a rectum pulled in which direction?
rectum pulled cranial and inward compared to tuber ischii
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T or F: Poor general condition can cause pneumovagina?
true- correct the condition of the animal if this is the case
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Racing Fillys commonly get what condition? Why is this a problem?
- pneumovagina
- problem= aesthetics, objectionable noises, contamination
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What anesthesia do we use for a Caslicks on a mare?
local anesthesia to lips of vulva by injecting mucocutaneous jxn
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What is the general procedure for a Caslicks?
- 1. local anesth.
- 2. remove small band of skin/mucosa at jxn
- 3. suture edges together
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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
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What is a breeding stitch?
heavy piece of suture at ventral end of Caslick's, prevents stallion from destroying the suture line
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Why would we need to "suture a mare" the rest of her life after a Caslicks?
seal of vulva compromised
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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
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What is the 'variation of the Caslick's'?
same as Caslick's but only mucosa removed and stitches are more cranial inside vulva
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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
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What is a perineal body transection?
- frees attachments of rectum and repro tract
- then return vulva to more natural conformation (vertical)
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Why do most perineal lacerations occur?
secondary to foaling
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What is a first degree laceration? How does it heal?
- only skin and mucous membrane involved
- healing= not complicated, no special care
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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)
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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
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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
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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
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What are the 3 surgical techniques for closing a 3rd degree perineal laceration?
- 1. Modified Goetz
- 2. Annes Technique
- 3. Pull Back technique
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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
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In vaginal lacerations what complication can result from persistant straining? and what is a differential dx?
- -pelvic abcess
- -DDX for abdominal straining = rabies
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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
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What mares most commonly have urine pooling?
older mares in poor condition
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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
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How can I tell a prolapsed bladder from a prolapsed vagina?
look for ureters openings on bladder
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What are 2 things I can do to prevent straining in a mare with a prolapsed bladder?
- 1. continuous epidural
- 2. tracheotomy
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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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