restraint. This may take the form of experienced handlers in a quiet
environment, examination stocks, adequate lubrication, a twitch or sedation
(e.g. Domosedan®) and/or pharmacological relaxation of the rectum (e.g.
Buscopan®) of the animal to be examined; this is even more important in
young, nervous animals or animals with an extremely narrow rectum / pelvis.
Extra care should be exercised when using the ultrasound scanner since it is
easier to cause inadvertent damage with a blunt object. If damage to the
rectal wall is suspected (e.g. there is blood on the hand of the examiner) the
animal should be relaxed further and the rectum re-examined with a
thoroughly lubricated ungloved hand. A full or near full-thickness tear (Grade 3
or 4 out of 4) should be regarded as a candidate for emergency treatment
starting with rectal relaxation with Buscopan® (with treatment repeated at 20
min intervals), powerful broad-spectrum antibiosis (e.g. penicillin and
gentamicin) and anti-endotoxic NSAIDs (e.g. flunixin meglumine). Plans
should be made for immediate repair or appropriate dietary management, or
the animal referred for a second opinion (or euthanased in the case of a large
intra-peritoneal full-thickness rupture). The circumstances of the incident
should be recorded in detail and a full report made to the owner and kept in
the patient’s files.
Normal procedure for examination:
Nevertheless, per rectum examination of the reproductive tract is the
cornerstone of most broodmare appraisals. Of course, it is important to
combine the findings of both palpation and scanning since together they
provide much more information than either in isolation. The examination
should begin with palpation of the uterus near its bifurcation to determine its
size, especially with regard to the success of involution after foaling, and its
tone, thereby providing information with regards to the stage of cycle and/or
pregnancy. The oestrous uterus is classically described as being relaxed
(atonic), however, during late oestrus it can occasionally feel quite firm and
‘blown up’ due to the oedematous endometrial folds within the uterine wall.
The ovaries should be palpated to determine their overall size, shape, and the
size and consistency of any structures that they contain. Palpation can be
invaluable because, for example, a pre-ovulatory follicle will often feel soft
while a recent ovulation may be palpable as a tender (painful for the mare)
depression at the ovulation fossa before it is visible ultrasonographically. The
scanner is of particular use for detecting subtle, non-palpable indices such as
uterine oedema, which indicates oestrus and/or uterine irritation, or thickening
of the follicle wall as ovulation approaches, and for demonstrating
accumulations of free fluid or endometrial cysts within the uterine lumen and
for counting and measuring ovarian follicles/corpora lutea and thereby more
accurately determining the timing (and number) of ovulation. The scanner is
also extremely useful in detecting the nature of abnormalities of ovaries,
uterus or broad ligament (e.g. tumours, haematomata).
Vaginal examination
Before performing a vaginal examination the perineum and vulva must be
cleaned thoroughly. In maiden mares, the speculum should be inserted
carefully due to the possible presence of an intact hymen. The appearance of
15-‐18
February
2016
East
London
Convention
Centre,
East
London,
South
Africa
89