Understanding dystocia in the field: part 2

Part 1 of this article discusses the physiology and causes of dystocia in horses, as well as the equipment and drugs needed for managing dystocia and assessing, planning and diagnosing in the field. This article considers planning and communication skills, correcting dystocia and prognosis for mare and foal.

Once the nature of the dystocia has been diagnosed, a concise conversation with the owners should ensue. The likely prognosis for mare, foal and subsequent fertility, as well as costs associated with assisted vaginal delivery, controlled vaginal delivery, caesarian section and fetotomy (if appropriate) should be discussed. Owners may need to be asked whether preservation of the mare's life, or delivery of a live foal is the priority. If the mare's survival is the primary consideration, it may be pertinent to ask whether that decision is caveated by sound future fertility.

This discussion can be a difficult one, but is vital in determining the next step in order to optimise the outcome. Often the decision is influenced by finances, obstetrical expertise and proximity to a specialist referral centre. Protracted manual manipulations are not recommended if future fertility is the primary concern, because of the abrasive nature of repeatedly introducing and withdrawing an arm, as well as unavoidable bacterial contamination of the uterus. Resolute decision-making is key; if initial attempts at manipulating the neonate are unsuccessful, an alternative course must be considered. If a suitable hospital is nearby, and finances permit it, prompt referral for controlled vaginal delivery or caesarian section may represent the most favourable chance of a positive outcome for mare and foal survival, as well as future fertility.