Follow-up on Butter - mare w/dystocia this spring

[StarRidgeAcres]

On March 14, 2011 my mare Butter went into labor. She was in obvious distress, the vet came out, after over 2.5 hours the foal was removed via a fetotonomy. Butter had a very difficult time in the following days and I called the vet four different times and asked him to come out and put her down. That's how much pain I felt she was in and how horrible she was feeling. Each time he came out, examined her and said he'd do it if it was what I wanted, but he felt she was still going to pull through. Fortunately she did and seems completely healed at this point 4 months later.

I've spent a lot of time over the last 4 months replaying the situation over and over in my head, talking to my vet, asking anyone who will listen and just in general sort of obsessing about it. I know dystocias happen. The filly's forehead was what was presenting; nose and front legs pointing downward. We could feel the forehead and one of the ears which is how we knew what position the foal was in.

Now here is the part I just can't resolve in my mind. Why, in a 34" mare that has had multiple foals previously, was there NO ROOM in there to push the foal back and reach the nose and legs to reposition? Four different people tried: myself, my neighbor, the vet and the vet tech. Both the vet and I have fairly tiny hands. When applying pressure to the forehead to trying and move it back a bit, it was like touching a brick wall. The foal would NOT BUDGE an inch. It was so tight in there that even once the decision was made that saving the foal wasn't an option and it was time for the fetotonomy or a c-section, it took the vet another 35 minutes to get (sorry, don't know the name of the instrument) the wire around the foal's head. He just could not get even two fingers along side the foal's head to get the wire in position. It's not a situation where there wasn't enough room to reach an entire arm in to get the front legs, we couldn't even get a couple of fingers, much less a hand or arm in there. The foal would not move backwards at all. Not even an inch.

So I still keep trying to understand why it was so "full" in there. The only thing I can think of is the mare and her weight. I'm wondering if I let her gain too much weight during her pregnancy and if her belly fat was taking up room that would normally be available to the foal. I realize this may be a totally ridiculous thought, but I can't come up with anything else. The filly was not abnormally large. Her head was dainty, she was not a dwarf, her legs weren't overly long (6" cannon) and she was the typical narrow-chested, skinny foal like most are when they first come out. I've had WAY larger foals born to smaller mares.

I would like to know what others think may have caused this and specifically if the mare was overweight. I'm including some photos below. Unfortunately, I do not have one of her right before foaling.

This picture was taken 11/27/2010 - almost 4 months prior to foaling:

This picture was taken on 12/19/2010 - almost 3 months prior to foaling:

This photo was taken 3/23/11 - 9 days after foaling and still in incredible pain and being treated for infection (note discharge down her legs). She laid down probably 23 hours a day at this point. She didn't even move when I would give her her shots. It was horrible to watch, which is why I asked so many times about putting her down:

To me, her belly after foaling just seemed too large, like she was either too fat or she was swollen for some reason

 

[StarRidgeAcres]

Sorry, duplicate post.

 

[StarRidgeAcres]

The next photo is her at 328 days with her previous foal in 2007:

This was taken 3/3011. Two weeks after this recent foaling.

 

[Eagle]

Parmela, I am so glad that Butter is doing well and I know just how you feel. We try to find the answers to make some sense of it all. I don't know if anyone here can help .

In the photo where she is 3 & four months to go she does seem very big, this could be caused by her winter coat and the foals position. In the last position it could be due to all that she went through or the fact that she has had several foals already.

I pray you find your answers and peace.

 

[Riverrose28]

I'm sorry I posted on the first one I came to, should I copy and paste or just leave it?

 

[StarRidgeAcres]

I'm sorry I posted on the first one I came to, should I copy and paste or just leave it?

Please re-post hear as I want others to read what you had to say. So sorry about your mare. How horrible to experience.

 

[targetsmom]

First of all, I am so glad to hear Butter seems complete healed after that horrible ordeal. I would guess that something else was going on in there. We had a horrible dystocia/fetotomy in 2009 and the mare recovered so well that she was re-bred a month later and delivered safely the next year. Of course we didn't do that without a lot a checking. This mare, who has had 8 pregnancies (5 live foals), regains her girlish figure immediately after foaling. I notice that Butter does not, and wonder if she could have something like uterine tumors taking up space??? Have you ever had her ultrasounded? Not sure how common these might be in mares, just know they are fairly common in other females.

 

[Equuisize]

Looking for answers is a difficult task.

I am also one who always need to know why.

Our mare, Zoe is 34 inches... her 4th filly came out fat

as a toad, not a wrinkle on her nor any ribs showing. Big baby.

She is still the one I have weight problens with. As I type, she is

in the 'fat girl' pasture.

Zoe had been on her 30 day out foaling rations for over 2 months.

Vet came out to give 9 month Pneumobort shot and said she going to pop anyday.

I said she's not due till August. He says she'll never make it. Ha!

Zoolii was born Aug 8th, right on time.

She was the only baby I had to help Zoe with.

She presented with left foot and nose. I have tiny hands and I went in

and popped her right foot forward and Zoolii was out on the ground before

I got my arm out.

Only explanation, to me, was Zoe being so fat from 2 months of extra feeding.

I can feel you are agonizing over this and that could be your answer that

Butter was carrying some extra pounds.

I'm so sorry she lost her baby but glad to hear she is recovering nicley.

 

[StarRidgeAcres]

First of all, I am so glad to hear Butter seems complete healed after that horrible ordeal. I would guess that something else was going on in there. We had a horrible dystocia/fetotomy in 2009 and the mare recovered so well that she was re-bred a month later and delivered safely the next year. Of course we didn't do that without a lot a checking. This mare, who has had 8 pregnancies (5 live foals), regains her girlish figure immediately after foaling. I notice that Butter does not, and wonder if she could have something like uterine tumors taking up space??? Have you ever had her ultrasounded? Not sure how common these might be in mares, just know they are fairly common in other females.

Mary, this is EXACTLY what I'm thinking! She just didn't drop all that "baby weight" like all other mares of mine have done very quickly after foaling. I can even recall saying to the vet "she just doesn't look right. She still looks pregnant." and since he's not a "mini" vet per se, he said he just didn't know what she should look like, but her appearance didn't alarm him.

Most of my mares almost look thin, they get the hollow look in the flank and their side (ribs) look slim almost immediately. Butter didn't this time.

I think the suggestion of an US to look for tumors or something is a good one. Now that she's healthy again, I could take her to the university and maybe they could tell me something.

 

[cretahillsgal]

Just going from what you have said and the pictures I don't think she is too fat. Yes, her belly is huge, but the rest of her does not look fat at all.

Did the vet give her a sedative and meds to stop her contractions? I don't remember.

To me it sounds as if maybe the foals head had gone far enough into the canal that the reason it could not be pushed back in might be because the head was catching on the pelvic rim. Like when you have something sticking up in a drawer and it will close fine, but then ya cant get it back open. Might not be what the problem was, but was the first thought that came into my head.

I know what you mean about wondering why. I had 3 dystocias this year and it was awful! One had the head turned back, one was breech, and the other was breech but was actually an early abortion with a small fetus so was easily corrected. I try not to think back and wonder what if, but its so hard when you know it could happen again.

BTW, my worst dystocia, was an older mare like Butter who had previously had 13 foals without any problems whatsoever. And we were 2 hours into it and fixing to do a c-section when we tried one last thing and finally got the dead foal out. We will never know...

 

[supaspot]

she does look enormous but its impossible to say if thats fat or if she just carried alot of fluid , her butt and shoulders dont look overly fat so Id guess from the pics thats its just water , you can drive yourself mad trying to find answers , I think you are feeling guilty and blaming yourself , you may never find the answer so forgive yourself

 

[AnnaC]

I posted on the other topic as well, so will repeat some of what I said. I also want to thank you for updating us on Butter - so glad to hear that she is fully recovered after that awful ordeal.

Weight wise I do not think she is over weight, unusually large in her tummy, yes, but too much weight over her quarters and in the front over her shoulders and chest, no!

I had a mare foal this year (always gets huge), we lost the foal as she foaled early out in the field and the foal didn't make it out the bag. But this mare never lost any weight on her sides or her tummy, so much so that for a short while we wondered if she had a second foal in there! The foal she lost was full sized, but skinny and with long slender legs, so we wondered if there was possibly another tiny body in there. But no, and all is well internally too, but this mare is still her normal huge self!!

I dont have any reasons to offer for the fact that you would not push Butter's foal back, nor why you couldn't squeeze past it's head, except that perhaps its body was twisted up somehow right behind the head and thus backward movement just wasn't an option.

You may never know the reason, but at least Butter is ok and that is the main thing.

Sending ((((HUGS))))

 

[shelia]

I read somewhere, or maybe my vet told me that when a mare goes into labor they dilate and have contractions, but within a short time, (don't remember how long) They start to tighten up again. If the foal gets stuck in there for too long everything tightens around it. It can make it nearly impossible to move forward or backward. the contractions are to push that foal out. they are not to push it back in. It doesn't matter how much room thay had before.

 

[Ridgerunner]

Parmela, I'm so glad to hear that Butter's okay! I remember when she lost her foal. As for you not being able to push the foal back to reposition it, my vet told me that when a mare goes into labor the uterus starts contracting, and the longer she's in labor, the smaller the uterus gets. Kinda like shrink wrapping the foal! I'd guess that's what happened, and there's really nothing you could've done about it. We always have 'why's' when we lose one. We lost a beautiful colt this year due to him being breech, and I can't keep from thinking, 'if only we could've gotten him out quicker.'

Give Butter an extra hug tonight.

 

[Katiean]

I delivered an arab foal that got hung up. His head was out to his eyes and he stopped. It took us about 20 minutes to get him freed up and he popped right out. Then my QH foal had one leg back. I had to go in and find it and all was well. I guess I have been lucky with the minis. I saw late abortion where the foal just slipped out presented properly except he was upside down. I have never seen a foal born as fast as he was. He was fully formed just a twisted cord. What a loss. It really is nothing that we do wrong. That is just life and sometimes it just happens. I hope you do not blame yourself. I do not think you did anything wrong.Fat horses, normal weight horses and even skinny horses all foal and most have no problems. It just happens. Look at the human baby's born. It's the luck of the draw.

 

[Sandy B]

With our dystocia this year that we lost both the mare and the foal, my vet used two gallons of lube in the 2.5 hours he worked to try and get the foal out. He gave spinals and sedation to try and ease contractions but it was like working on a brick wall too. They do get very very dry inside after awhile. After the first 3 minutes our mare was put out and hung from the rafters to try and manipulate the foal by dropping it back in the uterus. Did you guys do that? My vet said it is nearly impossible to correct a severe dystocia without hanging them by their hind legs a little. Unfortunately in our case, the foals head was too large to fit through the pelvic ring. This mare had had foals before too and was not over-weight, but in perfect condition.

Your mare does not look at all fat to me and honestly how many of us have over-weight or healthy looking broodmares. We do have to feed them for them to nurse those foals and to carry foals. I have a mare that is very heavy(definitely fat) that shot her foal out this year 30 minutes after we checked her and did not exhibit one labor sign. We lost that baby too as it did not make it out of the sac. She was just as fat after she foaled and is such an easy keeper I think she could have a few crumbs and still be fat.

I personally do not think over-weight mares have a higher rate of dystocia or failure to correct dystocia. Fat is just that... fat. It is not rock hard. More than likely the mare was contracting and dry inside and that makes it like a rock.

I am so glad that your mare recovered well. You were so lucky in that regard.

 

[bannerminis]

You know I think that its just so sad and not to have an answer does make it hard to move on and you keep questioning things. I wonder if the foal was just stuck in such a way that she couldnt be budged.

I hope you get some peace soon. I am so glad your mare is ok and she is so pretty.

I dont think that fat has anything to do with it. And in those pics like the others have said that she is huge but looking at her bum and neck it doesnt look like she was fat.

My mare Slaney must carry a lot of water as she always looks like she is going to have twins. She is also a fatty but never has an issue foaling - she foals like a rocket normally.

 

[HGFarm]

Are you sure the foal was still alive when the mare went into labor? Or had the foal died already for some reason, was stiff and the mare was aborting rather than a regular labor? Just a thought there.

Everyone can only guess- you will never know for sure- and that is just Mother Nature. I have had a couple of large mares too that had dystocias and were very difficult to remove. They went on to have foals again without ever a problem.

I am so glad your mare is doing well now- that is great news. Dont beat yourself up over this- it happens and again, folks can only make a wild guess at what may have happened.

 

[drmatthewtaylor]

Too little info to speak about Butter specifically, but here is some general info that may apply.

During gestation mother and foal turn over large amounts of fluid. If the absorption membranes do not work correctly then fluids accumulate (hydrops amnion or allantois).

During labor the uterus pushes the fetus toward the pelvic outlet, these are separate from the abdominal contractions that push the fetus out. If the fetus does not present with a limb or nose into the pelvis then the abdominal contractions are at least delayed and can be absent (this is called the Ferguson's reflex).

If the uterus continues to contract without rapid expulsion of the fetus then all of the fluid will be expelled thus leading to a situation where there is not enough room inside the uterus to manipulate a malpresentation.

Being fat or thin does not limit or improve the ability to manipulate a fetus.

Hope this helps.

Dr Taylor

 

[StarRidgeAcres]

Thank you to everyone who has responded. It's given me lots of things to consider and I've learned many new things which is what is so wonderful about the LB community.

As for you not being able to push the foal back to reposition it, my vet told me that when a mare goes into labor the uterus starts contracting, and the longer she's in labor, the smaller the uterus gets. Kinda like shrink wrapping the foal!

That is exactly what it felt like. No fluid, just uterus and foal.

If the uterus continues to contract without rapid expulsion of the fetus then all of the fluid will be expelled thus leading to a situation where there is not enough room inside the uterus to manipulate a malpresentation.

Thank you Dr. Taylor for responding. We all appreciate your time very much.

I do believe this is what happened. At 7am when I checked her all was fine. No signs of anything imminent. I went back to the house, took my shower, got dressed, let the dogs out, etc. Looked at the camera at 8am and could see something was obviously wrong! I rushed out and the sac was broken and hanging partically out and she had obviously been vigorously rolling trying to reposition the foal I assume. If she had gone into labor just after 7am and had been trying for an hour then I can see where all the fluid would have been expelled (especially since it was obvious the sac was broken). I felt inside and it was like hitting a brick wall. The foals forehead was just (estimating here from memory) about 8 inches from the opening of her vulva. Maybe less. I stopped called the vet, called my neighbor and then starting trying again to reposition.

There was a snow storm that morning (of course) so it took the vet 35 minutes to arrive. It was another 2.5 hours before the entire foal was out. At two points during the process I asked the vet if we should just let the mare go as her eyes looked glassed over and she was no longer moving or struggling. He felt she could be saved and as it turns out he was right. Not bad for a vet that may see pigs, cows, alpacas and cats all in the same day!

This practice is certainly not equine only.

And someone asked if the foal was dead when the labor started...I can't say, but I believe the foal was dead by 8am when I first felt inside.

Thank you all again. I still can't believe what I put into that baby...two different mares, 3.5 years of trying, transportation, insurance, mare care, ultrasounds, stud fee, etc. Only to be told she wasn't bred and have her sent home. Then I realize after a few months that she is in fact bred, but have no idea of any breeding dates. We actually completed her foaling stall, installed the camera and made a pen for the baby and mom to run in less than 12 hours prior to this happening. Otherwise the poor mare would have probably gone through this trauma outside, in the snow and sleet with other mares standing around.

That's the only scenario I can think of that would have made it even worse.

She just didn't look anywhere close. I'd foaled her about before, she had almost no bag, was somewhat loose in the tailhead but not what I would have expected, baby still looked to be laying side to side and not in position. She was eating and had solid stool at 7am. The foal was a tiny palomino filly with blaze and a bit of one sock. I haven't checked, but I'm not sure the stallion had any other babies born this year. I hope he did as he's an important part of the breed. I hope I didn't lose his last baby.