Let's Talk About Twisted Cords

[RockRiverTiff]

Yesterday was a rough one for me. I'd done the mid-day checks before running some errands and everyone was fine. While I was out I got a call from Dick that a mare had miscarried. When I got to the farm the mare met me at her gate and walked with me to her foal. She really thought I could help. It breaks my heart that they have so much faith in us. The positive here is that the mare is doing great. All her vitals were normal, but I've had her stalled under surveillance for the last day and she's been eating, drinking and pooping normally.

The first thing I noticed was the red bag. I pulled the baby out, and her big eyes were wide open - honestly my first instinct was to try to resuscitate her. She wasn't even 9 months along yet with super fine hair and her little leg bones weren't as big around as my thumb. I had just talked to our reproductive vet's office and knew she wasn't in the area, so I called the back-up vet.

He gave me quite a lesson. I wish I'd had the presence of mind to take notes. The diagnosis was a twisted cord, but he said a lot of abortions are misdiagnosed as that. Or moreso that the cord gets twisted *after* the foal is in trouble because it's moving in distress. He pointed out the fluid bulging between the twists and the significant bruising near them and the naval and then told me where to look for lesions, discoloration, etc that would suggest another cause. I thought I'd been thorough in checking everything over in the past, but to have a professional there pointing everything out and explaining it was really an eye opener.

I know I'm not alone this year in losing a foal to this, so I'm curious about what others have learned about twisted cords. Does anyone believe they're preventable? That there's a predisposition or other contributing factors? I know it's a grim subject, but when I feel helpless about something it always helps me to feel like I'm learning from it.

 

[drmatthewtaylor]

Sorry about your loss.

Your Vet is right, twisted cords are over diagnosed. They are something that owners can see. Abortions sent to referral labs are diagnosed only about 1/3 of the time and that's just too few to keep a client happy.

I do not believe twist can be prevented reasonably. One could u/s frequently and then do intrauterine surgery to correct, but not too reasonable.

Dr Taylor

 

[RockRiverTiff]

Thank you for your input Dr Taylor. Out of curiosity, what % of veterinary facilities would you say actually offer intrauterine surgery? I wasn't even aware it was available for twisted cords.

 

[StarRidgeAcres]

I've never officially had a loss attributed to a twisted cord, but I have lost pre-term foals and thought to my untrained eye that the cord was twisted. I have had several live, lealthy foals born just fine and when I examine everything I've noticed the cord being twisted many, many times and have seen fluid buldges between the twists. I've not had a lost foal with its eyes open. That would catch me off guard I think.

I did lose a black pinto colt several years back from a mare that I had no breeding dates on and actually thought she was open. I had NO idea the mare was anywhere near ready to foal, much less even pregnant. Actually I was so confident (and obviously wrong) that she was open I didn't even US her to confirm one way or another.

She foaled what looked to be a full-term colt that was out of the sac and several feet away from the sac, with the LGD standing between the mom/baby combo and the rest of the herd. She was keeping the other horses away. The baby was cold to the touch. I never could figure out what really happened. Did the foal die due to not getting out of the sac and later the dog pulled the sac off? The cord was twisted some, but not more than what I associate as being normal. The foal wasn't covered in shavings and had no trauma like it had rolled around or the mom had pawed it. So the foal was gone and I put him in a plastic bag and into the fridge we had in the barn for when the vet could come out the next day to check the mare. The next day when the vet came out I got the foal out of the fridge. She was examining him and I noticed fecal matter in the plastic bag. I was horrified!

I felt like I'd put a live foal in the refridgerator. My vet assured me that I hadn't and it was normal, but to this day I wonder if I killed that baby by putting him in the fridge. The vet had suggested a twisted cord, but I will always wonder what really happened and if I killed that baby.

It's a horrible image to live with.

 

[Michelle@wescofarms]

Hey Tiff,

We had one that UC Davis said was a twisted cord, and another (middle of the night) exactly the same that the did not exam. So we made the 'assumption' it was. Was it? IMHO yes.

I'll be putting the pics up again on our website sometime in the next month. We cleaned up and photo'd the first foal (for the dam's records) and you can see the twists the (sorry I don't remember the technical term) rupture (congested with blood, etc). I don't want to post pics here as it's foaling season and dead foals aren't ever pleasant.

Guess we need to refer to it as cord torsion as twists are normal.

Good article - Umbilical cord torsion

Book that discusses this as well -

Current therapy in equine medicine By Norman Edward Robinson, Kim A. Sprayberry

 

[RockRiverTiff]

Parmela that thought would haunt me too, but you have to assume your vet was honest with you (for sanity's sake if nothing else). I don't know if it was fluid or backed up blood the vet was pointing out - it made sense at the time but he was throwing out a lot of terminlogy and I really wasn't "all there."

Michelle I'll keep an eye out for the pictures, as unpleasant as I'm sure they are. I'm a bit of a control freak, so when something bad happens that I can't control I tend to feed that need with information. I know continuing to call it a twisted cord can confuse things - the vet called it torsion too - but I've gotten so used to reading about "twisted cords" that I think it'll be hard to reset my mind on that one. The article's great - really easy to understand and applies to a lot of my own questions.

Here's a more in-depth article I've been going over today (warning: it includes a lot of graphic photos):

Examination of the Equine Fetal Membranes

 

[iowa]

Thanks for that link. I read the entire article and learned a lot about the possible causes of abortion, red bag, cord torsion, etc. It was very worthwhile.