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Equine Clinical Case Challenge—Ultrasound of a Pregnant Mare

History:

This 6 year old maiden mare presented with a history of four live-cover breedings during her heat cycle. The mare was confirmed "in foal" with a single ultrasound at 14 days post-ovulation.

 

Case Details:

At approximately 9 months of gestation, the mare was noted to have significant udder development and was dripping milk. She was started on Regumate (20cc orally once daily) and referred to Tufts Hospital for Large Animals at Cummings Veterinary Medical Center for further evaluation.

Below is the video of the trans-abdominal ultrasound.

What is your diagnosis and what treatment would you recommend?

Diagnosis:october ultrasound photo

Ultrasound revealed a viable fetus with a fetal heart rate of 96 bpm as well as a second, smaller fetus with no visible heartbeat. A rectal exam revealed a lack of cervical tone with a normal CUPT (combined utero-placental thickness) but some evidence of placental separation near the cervix.

Treatment and Outcome:

The mare was continued on Regumate and was also treated with SMZs until the vaginal discharge resolved. Repeat trans-abdominal ultrasounds were performed by the primary care veterinarian every 3 weeks throughout gestation. The mare delivered a small, weak, dyspneic colt at day 326 of gestation, but unfortunately, he died within an hour of birth.