Comparison of surgical and medical treatment of 49 postpartum mares with presumptive or confirmed uterine tears.

OBJECTIVE

To determine outcome after medical or surgical treatment of postpartum mares with confirmed or presumptive uterine tears.

STUDY DESIGN

Case series.

METHODS

Postpartum mares were included if foaling had occurred within 7 days and uterine tear was confirmed surgically or, in medically treated mares, by palpation or presumed based on peritonitis. Information (age, breed; physical examination, laboratory and abdominocentesis findings; treatment, survival rates, length of hospital stay, treatments costs, and breeding performance after discharge) was obtained from the medical records (1990-2007). The influence of variables was compared between medical and surgical treatment, and between survivors and nonsurvivors.

RESULTS

For 49 mares, survival was 75%, with no significant difference between medical (11/15; 73%) or surgical (26/34; 76%) treatment. Admission variables, treatment cost, duration of hospital stay, and likelihood of foaling after discharge were not significantly different between treatment groups. Nonsurvivors were significantly more likely to have gastric reflux, higher heart rate, anion gap, lower total CO(2), and leukocyte count, compared with survivors. Tears were significantly (P=.018) more likely to occur in the right uterine horn than in other parts of the uterus.

CONCLUSIONS

Uterine tears occur more commonly in the uterine horns, more so the right horn, and survival is similar with surgical or medical treatment of uterine tears in postpartum mares.

CLINICAL RELEVANCE

Medical treatment may be a reasonable alternative to surgical treatment for uterine tears, although the severity of tear that can resolve with medical treatment is unknown, and medical therapy can be as expensive as surgical treatment.