This section is from the book "The Horse - Its Treatment In Health And Disease", by J. Wortley Axe. Also available from Amazon: The Horse. Its Treatment In Health And Disease.
This accident is less often encountered among quadrupeds than among bipeds, owing chiefly to structural differences which need not here be specified, and also to the erect posture of the latter favouring gravitation and the continuance of bleeding. Against this the horizontal position of the womb in the former is conducive to the formation of clots and the natural arrest of hemorrhage.
In the mare, alarming cases of flooding are sometimes met with, and, whether due to the accidental rupture of blood-vessels in the act of parturition, to natural weakness of the walls of the uterus, or to anatomical peculiarities, call for immediate attention. Flooding may occur after premature labour or abortion, easy and natural births, or in presentations necessitating manual interference in delivery. Among the more frequent causes, perhaps, may be mentioned the entanglement of the foetal envelopes in the passage during delivery, when they are torn away from their uterine connections before the time has arrived when, in the absence of the foal, such contraction of the womb can be effected as shall close the mouths of the broken vessels. The experienced accoucheur will gently separate the membranes if he finds them retarding delivery; but, as has been pointed out, labour is so sudden and brief in the mare, as a rule, that powerful expulsive efforts may have already done mischief in the absence for only a few minutes of a watchful attendant. It has been observed among human obstetricians that post partum hemorrhage is frequent or otherwise in proportion to the rapidity of delivery, and we might, pari passu, look for flooding in mares more often than among other domesticated animals which occupy more time in parturition. This, however, is not the case.
The period occupied in delivery would seem to determine the disposition to hemorrhage, whether by unaided expulsive efforts on the part of the animal or by artificial interference. The previous state of health of the mare is a factor doubtless to be reckoned with, as it will be obvious that the vessels of a debilitated animal will have less power of contraction than those of a more healthy and robust constitution. Predisposition to hemorrhage is also due in some cases to congenital weakness of the uterine mucous membrane and to injuries sustained in previous difficult labours.
Persons without experience of brood mares might assume that uterine hemorrhage would necessarily be attended with an immediate discharge of blood per vulvam, but this is far from being the case, for the uterus in its dilated condition may continue to retain it for some time and in large amount without any outward appearance of its presence. Where this is so the more frequent signs are those of trembling, coldness of the surface and extremities, pallor of the visible membranes, a quick but feeble pulse, interrupted heart-beats, and throbbings of that organ, followed by anxiety of countenance, staggering gait, sighing, and inability to maintain a standing attitude. Cold perspiration and muscular tremors invariably appear before the animal finally sinks upon the ground and dies in convulsions.
To arrest the blood-flow and sustain the vital powers must be our first care. The placenta or after-birth is to be removed, for its presence is a hindrance to that contraction of the womb which is so necessary a sequel to parturition. The mere fact of its removal will in many instances bring about the desired effect, but undue force in effecting this is to be deprecated, and the expert in such matters will strive to remove the placenta by the gentlest traction, while leaving no portion of the viscus unexplored. Experienced veterinary obstetrists recommend the introduction of the hand into the uterine cavity, as its presence and gentle movement over the mucous membrane excites the organ to contract, thereby closing the broken vessels. It is important that the organ should be freed from clots of blood, which might otherwise decompose and lead to septic conditions. The accoucheur is here confronted with a difficulty, since he must interfere with nature's ordinary method of arresting hemorrhage by removing the clot, or risk the development of pathogenic organisms and the consequences they entail. The practice of introducing cold water, or a sponge saturated with it, has sometimes proved effectual in arresting uterine bleeding, and on the other hand very hot water has been advocated by some as a styptic agent. Neither the hand nor any medicinal substance should be inserted, with a view to arrest hemorrhage, without employing some antiseptic (see Antiseptics), and regard must be had to the composition of any drug subsequently employed, or some chemical decomposition may neutralize the effects of the agents used. For example, the mistake is often made of employing permanganate of potash as an antiseptic and glycerine as an emollient, the two being incompatible.
A solution of chinosol in the proportion of one in six hundred is very suitable for irrigating the womb or for saturating the sponge, if it is decided to introduce one. In severe cases, where collapse is feared, the stronger styptic of perchloride of iron or somewhat dilute vinegar may be substituted for cold-water injections. Solutions of tannic acid, or glycerine-of-tannic acid (where permanganate or Condy's fluid has not been used), or of witch hazel should be used. The latter being held in great esteem for the purpose in America.
It may be advisable, while these measures are proceeding, to apply cold douches over the loins, at which time a small dose of some alcoholic stimulant should be given. It will be desirable also to give, in the form of draught or ball, one or more of those internal styptics which act through the medium of the circulation: gallic acid, salts of lead, morphia, tincture of iron, ergot of rye, etc. Of the remedies last named, ergot is perhaps of least value in mares, and the fact is mentioned because it is a drug so highly valued in human medical practice. Should we fail with the remedies above named, we have still left a class elsewhere described as revulsives, in the shape of mustard cataplasms, which may be applied over the region of the loins and upon the hollows of the flanks. Vigorous rubbing and hot bandages should be applied to the legs, and plenty of clothing to the body.
There should be no attempt to counteract febrile symptoms, that may subsequently develop, by purgative medicines, but rest should be secured for the organs recently involved in what should always be regarded as a serious mishap. Some bicarbonate of potash may be given in the drinking-water, and the diet should be gently laxative during convalescence, linseed forming an important item in the menu (see Nursing and Feeding of the Sick).