HOW-TO SESSION: LIFE STAGE MANAGEMENT


unable to be reduced. If the hernia sack ruptures, edema forms in the inguinal region or ventrally on the abdominal wall, this necessitating surgical correction.


4. Examination of the Mare


Reproductive The requirement to rebreed the mare prompts ex- amination at foal heat, otherwise no opportunity for evaluation of the mare may be available in the early post-partum period (Appendix 2). Integrity of the perineum is vital for health of the reproductive tract. Early placement of a Caslick suture post foaling is shown to improve reproductive performance, with mares sutured at 48 hours post foaling having increased pregnancy rates than those sutured at foal heat, making it imperative that any further delay is avoided.19 Ultrasonography of the genital tract beginning at 7–9 days post-partum will allow determination of the time of first ovulation, with those mares ovulating before 10 days known to have a reduced pregnancy rate and higher embry- onic losses.20 A decision can then be made to breed if appropriate or induce luteolysis and initiate a more fertile cycle. Uterine involution should be complete at this time, with no evidence of intralu- minal fluid. Ovarian activity should be obvious, with follicular development progressing and endo- metrial edema present.


General Health


Examination of the oral cavity and particularly the teeth is important. As the mare is under consider- able nutritional stress, the ability to consume an adequate ration and digest the contents depends upon integrity of the dental arcade. Malalignment and pain compromise mastication, potentially re- ducing digestibility of the ration and increasing the chances of esophageal obstruction. Lameness limits mobility regardless of the source (hooves, joints) and may precipitate stress with any associated pain. Ability to forage is reduced, and elevation of stress hormones exacerbates insulin re- sistance and depresses hormones involved in pro- moting cyclical activity.21 Close inspection of the hooves and at minimum flexion testing is indicated in the lame foal heat mare. Skin reflects general health but may in itself un-


dergo pathology. Hypertrichosis and hyperhidrosis are classical findings for pituitary pars intermedia dysfunction (PPID). This may predispose to der- matitis or folliculitis of localized or generalized dis- tribution. Dermatophilosis is relatively common with a characteristic appearance, and while easily treated is not always addressed. Previously un- seen sarcoids, cutaneous masses, or neoplastic le- sions may also be noticed at this time of closer examination post foaling. In addition to milk pro- duction, the mammary gland should be examined for


456 2016  Vol. 62  AAEP PROCEEDINGS


signs of cutaneous trauma, previously unseen tu- mors or sarcoids, and mastitis. Endocrine and metabolic dysfunction may be sug-


gested by coat changes (as above) and conformational changes related to loss of muscle mass and abnormal subcutaneous adipose tissue deposition. Areas of note include the tailhead, behind the withers, in the supraorbital fossa, and most significantly, over the nuchal ligament. Other compatible clinical signs in- clude increased water intake, the presence of chronic infections (sinusitis, pneumonia, endometritis, cutane- ous), and periods of somnolence. Laminitis in associ- ation with fresh grass access, or without a concurrent provoking condition, is suggestive but not confirma- tory of insulin resistance. Feed requirements increase markedly over main- tenance once lactation begins, with mares’ dry mat- ter intake regularly achieving 2–3% of body weight,22 with energy and protein needs also chal- lenging to meet. Essential amino acid intake can also be difficult to achieve in the absence of high- quality protein. Where forage quality is average, concentrate intakes should be in the range of 0.5–1% of body weight. Where lower-quality forage is given or intake restricted, larger amounts of concen- trates are needed with the caveat that high grain intakes increase the risk of digestive disturbances. Therefore, higher-quality forages should be provided for lactating mares when possible. High concen- trate intakes should be divided into two or three servings per day.


5. Timely Interventions and Opportunities to Add Value


Ultrasonography of the Foal


The preferred ultrasound probe for younger foal ex- amination a microconvex probe with a narrow foot- print, of higher frequency (5–10 MHz range). Most structures can also be imaged by use of a rectal probe (5–6 MHz range); however, it may be more difficult to achieve an acceptable acoustic window in some locations due to probe length and shadowing by bony structures (e.g., ventral thoracic wall).


Lungs


Ultrasonography allows rapid assessment of the pleural space and superficial lung parenchyma, with deeper structures visible where consolidation or ab- scessation is present. Placing the probe in the in- tercostal space parallel to the ribs maximizes the acoustic window; the probe is generally placed per- pendicular to the thoracic wall; however, areas shielded by the ribs can be assessed by sweeping the ultrasound beam horizontally. Assessment of the cranial thorax (cranial to the third intercostal space) presents some difficulty given that the triceps mus- culature covers this area; however, the probe can be placed under the right triceps musculature with the probe angled toward the left shoulder to image the cranial mediastinum. Evaluation of the lung fields


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