Ultrasonography of intra- and extrauterine hemorrhage.
Keywords: ultrasound, hemorrhage, uterus, mesometrium, equine1. A hematoma seen in the mesometrium (Me) at the time of foal heat breeding. Like the majority of mares with mesometrial hematomas, this mare showed no outward symptoms at the time of foaling. The structure was clearly palpable per rectum; hence the ultrasonograph.
2. A similar hematoma to that described above but older, more consolidated and more echogenic.
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3. Intra uterine (IU) hemorrhage in a mature mare presented because of a foul smelling vaginal discharge at 35 days post foaling. The mare was systemically normal but ultrasonography and a glove hand examination of the uterus revealed masses of clotted blood, seen here on ultrasound in the left uterine horn. This was hemorrhage was presumed to be due to a severe partial thickness endometrial tear, sustained during parturition. The hooves of foals can cause these tears.
Most of the clotted blood was removed by hand then the uterus was flushed with saline. Antibiotics and tetanus toxoid were administered. The uterus appeared to be normal on ultrasonography at the time of discharge but the mare was lost to follow up.
4. Two images of an unusual intra-endometrial (IE) multilocular cyst at the approximate time of foal heat. Its contents were not consistent with the non-echogenic fluid usually seen in endometrial lymphatic cysts. However, this mare was known to have endometrial lymphatic cysts before she conceived. Therefore it is possible that this was a group of cysts that was traumatized during foaling, causing hemorrhage within the cysts.
Reference
Dolente, B.A. et al. 2005. Mares admitted to a referral hospital for postpartum emergencies: 163 cases (1992-2002). J.Vet.Emergency and Critical Care 15: 193-200
