Peritonitis Secondary to Uterine Tears in Postpartum Mares: Retrospective Comparison of Surgical Versus Medical Treatment
Peritonitis secondary to uterine tears is a common problem in mares during the first week postpartum. Surgery has been suggested to be the best option for preservation of the mare's life and breeding soundness. Due to the risks associated with anesthesia and the potential additional costs incurred, a critical comparison of medical and surgical treatment of postpartum peritonitis mares is warranted. The objectives of this retrospective study were to determine the factors associated with survival in mares with peritonitis secondary to uterine tears and to compare the value of medical versus surgical treatment. Forty-nine postpartum mares diagnosed with peritonitis based on abdominocentesis or with a uterine laceration confirmed at surgery were included in the study. Mares with rupture of a gastrointestinal viscus or vaginal lacerations were excluded. Information on age, breed, physical examination findings, laboratory testing, abdominocentesis, treatment, breeding performance following discharge, length of hospital stay, and hospital bill was obtained from each medical record. The overall survival rate was 75.5%. In the univariable analysis, nonsurvivors were significantly more likely to have gastric reflux, a higher heart rate and anion gap, and a lower total CO2 and leukocyte count, compared to survivors. Fourteen mares were treated medically and thirty-four were treated surgically. Admission variables, survival rate, hospital bill, duration of hospital stay, and likelihood to foal following discharge were not significantly different between mares treated medically or surgically. Based on these results, medical treatment of postpartum mares with peritonitis should be considered a reasonable alternative to exploratory laparotomy.