Peritonitis secondary to necrosis of the apex of the urinary bladder in a post parturient mare

Assessment of peritonitis in the complicated post partum mare

“…Despite this variety of complications, the presenting signs are often vague and nondistinct. The above report by Snalune and Mair (2006) demonstrates this, with the recorded history of depression, mild colic and pollakiuria. Clinical signs that might be explained by a wide range of disease processes dictate a complete history, close observation and a thorough clinical examination.…”

“…Careful examination of the caudal abdomen is required in all complicated post partum mares. The painful response to transrectal palpation in the mare described by Snalune and Mair (2006) was, in my opinion (not being there), most probably due to the distended, traumatised bladder. In my experience, few conditions will elicit as much reaction on transrectal examination as digital pressure on an overly full bladder (innervated).…”

“…Grey zones exist in any classification scheme, but a major indicator of an abnormal peritoneal fluid sample is identification of a compartment for further evaluation. The mare in the report by Snalune and Mair (2006) had peritoneal protein elevated to a greater degree relative to the nucleated cell count. Mares with a haematoma of the broad ligament can have peritoneal protein values up to 50 g/l and a normal total nucleated cell count (Frazer et al 1997).…”

“…The clinicians involved in the preceding report (Snalune and Mair 2006) are to be commended for their successful management of this mare. Although the bladder survived the insult, repair of ruptured bladder in the mature horse, especially if it involves partial resection, can be difficult due to the poor exposure afforded via a ventral abdominal approach.…”

“…Maintaining continence, function as a reservoir for urine and the ability to fill and empty normally is the goal of any intervention. The mechanism proposed by Snalune and Mair (2006) of apical bladder necrosis due to vascular occlusion of right cranial vesical artery is interesting. I have previously expressed a similar proposed mechanism for signs of abdominal pain post ovariectomy, i.e.…”