Placentitis...Please help. UPDATE: No Happy Ending here.

[Ducati]

So last weekend my mare was diagnosed with placentitis at 264 days. Has milk dripping but no discharge and no other symptoms. Ultrasound showed slight thickening of placenta. Bloodwork came back “normal”. She was started immediately on SMZs, regumate 2x day and pentoxyfylline. She also received one initial dose of banamine. Mare is a 15 year old maiden. She is being closely monitored day and night. I believe we were able to catch it early. Today she is at 267 days.

I realize that there have been other posts about placentitis and I’ve read them all. Most of them are from quite a long time ago so I’m wondering if anyone can provide some new insight or stories. I can’t find any statistics anywhere on what the odds are of my mare carrying close enough to term to deliver a healthy foal. I am beside myself with worry and I need some solid information to grasp onto. Any help would be much appreciated.

[Dance_To_Oblivion]

Last year my mare was diagnosed with ascending placentitis at 262 days and she held that foal for until 345 days and delivered a healthy colt. Since her placenta was so awful (seriously I have shown vets pictures and they were shocked a healthy foal came out of it) we did 10 days of antibiotics on the foal just to be safe. a friend of mine does placentitis research and she told me that if my mare held for the first 48-72 hours after I noticed the problem I had a pretty good chance of getting a live foal.

Massive jingles for your mare and foal!

[Daventry]

I have a mare that was diagnosed with placentitis on Day 259. No dripping milk but her bag suddenly started to fill. She was immediately put on TMS, Pentoxofylline, Banamine and Regumate. She was gradually weaned off of Regumate and Banamine and had her last doses on Day 328. By Day 341, she was fully bagged up and my gut told me to stop the other medications and she foaled a healthy filly on Day 343. I will say that through the entire diagnosis, we were diligent with her medication and never missed any of her doses.

A great resource for placentitis is the EquineRepro group on Facebook. There are a lot of knowledgeable veterinarians and equine reproduction specialists on there. https://www.facebook.com/groups/EquineRepro/

[Dr_Doolittle]

I’ll weigh in here too with a success story.

My 14 year old maiden mare developed placentitis at around 260-270 (I don’t remember exactly) and started bagging up. Since I was getting conflicting advice (the Repro center where I was going to send her to foal out said “that’s her milk vein”), so it was a few days until I called the local repro vet who diagnosed placentitis and put her on Uniprim, Regumate, and Pentoxyfylline; she did an exam and said she had to “push my filly’s head back down” because she was already moving up the birth canal! Yikes. She said there was already “partial placental separation”, so worse than your mare.

Of course I was beside myself with worry.

My mare was at my boarding facility and on night turnout - my BM at the time had no repro experience, and during treatment I worried daily that my mare would foal prematurely in the field and my BM would find them I had trouble sleeping and lost weight (naturally my husband lost his job and my mother got colon cancer the same spring.)

The weeks went by and my mare responded to treatment; the repro vet came back out to check her and said she was “80% healed”!, Hallelujah! Since I didn’t want to take any more unnecessary chances, I trailered her to the Repro center a couple of weeks early so she could be monitored (Foalert was put in and they had a vet on-site), and drove an hour to see her every day, graze her, groom her, watch her stomach, etc.

She started looking pretty uncomfortable at about day 320 - the filly was bouncing around (she had always been very active in-utero - my poor mare), and the vet said it could be any day. You know how it is with maidens!

We were hoping she would hold on until day 325, and she did; delivered a healthy filly (now 7 1/2) who is the light of my life <3 She is not a big girl (finished at 15.2), but the mare is 15’3" and the sire (Escudo 2) was barely 16’0 - I WANTED a small horse since I am myself small, so it worked out perfectly. The mare is very healthy and is competing successfully.

A thought on placentitis: with older mares, the vulva is often a bit sunken, and it only takes one bacterium to infect the uterus. My mare had a partial Caslick done after foaling (she tore a bit), but if I had thought about it, I would have noticed that her vulva was a bit tipped and sunken and asked the vets whether a Caslick would have been a good idea way earlier in the pregnancy.

In any case, don’t despair! If treatment is started promptly there is a good chance she will heal and hold onto the foal until it is “fully cooked.”

Big jingles for you and your mare, and please keep us updated!! Fingers crossed.

[Ducati]

Thank you all for the stories. I appreciate it! Vet came and did a recheck yesterday and the placenta thickness had reduced by 50%, so I guess all the meds are doing their job! He said he was optimistic, which makes me inclined to move forward with cautious optimism as well. There is a small amount of separation near the cervical star, but not in other areas so that is encouraging as well.

[skydy]

Here is an interesting article; https://www.bloodhorse.com/horse-racing/articles/238351/nocardioform-placentitis-linked-to-rise-in-foal-deaths

Glad to hear your mare is improving. :yes:

[ElementFarm]

@Ducati, how’s your mare doing?

Mine looks like something’s brewing (at day 303 today) and she’s on SMZs, Regumate, and Banamine now, with an appointment first thing tomorrow morning. Right now just showing some udder development, but if there is any discharge, she’ll go to the University clinic and be seen immediately. Of course I’m worried, especially as this mare foaled a redbag, premature, dummy foal in 2016, likely due to undiagnosed placentitis. That filly is coming 4yo now, and just lovely, but it was a long ordeal and definitely don’t want to go through that again.

So, hopefully your mare is still doing well, and I appreciate everyone’s happy-ending stories. Keep 'em coming!

[Ducati]

@ElementFarm thanks for asking. She is at 276 days today and the vet has been coming bi-weekly to do transrectal ultrasounds to monitor the thickness of the placenta and the amount of separation. They also did a casilisk’s on her to prevent any more infection from getting in there, just as a precautionary measure. The last visit was on Monday and he said the placenta was almost back to the “normal” thickness, in other words, it was no longer inflamed. He said to keep her on the SMZs until today, when he is coming back to check yet again, and if everything still looks good then they are going to take her off the SMZs for a week and check again next Friday to make sure nothing is flaring back up. They are doing this because he says it is not good for her to be on SMZs in perpetuity unless it is absolutely necessary, because there are risks to her GI tract and her body in general. So that’s the plan as of now. One thing to note is that her udder is still bagged up and slightly dripping milk on and off. But I guess the fact that the placenta is no longer inflamed and the separation is not progressing any further is a good sign. That’s all I have to report at the moment! Thanks for your concern. How is your mare doing???

[ElementFarm]

@Ducati, that’s great news!

My mare seems fine. We took her up to the University clinic, and her placenta and bloodwork all look good. She’s heavily pregnant and this point, and they said it looks like she’s just going to go on the early side. She’s at 311 days today, and we’re monitoring closely and continuing regumate until Day 320 when we’ll start to slowly wean her off. The State vets weren’t too concerned, as long as she holds another 2 weeks or so. I’m crossing my fingers and toes, but for now, things seem to be okay…

[Wordplay1832]

We discovered placentitis in my 12yo maiden OTTB at just under 300 days. We took her to the clinic to pump her full of abx and hormones to try to clear it up and keep her pregnant until at least 320. She foaled a healthy filly at 322, and she’s now coming 5 and is wonderful.
It was huge peace of mind for me to have her at the clinic on cameras, the vet was there for delivery which luckily went smoothly. The placenta apparently looked pretty darn good, a little deterioration (if that’s the right phrase) from the infection but mostly normal.

[Ducati]

Ok today we are at 283. The inflammation on the placenta had cleared up on the ultrasounds so the vet wanted to take her off the SMZs last Monday and see if the infection remained at bay without them. (He said it would be preferable to not keep her on antibiotics for the remainder of her pregnancy because it could be bad for her GI). He came back today (Friday) to do a recheck and the infection/inflammation came back. I question why he took her off of them in the first place since we were trending in the right direction and everything was going well. But what do I know, Im not a vet. Anyways, they put her right back on the SMZs so hopefully that will continue to keep the infection at bay. She is also still on the regumate. She is still bagged up and dripping milk. She has been doing so for nearly 20 days now. This waiting game is so horrible, and there are no assurances as to the outcome of this whole ordeal. The vet did say that this is not a severe case of placentitis, as the combined thickness measurement of the placenta/uterus is anywhere between .7 and 1.4 cm. depending on where he measures, and there is not a ton of separation. But he is concerned about the dripping milk. @ElementFarm I hope your situation is going well. Thanks everybody for the positive stories!

[JB]

It would be a good idea at this point to find some tested frozen colostrum, and just use it as the first milk, not even waiting around to see if the mare’s milk is good enough, or that the foal will absorb enough antibodies. Many big hospitals have some stock, I got mine from New Bolton several years ago.

[ElementFarm]

@Ducati

Ok today we are at 283. . @ElementFarm I hope your situation is going well. Thanks everybody for the positive stories!

My mare is at 316 today and has been at the vet clinic (state university) for several days now. Last week she looked like she was about to foal, so they threw lots of drugs at her, and stopped the premature labor/prep. She is still dripping milk, but everything else looks improved. The one big concern though, and I’ll likely start another thread on this, is the fetal heart rate is very low, and has been all week (like 50 low). They say that keeping it inside mom, cooking, is the best thing at this point, but they are still worried about the heartrate.

We’re cautiously optimistic, since it looks like we may make it to 320, or at least closer to that milestone. Of course vets will provide frozen colostrum or plasma if it looks like mare’s dripping milk lost all her colostrum. And who knows if that low heartrate is a sign of some sort of problem with the fetus.

[Laurierace]

Best wishes for everyone involved! Glad she is in good hands, hope all goes well

[Ducati]

Update. My mare is at 296 days today, Monday will be day 300. She is still looking the exact same, no change from the original state of being bagged up and dripping milk on and off. The vet had a colleague come out to do a trans abdominal ultrasound to determine the foal’s activity level, size and heart rate. I was told the heart rate was normal and the foal is just ever so slightly small for this stage of development. I am thankful she is at such a great breeding facility where she is monitored 24/7! She will have to continue the SMZs and regumate for the duration of her pregnancy (since they tried to take her off of SMZs for a few days and it was a failed mission!) so we put her on Probiotics to help protect her GI.

[Ducati]

SAD UPDATE: My worst nightmare has come to fruition. My mare gave birth to a dead foal in the middle of the night 2 nights ago. She was at 303 days. She had a checkup on Monday and the foal was very much alive, and then on Wednesday night it was born dead. I am heartbroken and sickened by this entire experience. The vet said the placenta was badly infected in the horn that the foal was NOT occupying, which he said was strange. The area of the placenta near the cervix looked fine, so he is now thinking that this was not ascending placentitis as originally diagnosed, but rather some type of placentitis that was transmitted from within the mare’s bloodstream. The foal was born weighing less than 25 lbs and didn’t even take a breath- it was already dead. My mare, thankfully, seems to be doing just fine and is turned out with her friends already munching on hay. I am thankful for that. But waiting for basically a year for a foal that never comes is the most cruel heartbreak I have ever experienced. It all feels like a terrible waste.

[NancyM]

Yes, it is emotionally crushing to lose a foal like this. BTDT, all horse owners who breed any number of foals will experience this, it is balanced by the thrill of success which is the other option. And you never know which is going to be in your immediate future, as your mare starts to foal. I’ve bred and foaled out a fair number of mares over several decades, and it became a situation where I would dread the outcome, as I watched the water break on the barn camera screen, and got dressed and headed up there to see what would happen, what the immediate future was going to be.

I have experienced two cases of placentitis in mares, and neither ended well. Both were sets of twins, that went undetected, and one had died in there, and that was the cause of the infection. One situation was identical twins, there was only one placenta. One was born alive, basically a “live abortion”, I don’t know how as there was basically NO placenta left, but she could not be saved. The other was fraternal twins, one dead (the good one) and one alive (the “secondary” one) but septic, and with physical issues… but I saved her, because I am a sentimental fool. Still have her 14 years later, she is a pasture pet only. My vet tried to talk me into putting her down twice in the weeks after her birth, predicting her demise, but that is a tough decision to make when she is getting up and sucking, and nickering to me every day as I go in with her medications for months on end. So I kept on saying, “We can put her down tomorrow, for TODAY, she is OK and still wanting and trying to live.” And she did, such as she is.

The heartbreak of losing a foal like this is enough to discourage many from entering into the situation again. And sometimes vets simply can’t help the situation successfully, no matter how hard they try, and what measures are taken. But, I did rebreed the mare who lost the identical twins, and had success in future years, with live foals, and only one at a time. But the human carries the scars of going through these experiences.

Sending you sympathy today. It’s the part of breeding horses that we don’t want to experience. But it is always a possibility that a breeder is going to experience at some point. Loss. Your mare is OK, that is the “good” part of this. Could have been worse.

[Dr_Doolittle]

OP, I am SO sorry 😣😥

Big {{hugs}}, my heart goes out to you.

[skydy]

Oh, no. I’m so sorry. It’s a terrible thing to happen.

I am glad your mare is OK.

[EventerAJ]

It sounds like this may have been a case of nocardioform placentitis. It has been especially prevalent in central Ky this year, and may be correlated with the hot, dry summer last year. https://www.thoroughbreddailynews.com/foal-deaths-from-nocardioform-placentitis-spiking-in-kentucky/