What is your protocol after pinching a twin?

[JoZ]

I’m asking on behalf of a friend. Her mare was at 25 days when the twin was pinched – embryos were quite distant from one another and it was easy to isolate and pinch the smaller. Very little uterine disruption according to the vet. My friend is wondering about the recommendation to use Regumate for a week, a two-part question:
-Is it necessary?
-Is it OK to give Regumate for just a week? When same friend’s mare (different mare) lost an embryo and was rebred, she went on Regumate until something like Day 100. At that time friend was told that it was not advisable to use Regumate for less than 3 months or so. Friend might have misunderstood or I may have lost the gist in the game of telephone, but bottom line is that my friend is uncomfortable with the recommendation of using R. for a week.

Advice/ideas?

[Home_Again_Farm]

Regumate for a week to 10 days is standard after pinching a twin. We had to pinch a twin in 2003. My vet also gave the mare Banamine. He had me wean the mare off the Regumate after 10 days.

[RunningwaterWBs]

@Home Again Farm;6319624

Regumate for a week to 10 days is standard after pinching a twin. We had to pinch a twin in 2003. My vet also gave the mare Banamine. He had me wean the mare off the Regumate after 10 days.

Agreed. In 2010 I had a mare that twinned and was in the unique situation of going through IVF myself. No way was I risking contact with Regumate, so the vet pinched the twin and we hoped for the best. Got an awesome filly (and twins for me!) in 2011.

That said, I wouldn’t recommend going without it; Regumate is a great precaution to take and ten days worth doesn’t cost that much.

[Equine_Reproduction]

@JoZ;6319501

I’m asking on behalf of a friend. Her mare was at 25 days when the twin was pinched – embryos were quite distant from one another and it was easy to isolate and pinch the smaller. Very little uterine disruption according to the vet. My friend is wondering about the recommendation to use Regumate for a week, a two-part question:
-Is it necessary?

It depends :). When I pinch a twin, I like to have the mare on Banamine which is a prostaglandin inhibitor. If I can go in and easily pinch the twin without too much disruption or “trauma”, that’s all I will use. If I feel that there was more manipulation than usual, I’ll place the mare on altrenogest (we just give the biorelease shot of it that is available from BET Pharm - no muss no fuss) for a week.

-Is it OK to give Regumate for just a week?

Yes.

When same friend’s mare (different mare) lost an embryo and was rebred, she went on Regumate until something like Day 100. At that time friend was told that it was not advisable to use Regumate for less than 3 months or so. Friend might have misunderstood or I may have lost the gist in the game of telephone, but bottom line is that my friend is uncomfortable with the recommendation of using R. for a week.

Advice/ideas?

I think the problem is that many (most?) don’t understand what exactly the altrenogest/exogenous progesterone is doing. When pinching a twin, you cause the release of prostaglandin. Prostaglandin is what one uses to short cycle a mare and it works by lysing the corpus luteum. ANY time your mare suffers a trauma - leg injury, falls and hurts herself, runs through a barbed wire fence, pinching a twin, etc. - she will naturally release prostaglandin. However, how MUCH she releases is the unknown factor. During the early stages of pregnancy, those CL’s are responsible for early pregnancy maintenance. So, any time a mare suffers a traumatic injury, grab for the supplemental progesterone and prostaglandin inhibitors, until you make it through the initial pain/trauma.

With mares that just don’t produce enough progesterone naturally, people reach for supplementation. I think it would be surprising how few mares actually NEED it, but it has become the panacea of choice whenever a mare doesn’t settle or maintain a pregnancy. If indeed you are dealing with a mare that has low progesterone levels, you should be keeping her on the supplementation until day 120 to 150.

Hope that helps explain it a bit. Fly by postings this time of year and sometimes not the most complete responses. Good luck!

[clint]

Is it common to pinch at 25 days? Several years ago I had a mare twin, and at 16 days they were on top of each other, so no pinching and they wouldn’t manipulate either. By 25 days, they were at separate horns, but it wasn’t deemed wise to try and pinch one at that date because of the uterine disruption/stress.

[Home_Again_Farm]

Most vets try to pinch at 14-16 days, while they are still highly motile.

[rodawn]

[QUOTE=clint;6320231]
Is it common to pinch at 25 days? Several years ago I had a mare twin, and at 16 days they were on top of each other, so no pinching and they wouldn’t manipulate either. By 25 days, they were at separate horns, but it wasn’t deemed wise to try and pinch one at that date because of the uterine disruption/stress.[/QUOTE]

It’s far more stress on the mare to try to carry twins - usually resulting in mid-term abortion of the fetuses. And, as you know, if she happens to get past 320 days (minimum survival age of the fetuses), the risks to the mare are very high, let alone losing 1 or both of the twins. Delivery of one foal for the mare is fatiguing enough. It takes her beyond exhaustion to try to deliver the second one.

Pinching off at 14 days is ideal unless you can’t separate the 2 embryos and then waiting until they move apart from each other is the next best option - and at 25 days it is still fine, but as Kathy and others pointed out, the mare should be started on a course of Banamine and Regumate for at least a week.

[clint]

Rodawn, I’m well aware of the twin issue, and would never let a mare carry them. However, when this mare’s embryos moved apart at 20ish days, no vet seemed to think the pregnancy would survive the pinching. We actually waited until 100 days to reduce the pregnancy, which was an educational experience but unfortunately not successful and they were then aborted. It was also the last time I ever had a mare checked for a pregnancy after 15 days. Sixteen days is too late.

[Equine_Reproduction]

[QUOTE=clint;6320231]
Is it common to pinch at 25 days? Several years ago I had a mare twin, and at 16 days they were on top of each other, so no pinching and they wouldn’t manipulate either. By 25 days, they were at separate horns, but it wasn’t deemed wise to try and pinch one at that date because of the uterine disruption/stress.[/QUOTE]

No, it’s not common. As HAF noted, most try to pinch between 12 and 16 days. We start looking, ESPECIALLY if we know there’s been a double ovulation, at 12 days. That gives us time to try and reduce one while they are still vlery mobile. And, if they happen to be on top of each other, you can check the next day…or the next. Personally, rather than waiting until that late, I’ll attempt to reduce one at 15 or 16 days even if they are right on top of each other in the hopes I’m successful. Just did one like that last week and confirmed a heartbeat today :D! But, it’s going to be the personal preference of whoever the technician is doing the reduction!

Good luck!

[Aven]

That is very interesting to know about banamine. 8 or so years ago I bred an Irish tb mare to Amiral and ended up with two little black dots. The vet pinched at 18 days and sent us home. Stressful due to no lfg we had paid per dose. However came back the next week and there was one happy little black dot! The vet didn’t give us anything to give the mare.

[aab]

I am just curious, how much Banamine and for how long? Is it possible to give the biorelease shot the next day? The scenario being the vet comes in the afternoon to check and pinch, order shot for overnight delivery from BET, give the shot the next day on arrival. Would the Banamine given immediately be enough to hold the Prostaglandin production down for say 18 hours until the arrival of the biorelease shot?

Sorry JoZ, I don’t mean to hijack your thread. I am on the two week wait after a double ovulation.

[ElegantExpressionsFa]

[QUOTE=Home Again Farm;6319624]
Regumate for a week to 10 days is standard after pinching a twin. We had to pinch a twin in 2003. My vet also gave the mare Banamine. He had me wean the mare off the Regumate after 10 days.[/QUOTE]

This is what my vet had me do only in 2004

[europa]

This is making me nervous my Maiden in all likelihood will be having a twin pinched tomorrow.

Can anyone give a percentage of successful pinching to outcome of live healthy foal?

[rodawn]

[QUOTE=aab;6320972]
I am just curious, how much Banamine and for how long? Is it possible to give the biorelease shot the next day? The scenario being the vet comes in the afternoon to check and pinch, order shot for overnight delivery from BET, give the shot the next day on arrival. Would the Banamine given immediately be enough to hold the Prostaglandin production down for say 18 hours until the arrival of the biorelease shot?

Sorry JoZ, I don’t mean to hijack your thread. I am on the two week wait after a double ovulation.[/QUOTE]

It has to do with the weight of your mare for both drugs.

My mares average 1300-1400 pounds so they get 10 cc of Banamine (aka flunixin) and 12 mL of Regumate for 7 days and then the Regumate is weaned off, not cut off cold turkey, and your vet should supply you a dosage weaning schedule. Both can be fed in their feed.

There is a dosage chart here: http://www.regu-mate.com/label.asp

Label information for Banamine (flunixin). It is off-label use for the anti-prostaglandin properties. Label information:
http://intervetus.naccvp.com/?m=product_view&u=intervetus&p=intervetus&id=1047018

More information on prostaglandin effects versus banamine, although they do not specifically talk about prostaglandin effect on the uterus carrying a fetus, but the effects are similar as if you injected prostaglandin to induce a heat - if the presence of prostaglandin is heavy enough it will terminate the pregnancy and bring the mare back into heat (after the endometrial cups disappear post day 120-150):
http://www.banamine.com/research/prostaglandins.asp

THis last one is of particular interest and is in agreement with what Kathy stated above - any time your pregnant mare suffers an event - lameness, injury, illness, severe stress you should pop her on a course of banamine and Regumate for about 7-10 days and then wean off the Regumate.

Speaking from personal experience, I had a mare suffer a severe choke, following which she suffered a nasal hemorrhage from the endo tube nicking a tiny artery. The vet who attended her was a greenie not long out of college. He recommended Excenel antibiotics (liquid gold, that stuff) to ward off pneumonia, and 10 days of Banamine and we did that, but he neglected the course of Regumate and my mare lost her 150-day pregnancy. Who knows if the Regumate would have helped as her trauma was life-threatening and that in and of itself will threaten the pregnancy, but we’ll never know now. However, a friend’s mare had a mild, promptly-noticed bout of pregnancy-induced laminitis and they popped her on banamine and regumate and it nicked the laminitis pronto, and the pregnancy was saved.

[Home_Again_Farm]

@europa;6321705

This is making me nervous my Maiden in all likelihood will be having a twin pinched tomorrow.

Can anyone give a percentage of successful pinching to outcome of live healthy foal?

Europa, if the twin is pinched early, things usually go fine.

[Equine_Reproduction]

[QUOTE=europa;6321705]
This is making me nervous my Maiden in all likelihood will be having a twin pinched tomorrow.

Can anyone give a percentage of successful pinching to outcome of live healthy foal?[/QUOTE]

Done early enough and with a competent technician, VERY high. I probably am sitting at around 98%. Did 3 last week and all three are still in foal this week :).

So, I wouldn’t worry too much about it. Good luck!

[sfstable]

[QUOTE=europa;6321705]
This is making me nervous my Maiden in all likelihood will be having a twin pinched tomorrow.

Can anyone give a percentage of successful pinching to outcome of live healthy foal?[/QUOTE]

I have a mare that “twins” on almost every breeding. We haven’t lost one pregnancy to “pinching” yet. I think as Kathy said if done correctly that you have a great success rate.

[aab]

rodawn, thank you!

Very interesting to find out that any trauma triggers the release of Prostaglandin. I wish I had known… The same mare I referred to previously suffered a laceration to her eyelid which required stitches and numerous vet visits. She was 6-7 months pregnant at the time. Although she was given Banamine, my vet never suggested giving her the Regumate. Thankfully, she delivered a perfect filly the following April.

Thank you for making me wiser should something like this happen in the future.