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Rectal tears...

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  • Rectal tears...

    As I am still a bit peeved at the charges for a simple palpation (more then an U/S! ), I start thinking again about how I need to learn to do this myself.

    I started thinking... How frequently do you see rectal tears (my worst fear if I am to do the work myself) in an unsedated mare?

    My reasonning being, I suppose that if you proceed carefully, the mare should react to pain if you are about to tear the rectal wall?? Therefore, making you back off before the worst... No?

    Just wondering... I am NOT about to put on my gloves and proceed!
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  • #2
    They are the leading cause of professional liability claims against equine DVMs.
    That might just be one reason they're pricey.
    And no, the mare won't necessarily give any warning that you're about to cause damage.
    "It's like a Russian nesting doll of train wrecks."--CaitlinandTheBay

    ...just settin' on the Group W bench.

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    • #3
      Originally posted by Ghazzu View Post
      They are the leading cause of professional liability claims against equine DVMs.
      That might just be one reason they're pricey.
      And no, the mare won't necessarily give any warning that you're about to cause damage.
      Ditto this. There won't be a warning; probably the first sign will be blood on your glove when you remove your hand.
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      • #4
        When I took a basic repro course that the University of Guelph many years ago I remember one of the participants telling us that after the course she planned on buying an ultrasound machine so that she could do her own and save money (we had practiced on cadaver mare repro tracts a few times during this course)

        The course vet said "Thats a GREAT idea! And the money you save doing your own ultrasounds you can put aside for us to come up and repair the rectal tears you will cause"

        He then went on further to say about them being the leading reason for malpractice suits and how the fresh out of college student vets that have practiced doing them for many years were still very hesitant doing them out in the field

        This is one thing I dont begrudge paying a vet for. Never. Not at all ...
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        • #5
          The course vet said "Thats a GREAT idea! And the money you save doing your own ultrasounds you can put aside for us to come up and repair the rectal tears you will cause"
          And if the vet causes it you still have to pay for the repairs.
          Véronique
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          • #6
            rectal tears, and worse. Really, let the pros do their work, as you do yours.
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            • Original Poster

              #7
              Originally posted by Ghazzu View Post
              They are the leading cause of professional liability claims against equine DVMs.
              That might just be one reason they're pricey.
              And no, the mare won't necessarily give any warning that you're about to cause damage.
              I must add, so that I don't offend all vets here, that I am still peeved because in this particular case, I had asked for an U/S, vet opted that a palp would be best... Fine I said, but the bill was 50% more then anticipated! Sheesh. Probably double what most of you quote on here...

              But I disgress.

              I am very very very surprised that the mare wouldn't give any warning. You would think it would be painful...

              How are they repared?

              I understand it is a risky procedure, but at the same time, all vets are human and were ordinary folks at some point! I don't see why it would be so impossible for a "civilian" to learn the ins and outs of breeding work in a good training environment with the tutoring/coaching/follow-up of an experienced vet... No?
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              • #8
                I had a very nice broodmare die from a tear by an experience repro vet. He told me she tore, but didn't make a big deal about it. She went down 12 hours later and by that time, it was too late. I did not ask for compensation and he did not offer.

                After seeing this happen, I would NEVER do my own palps. If a very experienced repro vet can tear an experienced broodmare, my hands have no business being up there!!
                #JusticeForSunshine

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                • #9
                  Personally, I do NOT have the experience to do that myself or the wish to o so...however, my vet(s) have a separate release they make you sign when breeding your mare.......specifically exempting them from any liability from rectal tears.

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                  • #10
                    Originally posted by Ghazzu View Post
                    They are the leading cause of professional liability claims against equine DVMs.
                    That might just be one reason they're pricey.
                    And no, the mare won't necessarily give any warning that you're about to cause damage.
                    Small correction . It's the leading cause of professional liability claims against ALL vets, not just equine.

                    It takes at least 100 guided palpations before one can be considered even remotely competent at being able to identify what you are feeling. And, as others have noted, the mare rarely will give ANY indication that you have perforated.

                    I think one other thing that does need to be stated here is that often, vets don't KNOW what to do when they've perforated the rectum and getting the mare to an appropriate facility that can repair the tear is often problematic. Rectal tears are also one reason that we STRONGLY recommend going with a veterinarian or technician that is well experienced in the procedure. Most vets fresh out of school, unless they have done a rotation through equine reproduction just don't have the experience that I would be comfortable with having them palpate or ultrasound one of my mares. They typically fall far short of that 100 guided palpations. Not slamming vets, just stating facts - and most vets worth their salt will, if asked, admit that when they come out of school haven't had their hands in enough mares to be considered even remotely competent at palpating. Make sure you pick someone that "is" experienced.
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                    • #11
                      The thing with rectal tears is that the person palpating doesn't have to be rough or do anything wrong to have a tear occur. All it takes is a mare straining at the wrong time, or deciding to act up a bit while she is being palpated. Really the equine rectum is a relatively fragile thing. Although this isn't something that we've had to deal with (knock on wood), some vets feel if you do a lot of them that it is just a matter of time (and I pray that isn't true ).
                      All rectal tears should be considered a serious emergency, especially until the severity of the damage can be determined. Grade I and IIs can be medically managed, anything worse needs to be referred to a surgical facility. Here is a really good overview of the whole issue: http://www.merckvetmanual.com/mvm/in.../bc/160815.htm
                      Already excited about our 2016 foals! Expecting babies by Indoctro, Diamant de Semilly, Zirocco Blue and Calido!
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                      • #12
                        The horse we had that the vet did tear rectally was a gelding. He just shifted from one foot to the other, and that is what CAUSED the tear. Absolutely no reaction after, but the vet become suspicious as he could feel "too much".

                        In this case, he was a old boy, so not a surgical option, and we lost him a few hours later to a bleed out.

                        Just use the daily injections (P & E http://www.equine-reproduction.com/articles/pe.htm ), and timed insemination without a vet, and you will most likely get pregnancies that way on an easy mare.

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                        • #13
                          EM, what are you checking for? Your in foal mares should be palp'd at this point, no US for them now.
                          Or are you starting to breed already?
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                          • #14
                            Ive got several clients breeding already. This is the earliest I have EVER had to collect and ship semen

                            Some are local - some are in the warmer States. This is the pits trying to get everything safe and secure for the stallion to mount (outside phantom) and to keep the semen happy and warm as well until it gets processed ...

                            I will be starting to breed my own mares in a couple of weeks - once that warm stretch hits as it always does in March and they start to cycle like crazy ...
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                            • Original Poster

                              #15
                              Originally posted by imajacres View Post
                              EM, what are you checking for? Your in foal mares should be palp'd at this point, no US for them now.
                              Or are you starting to breed already?
                              Oh it was a while back to check before starting the rhino shots and what not.

                              No one to breed right now! They are both still in foal... Thank goodness!
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                              • #16
                                My dear Wallis suffered a rectal tear last year. This was a relatively young vet, but one that specialized in repro work. There was no warning and the mare did not react, she just noticed the blood on her sleeve when she removed her arm. Thankfully it was a low grade tear that did not require surgical intervention, but she was hospitalized for two weeks, missed two breeding cycles and cost me THOUSANDS of dollars. For this reason, I am just too chicken to think about doing my own ultrasounds.
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