Standing repair of uterine horn tears in mares (16 cases) following exteriorisation by flank laparotomy

Summary Background Full‐thickness uterine tears are an infrequent but life‐threatening postpartum complication in mares. With appropriate surgical and/or medical treatment, the reported prognosis for survival is good. However, a significant proportion of complications in mares treated surgically under general anaesthesia happen during the anaesthetic period. Objectives To describe repairing full‐thickness tears involving the tips of the uterine horn in 16 postpartum mares with the mares standing and sedated. Study Design Retrospective study. Methods Following diagnosis of a tear in the tip of the uterine horn by direct palpation per vaginum, and routine surgical preparation, a modified grid flank laparotomy was performed on the same side as the tear. The tip of the affected uterine horn was exteriorised and the tear was closed in two inverting layers using absorbable suture material. Following closure of the tear, the exposed uterine horn was replaced into the abdomen and the laparotomy incision was closed routinely. An abdominal drain was then placed in the ventral abdomen to facilitate postoperative abdominal lavage and drainage as part of the treatment of the secondary peritonitis. Results Uterine horn tears (eight left; eight right) were successfully repaired in 16/16 mares. The procedure was well tolerated by all mares. Fifteen mares survived to hospital discharge, and 13 have since conceived at least one pregnancy. Three mares developed incisional infections. The single nonsurvivor died from septic shock approximately 4 h following repair of the tear. Main Limitations Retrospective nature of study and small number of mares that met inclusion criteria. Conclusions Standing repair of tears involving the tip of the uterine horn, exteriorised through a flank laparotomy, can be safely performed in sedated mares with a favourable outcome.