The Poll Presentation

 D. E. Larsen, DVM

I was cleaning up at Robert’s place in Brownsville when his wife came out of the house at a trot.

“Doc, your office is on the phone and would like to talk with you,” Alice said. “We have an extension near the back door that you could use now without removing your boots.”

I headed around the house, and Alice with waiting at the back door with the phone receiver in her hand.

“Hello, what’s up?” I asked.

“Elaine is at a place just over the hill on Mountain Home Drive,” Ruth said. “She has a mare in labor, and there is a problem. She was hoping I could catch you. She would like you to stop by and give her a hand.”

When Elaine joined the practice, it gave me the opportunity to step aside from working with horses. Now, I am being pulled back in to help. 

“I know the place,” I said. “If she calls back, tell her I am done here and will head that way as soon as I clean up a bit. I should be there within fifteen minutes.”

“I don’t think she will call back,” Ruth said. “She sounded pretty exhausted, and I think she is having problems with this mare.”

I hurried, cleaned up, got everything in the truck, and headed to Mountain Home Drive.

Difficult deliveries in the mare were extremely rare and my worst nightmare. The contractions are so powerful the foal is usually delivered rapidly. Difficulties are hard to deal with because of those contractions. War stories abound. Veterinarians get their arm broken when it is between the foal and mare’s pelvis during a contraction. Stories of having to anesthetize the mare to make any manipulations of the foal’s position or placing a stomach tube into the trachea of the mare to reduce her ability to do an abdominal push. 

I had once asked a horse veterinarian how he handled difficult deliveries.

“I call one of you cow doctors,” he had replied. “You’re the ones who do all the delivery work. I see a problem once every five years.”

I could only imagine what Elaine was dealing with today, but I wasn’t looking forward to helping her.

Elaine was waiting outside the old garage by the edge of the driveway. I could see the mare down inside the old garage.

“What do you have going on?” I asked.

“She has been in labor since sometime during the night,” Elaine said. “I think she has just about had it. The foal is in a poll presentation, and its head and neck are stuffed into the birth canal so hard I can’t budge it. She strains so hard against my efforts to push the head back. I thought you might have a little more strength and be able to correct this presentation.”

“I would assume the foal is dead,” I said.

“I think so, but I don’t know how to be certain,” Elaine said.

“We should be able to reach an eye,” I said. “You stick a finger in his eye, and if he is alive, he will react to that with a contraction of the eyelids or something. You check that while I get my coveralls and boots.”

When I was ready and scrubbed up, I knelt beside Elaine behind the mare.

“There was no response when I stuck a finger in his eye. He is probably long dead,” Elaine said.

“Let me get in there and see if I can move this head,” I said, reaching my left arm into the mare’s vagina.

The foal’s front legs were in the birth canal in normal position, and the top of the head was the next thing I encountered. The bridge of the nose was impacted against the brim of the mare’s pelvis. I pushed with all strength on the foal’s head. The mare stained, and the head hardly moved.

“In the cow, I would push this head back alongside the calf, put the leg back into the uterus, and then pull the head back to normal position. It would be simple to get the leg back up to normal position and deliver the calf. But I can budge this foal’s head.”

“What do you think? Should we sedate the mare and try?” Elaine asked.

“When we have a dead fetus, my training says we make decisions that are easiest for the mother,” I said. “I think we should cut the head off.”

“I know you do fetotomies all the time on cattle, but I have been told they are dangerous in the mare,” Elaine said.

“The concern in the mare is the exposed sharp bone lacerating the birth canal,” I said. “I can cut the head off with a fetatome and cover the exposed bone with my hand. She will spit this foal out with one or two contractions.”

Elaine took a deep breath. “Okay, let’s get it done,” she said.

While Elaine was putting the fetatome together, I threaded a length of OB wire between the foal’s head and neck. This would cinch down and make a clean cut right at the base of the skull. We threaded the wire into the fetatome, and we were ready to go.

“I will hold the fetatome in position, and you work the saw,” I said. “When the cut is complete, I will pull the head out and then place my hand over the exposed neck bone. That will be a rapid move because once that head is out, this old gal will be pushing.”

I placed the head of the fetatome against the side of the foal’s head and had Elaine take up the slack in the OB wire. I double-checked the position of the wire.

“Okay, let’s go, long, slow strokes to start, then pick up the speed,” I said. “This will be an easy cut. You will be done before you know it.”

Elaine started the saw, and the wire sliced through the foal’s neck in a half dozen strokes.

I grabbed the head by an ear and pulled it out of the mare, immediately putting my hand back in to cover the exposed bone of the foal’s neck.

The mare made a strong contraction, pushing the foal into the birth canal. The exposed bone popped out of the vulva. I grabbed the foal’s legs and gave a tug, and the mare pushed again. The rest of the colt was out, followed by all the membranes.

“Wow! That was some fast action,” Elaine said. 

We stood up, and the mare rolled up onto her sternum, and then she stood up. She turned to look at the foal but Jose, the owner was already pulling it out of the garage.

“What do you think we should do for her now?” Elaine asked. 

“I will put some antibiotic powder in her uterus and check for any damage to the birth canal,” I said. “I think giving her some IV antibiotics, maybe a dose of dexamethasone and oxytocin, would be a good idea. Whatever you think.”

I placed five grams of tetracycline powder into the mare’s uterus and did a thorough exam of the uterus, vagina, and vulva. There were no birthing injuries. This mare should be in good shape for breeding in the future.

“Okay, Elaine, you finish up here, and I will run back to the office and get things caught up there,” I said. “I think this gal is fine and should have no problems, but I would suggest some antibiotics for a few days at least.”

I was thinking of how good it felt not to deal with the mare and the owner following the delivery. People always feel like they are on the losing end of things when the foal doesn’t survive. They don’t understand how close they were to lose the mare also.

This mare did well following the delivery and lived to have at least a couple of foals in the future with no problems.

Photo by Faris Hamza on Pexels.