What is Recto-vaginal Fistula ?
A recto-vaginal fistula is a hole or opening within the wall that exists between the mare’s rectum and vagina. The condition can be seen as a congenital anomaly, though it is most often due to an accidental break at the time of a foal being delivered.
When a mare is giving birth, the feet of the foal typically come through the birth canal first. In some deliveries one of the feet of the foal can rip through the top of the mare’s vagina and into the rectum. Should the foot not be able to be pulled back into the mare’s vagina before it is delivered, a hole will be left. This condition is not uncommon among mares delivering their first foal.
A hole or opening within the wall between the rectum and vagina of a mare is called a recto-vaginal fistula and is typically the result of an accidental break during the delivery of a foal.
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Symptoms of Recto-vaginal Fistula in Horses
Should your horse experience a recto-vaginal fistula, you may notice the following:
- Fecal matter in her urine
While a recto-vaginal fistula can be seen as a congenital abnormality, it is typically the result of an accident during the birthing process, where one of the feet of the foal being delivered rip through the mare’s vagina and into the rectum. When the foot of the foal is unable to get put back into the vagina of the mare, the next push that occurs can lead to a hole being created.
A recto-vaginal fistula is considered a third-degree perineal laceration and includes damage to the rectal mucosa. A first degree perineal laceration includes just the skin and mucosa of the vagina. In second-degree perineal lacerations the following are involved:
- Vestibular mucosa and submucosa
- Dorsal commissure of the vulva
- Perineal body musculature
Causes of Recto-vaginal Fistula in Horses
Some horses may be born with a recto-vaginal fistula and depending on the horse’s condition, it may or may not be able to be corrected.
When a recto-vaginal fistula occurs during the birthing process, it is usually due to a foot of the foal causing the tear. The fistula may also be a result of the manual manipulation that occurs when someone is helping the horse give birth and in some cases is the result of the mare’s efforts to deliver their foal.
Diagnosis of Recto-vaginal Fistula in Horses
Should your mare give birth without veterinary assistance and you notice that there appears to have been an issue upon the foal’s delivery, you will want to contact your veterinarian. A recto-vaginal fistula should be evident upon an examination of your horse. Your veterinarian may want to restrain or sedate your mare for a rectal examination. During your visit, your veterinarian may ask you for details regarding the delivery of the foal and whether you have noticed any symptoms in your mare since she gave birth to her foal.
Treatment of Recto-vaginal Fistula in Horses
Should your mare have a recto-vaginal fistula, it will likely be treated by surgery. This will fix the tear and restore normal function in your mare. Obtaining treatment is very important as fecal contamination in the vagina can lead to significant danger for your mare. It is likely that your veterinarian will recommend that your mare take antibiotics in order to reduce the possibility of infection as a result of the fecal-vaginal contamination.
Depending upon the condition of your mare, your veterinarian will decide the best surgical techniques for her situation. While some veterinarians recommend immediate surgery, typically, surgery will not take place for about eight weeks after the injury has occurred. During this time the swelling your mare is experiencing will decrease, leading to a better outcome.
Recovery of Recto-vaginal Fistula in Horses
It is important that you follow the recommendations of your veterinarian regarding the treatment for your mare. Make sure to administer antibiotics as prescribed and attend follow up appointments as recommended. Should your horse undergo surgery for the condition, you will want to follow the directions that your veterinarian provides you for her aftercare (including rest and follow-up) in order to ensure the best possible outcome for her.
In order to prevent your mare experiencing a recto-vaginal fistula, you will want to be sure that experienced care is available for your horse during a difficult delivery. In some cases, a trained and experienced professional may be able to shift the foal or stop its foot from creating a hole.