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Dan C., DVM
Dan C., DVM, Horse Veterinarian
Category: Horse
Satisfied Customers: 1174
Experience:  Solo Equine Practitioner/Mobile Practice Owner for 16 years.
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I have a TBX mare aged 22yrs and have just found out

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Hello I have a TBX mare aged 22yrs and have just found out that about 10yrs ago (well before I had her) she had a marble inserted into her womb and this is still insittue. She has developed pydrometra and recently had colic signs, my vet agave her injections which helped but he is saying it must come out. My worry is that if it has been there for that amount of time what would you do if it is embedded into her womb
Submitted: 11 months ago.
Category: Horse
Customer: replied 11 months ago.
(Posted by JustAnswer at customer's request) Hello. I would like to request the following Expert Service(s) from you: Live Phone Call. Let me know if you need more information, or send me the service offer(s) so we can proceed.
Customer: replied 11 months ago.
I need to know asap please or i wish to cancel
Expert:  Dan C., DVM replied 11 months ago.
Greetings, and thanks for the question. My apologies for the long delay. I’ve been out all day and just got in to see your question. I’m somewhat surprised that another Equine Veterinarian didn’t get to you sooner. I hope I’m not too late.Sorry to hear about your mare’s unfortunate condition. The marble could indeed be the cause of the pyometra, but the condition can also develop for other reasons, especially in older mares, such as perineal conformation, which creates the condition for bacteria to enter into the vagina more easily. Whatever the case, it does need to be treated! I do have a few questions for you so that I may give you a thorough answer.1): Is there pus visually coming out of the vulva region?2): Did your Vet flush her uterus with any type of solution?3): Did your Vet perform an ultrasound, by chance, of her uterus and vagina?4): How long has the condition been present?5): Do you know if she has been running a high fever?To answer your specific question; there is a good chance that the marble has become embedded in the lining of the uterus. If this is the case (a manual exam should be able to determine this), she would most likely require a surgery to remove her uterus, depending on where the marble might be lodged. If it is in an ovary, then the procedure could be done standing, with the mare sedated. The procedure for removing an ovary takes about 15 minutes, and is very safe if done properly. If the marble is indeed in the uterine lining, a more extensive surgery would be required. It would require full anesthesia, and the uterus would have to be removed via an incision into her abdomen. This would be costly, and also somewhat of a risk due to her age, and recovery would most likely be rather long and difficult. It would best be performed at a University Teaching hospital. So either via ultrasound or manual exam, it definitely needs to be known where the marble is, and if it is embedded.Again, I do hope I’ve replied in time, and I’ll be looking for your reply.Sincerely,-Dan C., DVM
Customer: replied 11 months ago.
she had a scan done in March and the vet at the time told me because of her age i have 2 choices 1 leave her alone or 2 go the full hog to remove it but no guarantee it would not break and rupture the womb as they did not know what it was made of, so i choose to leave her alone and not put her through the ordeal. Now she has had colic like symptoms he is saying it has to come out or she needs to be put to sleep. She has been well in herself all this time and this only happened after she was stabled do to bad weather. She was put out on lone as a companion/light hack( 1-2 times a week) but i found out she was being ridden daily against my wishes. Yes she is loosing discharge and has done since i had her (May 2014) and her previous owner who had her for 8 years and was not aware of the marble she thought she was just a flirty girl. Her vagina is open and he was originally going to do a claslick stitch but said there would be no point as she would keep opening it up.
Customer: replied 11 months ago.
No no flushes , yes internal scan , no fever
Expert:  Dan C., DVM replied 11 months ago.
Thanks for your reply:A tough situation and decision(s), indeed. .. Has the marble ever been located? It would be a difficult surgery and recovery for her, but it sounds as if you’re being put between a rock and a hard place, so to speak. Has she ever been treated via flushing? I have treated difficult pyometra cases where I would leave a certain type of catheter called a Foley Catheter, which can be left in the uterus to assist with drainage, as well as flushing the uterus manually with sterile saline repeatedly until it flushes clear. This normally is repeated for several treatments. I’ll then follow the flushings with infusing the uterus with antibiotic. If her condition hasn’t been treated in this manner, it would be worth a try…it certainly wouldn’t hurt. Otherwise, it seems as if your only options are the aforementioned ones. And perhaps a long-shot: if the marble could be manually located and removed trans-vaginally, meaning basically to perform the surgery standing under sedation. It certainly wouldn’t be without risk, however, as there could be a good chance of accidentally perforating the uterus, which would create an almost fatal scenario. I would most likely put that into the hands of a very skilled surgeon, as it would literally be a blind surgery. In summary, if she were my patient, I would attempt the flushing/lavage treatment initially. If that was not successful and the marble couldn’t be located then you as her owner would have to make the decision as to attempt the surgery with all of the known risks, or have her put to sleep. I’ve never come across this type of scenario previously, and I can sympathize with your position. I do hope that I was able to be of some help in making the situation a bit clearer. Please let me know if you have any further questions, and also, please let me know how everything turns out for her. I’ll be thinking of the both of you.All the best,-Dan.
Customer: replied 11 months ago.
Thank you for being very helpful but I feel I could not put her through having it removed at her age as I do believe with it having been in there for so long it must be embedded because a lot of mares I know have passed them out themselves. He originally said to me that giving her antibiotics would be a waste of time and if I left her as long as she continues to pass discharge she would be ok its when she stops I could just find her dead. I feel that he just saw the marble and determined that was the reason for the discharge with out considering other options. I only took her in because my friend fell ill and no one else would take her and she is a lovely horse.
Customer: replied 11 months ago.
R u saying she can have the flushes even if the marble does not come out because he told me that once he started it would have to continue till the marble was removed.
Expert:  Dan C., DVM replied 11 months ago.
I would say that, yes, she can still be lavaged. I would attempt a manual uterine exam initially to attempt to locate the marble’s position. Personally, I don’t see the reasoning that she would have to be flushed until the marble comes out. If the marble is well-encased, that may not even be the cause of the pyometra. I, for one, attempt to find the cause of a disease, that way I know the best method of treatment.However, she is not my patient and there may be other details that I’m not aware of that your Vet is. I would also think that putting in a Caslick’s would make the condition worse, as it would inhibit drainage, possibly causing a rupture. But again, that’s my professional opinion and your Vet may have a good reason that I’m not aware of. Have you considered a second opinion? Or perhaps having her seen at a Teaching Hospital?But based on the information you have given me, again, I see no reason not to flush her. It’s only allowing the condition to worsen, and giving shots externally will not correct the condition. Second opinions can sometimes be of a great help, and a good Vet should welcome them.Thanks again,-Dan.
Expert:  Dan C., DVM replied 11 months ago.
Good Afternoon:Just checking to see if you had any further questions. I know there are some tough decisions that you’ll have to make, please let me know if I can be of any more help.All the best,-Dan.
Customer: replied 10 months ago.
Thank you I have decided to find another vet who will be willing to flush but not insist on removing the marble if it does not move. I guess you are well away from Norfolk England

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