Prenatal Diagnosis of Megacystitis and Hydronephrosis in an Equine Fetus: How Transabdominal Ultrasonography Can Help to Diagnose Fetal Abnormalities

Premature udder development constitutes an alarm signal in pregnant mares. The objective of this clinical case report is to highlight the importance of transabdominal ultrasound examination of the fetus in these cases and to report a unique case of prenatal diagnosis of obstructive uropathy based on the observation of severe fetal hydronephrosis and megacystitis in utero. A 4-year-old French chaser primiparous mare was referred for evaluation of premature udder development during the ninth month of pregnancy. The mare had clinical signs within normal limits, a developed and sensitive udder with secretions, and no vulvar discharge. Transrectal examination revealed the presence of an immobile fetus. Combined uteroplacental thickness was within normal limits. Transabdominal ultrasound revealed a single live fetus in posterior presentation with several abdominal abnormalities. Unilateral hydronephrosis and megacystitis lead to a hypothetical diagnosis of fetal multiple urinary tract malformation with outflow obstruction. Treatment was discontinued and the mare was monitored. Abortion occurred spontaneously a week later. Postmortem examination revealed a ruptured bladder of abnormally large dimensions and a severely distended left kidney without parenchyma (filled with free urine) and lack of permeability in the left ureter and urethra. Postmortem diagnosis was consistent with our prenatal ultrasonographic diagnosis. Even though described during human pregnancy with various etiologies and severity, prenatal diagnosis of fetal hydronephrosis and megacystitis has not been reported in equine veterinary medicine before. These malformations need to be characterized more precisely in the future. This case highlights the importance of transabdominal ultrasonography to detect equine fetal abnormalities.

Fetal Death Associated With Premature Mammary Gland Development and Lactation in a Mare Treated With Weekly Injections of Long-Acting Progesterone

A 14-year-old, 530-kg, multiparous, pregnant Quarter Horse mare was referred for evaluation of premature mammary gland development and lactation. The mare was in the seventh month of gestation. The mare had a history of subfertility and was receiving weekly injections of long-acting progesterone, prescribed by the referring veterinarian. The last dose had been administered four days before presentation. Upon presentation, the mare had vital signs within normal limits, a moderately developed, nonpainful udder with galactorrhea, and no vulvar discharge. Transrectal palpation revealed a well-toned uterus and cervix and discreetly palpable fetal parts, however, ballottement of the fetus did not result in appreciable fetal movement. Transrectal ultrasound was unremarkable, but transabdominal ultrasound revealed one underdeveloped, immotile fetus in the left uterine horn with no heartbeat. Abortion was induced with repeated doses of cloprostenol. Fifty-four hours after the first cloprostenol injection, the mare displayed signs of labor, the cervix was manually dilated, and the fetus and fetal membranes were expelled with gentle manual manipulation. Standard postabortion care included uterine lavage and oxytocin for 48 hours before being discharged to the care of her owners. Fetal crown-rump length (53 cm) was consistent with a 6-month fetus rather than its gestational age of 7 months. The umbilical cord was edematous, and a distended, fluid-filled structure surrounded the cord at the intersection of the allantoic and amniotic segments of the umbilical cord. This structure was determined to be the severely dilated urachus. Microscopic findings included placental stromal mineralization, distended umbilicus adventitia, and dilated umbilical lymphatics with no other significant findings. Remaining abortion diagnostic tests were unremarkable. The mare recovered well and was discharged to the care of her owner two days after abortion. The following breeding season the mare carried a healthy foal to term.