34th Annual Scientific Meeting proceedings

Objectives:

Bladder eversion, which is the displacement through the urethra, can occur as a result of increased abdominal pressure and excessive straining. This phenomenon is possible due to the mare’s short and wide urethra.

Case Description:

An 8-year-old Standardbred broodmare was presented for dystocia. Ultrasonographic examination confirmed that the foetus was not alive. The mare had frequent and strong uterine contractions. Foetal membranes and a protruding organ were observed through the patient’s vulva. The protruding bladder contained a firm structure that made manual repositioning unsuccessful, and ultrasonography suggested the presence of intestine. As a result, an exploratory laparotomy was performed, which revealed that the small intestine was trapped as it passed through the urethra and into the space created by the everted bladder. The small intestine was repositioned, and no resection was required. The dead foal was delivered through C-section. The mare recovered uneventfully from general anaesthesia. Post-operative care included intravenous fluid therapy, lidocaine continuous rate infusion, opioid analgesia, antimicrobials, NSAIDs, oxytocin, epidural anaesthesia, phenazopyridine, urinary catheter placement and bladder lavage.

Outcome

Postoperative complications included retained foetal membranes, postoperative ileus, cystitis, and incisional oedema. The mare was discharged 10 days after surgery and no additional complications were reported on follow-up. 

Conclusions:

To our knowledge, this is the first documented case of bladder eversion and small intestinal entrapment. A thorough assessment is essential to avoid a mistaken diagnosis of premature placental separation. When addressed promptly and following intensive care, these cases can have a satisfactory outcome.