# How reliable is a manual exam at 9 months gestation?



## Spyda (17 January 2009)

Also in NL.

I had my mare (who was due to foal, 31st March'ish) palpated a couple of days ago. Vet said the mare was 'very tight' but that she couldn't feel anything remotely rugby ball shaped.  She finished the exam with the conclusion that the mare was no longer in foal. 

*Can I safely assume that an about-9-months gestation foal is going to be too large to avoid being 'felt' during a manual exam. *

I posted a photo of the mare last week and most people concluded she did look in foal, although people at my end who see her think she looks small.  I'm left confused about what to think.

So, may I rely on the manual, performed by the vet, being reliable?

Many thanks.


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## rabatsa (17 January 2009)

I do not know the answer but a vet I know said a mare was not in foal and it foaled a week later and he said that another one was definately in foal as he had practically shaken its hoof when the mare had not been anywhere near a stallion. My RDA group ended up blood testing geldings to try and find a rig!!!! That is one vet I would not trust to PD a mare.


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## DunRoamin (17 January 2009)

we bought a new little mare into our yard and had the vet check her out as she was very fat and had quite swollen teats, he said she was not in foal nd was just stuggling to get back in shape from her previouse baby, wat do u know 3 weeks later out popped a lovely little colt! so we now no longer use him


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## Penniless (18 January 2009)

We got our vet out the other day to check on one of our broodmares who is due in March.  We suddenly realised over Christmas that she's not gaining weight and doesn't have any broodmare shape to her (this will be her 5th foal).  He looked at her and said that like us, he felt that she didn't look like being in foal.  He did a rectal and said although the uterus etc. felt as if she was pregnant, he couldn't feel anything at all.  He then stripped off his jacket so he could reach in further, and said that there was definitely a foal, albeit very small but it was wriggling around.  So don't just assume she's not in foal.


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## almorton (18 January 2009)

blood test. 
its the only way you will know! 
we just had a mare confirmed in foal today as i had an inkling something wasnt just right, even though everyone said i was being paranoid i had the vet out to take blood and guess what!
the blood test works on a hormone produced by the foal, so if the mare tests +ive she is in foal. about 50 quid i think but worth it for peace of mind!


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## AndyPandy (18 January 2009)

OK - *please* excuse the poor diagram, but I thought I'd put do one quickly and put it up, because a few people are having the same problem.

As the foal develops, the uterine position changes within the mare, and drops lower into the abdomen. 

On the diagram, the two distance markers, show the distance from the vets palpating hand, to the uterine horn. You'll see the distance on the right side (to the non-pregnant, or early pregnant uterine horn) is a good deal shorter than the distance to the 8-month pregnant uterus (the red dashed outline). So, for the vet to find the foal, they need a long arm, to be fairly experienced to be happy going that deep, and to be lucky enough to have the foal lying in a position where it can be easily identified.

Greygates is right, that an estrone sulphate blood test with provide clarification on the matter, so I'd definitely try to get one of those done!

Hope that helps - will try not to put too much more of my artwork up


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## Spyda (18 January 2009)

Wow, thank you SO much for that drawing.  Really helpful.  Even if my mare's not in foal that diagram will be really helpful for future reference.

*<u>Question I am left with is:</u> Can I assume the vet would have detected the uterus in it's normal not-pregnant position, though? Wouldn't that be a pointer to the mare not being in foal?*

Not sure how experienced the vet was who palpated her. Was another vet from the equine specialist practice I use. She was not 'in there' for very long feeling around and commented several times, "She's _really_ tight." She finished up by saying that she was expecting to feel a "rugby ball bouncing back" but that she couldn't feel anything.  She said the mare didn't look like she was in foal, as she wasn't particularly big. She told me to stop the Regumate immediately and that I could commence riding her again if I wanted. 

I am now kicking myself that I knew so little about it at the time. Just cannot fathom why the vet _herself _didn't recommend taking a blood test.  She's either very confident in her findings, or a complete novice at it.

Call out charges are jolly expensive and it makes me cross to think I am going to have to call up and arrange another flipping visit


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## AndyPandy (18 January 2009)

It's impossible to tell via the forum, I'm afraid. No matter how well you describe it, because we just don't know what the vet felt and how experienced she is... the "really tight" comment could be referring to your mares sphincter, or she could mean something else...

A wee foal test checks for the same hormone as the blood test, but one or both would be worth it, just to see what's going on!


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## Penniless (18 January 2009)

[ QUOTE ]
So, for the vet to find the foal, they need a long arm, to be fairly experienced to be happy going that deep, and to be lucky enough to have the foal lying in a position where it can be easily identified.


[/ QUOTE ]

Very well said and described Andy Pandy - you can now see why we were saying on our post that our vet had to remove his jacket to get length on his arm.  And as you said, it does need an experienced stud vet to know exactly what they are doing.


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## Faberge (18 January 2009)

Not sure if you saw my recent post about my mare, due in early June....

Vet came out and did manual exam on wednesday, said there was nothing there and uterus was shape he would expect to see from a mare that had just given birth - he even put the mare facing up a hill to try and increase the chances of feeling something. He is an equine reproduction specialist. He then came back with the scanner on Fri (because I asked him to, not because he thought it was particularly worth it) and showed me that she was empty and then after about 5mins of poking about he hit something hard and confirmed that she was actually in foal.... Moral of the story: Never trust a manual exam! If a scan is inconclusive or not possible go for blood tests. It is worth the money for the peace of mind.

Good luck with your girl. X


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## Spyda (19 January 2009)

<u>Update:</u>
I've just bought a twin pack of Wee Foal tests. Hoping they come later this week and put my mind at rest one way or another. Hope they come quick as she's reaching the 300 day limit for the test........  
	
	
		
		
	


	





PS: I'm 99% sure she's not in foal, but 99% hoping she is - if that makes sense! 

_"Plan for the worst, but hope for the best"._


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## CrazyMare (19 January 2009)

How big is your mare and how big is your vet?

Reason I ask is my vet is a strapping 6ft bloke. My mare is 13.1h. He won't manually examine her as he wouldn't be able to. He only scans her.

If its a little mare and big vet that might be part of your problem too.


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## Spyda (20 January 2009)

Mare is 15.1 and the vet was a woman, about 5ft 5in tall'ish.


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## Ladyfresha1 (20 January 2009)

I am also on the is she/isn't she fence. My vet did an ultrasound on my mare at 15 days and it was inconclusive, he said her Corpus Luteum was still large and he could not see anything. I was thinking maybe this was a good sign. He came back 4 days later and told me she was not in foal (he didn't seem to spend long looking). He then gave her a PG injection to bring her back into season (can't spell it). I decided not to cover her again in the end. 

She is now looking a little round in the belly, she has lost weight with being out in the winter from everywhere else but her belly is getting rounder. She is up to date on her worming and looks well. If she hadn't had the injection I would be thinking she was in foal. I am now wondering if I should have trusted my vet! I have changed to a different vet who has been recommended to me by a local breeder. 

Is it possible for a mare to hold on to a foal even though she had been given PG? She did not show any outward signs of coming back into season but she doesn't really tend to anyway.

I am going to have another look at her and see if there has been any further change. I will maybe buy a wee test as well. I am going to have a chat with my vet as well. Do you think I am just hoping for something that is not possible as she had PG?


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## Spyda (20 January 2009)

I am afraid I cannot help with the prostaglandin question. Hopefully someone else on here will have experience and be able to help you.  I'll watch with interest and keep my fingers crossed for you.


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## Ladyfresha1 (20 January 2009)

I am probably being silly! Maybe just hopeful thinking! I will take some pics at the weekend. She was covered 5 months ago.


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## Spyda (22 January 2009)

Well, I used the Wee Foal kit last night and she's definitely NOT IN FOAL.

Great test kit, I must say. Very easy to use and gave a really quick and easy to read result.

I'd thought getting the mare to pee might be the hardest part but I left her out a couple of hours longer yesterday evening and made sure I added a nice layer of clean fresh straw to her bed and low-and-behold, within 2 minutes of coming in she pee'd. I was there poised with my bucket, ready. Bingo. Easy peasy! 

*BTW *If anyone's looking for a Wee Foal test, I bought a double pack so have a spare one looking for a new home.  I certainly won't be needing it now


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## woostar (25 January 2009)

This one baffles me every time.

I work dealing almost exclusively with mares, and as a vet i become more and more confused and also annoyed.

If the vet who rectalled the mare was inexperienced then that is obviously an issue for you to take up with the practice. At this time of year i get asked maybe upto 6 or more times a week to check a mare as she "doesnt look in foal".

Ihave never resorted to a blood test,

as you rightly say above - IF THERE IS NO FOAL IN THERE THEN YOU SHOULD BE ABLE TO FEEL A NORMAL SIZED (ALBEIT SMALLER AND FLOPPIER) UTERUS.

The answer is YES YES YES YES

I put my arm in a mare i expect to find one of 4 things - 

1. a normal sized uterus - therefore not in foal (especially if your talking at this time of year)

2. a foal - can feel limbs etc therefore IN FOAL

3. no foal - but no uterus (i find this is most likely the case between 4 and 6-7months of gestation) as the uterus enlarges with the foal within it will eventually roll over the brim of the pelvis and down into the abdoman, this is when it cant be felt very easy ( as said above:


You'll see the distance on the right side (to the non-pregnant, or early pregnant uterine horn) is a good deal shorter than the distance to the 8-month pregnant uterus

I dont strictly agree with this as at 8 months id fully expect to feel a foal (unless I was examining a mare that was the size of a bus!)

4. a distended rugby ball uterus with or without a foetus palpable. IN FOAL

Either way, I would never resort unless in extreme (the mare that will kill you at all costs trying to get near her).

Im sorry you have had a bad experience. My suggestion would be get one of the more experienced vets to examine her, if it was indeed her being in experienced.

I do though have to take into consideration I am a studvet and hence am used to this, it can be hard, but as I said earlier a blood test is expensive and time consuming, a quick rectal  30 seconds, but just get someone experienced to do it.

PS I do see a lot on the forum of particular individuals getting hang ups and bad mouthing vets an awful lot ( no names mentioned) but i do believe that these small number of bad experiences do hence get generalised and this doesnt do anything for that particular vets confidence or vets reputation in general, this is obviously a scenario where the experience of the vet comes into question though.


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## Spyda (25 January 2009)

I appreciate your reply and opinion, but I have only bred this particular mare 3 times and TWICE (in two separate pregancies and using two different practices) have had vets cock-up a manual exam on her. First time she was palpated by a vet at rising 5 months gestation, and I was cheerily told a foot could be felt and the mare was 100% in foal. Four days later my stud vet visited the yard to administer the EHV jabs. He looked at this mare, asked to scan her and confirmed she was empty. *And * no she hadn't just lost the pregnancy either.   
	
	
		
		
	


	





I then called the first vet's practice to be told the vet I'd had out was newly qualified and had obviously made a mistake. The practice kindly offered to deduct the cost of the palp but expected me to _still_ pay their £36 CALL OUT FEE.  
	
	
		
		
	


	





I replied, "So, I am expected to pay £36 for the privilege of _your_ inexperienced vet visiting my yard to mis-confirm my mare as being in-foal?!" Not surprisingly I told them to take a running jump and haven't used that practice again - not because of the inexperience of the newly qualified vet (we all have to learn), but for the arrogant attitude of the Practice Manager who expected _me _to pay anything towards the waste of time visit. Duh?! Is it just me, or do some vet practices simply take the ****????

Gosh, don't me started on the subject of _poor old picked on vets_. I could happily regaile the numerous stories I have where vets have tried to pull a fast one.  Respect is due, only where respect is due. And, just sometimes, even a vet can fail to win respect through their actions. Okay, gripe over.

* creeps back under her stone to hide *


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## Dizzykizzy (25 January 2009)

I am with you Spyda, after my mare lost twins then a subsequent pregnancy, I was naturally very anxious. Vet confirmed she was in foal with a singleton which I asked her to repeat at least 3 times as I was so delighted.
Imagine how I felt when 9 months later she aborted twins again.........
And these were supposed to be good stud vets, I didn't get an apology even never mind a refund of my fees.
I know all vets are not so careless but sadly mistakes are made and heartbreak the result.


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## woostar (26 January 2009)

I couldnt agree more, youve obviously had some bad experiences. I suppose it all comes down to experience then. Who ever told you they could feel a foot was obviously not very experienced.

Yes very cheeky to ask for call out fee also, i would waver the entire thing.

I feel as though you have been taken the p**s out of yes, and as such i would recommend using only someone who has the experience in that relevant area.


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## woostar (26 January 2009)

Bad experience again. Again use someone who is known for reproductive work. Do though consider the possibility of monozygotic twins. 

I.e a single conceptus that has split into identical twins.

I had a mare do this last year and it wasnt until nearly 40 days that two were clearly visable as two sepearte entities.


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## JanetGeorge (26 January 2009)

[ QUOTE ]


I had a mare do this last year and it wasnt until nearly 40 days that two were clearly visable as two sepearte entities. 

[/ QUOTE ]

Interesting - monozygotic twins are quite rare in the equine though, aren't they?  Was the pregnancy terminated or were you able to deal with it - either with intervention or natural reduction?

I have half-a-dozen mares that twin with boring regularity.  Fortunately my vet is pretty adept at spotting them at the 14 day scan and pinching one successfully.  Two of these mares had daughters join the herd last year and BOTH of them twinned at first insemination - one successfully reduced to a singleton.  In the second filly, they were SO close together that best efforts resulted in them both being lost - then she twinned to second insemination but that WAS successfully reduced.

There is no doubt that there are a LOT of vets scanning who shouldn't be - at least not without more training.  But there are also SOME mares who can be 'difficult',  I have one old girl who I bought cheap as she was meant to be empty - she wasn't.  EVERY year she gives my vet trouble - she hides the damn things!!!  But I just have to remind the vet - this is Portia - and he keeps looking until he finds it!


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## woostar (26 January 2009)

Yes monozygotic twins are very rare. You cant manually reduce as they are simply in the same sac, popping it kills both. I had to abort the mare as she was very valauble and would never have run the risk. These two were super sneaky as were in the same sac but very very close i.e sat on each others backs.

I had 3 mares with it last year, but that more than likely is due to the sheer amount of mares i see (primarily do studwork and related things). but yer very very rare.

Some mares are prone yes. there is mares i see year after year (and dont necessarly force them to ovulate with drugs) and if they dont twin i get suspicious they have a cyst!


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## Dizzykizzy (26 January 2009)

My mare didn't have monozygotic twins either time as both times she had a colt and a filly.
We aren't breeding from her anymore in fact she has now gone back into ridden work and is doing very well notching up the rosettes. Not a happy ending for us but a good one for her.


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## cundlegreen (10 February 2009)

I've got a maiden mare who was very poor when covered. Got in foal 1st go, now due in April and just looks in reasonable condition.Every mare I have in foal, from 5mths on I feel under their tummy ( very good for maidens getting used to fiddling about!) and can soon feel movement if patient enough. This maiden got cast the other day and I was alittle concerned although she wasn't! Still getting some good "kicks" from inside, so I'm perfectly happy. Am I the only one who does this? I do feel manuals late on can be a bit of an intrusion especially if the mares a sensitive soul.


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## JanetGeorge (10 February 2009)

[ QUOTE ]
I've got a maiden mare who was very poor when covered. Got in foal 1st go, now due in April and just looks in reasonable condition.Every mare I have in foal, from 5mths on I feel under their tummy ( very good for maidens getting used to fiddling about!) and can soon feel movement if patient enough. 

[/ QUOTE ]

At anything less than about 9 months, if you feel movement, it's probably wind! 
	
	
		
		
	


	




  There's an awful lot of mare between your hand and the foal - to say nothing of the uterus, the bag and a LOT of fluid.  And a 6 month old foetus still has very soft bones that you'd struggle to feel a kick from if it was in your handbag.


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