# Retained Placentas



## luckilotti (11 June 2012)

What a night!  

sorry for long post but i thought i would give you a lot of the details so hopefully if you have any advice it will help etc. 

i had my 1st mare of 2012 foal at midnight, she foaled stood up and didnt cleanse.  Baby had to be helped to his feet (after about 90min), he couldnt latch on at all so we striped some milk off and gave him a bottle to make sure he had some.  I phoned the vets and explained i needed an emergency call out.  I was told an approx time (which is much longer than ususal) but i thought they maybe were busy so all i could do was wait.  They were quite a bit longer than the said but a vet arrived.  The vet checked my mares heart, then temperature.  She had a shot of painkillers, antibiotics and oxytocin.  The vet had a bit of a tug about etc but it wasnt for shifting, if anything it came out by approx 2-3" more than previously - at this point it had been retained for 7 hours.  I was left a couple of syringes with more oxytocin in to give 45 min apart, i was told if it hadnt come away 30 min after the last jab, they would come back and try and flush her to get it to seperate etc.  Well, it never came away, i spoke with the vets and they said they would call me back with when a vet could get back to me.  30 minutes past so i called them to see where we were upto.... i was told the vet would be with me an hour later (this would have been 11 and a half hours it would have been retained for!!).  I went in the box with them rather stressed at this point as time was ticking.  i decided to give her a little walk and yay - she cleansed!   
I called the vets to tell the, and they just said good we will cancel the vet.  Nothing more was said/asked.

Now, i have checked the placenta - all present and correct, no holes, no bits missing.  It is very similar in colour and texture to previous placentas i've checked.  

But.... 10.5 hours is a long time for it to have been in her - do i need to be watching for anything else which could indicate problems?  the vets were very casual about it and clearly not that worried but i am not dumb and to me - it being retained was and issue for that length of time. 

any thoughts?  

thanks,


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## hayinamanger (11 June 2012)

I don't want to worry you, but that is a long time.  I would be happier if she were washed out and given some abx.  I would ring the surgery and ask to speak to one of the equine team, if no one is in, insist that someone rings you straight back.

I hope all is well.


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## Tillyfilly (11 June 2012)

Tilly retained her placenta, vet gave her 2 jabs, oxytocin 1 at 1 hour and one at 5 hours with something for the toxins n anti bs. Still retained 12 hrs later so intravenus and it eventually came away. On 5 day course of anti bs n to look out for pus / bad smelling fluid. This was last Sat n she's been fine touch wood. Would have flush n infusion into womb if not. Check mare regularly, i'd want some anti toxin and anti bs to be sure though.


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## Beans1 (11 June 2012)

I had one retain, vet removed manually after about 6 hours I think, then mare was washed out by vet daily for next 3 days and given 5 days of IM antibiotics, may have been over kill but I just thought better safe than sorry.  Hope that helps


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## jj1966 (11 June 2012)

I had one retain for 24 hours last year, it came away in you hands (rotting) when we eventaully got it all out, vet was marvelous he was with us morning noon and night flushing. After lots of antibiotics everything was fine and mare given the thumbs up but it was stressfull to say the least, but friesians are prone to this, so it wasnt a total shock apart from the length of time it took.
It goes with the territory with breeding foals I am afraid.


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## Toast (11 June 2012)

I'd give the vets a ring and possibly ask for some antibiotics.


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## koeffee (11 June 2012)

I have a mare who retains most years!!!! my vets are fabulous, first time, we hit 6hrs and a few oxcytocin jabs and he fished it out and she was washed out and given antibiotics, last time new vet, again early hours there within half hour, several jabs, came back a couple of hours later again went in and fished, i wouldnt be happy with the service you got i must admit, i pay thousands with vets each yr. i like to get my monies worth!!!


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## HBM1 (11 June 2012)

My mare retained her placenta on Saturday even after the vet gave an initial oxytocin an hour after birth.  She still didn't cleanse for 7 more hours but with another dose of oxytocin and a lot of help from the vet it all passed.  She then had a flush of four litres of fluids, followed by antibiotics flushed in and left.  She also had painkillers.  this was by now Sunday morning.  

this was followed up today with another four litres flushed in, plus more antibiotics left in. 

Tomorrow we will do the same.

also as well as this she has had antibiotics morning and night mixed in with her feeds.

I am very happy with my vet's response and my mare has shown  no ill effects, thank god, and is very happy.  she is also going out for an hour for a move about, even though the weather is dire for June!  

I think your vet's response is lacking and even if my vet is doing a bit of overkill, and I don't think he is as I don't think you can  mess with it, then I would rather have mine do as he is doing than yours I'm afraid.

I hope the mare is ok, but I would be insisting on flushing and antibiotics.  My vet said toxic laminitis can come on incredibly quickly and your mare could still have poisons in her as the placenta will have started to die off by then, and they then cause septicaemia.

edited to add he also gave her a jab which helps to bind the toxins, but I can't remember what it is called - begins with a p!


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## air78 (12 June 2012)

I find this thread very interesting, as I, myself, had a retained placenta after the birth of my daughter (sorry if TMI).

The placenta retained for about 8 hours before being removed. On removal it came away cleanly and was in a healthy condition. I received no further medical intervention, antibiotics or 'flushing' etc and had no further problems.

I am really raising a point about the over prescribing of antibiotics and routine treatment etc. is it always necessary for the vet to flush and prescribe drugs etc?and as an owner howdo we know if the vet is being over zealous in their treatment?


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## jj1966 (12 June 2012)

I dont think a vet can ever be over zealous in treating this situation, it is extremely serious in a mare, septicaemia, severe laminitis and even death can be a result of this problem, does anyone want to take that risk on their mare!


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## HBM1 (12 June 2012)

jj1966 said:



			I dont think a vet can ever be over zealous in treating this situation, it is extremely serious in a mare, septicaemia, severe laminitis and even death can be a result of this problem, does anyone want to take that risk on their mare!
		
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100% agree with this.  In my mare's case, some of it was already brown, though the main piece was pink.  The toxins ooze out fairly quickly and if not removed and dealt with make their way into the bloodstream.  My vet said he once saw a mare actually "walk out of her hoof" her toxic laminitis was so bad.  There is also extensive research/reports regarding septicaemia and death in human mothers too.


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## Dry Rot (12 June 2012)

We are foaling here now (only 3, 2 to go) and have had retained placentas in the past so it is a concern. I have the standard veterinary text book here and just looked up what one of the author's has to say, "Although many clinicians recommend flushing the uterus of a mare that has had septic or toxic metritis or manually removing the placenta, I am opposed to both practices". He goes on to explain that that can lead to more problems.

I had a mare with a retained placenta a couple of years ago and the vet who attended is a professor, an ex-vet college lecturer, who works part time for the local equine vets. He explained the exact same thing. The mare cleansed perfectly given oxytocin and time, which is what both he and the book recommend. 

Personally, I would always rely on my vet to do his job, judge him by the results, and sack him if he fails too often.


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## luckilotti (12 June 2012)

Thanks for all of the replies. 
i had a manic night with my 2 other mares foaling one after the other - you do foal watch for weeks then they are likes buses and all come at once!

There is a different vet due on the yard this week so i am going to be quizing them.  I am really really not happy with the attitude of the vets - i dont use this practice anymore for breeding related things as i lost faith a few years ago in them however, the fantastic vets i use for the reproductive side cant cover me for emergencies as i am far too far away for them (apart from the time to get to me, if they then had a call at the opposite end of their area they cover, it wouldnt be far as it would take hours to get to them which i totally understand).  

My mare thankfully seems ok so far.  The placenta looked 'normal' as such when i checked it, no signs of it going bad but what if i had been a new breeder and didnt know what a placenta should be like - shape etc?  There is no discharge as i keep checking her.  We have a vet out on the yard on Thursday so if she continues as she is now, i am going to ask them to flush her out anyway incase there is a bit of something in there still festering away. 

i think i am going to write quite a long letter to the practice as i feel after different issues over the years, maybe the senior partners really need to know how locals are feeling about them, especially an older long term customer who has been with them 20 years or so, who used them back when they were a smaller practice you could rely on rather than the massive practice it is now, whereby you get any vet (now normally just out of vet school - i know they all have to start somewhere but when its your horses... you like an experienced opinion!)


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## flintfootfilly (12 June 2012)

I don't usually post on this board.  I tend to get too engrossed with what's on the veterinary board to spend time elsewhere!

But I saw the title of this post, and thought I'd add my comments.

I've bred 3 foals, and each time the mare retained her placenta.  On the first two occasions, the vets chose to remove the placenta manually at around 3 hours (from memory).  The last time they gave an oxytocin shot, and then a second one, and the placenta came away a few hours later.

I thought no more about it, because I'd been told that retained placentas were more common in ponies/cobs than in sports horse types, and I suppose I just guessed that it must be down to conformation.

However, recently I've been trying to get to the bottom of muscle problems in all 6 of my ponies, and this has led me to read up a lot on muscle problems, and selenium in particular in relation to this.

Although I could not find many papers about the influence of selenium deficiency on retained placentas in horses, there was one paper on how selenium supplementation affected the retention of placentas in draft horse mares:

http://www.j-evs.com/article/S0737-0806(02)70036-1/abstract

and it is widely accepted that retained placenta is associated with selenium deficiency in other species including cattle.

A forage analysis has revealed that my gang receive only about a third of the recommended amount of selenium in their daily ration, and so along with other things that are suggestive of a selenium deficiency I am now ensuring that I feed a balancer with 1mg selenium (as yeast) per day to each 500kg pony (NRC's recommended daily intake level).  I've also chosen to supplement at a higher level short term to redress the deficiency more quickly, but I'm having to be careful with that to avoid toxic levels.

Anyway, just thought I'd throw this in to the discussion, but if I ever have retained placentas again, my first port of call would be to check dietary selenium intake, and possibly whole blood glutathione peroxidase (GSH-px) as an indicator of selenium.  However, my belief is that the current reference range for GSH-px is too low to pick up chronic selenium deficiencies, so for example all 6 of my ponies come within the "normal" range, despite them starting to respond to higher level selenium supplementation in their diet (measured in terms of their tolerance to work).

Oh, there was one paper about Friesian mares and retained placentas, which didn't find a difference in GSH-px levels between those who retained placentas and those who didn't.  But for me, there seems to be enough stuff out there about other species for me to be in no doubt that selenium deficiency can increase the chance of retained placentas (and also increase the time it take for foals to first stand).  And at the other end of the scale there's the worry of white muscle disease in severely deficient foals.

Sarah


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## JanetGeorge (12 June 2012)

My very good vet is part of a mixed practice and some of the vets you get on emergency cal out aren't much good with mares.  My vet supplies me with Oxytocin for emergency use - and has instructed me in how to remove a placenta safely if the Oxytocin doesn't do the trick.  But I would be furious at the casual approach of the OP's vet to the aftermath of a retained placenta - my vet's attitude is that 4 hours is the MAXIMUM delay - after that you need to throw the book at them - flush out and antibiotics!


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## JEZA (13 June 2012)

Dear OP (and air78)
Ive had quite a few mares foal. A few years ago special cob mare had a long awaited foal and retained her placenta. 
Called vet, very sensible youngish lad from Australia. Said in outback, not easy to get vet for this, so regularly (say 4 times a day) feed the mare. He said as long as she was fine, eating well and foal well, dont worry. I rang the stud who had the stallion, they said the same. 

The mare proved them both right. On the 2nd day post foaling!!! she passed the placenta.

I personally wouldnt rush into all the "flushing", but then maybe I was lucky. We would never have caught our mare anyway. She was usually very friendly, but went shy for about a week after foaling.


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## JanetGeorge (13 June 2012)

JEZA said:



			Dear OP (and air78)


I personally wouldnt rush into all the "flushing", but then maybe I was lucky.
		
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You were very lucky - and so was the mare!


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## rachi0 (13 June 2012)

I foal down over 150 mares a year - we would have approximately 5-8 mares retain their placenta for more than the 'recommended time'.

We no longer give oxytocin after 2 hours of foaling... just because of the risk of haemorrhage so close to foaling.. 

If everything is looking good with the mare.. we would add a small amount of extra weight to the placenta that is hanging out her back end..
we will give oxytocin after 5 hours if the mares Heart rate, colour and temp are all ok. and that would be 0.5-1ml I/M or I/V. Mares temp would be take every 3-4 hours.. (we are lucky and have people with the mares 24hrs) the mare would be given some pain relief. If she still hadn't cleansed after 8 hours.. she would be give Penicillin (i/m) and Gentamycin (i/v). she would be given oxytocin every 2 hours.. by this point the vet would have seen the mare... (vet starts at 6.30am)... but for example if the mare foaled at 6pm.. retained the placenta she still wouldn't be looked at until 6.30am unless there was a problem.. we have given a covering shot of antibiotics.. she is being monitored regularly.. 

she would be flushed once - twice a day for 3 days depending on how the vet thought she was flushing... 

- our mares foal outside.. so a little walk or run around is also good for getting the natural oxytocin going in the mare... (i'm not saying lunge your mare that has just given birth) - most mares will actually do this by chasing after their new baby that has just found its legs.. 

The longest I've had a mare retain a piece of placenta for is 3 days.. - a temp vet said the piece wasn't in there although i clearly thought a piece was missing (mare had trodden on placenta after foaling so it was rather shredded).. i took the mares temp regularly over those 3 days.. and on the 3rd day in the afternoon her temp spiked to 39.7c having been 38c approx 4 hours previously... she started to look foot sore.. called out regular vet.. he flushed a good size disgusting piece of placenta out of her.. she was already being covered with antibiotics ... next day she was fine - was flushed twice a day for 3 days....


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## Holly831 (13 June 2012)

air78 said:



			I find this thread very interesting, as I, myself, had a retained placenta after the birth of my daughter (sorry if TMI).

The placenta retained for about 8 hours before being removed. On removal it came away cleanly and was in a healthy condition. I received no further medical intervention, antibiotics or 'flushing' etc and had no further problems.

I am really raising a point about the over prescribing of antibiotics and routine treatment etc. is it always necessary for the vet to flush and prescribe drugs etc?and as an owner howdo we know if the vet is being over zealous in their treatment?
		
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I have a mare who always retains hers so I have Oxytocin here ready for her.
In a horse the placenta starts to break down as soon as the foal is delivered (if you have ever smelt/touched one that has been retained for 12 hours you will know what I mean!) This is not the case in humans.

This year my Ellie's foal was malpresented & huge and despite vets attendance (stud vet) we didn't manage to save the foal and mare was in a poor state. She retained for around 5 hours despite Oxytocin. When it came away it was complete but had started to breakdown. 

On day 3 post delivery I woke up to a very sick mare - endotoxic laminitis. The initial prognosis was very poor (less than 5% chance of survival) but with expert care & intensive treatment (vet & farrier) we pulled her through. Nearly 3 months later she is still not fully recovered but we are hopeful she will get there.

My advice to anyone would be to ask for an iodine flush, further Oxytocin & a course of antibiotics as a minimum. I looked back at my camera footage the night Ellie became ill and she looked fine at 4.30am, she then laid down. I went to feed her at 7.00am and she was a complete mess - that's how quickly it can take hold! Vet believes she is only still with us because we got to her so quickly (vet was here by 7.15am) and started flushing, giving IV & inter uterine AB's + Oxytocin + anti inflammatories which we continued for 5 days.

I believe it is worth the expense etc to at least flush out post retained placenta and although I too believe AB's are over prescribed it is one of the few times I think they should be given if the placenta has started to break down.


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## jj1966 (13 June 2012)

Holly 831

Last year I had to pick up placenta that was over 24 hours old when it finally dropped, it was disgusting! It fell apart in my hands (gloved of course) it was rotting quite badly, I cant desribe the smell! 
my heart went out to my mare for having to deal with this stuck inside her for such a time, but it wouldnt move no matter how much manipulation by vet.  She retained nearly 90 percent for this period only a small amount that was straggly was cut away so she wouldnt stand on it and tear the rest, tried to tie a knot but it kept falling out so cutting was the only option.

This mare experienced this before 9 years ago before I had her and was very ill due to it, but has produced foals with no complications since, so that is twice in 15 years, its a risk we take breeding but I would go to any lenght to make sure my mares have the best care when foaling.


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## elijahasgal (13 June 2012)

Four years ago my mare retained her placenta. She was taken into the vets after 36hours, (which we had consistently been giving her oxitocin) to find that she had lost it during the night (I had turned her out to wander and relax in a field totally away from anything else)  But they still flushed her out for the next 2 days, and she was on the borders of being really ill. Now I foal her out (she drops her foal reliably before I bring her in  ) and bring her and her foal in when it is on its feet, and she has had alone time to feel safe enough to go down and roll and release it.  I believe for her that alone relax time is essential


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## luckilotti (15 June 2012)

Thanks for the further replies. 

Well, a different vet came out today from the same practice - they wouldnt do ANYTHING with my mare (she didnt actually even go to her stable!)
I was told they wouldnt be able to flush her out now a few days after foaling.... and even if they could, it wouldnt make any difference. 
i was told 10.5 hours isnt long and that it would all be ok as she had the jabs at about 7 hours of it being retained so it would be ok.
It's times like these i wish i could just move my place closer to a vets who seem interested!   :-(


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## eventrider23 (15 June 2012)

luckilotti said:



			Thanks for the further replies. 

Well, a different vet came out today from the same practice - they wouldnt do ANYTHING with my mare (she didnt actually even go to her stable!)
I was told they wouldnt be able to flush her out now a few days after foaling.... and even if they could, it wouldnt make any difference. 
i was told 10.5 hours isnt long and that it would all be ok as she had the jabs at about 7 hours of it being retained so it would be ok.
It's times like these i wish i could just move my place closer to a vets who seem interested!   :-(
		
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That is ridiculous - if you call a vet out for something, barring it being not a good thing or harmful for them to do then especially as it is you paying them then they should do it!!!!  You can wash a mare out at anytime to remove toxins, etc - after all look at mares being AI'd - if they seem to have a dirty uterus it is flushed out before anything else is done!


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## s4sugar (15 June 2012)

My mare stood on the cord at her last foaling. When she hadn't cleansed after an hour I phoned the vet and was told to drive over & pick up Oxytocin and a course of antibiotics. 
She got the Oxytocin about two hours after foaling and a second shot after another three hours. 

Seven hours after foaling she was manually cleansed and this was the result;-







No problems afterwards and no flushing as everything came out cleanly and with no visible rotting.


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## luckilotti (15 June 2012)

eventrider23 said:



			You can wash a mare out at anytime to remove toxins, etc - after all look at mares being AI'd - if they seem to have a dirty uterus it is flushed out before anything else is done!
		
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This was my arguement - so then i was told that it wouldnt make a scrap of difference lushing her out as if something was going to start - it would start anyway....
She had obviously looked at the file from earlier in the week but got the time frames confused - thought the vet was there 1.5/2 hours earlier then they were (they must have put the time i called them rather than when they actually got there).

I am now wondering if i would be better using a non equine specialist vets in the area, at least that way if i say i need x. y and z doing - they may just go with it? 

Thankfully - my mare is still looking ok but i'd rather make sure for definate rather than risk any horse.


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## Hornby (15 June 2012)

Tried to PM you, lucky, but messages are full


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## rachi0 (16 June 2012)

Keep taking your mares temp ( twice a day for at least a week) watch out for hot / sore feet.... Have u been given oxytocin? I would be jabbing my mares 3 times a day. My cutoff temp is38.5c.if the mares temp hits that its an emergency and vet will need to flush asap


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## flintfootfilly (3 September 2013)

I realise this is an old thread, but thought I'd just update the comments I originally put in a reply last year.

I have bred 3 foals.  Each of the 3 mares retained her placenta, and needed the vet to visit and induce its release.  My ponies are Dales ponies - however, other Dales breeders that I know have not had the same number of retained placentas as me.  The vet who attended one pony said they see retained placentas more commonly in pony types than finer types, so I assumed it must be something conformational..... at that time!

Fast forward a few years, and I discover that it is widely accepted that dietary selenium deficiency can cause retained placenta in cattle and sheep.  It is less widely known in horses, but I came across 2 papers which demonstrated this.

I now have 5 ponies who all show raised muscle enzymes and work intolerance.  After lots of tests and reading, I believe it's down to a long term selenium deficiency in their diet.  These ponies are unable to do a normal day's work.  One pony ground to a halt 49 times whilst being led round from another pony at a walk for an hour.  Others grind to a halt from trot.  One couldn't sustain canter for more than a few strides before grinding to a halt.  Symptoms very similar to EPSM/PSSM.

Forage analysis on grass/hay/haylage is so easy these days.  Selenium of less than 0.1mg/kg dry matter is deficient.  My levels were 0.04 - 0.05mg/kg DM, a level associated with muscle disease in a wide variety of species worldwide.

In trying to address this by giving a good balancer or vit/min supplement.  10 months on one containing only inorganic selenium (sodium selenite) did not bring about a sustained improvement.  2 months on organic selenium (Selplex, or selenium yeast) brought about a significant improvement in muscle enzyme levels in the blood of all ponies 4 to 5 months after I gave the organic selenium.  I switched to organic selenium again nearly 4 months ago, and the most recent blood tests have again shown an improvement.

So for me, I would give a good balancer with around 1mg of organic selenium in a daily ration (For a 500kg pony).  My favoured balancers at the moment are Blue Chip and Dengie Alfa A balancer for this reason.

Hope you don't mind me posting this rather sobering thread, but I'd hate someone else to go through all the c**p that I've had to endure for the sake of a simple forage analysis and/or a daily balancer.

Interestingly, looking back at the original post in this thread, it took the foal about 90 minutes to stand (significantly longer than it normally takes a foal to stand).  My "foal" who is now 8 years old, and is the worst affected with muscle problems (CK, main muscle enzyme, chronically raised at around 3,000-3,800u/l, reference range up to 225) also took 90 minutes to stand.  My other 2 more normal foals stood in around 20-30 minutes.

Sarah


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## luckilotti (22 September 2013)

Thanks for reply Sarah, I haven't been on here for a long time. 

The same mare foaled the colts full brother this year, she foaled perfectly and passed the placenta very quickly this time.  

Sadly, the colt referred to in my OP from last year, we tragically lost on the 9th September due to a twisted gut   I have never ever lost a youngster and well, I am devastated, he really had something about him.  I am just so glad I was with him as he was PTS, we have no idea what caused it, all the vet could suggest was as a youngster, that he may have been running around, bucking etc overnight and that was the result    Maybe he wasn't ever meant to make it past his birth?  I'm still at that stage that I want to give up, although I know deep down that will never happen but I am just so gutted


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## Capriole (22 September 2013)

That's awful, Luckilotti. So hard when you lose a foal. We had one PTS a couple of years ago and it really knocked my OH for six, the cherry on top of one of the worst years ever. Seems such a waste of a life and all that promise. Don't give up though


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