Multiple Cesarean Section Jenny

Abstract Background: Jenny dystocia occurs very rarely and is mainly associated with postural defects due to long fetal extremities. However, the management of dystocia in equines is relatively difficult compared to that in other large animals. Due to the absence of well-described published papers on cesarean section in donkeys, this condition can be life-threatening after unsuccessful surgical intervention. Patient presentation: A 4-year-old Jenny with a difficult birth due to a previous car accident presented for 3 consecutive years at different stages of labor onset. Up on early presentation, there was straining and frequent aggressive rolling. Further examination also revealed a fully dilated cervix and narrow pelvic cavity due to the downward bending of the iliac wing. Surgical sites (lower flank, ventral midline, and paramedian) were used for each delivery. General anesthesia was used in all three procedures, and local infiltration of 2% lidocaine along with light general anesthesia was used at the time she presented with a live fetus. Surgical sites aseptically prepared for cesarean section and dead fetuses were removed at the 1st and 3rd parity due to delayed presentation. However, on the 2nd parity, a live female foal was delivered. In all the approaches, the 1st layer of uterine closure was made by using a simple continuous suture pattern (biting all the layers of the uterine wall). Then, the sutures were oversewed with a Cushing suture pattern using #0 polyglycolic acid (PGA). The skin was closed by different suture patterns during each technique using nonabsorbable suture material # 1 silk. Postoperative subcutaneous swelling was observed and regressed gradually in all the approaches. The duration of skin suture removal was determined based on the extent of wound healing and the site of the incision. Conclusion: This is the first ever-identified surgical case in a donkey. Thus, this study was able to indicate different approaches for cesarean section in equines. Moreover, due to the bleeding nature of the equine uterus, simple continuous suturing was the pattern of choice for 1st layer uterine closure. It was also concluded that subcutaneous edema is unavoidable in donkeys.