Parturient fever can hardly be considered without reference to those maladies which are its precursors, the chief of which are known as metritis, and divided by pathologists into endo-metritis, as affecting or beginning with the internal surface of the womb, and metro-peritonitis, where first the womb is affected by inflammation, which is subsequently shared by the peritoneal membrane investing it. Any difficulties connected with delivery of the foetus which result in injury to the uterus of the mare may lead to parturient fever, as the result of absorption of septic organisms. Although injuries to the uterus exciting inflammation are mentioned above as the chief, they are not the sole causes, as the entrance into the blood-stream from any other point, as from the vagina, or possibly some muscular injury not immediately associated with the generative system, may have the like ill consequence of infecting the patient at a time when she is peculiarly susceptible to invasion.

Symptoms

It is not always possible to distinguish at first between metritis and parturient fever and to say at what time septic influences commence, as both are accompanied with suddenly increased temperature; neither is the intensity of the febrile symptoms a particular guide, for metritis and septic poisoning alike vary in degree, and may be severe and fatal or mild and transient.

Uterine inflammation or parturient fever may supervene at an early period, commonly between the second and eighth day after parturition; but much later periods are on record in mares, these animals differing from other domesticated species in the greater length of time after which septic troubles may commence. All may for a time have gone well with the mare, lactation be satisfactory, the maternal instinct fully exercised, and no apparent reason exist for apprehension, yet a sudden and severe rigor may appear accompanied by a rise of two or more degrees of temperature in a few hours. Then follows dulness, loss of appetite, a small, hard, quick pulse, suppression of milk, reduction in the size of the mammary gland, indicating a grave condition and shortly to be followed by shallow breathing, a hot and pasty state of the mouth, deep redness of the membranes of the eyes and nose with coldness or variability of the ears and extremities. Abdominal pain, simulating colic, with its better-known symptoms of striking at the belly, looking round at the flanks, stamping the feet, getting up and down, whisking the tail, accompanied with expulsive efforts similar to those known as "after-pains", which all animals involuntarily make in ridding themselves of the placental membranes. Pain, too, is apparent in the hind limbs, taking the form of cramp and a lameness that is paralytic in character. Where parturient fever exists apart from metritic inflammation there is a greater disposition to seek a recumbent posture, the latter being found too painful when an inflamed uterus receives pressure from the abdomen resting on the ground.

Where parturient fever is a sequel to metritis there will be swelling of the vulva and a discharge from the vagina varying in character from a thin serous fluid of pale straw colour to a purplish or chocolate hue. While this is a common symptom it is not necessarily present in those cases where infection has taken place at some other part than the womb. Where fever is accompanied with metritis there is arching of the back in addition to a persistent maintenance of the standing posture, which is only relinquished at the approach of death. With metro-peritonitis there is invariably more or less effusion of serous fluid into the abdominal cavity. If abundant, the movement of fluid is perceptible when hands are placed on opposite sides of the flank and alternately and suddenly compressed.

Three or four, at the most five or six, days will witness the termination of the malady in death in a large percentage of cases, but there has been a notable reduction in the fatality of the disease, as arising from inflammation of the uterus, since efficient irrigation of the organ with modern antiseptics has been more generally practised.

From the foregoing remarks it may be gathered that prognosis is usually unfavourable; the more so that the disease is seldom early enough recognized and professional assistance sought.