Diagnostics Used
These are tests that might be helpful to make this diagnosis or further characterize the condition.
Diagnosis
Conditions or ailments that are the cause of a problem that you see - your observation.
Your vet may diagnose
Perineal Lacerations- Foaling and Breeding Injuries
Synonyms: Third Degree Perineal Lacerations, Recto-Vaginal Fistula Third-degree perineal tear; rectovestibular laceration; rectovaginal laceration; recto-vestibular fistula; cloacal formation
Summary
Summary
A third-degree perineal laceration is a severe foaling injury that occurs, in which the foal's foot or nose is driven through the roof of the reproductive tract (vestibule/vagina) and up through the rectum and anus, destroying the shelf of tissue that normally separates the rectum from the birth canal along with the perineal body between anus and vulva. The result is a single common opening (a cloaca), so manure falls directly into the vagina.
The injury destroys the rectovestibular shelf (the tissue partition separating the rectum above from the vestibule/vagina below) and the perineal body (the wedge of tissue between the anus and the dorsal commissure of the vulva). Loss of both structures merges the rectum and vestibule into a common cloaca. Distinguish from a first-degree tear (mucosa/skin of the dorsal vulva only) and a second-degree tear (perineal body involved but the rectum and anal sphincter intact).
This is almost always discovered right after foaling. What you observe is a torn, open perineum with the anus and vulva blended into one opening, and manure passing from the vulva. You would get your veterinarian involved immediately for the acute injury — early wound care and tetanus protection matter — but understand that the definitive repair is deliberately delayed. It is not stitched at the time of foaling.
Your vet manages the fresh wound, confirms tetanus status, and lets the tissues granulate and firm up over 3-8 weeks. Surgical reconstruction of the shelf and perineal body is scheduled once the tissue will hold suture, typically about a month or more after the injury. Until then the mare is kept on a diet that keeps her manure soft.
Uncommon, but a well-recognized foaling injury. Occurs disproportionately in maiden mares.
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Breeds_Affected
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Any breed. No breed predisposition; risk relates to foaling and perineal conformation rather than breed.
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Affected_Groups
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Foaling broodmares, especially maiden mares. Occurs at parturition.
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DiagnosisCategory
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Reproductive / Urogenital — Broodmare [confirm against your live category picklist]
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diagnosis_keywords
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third degree perineal laceration, perineal tear, rectovestibular laceration, rectovaginal laceration, rectovestibular fistula, cloaca, foaling injury, manure from vulva, perineal body, broodmare, dystocia injury, Goetz repair
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RELATIONSHIP GAP QUEUE (unresolved — needs real FM record ids)
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I cannot auto-link these because I do not have the full FileMaker table exports in this session. Map each to a REAL record id (or CREATE / DROP), then re-anchor. New records won't resolve in the live bot until a fresh knowledge-graph export is pulled.
Observations (I Might Observe):
- "Manure or feces passing from the vulva" -> [id?]
- "Tear or wound of the perineum / vulva after foaling" -> [id?]
- "Straining after foaling" -> [id?]
Diagnoses (differentials / related):
- "Second-Degree Perineal Laceration" -> [id?]
- "First-Degree Perineal Laceration" -> [id?]
- "Rectovaginal / Rectovestibular Fistula" -> [id? or same record]
- "Vaginal / Vestibular Laceration or Bruising" -> [id?]
Diagnostics:
- "Vaginal / Perineal Examination" -> [id?]
- "Rectal Examination" -> [id?]
- "Reproductive / Breeding Soundness Exam" -> [id?]
Treatments:
- "Surgical Repair of Third-Degree Perineal Laceration (one-stage / Goetz)" -> [id? likely CREATE]
- "Caudal Epidural Anesthesia" -> [id?]
- "Tetanus Toxoid / Antitoxin" -> [id?]
- "Caslick's Vulvoplasty" -> [id?]
- "Laxative / soft-manure diet management" -> [id?]
Topics/Resources: none linked outside HSVG (citation firewall — no external URLs embedded in this record).
A third-degree perineal laceration is a severe foaling injury that occurs, in which the foal's foot or nose is driven through the roof of the reproductive tract (vestibule/vagina) and up through the rectum and anus, destroying the shelf of tissue that normally separates the rectum from the birth canal along with the perineal body between anus and vulva. The result is a single common opening (a cloaca), so manure falls directly into the vagina.
The injury destroys the rectovestibular shelf (the tissue partition separating the rectum above from the vestibule/vagina below) and the perineal body (the wedge of tissue between the anus and the dorsal commissure of the vulva). Loss of both structures merges the rectum and vestibule into a common cloaca. Distinguish from a first-degree tear (mucosa/skin of the dorsal vulva only) and a second-degree tear (perineal body involved but the rectum and anal sphincter intact).
This is almost always discovered right after foaling. What you observe is a torn, open perineum with the anus and vulva blended into one opening, and manure passing from the vulva. You would get your veterinarian involved immediately for the acute injury — early wound care and tetanus protection matter — but understand that the definitive repair is deliberately delayed. It is not stitched at the time of foaling.
Your vet manages the fresh wound, confirms tetanus status, and lets the tissues granulate and firm up over 3-8 weeks. Surgical reconstruction of the shelf and perineal body is scheduled once the tissue will hold suture, typically about a month or more after the injury. Until then the mare is kept on a diet that keeps her manure soft.
Uncommon, but a well-recognized foaling injury. Occurs disproportionately in maiden mares.
=========================================================
Breeds_Affected
=========================================================
Any breed. No breed predisposition; risk relates to foaling and perineal conformation rather than breed.
=========================================================
Affected_Groups
=========================================================
Foaling broodmares, especially maiden mares. Occurs at parturition.
=========================================================
DiagnosisCategory
=========================================================
Reproductive / Urogenital — Broodmare [confirm against your live category picklist]
=========================================================
diagnosis_keywords
=========================================================
third degree perineal laceration, perineal tear, rectovestibular laceration, rectovaginal laceration, rectovestibular fistula, cloaca, foaling injury, manure from vulva, perineal body, broodmare, dystocia injury, Goetz repair
=========================================================
RELATIONSHIP GAP QUEUE (unresolved — needs real FM record ids)
=========================================================
I cannot auto-link these because I do not have the full FileMaker table exports in this session. Map each to a REAL record id (or CREATE / DROP), then re-anchor. New records won't resolve in the live bot until a fresh knowledge-graph export is pulled.
Observations (I Might Observe):
- "Manure or feces passing from the vulva" -> [id?]
- "Tear or wound of the perineum / vulva after foaling" -> [id?]
- "Straining after foaling" -> [id?]
Diagnoses (differentials / related):
- "Second-Degree Perineal Laceration" -> [id?]
- "First-Degree Perineal Laceration" -> [id?]
- "Rectovaginal / Rectovestibular Fistula" -> [id? or same record]
- "Vaginal / Vestibular Laceration or Bruising" -> [id?]
Diagnostics:
- "Vaginal / Perineal Examination" -> [id?]
- "Rectal Examination" -> [id?]
- "Reproductive / Breeding Soundness Exam" -> [id?]
Treatments:
- "Surgical Repair of Third-Degree Perineal Laceration (one-stage / Goetz)" -> [id? likely CREATE]
- "Caudal Epidural Anesthesia" -> [id?]
- "Tetanus Toxoid / Antitoxin" -> [id?]
- "Caslick's Vulvoplasty" -> [id?]
- "Laxative / soft-manure diet management" -> [id?]
Topics/Resources: none linked outside HSVG (citation firewall — no external URLs embedded in this record).
my vet's role
Treatments May Include
These treatments might be used to help resolve or improve this condition.
PROGNOSIS AND RELEVANT FACTORS
Prognosis for return to breeding soundness after one-stage surgical repair is good. Reported conception rates after repair run roughly 62 to 70 percent, and in one classic series 12 of 13 bred mares conceived with 9 carrying to term. Outcome depends most on the shelf healing completely without breaking down or forming a rectovestibular fistula.Factors that influence the result: timing of the repair (waiting until the tissue is fibrous and will hold suture), keeping the manure soft so the repair is not strained, control of vaginal and uterine contamination before rebreeding, and the surgeon's technique and closure.
The main thing that undoes a repair is fecal strain causing dehiscence, which is why post-operative diet management is central to success.
my role
I might observe
You might make these observations when a horse has this condition.
Skills I Might Need
I might need these skills if my horse has this diagnosis.
Questions To Ask Your Vet:
- Is this a second-degree or a full third-degree tear — was the rectum and anus involved?
Does she need surgery now, or do we wait for the tissue to heal first?
How long until you can do the repair, and what diet should she be on in the meantime?
Was the uterus contaminated, and does that need treating before we breed her again?
What is her realistic prognosis for carrying another foal?
Will she need a Caslick's or any other procedure at the same time?
Can this be done standing at our farm, or does she need to come to the hospital?
What is the cost of the procedure?-
Do you do it or will you need to refer me?
Prevention
Not reliably preventable — most tears happen suddenly during an otherwise normal delivery, more often in maiden mares. Attended foaling allows early recognition and prompt acute care. Mares with prior perineal injury or poor perineal conformation warrant closer monitoring at subsequent foalings.
Related References:
Colbern GT, Aanes WA, Stashak TS. Surgical management of perineal lacerations and rectovestibular fistulae in the mare: a retrospective study of 47 cases. J Am Vet Med Assoc. 1985 Feb 1;186(3):265-9.
Climent F1, Ribera T, Arg?elles D, Nomen C, Prades M. Modified technique for the repair of third-degree rectovaginal lacerations in mares. Vet Rec. 2009 Mar 28;164(13):393-6.