Reproduction BSE

sihirlifil's version from 2018-04-01 15:45


Question Answer
First step of BSEIdentification!
Pertinent Hx questionsAge
Past use (hormone admin w/ athletes)
Reproductive status: maiden, barren, foaling
Live or AI (fresh or frozen?)
Previous pregnancies & outcome
Past abortion/twinning/dystocia/EED
Complications (RP, metritis)
Management conditions
What do you look for on PE?Discharge, vulvar conformation
"Windsucker" test
Integrity of barriers
What's the ideal vulvar conformation? labia?Perpendicular to ground with >2/3 of vulva below the ischium
Labia should form a good seal & close completely
How do you do the "windsucker" test? why do you do it?Part vulvar labia, listen for inrush of air
Tests integrigy of vaginal vestibular sphincter (old/thin mares more prone to pneumovagina)
What are the 3 barriers to contamination of the repro tract?vaginal vestibular sphincter, labia, cervix
After the PE, what's the next step?Rectal exam
Main risk of performing a rectal?Tears! Grad 3 & 4 require tx: 3 = Broad spectrum antibx, tetanus, anti-inflam, stool softening, anti-peristaltics, pack with gauze. 4 = Sx or euth
(Rectal) What information does the cervix give?Reflects presence of P4
If P4 high (preg/diestrus): long, firm, tubular
Low P4 (estrus/anestrus): soft, flatter, shorter
(Rectal) How do you examine the uterus?Always check for pregnancy first! Estimate size & tone of uterine horns (tone follows cervix)
Examine for contents (preg, fluid) & consistency
(Rectal) How does the uterus feel during estrus? Diestrus? anestrus?Estrus: softer, less tone
Diestrus: Increased tone, more tubular feel
Anestrus: thin, flaccid, difficult to palpate
(Rectal) After the uterus, what do you palpate?Ovaries
Evaluate size, activity, structures present & their size & softness
(Rectal) What can you feel on the ovaries?Follicles (incr in size, softer near ovulation)
Corpora hemorrhagica (depression immediately after ovulation)
Why is rectal ultrasound such an important tool?Immature CL can be differentiated from a follicle
CL & anovulatory follicles can be ID'd
Granulosa cell tumors can be differentiated from hematomas
Uterine size can be measured, contents ID'd, evaluate character
Recognize & classify uterine edema
(US) Which parameters predict time of ovulation?Increase in follicular size
Change in shape (Develop pear-shaped apperance, walls appear less smooth)
Echogenicity of antrum: hyperechoic particls in antrum close to ovulation
(US) What is this?
(US) How does the CL look?Within 12-24h: fills in, hyperechoic
Can have homogenous echotexture or trabecular, changes as CL matures
(US) How does the uterus look in anestrus?Thin & elliptical, homogenous echotexture
(US) How does the uterus look in estrus?Orange slice/wagon wheel (edema in endometrial folds)
(US) How does the uterus look in diestrus?Edema absent, uterus is round, homogenous
(US) Detectable uterine problems?Excessive edema, fluid in lumen during estrus before breeding, retention of fluid after breeding, fluid during diestrus
If you see this in the uterus 12-24h after breeding, what should you do?
Start therapy to improve uterine clearance
What's going on?
Endometrial cysts (role in infertility controversial)
(US) Why important for pregnancy?Diagnosis, manage twin pregnancy, early notice of uterine infection, allows mare time to rearrange re-breeding if not pregnant
After the PE and rectal exam & US, next step?Vaginoscopy
(Vaginoscopy) What stage is this?
Pink (estrogen enhances blood supply), edematous, relaxed, moist
(Vaginoscopy) What stage is this?
Pale, dry, closed
(Vaginoscopy) Looks how during pregnancy? anestrus?Preg: pale, tight, closed, covered with sticky blue-gray mucus
Anestrus: very pale, flaccid, may be open
(Vaginoscopy) Abormal findings?Pneumovagina
Urine pooling
Vaginitis, cervicitis
Adhesions, scars, lacerations, exudates
(Vaginoscopy) Problem?
Urine pooling
(Vaginoscopy) Problem?
Vaginal adhesion
Which diagnostic procedures are done (after vaginoscopy)Culture & cytology
Uterine biopsy
Best time to perform culture & cytologyLate estrus
Which swab is needed for culture & cytology?Guarded (alternative: low vol flush)
A POSITIVE culture with NEGATIVE cytology =Contamination
A POSITIVE culture with POSITIVE cytology =Isolation of a pathogen --> perform sensitivity
A NEGATIVE culture with POSITIVE cytology =Non-infectious inflammation, or problem with sample handling
Results of this cytology?
Endometritis (>1 neutrophil per HPF on 40x mag)
How is an endometrial biopsy performed?Pass biopsy instrument manually through cervix, pull hand out and place it in the rectum, push a fold of endometrium into the jaws, close the jaws, and tear out biopsy sample
When is endometrial biopsy indicated?Prepurchase exam
Barren mares
Mares requiring repro sx
What's happening in this biopsy sample?
Fibrosis around glands (eval if scattered, widespread, frequent, occasional, number of layers)
Biopsy grading: I =Essentially normal, expected foaling rate 80-90%
Biopsy grading: IIA =Mild changes, expected foaling rate 50-80%
Biopsy grading: IIB =Moderate changes, expected foaling rate 10-50%
Biopsy grading: III =severe changes, expected foaling rate 10%