Therio- Infertility in Mares 2

drraythe's version from 2016-04-29 14:36

IS having normal cycles

Question Answer
IS having normal cycles, IS maintaining preg past 35d... consider what possible 4 probs?(1) Periglandular fibrosis (2) Cervical lacerations (3) Luteal insufficiency (4) “old egg” syndrome
Periglandular Fibrosis--> hx: age usu affected? what probs are you usu seeing? (timing?)Usually old mares, Repeat Hx of EED betw. D35-D80
periglandular fibrosis usu causes EED at what days?D35-D80
how does periglandular fibrosis look like histologically?Degenerative endometrial changes
dx of periglandular fibrosis?Endometrial biopsy
tx of periglandular fibrosis?No known treatment, Supplementary progesterone throughout preg. But placenta may provide inadequate nutrition for foal
Cervical incompetence--> usu a hx of?Hx of dystocia/forcible extraction of foal at last foaling
clinical signs of cervical incompetence? (3)(1) Mare not conceiving after repeat breedings to fertile stallions (2) Endometritis (3) Pregnancy loss
if you want to palpate the cervix to determine if there is cervical incompetance, when in the cycle should you palpate?during diestrus
If you are concerned about luteal insufficiency, what can you use to tx?(of questionable significance, but) Regumate (type of progesterone)
If the mare is having normal cycles but is NOT conceiving, what 4 problems might you consider?(1) Persistent mating-induced endometritis (2) Chronic endometritis (3) Venereal disease (4) "old egg" syndrome
what is Endometritis?inflammation, presence of inflammatory cells (WBC’s) in the uterine wall and lumen
three different types of endometritis?(!) Acute post-breeding endometritis (2) Chronic infectious endometritis (Klebsiella & Pseudomonas; CEM) (3) Chronic degenerative endometritis (similar to endometriosis
post-breeding acute endometritis is a normal physiological immunoreaction. When is a normal time for it to stop, though?Post-insemination endometritis has completely subsided within 12-48h in 90% of all bred mares
how long does it take the good spermatozoa to reach the oviduct?4hr
how long for the inflammatory response of the uterus to the semen to subside?Within 24-36 h
The embryo reaches the uterus _________(time)_________ after ovulation6.5 d
during estrus, are uterine defenses high or low?high
describe the uterine defenses during estrus?on high alert! Cervix is « open » allowing secretions out, Cilial action, Increased endometrial gland secretion, Influx of neutrophils& WBC’s, Uterine contraction, Lymph drainage
when would you do a Perineoplasty?For very poor perineal conformation
“Typical” Susceptible Mare (presentation) for endometritis?Middle-aged or aged, Pluriparous, Pendulous uterus (poor contractility), Perineal defects
What is needed for good « uterine clearance »? (6)Open cervix, Good closure of vulva and vaginal folds, Ciliary action in uterus to move mucus to the cervix, Uterine contractions, Lymph drainage – contractions and functional lymph vessels
how does endometritis look on U/S for a dx?Free fluid in the uterus, Excessive uterine edema.
how can you dx endometritis from gross observation and examination of the mare?Vulvar discharge, Cloudy mucus in the vagina, Inflammation, hyperemia and redness around the cervix. Integrity of the cervix – manual exploration
two collection techniques to dx endometritis via cytology and bacteriology?Guarded swab technique or, Low volume flush
so U/S of a edometritis case basically always looks like Fluid, edema, echodense content....however, what might differ in an old mare versus a young one in terms of fluid distribution?Old mares: fluid accumulation in horns. Younger mare with tight cervix: fluid up in body cranial to the cervix
endometritis--> US--> Clear fluid before insemination may indicate...?delayed uterine clearance without inflammation (A in pic)
endometritis--> US--> Echodense fluid indicates....inflammation (pic D)
two tools used to collect Endometrial Cytology?Uterine swab, Uterine cytology brush
positive cytology for endometritis is? you know know that a positive cytology does NOT...>2 neutrophils / 400x field is a positive find. not all positive cytologies have a positive bacteriology
what does a normal endrometrial cytology sample look like?
what does a kenney grade indicate for a endometrial biopsy?The grade gives an indication/prognosis for the ability of that mare to conceive and carry a pregnancy to term
describe the technique for doing endometrial bxPerineal preparation, Sterile (inside out) rectal glove --> Cover end of biopsy forceps in your gloved hand --> Enter vagina and proceed through cervix--> Remove hand from vagina and enter rectum--> Palpated biopsy forceps through wall of the rectum and push endometrium into teeth of biopsy forceps--> Cut and twist, while quickly removing hand from vagina
Treatment for postbreeding endometritis--> Minimal contamination breeding (how do you do this?)Breed once at optimal time, Induce ovulation. Oxytocin Q4 hours or PGF Q12 hours. Uterine lavage. Monitor with U/S
what fluids do you use for uterine lavage?Saline or Lactated Ringer in 1 litre bottles or in large bags
how soon after insemination do you want to lavage the uterus to avoid postbreeding endometritis? What can you add to help with the effectiveness?First lavage 4-8h after insemination combine with oxytocin 10-20 IU (not more!)
along with uterine lavage, what else can you do (in select cases) to inc lymph drainage?In selected cases give PGF at 12 and 24h post breeding to improve lymph drainage (if necessary repeat 24 hr later)
can you admin abx along with lavage in cases of post-breeding endometritis?If necessary administer antibiotics systemic or intra-uterine (always after lavage)
can a lavage include antiseptics?Instead of physiological saline or lactated Ringer solution some clinicians prefer to use a desinfecting and slightly more irritating solution of 0.05% povidone-iodine solution... This is not Iodine solution!
If you are going to include antiseptics in your uterine lavage, what do you make sure to do after the lavage?Make sure to recover all fluid and follow-up with oxytocin or PGF
what is Misoprostol? what can it be used for?this is a PGE, and it can be used to (1) before live cover of mare with poorly relaxed cervix (2) suggested in mares with poor drainage due to partially closed cervix
what are the 3 mucolytics used and why do we use them?DMSO, N-acetylcysteine, Tris-EDTA. These are used as a solvent to dislodge mucus in the uterus
Chronic endometritis--> OPPORTUNISTIC--> when are mares affected by opportunistic pathogens?Will cause a typical persistant, mating-induced endometritis in “susceptible” mares (Resistant mares will clear themselves of infection)
Chronic endometritis--> OPPORTUNISTIC--> 3 examples of common opportunistic pathogens?Strep equi zooepidemicus, E. Coli, S. Aureus
Chronic endometritis--> Uterus specific pathogens --> when are mares affected by opportunistic pathogens?Will cause persistent endometritis in resistant and susceptible mares
what are the three uterus specific pathogens which can cause chronic endometritis?Pseudomonas aeruginosus (must type isolate), Klebsiella pneumonia (must capsule type isolate), Taylorella equigenitalis
how do you go about prepping slide for cytology of uterus?just roll onto slide and stain with diffquick
**CEM (contagious equine metritis )...what causes it? how is it spread? what should you know about it?caused by Taylorella equigenitalis, it is a NOTIFIABLE dz and it is a VENEREAL dz so usually it is spread from carrier stallion, or via a fomite
**what are the clinical signs of CEM (contagious equine metritis)? how long does it last?Transient endometritis, Mare usually clears herself. 25% may become carriers
**how do you dx CEM (contagious equine metritis), where do you get sample from and how do you transport?Swabs from clitoral fossa and clitoral sinus, In charcoal Amies medium to lab within 24h!! For culture (OIE regulation) or PCR
where are the clitora sinuses/ clitoral fossa?
which three agents cause venereal dz?Taylorella equigenitalis, Klebsiella pneuomonia, Pseudomonas aeruginosa