Therio - Infertility in Mares 2

drraythe's version from 2017-09-10 04:04

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 btwn. D35-D80
Periglandular fibrosis usu czs 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 Tx, 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
CSs of cervical incompetence? (3)(1) Mare not conceiving after repeat breeding to fertile stallions
(2) Endometritis
(3) Pregnancy loss
If you want to palpate the cervix to determine if there is cervical incompetence, 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 Dz
(4) "Old egg" syndrome
What is Endometritis?Inflammation, presence of inflammatory cells (WBC’s) in the uterine wall & lumen
3 different types of Endometritis?(1) 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 w/in 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?W/in 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 & vaginal folds
Ciliary action in uterus to move mucus to the cervix
Uterine contractions
Lymph drainage – contractions & fxnl 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 & examination of the mare?Vulvar discharge, Cloudy mucus in the vagina, Inflammation, hyperemia & redness around the cervix. Integrity of the cervix – manual exploration
2 collection techniques to Dx Endometritis via cytology & bacteriology?Guarded swab technique or, Low volume flush
So U/S of a Endometritis case basically always looks like Fluid, edema, echodense content...however, what might differ in an old mare versus a young 1 in terms of fluid distribution?Old mares: fluid accumulation in horns
Younger mare w/ tight cervix: fluid up in body cranial to the cervix
Endometritis → US → Clear fluid before insemination may indicate...?Delayed uterine clearance w/o inflammation (A in pic)
Endometritis → US → Echodense fluid indicates....Inflammation (pic D)
2 tools used to collect Endometrial Cytology?Uterine swab
Uterine cytology brush
Pos cytology for Endometritis is? You know that a pos cytology does NOT...>2 neutrophils / 400x field is a pos find. Not all pos cytology have pos bacteriology
What does a normal endometrial cytology sample look like?
What does a Kenney grade indicate for an endometrial biopsy?The grade gives an indication/prognosis for the ability of that mare to conceive & carry a pregnancy to term
Describe the technique for doing endometrial BiopsyPerineal preparation, Sterile (inside out) rectal glove → Cover end of biopsy forceps in your gloved hand → Enter vagina & proceed through cervix → Remove hand from vagina & enter rectum → Palpated biopsy forceps through wall of the rectum & push endometrium into teeth of biopsy forceps → Cut & twist, while quickly removing hand from vagina
Tx for post breeding 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 w/ 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 post breeding Endometritis? What can you add to help w/ the effectiveness?1st lavage 4-8h after insemination combine w/ Oxytocin 10-20 IU (not more!)
Along w/ uterine lavage, what else can you do (in select cases) to inc lymph drainage?In selected cases give PGF at 12 & 24h post breeding to improve lymph drainage (if necessary repeat 24 hr later)
Can you admin ABx along w/ lavage in cases of post-breeding Endometritis?If necessary administer ABx systemic or intra-uterine (always after lavage)
Can a lavage incld antiseptics?Instead of physiological saline or lactated Ringer solution some clinicians prefer to use a disinfecting & slightly more irritating solution of 0.05% povidone-iodine solution... This is not Iodine solution!
If you are going to incld antiseptics in your uterine lavage, what do you make sure to do after the lavage?Make sure to recover all fluid & follow-up w/ Oxytocin or PGF
What is Misoprostol? What can it be used for?This is a PGE, & it can be used to:
(1) before live cover of mare w/ poorly relaxed cervix
(2) suggested in mares w/ poor drainage due to partially closed cervix
What are the 3 mucolytic used & why do we use them?DMSO
These are used as a solvent to dislodge mucus in the uterus
Chronic Endometritis → OPPORTUNISTIC → when are mares affected by opportunistic pathogens?Will cz a typical persistent, mating-induced Endometritis in “susceptible” mares (Resistant mares will clear themselves of Infxn)
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 cz persistent Endometritis in resistant & susceptible mares
What are the 3 uterus specific pathogens that can cz chronic Endometritis?Pseudomonas aeruginosa (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 & stain w/ diffquick
**CEM (Contagious Equine Metritis)...what czs it? How is it spread? What should you know about it?Czd by Taylorella equigenitalis, it is a NOTIFIABLE dz & it is a VENEREAL dz so usually it is spread from carrier stallion, or via a fomite
**What are the CSs 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 & how do you transport?Swabs from clitoral fossa & clitoral sinus, In charcoal amies medium to lab w/in 24h!! For culture (OIE regulation) or PCR
Where are the clitoral sinuses/ clitoral fossa?
Which 3 agents cz venereal dz?Taylorella equigenitalis
Klebsiella pneumoniae
Pseudomonas aeruginosa

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