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Equine Therio > Common Complaints in the Non-Pregnant Mare > Flashcards

Common Complaints in the Non-Pregnant Mare Flashcards

1
Q

Contraception and undesirable behavior

A

• Unwanted horse issue
• Undesirable reproductive behavior in performance
mares

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2
Q

• Undesirable reproductive behavior in performance

mares

A 
 Estrus poor performance
 Cyclicity related tying up
 Nymphomania
 Aggressive behavior
 Male-like behavior
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3
Q

Causes of poor performance during estrus

A

 Pain at ovulation (ovarian hematoma or large follicles)
 May be very colicky

• Other differentials
 Vaginitis
 Cystitis

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4
Q

• Methods for elimination of estrus behavior

A 
Progestogens
Glass marbles (poor efficacy)
Oxytocin injections (efficacy 70%, 45 to 50 days)
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5
Q

Progestins used to eliminate estrus behavior

A

–Altrenogest (0.044 mg/kg)

–Progesterone (0.2 mg/kg)

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6
Q

• Most common ovarian

tumor in the mare

A

Granulosa-theca Cell Tumor (GTCT)

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7
Q

Granulosa-theca Cell Tumor (GTCT) characteristics

A 
• Typically benign, slow
growing, non-metastatic
• Affected ovary is large (8
to 30 cm in diameter)
• Non-affected ovary is
very small, inactive
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8
Q

Common complaints associated with GTCT

A

• Stallion-like, aggressive,
(most common)
• Anestrus
• Nymphomania

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9
Q

Granulosa-theca Cell Tumor (GTCT) Dx

A

– Transrectal palpation
– Transrectal ultrasonography
• Endocrinology

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10
Q

Endocrinology Dx of GTCT

A 
• Endocrinology
–Progesterone
–Testosterone
• >100 pg/mL
– Inhibin
• >0.8 ng/mL
–Anti-Mullerian Hormone (AMH
• > 8.0 ng/mL, diagnostic
• 3.8-8 ng/mL suggestive
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11
Q

• Treatment of GTCT

A

– Ovariectomy- confirmation by
histopathology
– Normal cyclicity expected in 3 to 12
months after unilateral ovariectomy

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12
Q

4 classes of ovarian neoplasms

A
  • Gonadostromal tumors
  • Mesenchymal tumors
  • Epithelial tumors
  • Germ cell tumors
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13
Q

• Gonadostromal tumors

A
  • Granulosa theca cell tumor

* Interstitial cell tumor

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14
Q

• Mesenchymal tumors

A
  • Hemangioma, leiomyoma

* Germ cell tumors

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15
Q

• Epithelial tumors

A

• Cystadenoma, adenocarcinoma

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16
Q

• Germ cell tumors

A

• Dysgerminoma, teratoma

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17
Q

Metastases to the ovary

A

• Lymphosarcoma, melanoma,

adenocarcinoma

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18
Q

Ovarian Hematoma features

A 
• Does not affect the estrous
cycle
• Regresses over a few weeks
• Occasionally take several
months (calcified ovary)
• May cause discomfort
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19
Q

Common complaints in

the non-pregnant broodmare

A
  • Anestrus
  • Abnormal estrous cycles
  • Repeat breeding (infertility)
  • Abnormal vaginal discharge
  • Abnormal external genitalia
  • Mammary gland disorders
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20
Q

Routine examination of the reproductive organs

A 
• Perineal conformation and
examination of the vulva
• Mammary gland
• Palpation per rectum
• Transrectal
ultrasonography
• Vaginal examination
• Endometrial cytology and
culture
• Endometrial biopsy
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21
Q

Adavanced examination of the reproductive organs

A
  • Endocrinology
  • Hysteroscopy
  • Cytogenetics
  • Laparoscopy
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22
Q

Anestrus- causes

A

• Physiological: Season, puberty, PREGNANCY
• Acquired vs. Congenital
 History
– Mare has shown regular cycle or has foaled before
– Mare never showed any reproductive activity

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23
Q

Anoestrus – Persistent CL

A 
• Diestrus can last 60 to 90 days
• Normal ovarian size, CL
present (ultrasound or
progesterone)
• Uterus: tone (no pregnancy)
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24
Q

Treatment of persistent CL

A 
 PGF2α (Dinoprost
thrometamine)
 Analogue (cloprostenol, less
side effects) ****
 Spontaneous recovery
possible
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25
Q

Anestrus – Persistent endometrial cups - cause

A
  • Embryonic Death (>35 days)
  • Endometrial cups already formed
  • Normal genital tract on palpation
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26
Q

Dx of persistent endometrial cups

A

• eCG (commercial kits)
• Biopsy or hysteroscopy
• Check for reasons of embryonic
loss: Fibrosis, metritis, iatrogenic

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27
Q

Anoestrus – Ovarian tumors

A 
Not very common
• Ovarian tumors that may cause anestrus
 Granulosa-Theca cell tumor (GTCT)
 Luteoma (rare)
• Need to differentiate from other causes of ovarian
enlargements
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28
Q

Anoestrus - Pyometra

A 
 Pyometra is usually not a
cause but a consequence of
acyclicity
 CL not always present
 Cervical or vaginal
adhesions
 Variable cycle history
 Very old mares
 Poor prognosis
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29
Q

Anoestrus – other causes

A

• Cytogenetic abnormalities: Ovarian dysgenesis (63 XO
Turner syndrome)
• Hormonal Treatments: Progesterone, Anabolic
steroids: negative feed back on the hypothalamus
• Nutrition: Weight loss after foaling, poor body condition
• Old mare syndrome
• Ovariectomized mares
• GnRH implants (ovuplant®) (no longer approved in the
USA)
• Immunization against GnRH (Not approved in the USA)

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30
Q

• Abnormal interval between ovulations causes

A

 Aging
 Anovulatory hemorrhagic follicles
 Unilaterally functional ovary?

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31
Q

abnormal duration of estrus

A

 Short or Split-heat (common in transitional mares)
 Long estrus (NO OVARIAN FOLLICULAR CYSTS IN THE
MARE!!!)
• Abnormal duration of the luteal

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32
Q

Abnormal luteal function

A
  • Failure of ovulation
  • Short luteal phase
  • Lengthened luteal phase
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33
Q

• Failure of ovulation

A

 Anovulatory hemorrhagic follicle

 Equine metabolic disease

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34
Q

• Short luteal phase

A

 Early release of PGF2α from the endometrium
(endometritis, intrauterine treatment)
 Abnormal corpus luteum function

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35
Q

• Lengthened luteal phase

A

 Persistent CL with spontaneous recovery

 Early embryonic death

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36
Q

Luteal insufficiency

A 
• Not well documented
• Most often suspected because of
 Small CL size
 Poor uterine tone
• Treatment
 Progesterone supplementation
– Altrenogest (0.044 mg/kg PO)
– Progesterone injections (compounded)
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37
Q

Repeat breeding (infertility) - Hx

A
  • Mare with regular cycles
  • Review breeding management practices
  • Health and reproductive history
  • Previous breeding soundness examinations
  • Endometrial biopsy
  • Common causes of infertility
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38
Q

• Common causes of infertility with regular cyclicity

A

 Fertilization failure

 Early embryonic death (before day 14)

39
Q

Fertilization failure

A

• Stallion / semen factor
• Breeding management
Gamete transport

40
Q

• Breeding management resulting in fertilization failure

A

 Technique
 Gamete survival
– Timing in relationship to ovulation
– Uterine environment (endometritis)

41
Q

• Gamete transport resulting in fertilization failure

A 
 Oviduct patency
– Oviductal mass
– Salpingitis
• Cervical lesions (trauma,
adhesions)
42
Q

Fertilization failure - Oviductal masses

A 
 Type I collagen
 At the ampulla-isthmus junction
 Diagnosis be exclusion of all other
cause
 Treatment- laparoscopic
application of PGE2 onto the
oviduct
43
Q

• Other bilateral disorders of the

oviduct (uterine tube)

A
  • Hydrosalpinx
  • Salpingitis
  • Ovario-bursal adhesions
44
Q

Early embryonic loss (before day 14)

A

 If the embryo dies before maternal recognition of
pregnancy. The mare will return to estrus within a
normal interval

45
Q

 Embryo quality

A

– Aged gametes

– Chromosomal abnormalities (stallion and mare)

46
Q

early embryonic loss is often caused by what

A

decreased embryo quality, poor uterine environment (cysts, fibrosis, infection), or abnormal hormonal development (luteal insufficiency

47
Q

Uterine cysts - how they affect fertility

A
  • Reduced embryo mobility
  • Abnormal placentation
  • Compromised cervical tone
48
Q

predisposing conditions of uterine cysts

A
  • Factors
  • Aged mares
  • Origin
  • Vascular changes
  • Lymphatic cysts
49
Q

treatment of uterine cysts

A
  • Aspiration

* Cauterization, laser ablation

50
Q

major cause of infertility in the mare

A

endometritis

51
Q

Etiology/pathogenesis of endometritis

A

 Contamination and establishment of infection
 Failure of anatomical barriers to infection
 Failure of uterine defense mechanisms

52
Q

 Failure of uterine defense mechanisms

A

– Uterine contraction (uterine clearance)
– Local immune response
– PMN function

53
Q

Endometritis: Risk factors

A 
• Age
• Breed
• Anatomy
 Perineal conformation
 Large pendulant uterus
 Endocrine disorders (Metabolic
syndrome)
• Endocrine disorders
 PPID
 Equine metabolic syndrome
 Reduced immune functio
54
Q

Endometritis - Diagnosis

A 
• Transrectal palpation and ultrasonography
 Large uterus
 Thick edematous uterus
 Overt uterine edema
 Intrauterine fluid accumulation
• Vaginal examimation
 Cervicitis
 Fluid in the vagina / vaginal discharge
• Endometrial cytology and culture
• Biopsy (GOLD STANDARD)
55
Q

Endometritis – Common isolates; bacteria

A

 Streptococcus equi spp. zooepidemicus
 E. coli
 Pseudomonas aeruginosa
 Klebsiella pneumoniae

56
Q

Endometritis – Common isolates; fungal

A 
(<5% of all cases)
 Candida spp.
 Aspergillus spp.
 Mucor spp.
 Others…
57
Q

Endometritis – Diagnostics

A

Cytology, culture, bx

58
Q

Endometritis - cytology

A

 Considered positive if >2 P

59
Q

endometritis - culture

A

 Poor sensitivity in chronic endometritis
 May culture one, two or even 3 bacteria
 Best results is to culture from the biopsy

60
Q

Endometritis - Treatment

A 
• Intrauterine therapy
• Uterine lavage
(Elimination of biofilm
Immunostumulation
Intrauterine antimicrobials)
• Systemic therapy
(Antimicrobials, Anti-inflammatories)
• Breeding management
61
Q

Endometritis – surgical treatment

A

Correction of predisposing factors to ascendant infections (eg caslicks, Repair of vestibulo-vaginal sphincter)
Correction of urovagina (urethral extension)
repair of cervical tear
elecation of uterine body (uteropexy)

62
Q

Repair of vestibulo-vaginal sphincter

A

– Episioplasty

– Perineoplasty

63
Q

Uterine lavage

A
  • Removal of intrauterine fluid and inflammatory debris
  • Sterile fluids (Equine uterine flush®, LRS, 0.9% NaCl)
  • 2 to 5 liters total volume
64
Q

Intrauterine antibiotic infusion

A

Intrauterine antibiotic infusion

65
Q

Endometritis – Other intrauterine treatments

A 
• Infusion of mucolytics or chelators
• Dissolve thick mucus and pus
• Help to remove biofilm and improves antibiotics
penetration
• Infused 4 to 12 hours prior to lavage
• Use of Tris-EDTA (Tricide®)
• 0.6% N-acetycysteine
•30% DMSO
66
Q

Endometritis - Antiseptics

A 
• 0.05% povidone-iodine in
LRS
• 0.5 to 2% chlorhexidine,
Some mares do not
tolerate antiseptic
infusion
67
Q

Treatment of fungal endometritis

A 
• Correction of anatomical defects
• Uterine lavage
• Uterine infusion
Systemic +/- topical antifungals
• Candida and Aspergillus form biofilms
----Mucolytics – Tris EDTA, N-Acetylcysteine infusions
68
Q

uterine infusion for fungal endometritis

A

• 250 ml 2% acetic acid for 3 to 4 minutes

69
Q

• 2 major classes of antifungals

A
  • Azoles (inhibit ergosterol synthesis, fungistatic)

* Polyenes (bind ergosterol, fungicidal)

70
Q

Persistent Mating-induced endometritis (PMIE)

A

Inability of the uterus to clear
inflammatory products and semen by
12 hours post-mating or artificial
insemination

71
Q

• Risk factors (Susceptible mares) - PMIE

A

• Uterine clearance mechanism defects
• Poor conformation
• Cervical fibrosis (Old maiden mare
syndrome)

72
Q

• Treatment options

A
  • Ecbolics (Oxytcin, PGF2α)
  • Uterine lavage
  • Topical therapies to relax the cervrx
  • Antibiotics
  • Anti-inflammatories
  • Acupuncture
73
Q

Treatment for PMIE: Ecbolics

A 
• Oxytocin
• 10-20 IU, IM (3 to 4 times /day
starting 4 hours post AI)
• Carbectocin
-Long acting oxytocin
analogue (not available in the
USA)
• Cloprostenol
74
Q

Cloprostenol

A 
• More sustained uterine
contractions compared to
oxytocin
• Premature luteolysis if given
frequently or used more than
2 days post-ovulation
75
Q

Cervical relaxation

A 
• Treatment of PMIE in “Old
maiden mare syndrome”
• Tight cervix
• Fluid accumulation pre and
post insemination
76
Q

cervical relaxation - drugs

A 
• Topical PGE1 (Misoprostol)
• Crushed tablest or
compounded cream
• Topical Nbutylscopolammonium
bromide (Buscopan®)
• Compounded cream
77
Q

Uterine masses/neoplasms - most common

78
Q

leiomyoma

A 
• Usually solitary
• Well-circumscribed
• Involves myometrium
• Large masses require
partial hysterectomy
(mares can still carry a
pregnancy
79
Q

Abnormalities of the external genitalia

A

persistent hymen

XX sex reversal

80
Q

• Persistent hymen

A 
• Perforate hymen
- Incidental finding in maiden
mares
- Easily ruptured manually
- Perforate hymen
• Imperforate hymen
- Accumulation of mucus in the
vagina and uterus
- Can bubble out of the vulva
- May require surgical excision
81
Q

Mastitis usually occurs when?

A

•Usually occurs after weaning

82
Q

clinical signs of mastitis

A
  • Clinical signs
  • Swollen, warm udder
  • Ventral edema
  • Fever
  • Hind limb lameness
83
Q

Dx of mastitis

A 
•Cytology and culture of milk
•Serous, serosanguinous or
purulent
•S. zooepidemicus most common
isolate
•Ultrasonography
84
Q

Tx of mastitis

A
  • Systemic antibiotics, NSAIDs
  • Frequent milking
  • Hot-packing or hydrotherapy
85
Q

Mammary gland neoplasia - Primary Tumors

A

Adenocarcinoma (MOST COMMON), adenoma

86
Q

Skin origin mammary tumors

A

• Squamous cell carcinoma, melanoma,

sarcoids

87
Q

metastatic tumors of the mammary gland

A

• Melanoma, mastocytoma,

lymphosarcoma

88
Q

clinical signs of mammary tumors

A
  • Mammary gland enlargement
  • Pain, discharge
  • Skin lesions
  • Weight loss
89
Q

• Diagnosis of mammary tumors

A
  • Ultrasonography
  • Cytology (FNA)
  • Biopsy
90
Q

metastatic pattern of mammary adenocarcinoma

A

• Metastasize to the inguinal lymph

nodes, liver, lungs, other organs

91
Q

treatment (if no mets) of mammary adenocarcinoma

A 
• Mastectomy
• Chemotherapy
• Radiation therapy
• Survival < 18 months even with
treatment
92
Q

Inappropriate lactation in neonates

A

• Elevated lactogenic hormones of maternal origin in fetal circulation

93
Q

• Galactorrhea

A
  • Milk production in non-pregnant /foaling mares
  • Elevated prolactin
  • Pituitary Pars Intermedia Dysfunction
  • Rule of mastitis
  • Treatment
  • Treat PPID with pergolide or cyproheptadine
  • Treat others with pergolide or bromocryptine, decreased feed (protein and energy)
  • Do not milk out as it will stimulate more lactation

Equine Therio (6 decks)

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