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Equine Therio > Disorders of Pregnancy in the Mare > Flashcards

Disorders of Pregnancy in the Mare Flashcards

1
Q

Started on slide 12

A

see slides

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2
Q

When does most fetal loss occur?

A

Before day 50

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3
Q

General diagnostic approach to abortion

A
  • Make sure it is an actual abortion
  • History (e.g. pregnancy diagnosis, vaccinations, movement)
  • Laboratory findings (fetus size, length, defects; umbilical cord; placenta; histopathology, serology, virology, bacteriology)
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4
Q

What is the major non-infectious cause of abortion?

A
  • Twinning
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5
Q

What should you think of as the cause of abortion if the fetus looks abnormal?

A
  • Congenital defect
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6
Q

What is abortion?

A
  • Premature expulsion from the uterus of the products of conception
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7
Q

Approximately what % are infections of all causes of abortions?

A
  • Approximately one third to half of all causes
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8
Q

What % of abortions remain undiagnosed?

A
  • 5-20%
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9
Q

Which viral diseases cause abortion?

A
  • EHV and EVA
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10
Q

What are the most common isolates for bacterial placentitis( and which is MOST common)?

A
  • Streptococcus spp (zooepidemicus)**
  • Staphylococcus spp
  • E. coli*
  • Klebsiella
  • Enterobacter
  • Pseudomonas*
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11
Q

Samples to be sent in for equine abortion

A
  • Fetus
  • Serum and vaginal swab from the dam
  • Placenta
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12
Q

Pathophysiology of bacterial placentitis?

A
  • Bacteria infiltrate and colonize the space between microcotyledons and microvilli of the uterus
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13
Q

Ascending placentitis causes

A
  • Look at spreadsheet
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14
Q

What is the cervical star?

A
  • It’s the part of the placenta right against the cervix

- You can see it become discolored with ascending placentitis

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15
Q

What should you think if you hear premature udder development and mucopurulent vaginal discharge?

A
  • Think ascendent placentitis
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16
Q

Features of placentitis in the fetus?

A
  • Persistent fetal tachycardia
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17
Q

Features of placentitis in the uteroplacental unit?

A
  • Thickening of the uterine wall (>13 mm)
  • Increased CUPT (>17.5 mm)
  • Pockets of hyperechoic fluids (pus)
  • Areas of placental separation
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18
Q

Endocrinology signs with placentitis (progesterone, estrogen)

A
  • Increased total progesterone concentration

- Decreased total estrogens

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19
Q

Acute phase protein changes in placentitis

A
  • Elevation of acute phase proteins (serum amyloid A and haptoglobin)
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20
Q

Outcome of ascendent placentitis

A
  • Often foals born healthy but small
  • Pregnancy may be a little shorter
  • Increased risk for perinatal asphyxia syndrome but similar survival rate and discharge time compared to controls
  • Treatment reduces risk of neonatal encephalitis, neonatal nephropathy, and neonatal enteropathy
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21
Q

Funisitis***

A
  • umbilical cord inflammation
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22
Q

Clinical signs in the mare of leptospirosis

A
  • VARIABLE AND NOT ALWAYS PRESENT
  • Fever
  • Hematuria
  • Acute renal failure
  • Uveitis may develop weeks after abortion
  • Mid to late term abortion (usually last 3 months)
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23
Q

Types of foals that can be born if dam has leptospirosis?

A
  • Stillborn or weak (important cause of FPTI)
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24
Q

Pathologic findings of leptospirosis in the placenta

A
  • Placentitis not involving the cervical star
  • Heavy, edematous, hemorrhagic
  • Occasionally covered with a brown mucoid material on the chorionic surface
  • Calcification
  • Funisitis in some cases
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25
Pathologic findings of leptospirosis in the fetus
- mild to moderate icterus - Liver enlargement, hepatitis - Tubulonephrosis and interstitial nephritis
26
Diagnosis of leptospirosis with agglutinating antibody titers in the mare - what value is diagnostic?
- >1:6400 often >12,800
27
Other diagnostics besides high antibody titers for leptospirosis?
- Fetal and placental lesions - Fetal antibodies - Isolation from placenta or renal tubules - IHC of the placenta, umbilical cord, or fetal kidney and liver - PCR
28
Prevention of leptospirosis techniques?
- Isolate aborting mare for 14-16 weeks - Urine FAT testing for shedding - Possible treatment of shedders or animals at high risk (e.g. those in a flood plain) - Limit exposure to stagnant water - Control reservoir animals - Vaccine available
29
When in gestation does abortion secondary to nocardioform placentitis occur?
- Late term abortion - Premature birth - Weak foals
30
Clinical signs in the mare of nocardioform placentitis?
- May show premature mammary gland development and/or galactorrhea
31
Placenta in nocardioform placentitis
- Chronic | - Severe, exudative, mucopurulent, and necrotizing placentitis at the junction of the placental body and horns
32
Fetus pathology in nocardioform placentitis
- Severely underdeveloped
33
What is the most commonly isolated actinomycete from nocardioform placentitis?***
Crossiella equi
34
Which type of EHV is most common in abortions secondary to EHV?
- EHV1 | - EHV4 possible but rare
35
Time period of abortion in EHV?
- most between 8-10 months
36
Can vaccinated mares still have an abortion secondary to EHV?
- Yes | - Thought to be reactivation of latent infection
37
Lesions in fetuses from EHV-1 relative to EHV-4
Those in EHV4 are more discrete than those caused by EHV1
38
Transmission of EHV (primary and others)
- Respiratory** - Abortion may be stress related - May occur in vaccinated mares (reactivation of latent infection)
39
Necropsy findings of EHV1 (* which are the most important)
- RIB IMPRESSION - FRESH fetus - Presence of pleural fluid - Intra-nuclear inclusion
40
Diagnosis for EHV abortion
- Virus isolation - Immunochemistry - PCR on fetal lung, liver, spleen, thymus - Necropsy findings are very important
41
Prevention of EHV abortion
- VACCINATION*** (vaccinate at 5, 7, and 9 months) | - Separation of pregnant mares from high risk horses too
42
Appearance of fungal abortion placenta
- Chorion may be dry and leathery or have a brown, tenacious exudate, especially at the cervical area
43
Spread of fungal abortion
- Usually ascending, some hematogenous
44
What are possible causes of protozoal abortion?
- Neospora - Trypanosoma equiperdum (dourine) - Babesia equi or caballi (piroplasmosis)
45
What is the cause of mare reproductive loss syndrome?
- Eastern tent caterpillar
46
What happens in mare reproductive loss syndrome?
- Early and late fetal loss - Placentitis - Uveitis - Endocarditis
47
What is the leading cause of non-infectious abortion?
- Twinning!
48
What causes twins in the mare?
- Double ovulations! | - Dizygotic (more like fraternal, not identical twins)
49
What determines the fate of twins?
- Location of vesicle with respect to each other
50
What % of twins in horses are bilaterally fixated or unilaterally fixated?
- 30% bilateral | - 70% unilateral
51
Outcome of unilaterally fixed twins?
- 83% reduction to single by 40 days
52
Outcome of bilaterally fixed twins
- 0% reduced to single by 40 days - Mid- to late-term abortion of both - Premature foaling
53
Diagnosis of twins
- See the vesicles at 14 days by transrectal or transabdominal ultrasound - If there are two CLs, stay there - Motility will happen in 5-10 days - you want them to separate so you can crush one of them to treat it
54
Ultrasound with twins
- Transrectal - Transabdominal - eCG
55
What can cause confusion with diagnosis of twins?
- Stage of development | - Uterine cysts
56
What can you do to differentiate twins vs a uterine cyst by ultrasound?
- You can wait a couple of days | - The vesicle will grow, but the cyst will not
57
Treatment for twin pregnancies before fixation?
- Crushing - 100% effective if twins are separated - No effect on pregnancy if done properly, but recheck mare and put on NSAIDs and possible progesterone
58
When does fixation occur?
- 16-17 days
59
Managing twin pregnancies after fixation (bilateral)?
- Crushing up to 30 days
60
Managing twin pregnancies after fixation (unilateral)?
- Wait and see | - Play the odds
61
Management of twin pregnancies after 30 days?
- TROUBLE - Can do transvaginal ultrasound-guided aspiration - Intra-cardiac injection - Wait and see - Abort both and lose the season
62
Management of twin pregnancies after 65 days?
- Transabdominal intra-cardiac injection - Cervical dislocation - Surgical removal - Abort both and lose the season - Complications - 50% success rate
63
Prevention of twin pregnancies
- Check mare during estrus for double follicles - THEN YOU HAVE TO SEE THEM AT 14 days - Check for pregnancy early and often - Manual crushing (easier said than done!)
64
Predisposed breeds for twin pregnancies?
- Thoroughbreds, heavy draft horses, warmbloods
65
Second cause of non-infectious abortion?
- Umbilical cord torsion
66
of twists that are considered normal with umbilical cord torsion?
More than 7 twists are abnormal - Up to 7 twists are normal - Also may see signs of hemorrhage and edema
67
What fetal abnormalities are seen in miniature horses?
- Hydrocephalus and other severe abnormalities
68
Possible causes of fresh, well preserved fetus?
- EHV, dystocia
69
Possible causes of underdeveloped fetus?
- IUGR (??) | - starvation primary to secondary
70
Possible causes of mummification?
- Twinning, progesterone therapy
71
Possible causes of pinpoint white foci in liver?
- EHV
72
Possible causes of fetal pneumonia?
- EHV, bacterial, MRLS
73
Possible causes of cervical star placentitis?
- Bacteria or fungi (ascending)
74
Possible causes of diffuse placentitis?
- Leptospira, Salmonella
75
Possible causes of placentitis at body, base of the horns?
- Nocardioform
76
Possible causes of intact cervical star?
- Premature placental separation, EHV
77
Possible causes of large avillous areas?
- Twinning | - Nocardioform placentitis
78
Possible causes of umbilical cord edema?
- Torsion, dystocia, MRLS, fescue toxicosis, umbilical torsion, hydrops
79
Possible causes of placental edema
- Dystocia, torsion, fescue toxicosis
80
Possible causes of allantoic cysts
-Uterine abnormalities, unknown
81
Uterine torsion clinical signs
- Colic varying degree of intensity or just ADR | - Rule out in any case of colic in mares >5 months
82
Diagnosis of uterine torsion
- Transrectal palpation | - Remember the clockwise, counterclockwise
83
What's important for choice of method of correction of uterine torsion?
- History, fetal evaluation, and placental evaluation
84
Possible treatments for uterine torsion
- rolling or surgical correction
85
Rolling procedure - what side is the mare placed on?
- Placed on lateral recumbency on the side of the torsion (NEED TO GO BACK TO BOVINE TO FIGURE OUT WHICH IS WHICH) - Plank on the opposite side - Roll at least 3 times - Check in sternal position - General anesthseia required
86
Surgical correction approaches for uterine torsion?
- Midline laparotomy | - Flank laparotomy
87
Mare survival in uterine torsion if <320 days or >320 days?
- 97% if <320 days | - 65% if 320 days or more
88
Foal survival in uterine torsion if <320 days or >320 days?
- 72% if pregnancy <320 days | - 32% if 320 days or more
89
Factors that impact uterine torsion outcome
- Degree of torsion | - Technique used
90
When should you not roll the mare?
- Compromised uterus or mare (base on transabdominal ultrasound for fetal death and/or hemorrhage) - Possible uterine rupture based on abdominocentesis

Equine Therio (6 decks)

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