Endometritis and the Problem Breeding Mare Flashcards
layers of the equine endometrium
luminal epithelium
stratum compactum
stratum spongiosum
lymphatics
Predisposing factors to endometritis
physical things like pelvic angles, vulvar conformation, VV sphincter, uterine position
age - gets worse with age and more fibrotic cervix, etc.
previous injuries
perineal conformation, windsucking
inflammatory and degenerative changes constantly
breed - clydes, shires, friesians, TW, TB
Acute Physiological Endometritis
normal and good for health, caused by sperm, bacteria, saline, blood, saline, medications. Should clear in 12 hours
HOw does the mare normally resolve acute physiological endometritis?
PMNs, Expulsion through cervix, and lymphatic drainage
What is bad about the non-physiological endometritis
can be harmful to health, fertility
hostile environ for spermatozoa and conceptus
causes EED, failure to conceive
Leads to the secondary infections
Non-physiological endometritis develops when?
after long natural mating, AI, along with pneumovagina, after any transcervical things
From the diagram, what are the factors decreasing uterine clearance?
poor conformation
excessive fluid influx
poor lymph drainage
poor myometrial response
Sequelae to non-physiological endometritis
weird cyclicity failure to conceive EED mid-gest abortion septic neonates placentitis post-partum metritis/RFM
WHat are the mare factors that cause the endometritis?
- age/parity - old maidens, cervical fibrosis (dystocia previous) –> less folds, less clearance
- perineal conformation - longer vulva –> pneumo –> inflammation, also
- uterine clearance - loss of support from stretched BLig –> pendulous non clearing uterus. ALso myometrial fibrosis
- cervical competence
- immune function - inflamm-aging
- mucociliary dysfunction in the endometrial folds –> loss of cilia and accumulation
HOw does myometrial fibrosis contribute to uterine clearance?
less activity or delayed onset contraction –> less clearance and lymphatic drainage. Is it calcium or NO?
What is inflamm-aging related to?
age and obesity causing pro-inflamm cytokines, may decrease fertility
What does strep zoo cause for endometritis?
hypersecretion of irritating, watery neutrophilic exudate, diffuse infection
Whats the deal with biofilms and endometritis
adhere to endometrium, secrete matrix to coat, go dormant, then start up when activated
What are the common pathogens of endometritis?
Gram positives mainly (strep zoo, staph, actinobacillus, bacteroides)
30% gram negs - e coli, klebs, pseudomonas, entercoccus, yeasts and fungi
Which pathogens cause STD endometritis? how to tell?
culture in mare and stallion
klebs, pseudomonas
taylorella equigenitalis
trypanosoma equiperdum
Susceptible mares are more likely to get - endometritis?
gram negative or mixed. the gram neg are harder to dx and treat.
What is the immune response to endometritis?
Innate - PMNs, compliment, phagocytes
adaptive - APCs w/ Ag, T cells come along –> cytokines –> produce Ig –> destroy infected cells (CMI and Hum)
What role does compliment play in endometritis in a normal mare? then in not normal?
Ig from seminal plasma and uterine secretions opsonizes the sperm –> release C5a, C5b, C3b –> attracts neutrophils –> come into the uterus.
Not normal mare - imparied opsonization –> not as good of PMNs
Difference between fresh and frozen semen for endometritis?
frozen has no seminal plasma. Seminal plasma protects sperm, limits duration of inflammation and influences myo contractions. so Frozen is more irritating and will more likely cause PMIE
Clinical presenation of endometritis and clinical signs
post mating inflammation
strep infections, some e coli
shortened inter-estrus intervals when going on.
Clinical signs of PMIE
tail rubbing, discharge, estrous behaviour, but no stallion wanting to., shortened inter-estrus, EED, failure to concieve
What is the likely cause of Chronic Inf Endometritis?
biofilm
in susceptible mares
insuff healthy glandular material
What does CIE look like?
habitual abortions at 5-6 motnhs failure to maintain preggo lose by 40 days ut infections in estrus and maintenance in diestrus (biofilm) Usually gram negatives
Which methods of Dx of endometritis are important in Gram negative infections?
Hysteroscopy
Endometrial biopsy
What to Dx endometritis?
Hx, PE,
Palp - no tone after ov., dep uterus
US - lots of edema, air, some gram negs
Vag exam - relaxed, mucus, patent
Cerv exam -
hysteroscopy - cysts, tumor, adhesions, biofilm,
endometrial cytology***** - double guard, LVL or cytobrush
uterine culture - remember this from robinson lectures - pos when >5% N, 25% debris
endometrial biopsy - look at fibrosis, nesting, glands,
Treatment goals for Endometritis
improve uterine clearance, reduce inflammation, eliminate pathogens, and prevent more
