Equine 1 Flashcards
1
Q
What are the steps in performing a BSE?
A
History Previous fertility Consider venereal pathogens General clinical examination Mammary Perineum Vulva, vestibule, vagina, cervix Uterine palpation and ultrasound Ovarian palpation and ultrasound
2
Q
What specific details do you want to know regarding the history when performing a BSE?
A
Current presentation of mare i.e. pregnant, foal at foot, barren, specific problem
Age
Previous breeding history
If barren then what management was, vet, number of barren years?
3
Q
What are you looking for when assessing the perineum of the horse during a BSE?
A
Long axis of the vulval should be vertical Vulvar labia should be well apposed No vulval discharge No vulval lesions Perineum should be intact Anus should not be recessed Normal vestibulo-vaginal seal
4
Q
What are the HBLB codes of practice?
A
Specific guidelines that are given each year for specific categories of mare
5
Q
What are some conditions included in the HBLB codes of practice?
A
Venereal transmitted bacterial diseases caused by the contagious equine metritis organism CEMO, Klebsiella pneumoniae and Pseudomonas aeruginosa Equine Viral Arteritis - EVA Equine Herpesvirus - EHV Equine Coital Exanthema - ECE Equine Infectious Anaemia - EIA Dourine Strangles Artificial Insemination – AI
6
Q
What bacterial pathogen has different capsule types as part of HBLB code of practice?
A
Klebsiella
7
Q
Which Klebsiella capsules are pathogenic?
A
1,2,5
8
Q
What is the problem when isolating pseudomonas as part of BSE?
A
The lab cannot differentiate whether it is an environmental contaminant or veneral
9
Q
What action is required if CEM is isolated in mares prior to covering?
A
Isolate and treat infected mares
Notify owners of mares
10
Q
What action is required if CEM is isolated in stallions prior to covering?
A
Isolate and treat
Notify owners of mares
11
Q
What action is required if CEM is isolated in mares and stalions after covering
A
Cease covering
Check all mares implicated in outbreak
Do not cover until 3 negative swabs each at least 2 days apart
12
Q
What is normally done to screen for viral veneral pathogens (EVA) in a BSE?
A
Blood sample is taken to ensure serologically negative to Equine Viral Artertitis
13
Q
What are some other organisms that you may come across in during BSE?
A
EHV1- plan vaccinations
EHV3- Equine coittal exanthema
EIA- serologically tested
14
Q
What are some indications for taking a uterine swab?
A
Undertaken for bacterial venereal pathogen screening - part of BSE
Undertaken incases of endometritis (cytology, bacteriology)
15
Q
What are you checking for during a vaginal examination?
A
Confirmation of normality and estimation of stage of the cycle
16
Q
What are you looking for in terms of a rectal examination during a BSE?
A
Confirmation of normality
Confirmation of cyclicity and stage of cycle
Confirmation of non-pregnancy
Evidence of gross pathology
17
Q
What are likely causes of 2 small ovaries?
A
- Mare is acyclical- anoestrus or prepubertal
2. Mare is abnormal (Turners syndrome)
18
Q
What are the causes of two medium sized ovaries?
A
- Mare is in the ovulatory period
2. Mare is pregnant
19
Q
What are causes of two medium sized ovaries with ‘something’ palpable on one or both?
A
- Mare is in ovulatory period
2. Mare is pregnant
20
Q
What are the causes of two large ovaries?
A
- Mare is in the transitional phase
- Mare is pregnant
- Mare is pseudopregnant
- Mare has prolonged dioestrus
21
Q
What are the causes of one very large ovary and one normal one?
A
- Mare is likely to have an ovarian haematoma or luteinised follicle
- Mare may have an early (small) ovarian tumour)
22
Q
What are the causes of one very large ovary and one very small ovary?
A
- Mare is likely to have ovarian tumour
23
Q
What are you looking for when doing ultrasound of the uterus?
A
Confirmation of normality
Confirmation of cyclicity and stage of cycle
Confirmation of non-pregnancy
Evidence of gross pathology
24
Q
What are you looking for when doing ultrasound of the ovaries?
A
Confirmation of normality
Confirmation of cyclicity and stage of cycle
Evidence of gross pathology
25
What are some additional tests that can be carried out when investigating a problem?
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Endometrial Cytology
Endometrial Microbiology
Endometrial Biopsy
Uterine Endoscopy
Karytopye
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26
What are you looking for on endometrial cytology?
Neutrophil number- if more than 5 neutrophils per MPF = abnormal
27
What are some indications for endometrial biopsy?
Barren mares
Repeat breeder mares
Mares with early embryonic death or abortion
Anoestrus mares
Mares requiring surgery of genital tract
Pyometra or mucometra
Fertility evaulation- pre purchase
28
What are the different pathological changes of an endometrial biopsy?
- Acute inflammation
- Chronic infiltrative inflammation
- Chronic degenerative changes
29
What are the different categories developed for endometrial biopsies?
I - no pathological changes, mare should have normal fertility
IIA- mild endometrial changes,
IIB- Moderate endometrial changes- infllammatory changes severe enough to decrease fertility and may be accompanied by fibrosis.
III- Severe endometrial changes, uteri may be incapable of supporting fetal development
30
When is karyotyping likely to be used?
Clinical suspicion of problem eg: Clitoral enlargement
Infantile vulva and vagina, Small uterus, Small inactive ovaries
In mare that should have reached puberty and is not within the winter anoestrus period
31
What is Turners syndrome?
Tubulogenital tract normal but small, ovaries very small and inactive
Surprisingly may show irregular non-cyclical oestrous behaviour
63XO condition
32
What occurs in early spring of the normal breeding cycle of mares?
Mares have transitional period with follicles that don't ovulate
33
What occurs in the late autumn period of the normal breeding cycle of mares?
cyclicity ends with silent or anovulatory heat
34
What are the clinical presentations of anoestrus in the mare?
Ovaries: small and hard, small follicles
Uterus: flaccid
Vagina: pale and dry
Cervix: small and closed
35
What are the clinical presentations of tranisitional period in the mare?
Ovaries: larger – soft follicles grow and regress
Uterus: transitional
Vagina: like anoestrus
Cervix: like oestrus
36
What are the clinical presentations of oestrus in the mare?
Ovaries: medium – something palpable (follicle -> CH)
Uterus: large and oedematous
Vagina: moist and hyperaemic
Cervix: broad and soft
37
What are the clinical presentations of dioestrus in the mare?
Ovaries: medium – early CH feels like follicle, CL not palpable
Uterus: small and tonic
Vagina: pale and dry
Cervix: hard and narrow
38
When is the optimum mating in normal mares?
24-48hours before ovulation
39
What is the clinical presentation of a ruptured pre-pubic tendon or abdominal wall rupture?
Massive ventral swelling and oedema, abdominal pain and often recumbency.
Mare develops a 'saw horse' stance with legs extended
40
How can you treat/prevent pre-pubic tendon or abdominal wall rupture?
Use of belly band in pregnancy
Live foals may be produced by assisted delivery after parturition induction
Traction usually required
41
What is the duration of normal pregnancy?
310-370days
42
How can parturition be predicted by?
Date of conception
Estimation of fetal age using ultrasound - diameter of eye
Relaxation of pelvic ligaments
Waxing up of the teats
Change in mammary secretion: calcium increases to more than 10mmol/l 1-2days before foaling
43
What are some indcations for induction of pregnancy?
Mares with dystocia or premature placental separation in previous deliveries
Mares with abnormalities such as rupture of prepubic tendon
Mare that are veryuncomfortable with marked ventral oedema and are running milk and have an open cervix
44
What are some of the complications with induction of parturition?
Most mares will require assistance
Dystocia due to inability of the foal to rotate during expulsion
Premature placental separation
Fetal hypoxia or fetal death
Dysmature / immature foals which have difficulties adapting to extra-uterine life and may die
45
What is the criteria for induction of parturition?
Adequate gestational length – at least 330 days although most veterinary surgeons would not consider induction until well past this time
Adequate mammary development and milk/colostrum production
Suitable softening of the cervix
46
What are some methods of induction of parturition?
1. Low dose oxytocin given every 10 mins until parturition commences
2. High dose oxytocin - single dose IM or IV
3. Twice the luteolytic dose of PG (Dinoprost)
47
What is the method of induction of parturition that is the easiest and is associated with a better outocme?
Low dose oxytocin
48
How should you treat contusions and lacerations?
Usually best to delay repair as heal well without treatmen
Except third degree laceration (see later for repair)
NSAIDs + topical treatments (lavage etc)
49
What is haemorrhage of the uterus associated with?
Uterine prolapse
50
Outline the normal events that occur in passing the foetal membranes in the mare?
Allanto-chorion ruptures
Foal born within amnion
Umbilical cord and amnion hanging from vulva
Umbilicus attached at base of horn where implantation occurred
Weight provides traction
Detachment from apex so placenta everts as it detaches
Normal placental passed within 3 hours of foaling
51
How can you treat a retained fetal membrane?
1. Bandage tail
2. Clean vulva
3. Separate allanto-chorion from uterus at vulva
4. Twist allanto-chorion so force evenly applied
5. Insert hand between uterus and allanto-chorion
6. If haemorrhage or not easily separating – STOP
7. Either attempt oxytocin treatment or preventative treatments and revisit in 8 hours Systemic antibiotics, Uterine antibiotics – site, NSAIDs, Calcium
52
What is post partum metritis associated with?
Retained placenta or following dystocia or assisted parturition
53
How can you treat post partum metritis?
Attempt to cause placental separation should be made
Removal of uterine fluid using scooping and/or lavage with 1-2 litres saline and immediate drainage by siphonage
Broad spectrum antibiotic systemically
Local infusion of antibiotic into the uterus
NSAIDs
Vasodilators etc
Treatment is repeated daily until the pus and placental debris have disappeared
54
What is the clinical presentation of hypocalcaemia in the mare?
Mild cases appear to be hyperaesthesia and dry faeces
This is followed by inability to prehend food (which worsens the condition)
Subsequently there is diaphragmatic asynchrony (‘thumps’)
55
What is the treatment of hypocalcaemia in the mare?
slow infusion of calcium borogluconate to effect whilst continuously monitoring cardiac activity
56
What is the aim of caslicks vulvoplasty?
Aims to close the dorsal commissure of the vulva and so improve the vulval seal
57
What are the indications of caslicks vulvoplasty?
Correction of mild conformational abnormalities which cause pneumovagina
Sunken anus
Sloping of the vulva
58
What is the technique for doing a caslick vulvoplasty?
1. Restrain mare
2. Clean vulva
3. Local infiltration
4. Remove 4 mm wide strip of vulvar mucosa at m-c junction
5. Do not remove skin as that will cause fibrosis
6. Close with interrupted or continuous sutures
7. Remove sutures (faeces stick to sutures)
59
What are some complications of caslicks vulvoplasty?
Faecal accumulation on sutures
| Wound breakdown
60
What is the aim of episioplasty?
Aims to produce some reduction in diameter of the vestibule
| Restores some degree of perineal function
61
What are the indications of episioplasty?
Correction of moderate conformational abnormalities which lead to pneumovagina
Elevated vulva in relation to pelvic floor
62
What are some complications of episioplasty?
Wound breakdown
63
What is the aim of eprineal body transection (pouret's operation)
Aims to increase the distance between the anus and the vulva
Resotres anatomy and function
64
What are the indications of pourets operation?
Correction of severe conformational abnormalities which lead to pneumovagina
65
What are some complications for Pouret's operation?
Penetration of peritoneum at surgery
| Wound breakdown
66
What are features of a 3rd degree perineal laceration?
Horrific appearance of vaginal and rectal wall
Haemorrhage and oedema
Faecal contamination of the vagina
Necrosis and sloughing for 7 days
67
What is the treatment for 3rd degree perineal laceration?
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TAT
Antimicrobials
Local irrigation
Vaseline
Leave 5-6 weeks for second intention healing
Ensure viable edges for suturing
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68
What should you advise the owner post treatment of 3rd degree perineal laceration?
No use for that breeding season
Anus may never function again
May require more than one attempt at surgical repair
69
How can you surgically repair a recto-vaginal fistula?
Create 3rd degree laceration surgically
| Repair as for 3rd degree laceration
70
What is the aim of the clitoral sinusectomy?
To remove the sinus areas to ensure that CEMO cannot be harboured prior to export
71
Why do twins rarely come to term in the mare?
Placenta of mare is epithelio-chorial (diffuse)
| The entire surface area of uterus is needed for successful nutrition of foal.
72
How many mares haves twins?
10% of mares
73
How can you diagnose pregnancy in the mare?
Failure to return to oestrus - day 18-24
(Elevated plasma progesterone day 18-20)
Transrectal ultrasound from day 12 (15 common)
Transrectal palpation from day 21
Plasma equine chorionic gonadotrophin from day 60 – 120
Transrectal ballottement of foetus from day 80
(Plasma or urine oestrogen from day 150)
74
When is the key time to diagnose twins in the mare, and why?
First ultrasound exam at day 14-15 because maternal recognition only occurs at day 17
75
During early PD (i.e. before day 17) where could the conceptus be?
Anywhere in the uterus, it is not until day 17 that the conceptus gets too large and cannot move around and will be at base of uterine horn
76
What are clues that a mare might develop twins?
Examination of mare during oestrus revealing 2 follciles which would develop into 2 CLs
77
What is the consequence of pregnancy loss before maternal recognition?
Return to oestrus
78
What is the consequence of pregnancy loss after maternal recognition but before day 40?
Long luteal phase in absence of pregnancy = pseudopregnancy
79
What is the consequence of pregnancy loss after endometrial cups form?
Mummification may occur
| Fetal death and expulsion more common
80
How can you differentiate a pregnancy from an endometrial cyst?
```
Conceptus - shape, will be spherical
Count the number of CLs
Size
Prior knowledge
Re-scan at next visit – cysts won’t have moved or changed shape
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81
When can you see embryonic mass on ultrasound?
From day 21
82
What is the normal physiology post ejaculation at breeding in the mare?
1. Cervix open, large volume of ejaculate and large penis.
2. Sperm deposited through open cervix and into the uterus ‘tranisent contamination phase’
3. Get a short duration inflammatory response
PMNs- influx of neutrophils into the uterus. Uterine contractions against fluid that has been deposited
4. Contamination resolved within 12hours
83
What are some risk factors for a mare developing mating induced endometritis?
Older mares- uterus hangs over front of the pelvis
Abnormal cervix
Uterine disease preventing uterine contractions
84
What is the fertilisation rate in mares with mating induced endometritis?
Same as normal mare, fertilisation rate not affected.
Get embryonic death.
85
What is the difference between endometritis in the mare and the cow?
Cannot get mating induced endometritis in the cow.
| In the mare get PG production and mare comes back into oestrus 16-18days later. In cows get a pyometra as lutea persists
86
What other species get mating induced endometritis?
Any species where sperm is deposited in the uterus i.e. sow and sometimes bitch
87
Why do most species not get mating induced endometritis?
Cervix closed, mucus plug present and only small amount of sperm ejaculated
88
What are the treatment options for mating induced endometritis?
1. Remove fluid- lavage and aspiration
2. Promote further drainage- oxytocin and PG
3. Control bacterial growth- intrauterine AB
4. Other options- dilate cervix if abnormal, lift uterus
5. If hasn't ovulated do not want to breed at this cycle
6. Examine daily
89
How can you prevent development of mating induced endometritis?
1. Use AI with semen contaminated with AB –
2. Clean stallion penis and mares vulva
3. Breed early: risk that sperm may not live enough but increase number of treatment days (sperm still in fallopian tube)
90
What are the treatment options for metritis?
1. Remove fluid, as for mating induced endometritis
2. Promote drainage as for mating induced endometritis
3. Reduce bacterial contamination as for mating induced endometritis
4. NSAIDs
5. Systemic Abs
6. Laminitis Tx
7. Fluids?
91
What is the aetiology of chronic endometritis in the mare?
Get bacteria from:
- breeding
- general high bacterial load
- persisted from when she foaled
92
What are some reasons for bacteria persisting in chronic endometritis?
Most likely reason is due to abnormal cervix
| Uterine disease
93
What is the pathogenesis of chronic endometritis?
Series of short cycles. Infected mare will release PG and have a bout 3 short cycles until long cycle where pyometra develops
