Equine - Mare BSE Flashcards
What are the indications for a breeding soundness exam?
pre-breeding evaluation or pre-purchase evaluation
What are all of the components of a complete BSE?
history, PE, reproductive exam, vaginal exam, endometrial culture and cytology, and endometrial biopsy
What general history information should you get at BSE?
breed, age, vaccination and deworming history, boarding facilities, performance and travel history, previous vs. intended use, medical and surgical history, and feeding schedule/changes
What reproductive history information should you get?
Information about the estrous cycle, previous breedings/pregnancies, previous foaling experience, breeding method, abortions, evidence of vaginal discharge
What questions about the estrous cycle history should you ask?
Does she show heat? Interval between heats? Last known heat? Teasing ability? Teasing method?
What should you examine on an external evaluation for BSE?
the mammary system, conformation of the vulva, perineum, and anus, Caslicks, vaginal discharge, and clitoral evaluation
What is normal perineal conformation?
long axis of vulva should be vertical, well apposed vulvar labia, intact perineum, anus should not be sunken, and intact vestibulo vaginal seal
What are the steps of the Caslick’s procedure?
- Sedate and restrain more
- Clean and sanitize perineum then local anesthesia was injected locally into the vulvar lips
- Two vertical incisions were made through the submucosal and connective tissue layers of the vulvar lips
- Stitches were used to pull together the lips vertically
- The sutures should be removed after 10-14 days
How is internal evaluation of the reproductive tract done?
transrectal palpation/ultrasound
What should be evaluated internally?
Cervix/uterine body/uterine horns/ ovaries, cyclicity, abnormalities, pregnancy
How big should the ovaries be?
they should fit in the palm of your hand - kidney bean shaped
How, structurally, should the uterus be during anestrus? Early estrus? Late estrus? Diestrus?
Anestrus - Flaccid, thin walled, quiescent
Early estrus - thicker, more vascular, heavy
Late estrus - heavy, thick walled
Diestrus - toned
How, structurally, should the ovaries be during anestrus? Early estrus? Late estrus? Diestrus?
Anestrus - small, firm, inactive
Early estrus - Small follicles
Late estrus - medium to large follicles
Diestrus - follicles of various sizes, CL present
How, structurally, should the vagina be during anestrus? Early estrus? Late estrus? Diestrus?
Anestrus - pale, dry
Early estrus - pink, moist
Late estrus - purple-red, vascular, moist
Diestrus - pale, dry
How, structurally, should the cervix be during anestrus? Early estrus? Late estrus? Diestrus?
Anestrus - pale, dry, high and tightly closed
Early estrus - softening, moist, and pink
Late estrus - very soft, reddish pink, dropped to the floor
Diestrus - pale, dry, high and tightly closed
How can the vagina be examined?
via speculum or manual examination
What is the objective of doing a uterine (endometrial) culture?
determine whether microorganisms are present within the cavity of the uterus causing endometritis
When is a uterine culture indicated outside of a BSE?
prior to live cover or shipped semen or problem mares
When are samples collected for a uterine culture?
during any season or stage of the estrous cycle but the preference is during the breeding season during early estrus
What are the steps of sample collection for uterine culture?
- Clean perineum
- sterile sleeve +/- sterile gloves
- Sterile lubricant
- Pass double-guared swab through opened vulvar lips, vestibule, vagina and to the opening of the external cervical os
- Advance the inner guard from the outer guard and expose the swab to the uterine lumen
- Withdraw inner guard into outer guard
- Avoid contamination of the swab going in and out
- Place swab into transport system and submit to laboratory for AEROBIC culture
What are the common isolated organisms in a uterine culture?
beta-hemolytic streptococci (zooepidemicus), E. coli, Pseudomonas aeruginosa, Klebsiella pneumoniae
Postive results do not necessarily indicate endometritis - what are come common contaminants of uterine culture?
alpha-hemolytic streptococci, Actinobacillus equuli, Salmonella enteritidis, Pasteurella-like species, Staphylococcus, Enterobacter, Acinetobacter, Proteus, Citrobacter, Alcaligenes, and Aeromonas
How is a uterine cytology done?
- Many times taken immediately after the culture swab
- Roll on to a glass microscope slide (or two)
- Stain with Diff Quik of Modified Wright’s
- View microscopically for evidence of neutrophils, debris and microorganisms
When would you want to do a low volume lavage?
in trouble mares
How is a low volume lavage done?
- Infuse sterile saline into the uterus using a closed system with a small uterine catheter
- Administer oxytocin to enhance uterine evacuation
- Effluent is collected by gravity flow and centrifuged
- Swab pellet, place in transport media, and submit for culture (and cytology)
True or False: Mixed miscellaneous microorganisms are significant results in a culture/cytology
false- they are not significant
What is considered a significant result from a culture?
Heavy growth of any microorganism is considered significant unlessthere was obvious contaminaiton
What results on a cytology is associated with active inflammation?
greater than 1-2 PMN per 5 HPF or epithelial to leukocyte ration of 10:1
What diagnostic test results points towards endometritis?
positive culture with evidence of inflammation
Does a negative cytology rule out endometritis?
no - the infection could be deep or chronic or there could be error due to the sample technique
What is the objective for an endometrial biopsy?
to evaluate the histologic and microscopic anatomy of the uterine lining and endometrium, diagnose uterine disease, and prognastic indicator of the mare’s ability to carry a foal to term
What are the specific indications for endometrial biopsy?
Barren mares, problem breeding mares, mares with a history of pregnancy loss, and/or pre-purchase exam
When is a sample collected for an endometrial biopsy?
It can occur at any stage of the estrous cycle
Where is a sample for an endometrial biopsy obtained from?
it is obtained at the base of uterine horns
What are endometrial biopsies put in?
Bouin’s solution or 10% formalin
What are endometrial biopsies evaluated for?
inflammation, fibrosis, and cystic dilation of glands
Endometrial inflammation is treatable/untreatable and reversible/permanent.
treatable, reversible
Endometrial fibrosis is treatable/untreatable and reversible/permanent.
untreatable, permanent
Endometrial cystic dilation of glands is treatable/untreatable and reversible/permanent.
untreatable, permanent
What is a grade I on the Kenney and Doig Grading System?
Normal endometrium
Minimal, focal inflammation or fibrosis
80-100% chance of maintaining a pregnancy
What is a grade IIA on the Kenney and Doig Grading System?
Mild to moderate inflammation and/or multifocal fibrosis
1-3 layers of fibroblasts surrounding glands or <2 fibrotic nests per 5mm linear field
50-80% chance of maintaining a pregnancy
What is a grade IIB on the Kenney and Doig Grading System?
Moderare inflammation and/or multifocal to diffuse fibrosis
4 or more layers of fibroblasts surrounding glands or 2-4 fibrotic nests per 5mm linear field
10-50% chance of maintaining a pregnancy
What is a grade III on the Kenney and Doig Grading System?
Severe inflammatory and/or diffuse fibrotic changes
5 or more fibrotic nests per 5mm linear field
Less than 10% chance of maintaining a pregnancy
What are some ancillary tests for BSE?
hysteroscopy, hormone analysis, and karyotyping
