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Disturbances in Reproduction > Equine - Mare Infertility: Infectious > Flashcards

Equine - Mare Infertility: Infectious Flashcards

1
Q

What is the etiology of vaginitis and cervicitis?

A

Irritation from air, urine, particulate matter or chemicals or breeding or foaling trauma

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2
Q

How is vaginitis and cervicitis diagnosed?

A

speculum exam +/- culture

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3
Q

What will you see on a speculum exam with a mare that has vaginities and cervicitis?

A

hyperemic mucosa +/- discharge

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4
Q

What is the treatment for vaginitis and cervicitis?

A

Caslick’s procedure, +/- lavage with sterile saline, maybe antibiotics

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5
Q

How is vaginitis and cervicitis prevented?

A

Use a breeding roll with maiden mares, attend all foalings, and a Caslick’s procedure

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6
Q

What is salpingitis?

A

the inflammation of the fallopian tube

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7
Q

What is the etiology of salpingitis?

A

isthmitis, ampullitis, infundibulitis

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8
Q

80% of cases of isthmitis occur with _______.

A

endometritis

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9
Q

What causes ampullitis?

A

an ascending infection from endometritis

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10
Q

Why does it take longer for the ampulla to recover from infection?

A

because it has a highly folded mucosal surface

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11
Q

What causes infundibulitis?

A

adhesions from Strongylus edantatus larval migration

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12
Q

How is salpingitis diagnosed?

A

It is very difficult to diagnose - diagnosis by elimination

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13
Q

What is the treatment for salpingitis?

A

no definitive treatment - prostaglandin may be helpful

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14
Q

What is pyometra?

A

accumulation of excessive amounts of purulent material within the uterus

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15
Q

What is endometritis?

A

uterine infection involving the only endometrium

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16
Q

What is metritis?

A

uterine infection involving all of the layers of the uterus - endometrium, myometrium, and serosa

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17
Q

What diffenses does the uterus have?

A

uterine clearance and immune response

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18
Q

What are the mechanisms of uterine clearance?

A

muscular expulsion, open cervix, uterine position, and lymphatic drainage

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19
Q

Susceptible’ mares have what in regards to the immune response?

A

Diminished opsonic antibody mediated elimination activity, factors within uterine secretions that interfere with PMN phagocytosis, and a deficiency in antigen processing within the uterus due to decreased macrophage response

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20
Q

What is the pathogenesis of pyometra?

A

chronic infectious endometritis results in loss of endometrial glands and cervical fibrosis

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21
Q

What are the clinical signs of pyometra?

A

prolonged anestrus (or diestrus), +/- vulvar discharge, no systemic signs

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22
Q

Do you need a CL to have pyometra?

A

nope

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23
Q

How is pyometra diagnosed?

A

transrectal palpation and ultrasound, and vaginal speculum examination

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24
Q

What will transrectal palpation and ultrasound show in a mare that has pyometra?

A

enlarged, edematous, fluid-filled uterus, +/- CL on the ovary

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25
Q

What may you find on vaginal speculum examination on a mare with pyometra?

A

It may or may not have purulent discharge

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26
Q

How is pyometra treated?

A

prostaglandin and uterine lavage or surgery

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27
Q

How do you surgically treat pyometra?

A

create a cervical laceration to create an incompetent cervix to allow for future drainage

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28
Q

What is the most common cause of infertility in mares?

A

endometritis

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29
Q

What do mares that are susceptible to endometritis exhibit?

A

a breakdown in their defense system - immune response + physical barriers

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30
Q

What are the predisposing factors to endometritis?

A

contamination during breeding, compromised uterine defenses, pneumovagina and fecal aspiration, may also occur following prolonged antibiotic treatment, cervical adhesions, or hyperadrenocorticism

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31
Q

What makes a mare more susceptible to endometritis?

A

age, parity, poor perineal conformation, lack of uterine tone, diestral fluid, and estral fluid

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32
Q

What are the sources of infeciton in a mare?

A

anatomical defects, breeding, iatrogenic combination, and parturition

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33
Q

What anatomical defects can lead to infection?

A

defects in vulvar lips, vestibulovaginal sphincter, or cervix

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34
Q

True or False: We always create a mild form of metritis during breeding.

A

TRUE

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35
Q

How can breeding cause infection?

A

contamination in the semen due to bacteria on the penis and sheath, semen is foreign to the uterus, and susceptible mares are more at risk due to decreased clearance post-breeding

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36
Q

How can we iatrogenically contaminate a mare?

A

improper cleaning of perineal area and not using asceptic techniques

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37
Q

How can parturition lead to endometritis?

A

infection from the environment, trauma, and retained placenta

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38
Q

What are the clinical signs associated with pyometra?

A

dam is not systemically ill, shortened diestrus, uterine fluid accumulation +/- vulvar discharge (matting of tail hairs), and failure to conceive

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39
Q

How is endometritis diagnosed?

A

history and clinical signs, transrectal palpation, ultrasound, vaginoscopy, culture, cytology, and biopsy

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40
Q

What will you see on ultrasound in a mare with endometritis?

A

echogenic particles within intraluminal fluid +/- thickened uterine wall

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41
Q

What will you see on vaginoscopy in a mare with endometritis?

A

hyperemic mucosa +/- exudate

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42
Q

What bacterial agents are commonly associated with endometritis?

A

Strep zoo, E. coli, K. pneumoniae, P. aeruginosa

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43
Q

What fungal agents are commonly associated with endometritis?

A

Candida, Aspergillus, Mucor

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44
Q

What possible contaminants agents are associated with endometritis cultures?

A

Staph, Alpha-hemolytic streptococcus, Bacillus

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45
Q

Cytology is an immediate indicator of an _____ infection.

A

active

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46
Q

Does a negative cytology rule out endometritis?

A

no

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47
Q

What would a biopsy be done to determine with endometritis?

A

degree and type of inflammation

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48
Q

What can you assess on biopsy in an endometritis case?

A

cystic glands and lymphatic lacunae

49
Q

What is the treatment for endometritis?

A

three-fold attack - uterine lavage, ecbolics, and antibiotics

50
Q

What is the purpose of a uterine lavage?

A

to remove pathogens and debris

51
Q

What is recommended to do to the fluid prior to uterine lavage?

A

it is recommended to warm it to increase uterine tone/circulation

52
Q

What fluids can be used for a uterine lavage?

A

LRS, saline, or distilled water + salt (34 grams per gallon - 25 cc or one 60cc cap full)

53
Q

What would you add to a uterine lavage to treat fungal infections?

A

2% vinegar

54
Q

What would you add to a uterine lavage to improve opsonization?

A

homologous plasma

55
Q

What would you add to a uterine lavage to inhibit endometrial adherence of S. zoo, E. coli, and P. aeruginosa?

A

Monosaccharide sugar solutions

56
Q

What would you add to a uterine lavage for a post partum lavage?

A

betadine - 5cc per liter

57
Q

What are the benefits of uterine lavage?

A

remove debris, improve uterine tone, and it can be performed 4-6 hours after insemination

58
Q

What is the purpose of ebolics?

A

to enhance uterine contractility

59
Q

When is the optimal time to use ecbolics?

A

use 4-12 hours post-insemination

60
Q

What are the ecbolics that can be used for treatment of endometritis? What is the most common?

A

Oxytocin (most common), Lutalyse (dinoprost), and Estrumate (cloprostenol)

61
Q

What antibacterials can be used to treat endometritis?

A

Gentamicin and Amikacin, Ampicillin and Penicillin, Ticarcillin, and Ceftiofur (Naxel)

62
Q

What antifungals can be used to treat endometritis?

A

Clotrimazole, Miconazole, and Lufenuron (Program)

63
Q

What are Gentamicin and Amikacin inactivated by?

A

organic material so make sure to do a uterine lavage beforehand

64
Q

Ticarcillin is a ____ specrtrum antibiotic, but it is not effective against ______.

A

broad; Klebsiella

65
Q

What antibacterial is safe to use around breeding? Characterize it?

A

Ceftiofur - broad spectrum, water soluble, and non-irritating

66
Q

True or False: Only the uterus needs to be treated with anti-fungals.

A

false - the entire uterus, cervix, and vaginal vault are treated

67
Q

When may Clotrimazole be indicated?

A

If there is a Candida fungal endometritis

68
Q

When may Miconazole be indicated?

A

If there is a Candida or restistant fungal endometritis

69
Q

What is the prognosis if there is a fungal endometritis?

A

poor

70
Q

What are the options for systemic antibiotic treatment and are they recommended?

A

SMZ-TMP or Enrofloxacin - Not the best choice because therapeutic levels intrauterine are questionable, duration of therapy is usually prolonged, and it can get expensive

71
Q

What is the pathogenesis of postpartum metritis?

A

Uterine defenses are compromised and the uterus becomes contaminated with a variety of pathogenic and nonpathogenic microorganisms

72
Q

What are the predisposing factors to postpartum metritis?

A

Uterine inertia, uterine torsion, hydrops, dystocia, retained placenta, dirty foaling area, being a draft mare, and lack of exercise

73
Q

When does postpartum metritis occur?

A

within 2 days postpartum

74
Q

What clinical signs are associated with postpartum metritis?

A

voluminous, malodourous, reddish-brown, watery discharge and systemic illness

75
Q

What systemic signs may a mare have with postpartum metritis?

A

febrile, depression, anorectic, ileus, tachycardia, tachypnea, endotoxemia, injected mucous membranes, laminitis, decreased milk production, increased neonatal losses

76
Q

What agents may cause fatal toxemia in postpartum metritis cases?

A

Clostridium tetani and perfringens

77
Q

How is postpartum metritis diagnosed?

A

Subinvoluted uterus, culture, cytolog, hemogram, and abdominocentesis

78
Q

What diagnostic test is not recommended for postpartum metritis?

A

culture

79
Q

What will you see on hemogram in a mare with postpartum metritis?

A

Increased PCV, leukocytosis with immature neutrophilia or neutropenia with toxic changes, increased fibrinogen, increased muscle enzymes and pre-renal azotemia

80
Q

What is the treatment for postpartum metritis?

A

Correct the underlying problem, supportive care, systemic antibiotics and anti-inflammatories, uterine lavage, and ecbolics (oxytocin and prostaglandin)

81
Q

When may you suspect biofilm as the cause of infertility in a mare?

A

The mare is having recurrent infections despite proper diagnositics/treatment

82
Q

What are the treatment options for biofilm?

A

Infusions (n-Acetylcysteine, Tris EDTA, others), uterine lavages (following infusion), and intrauterine antibiotic therapy

83
Q

When should a pre-insemination lavage be done?

A

immediately prior to breeding

84
Q

What is the benefit to doing a pre-insemination lavage?

A

Excessive fluid accumulation and known fertility issues

85
Q

What is the benefit to doing a post-insemination lavage?

A

Persistant post-breeding endometritis AKA delayed uterine clearance

86
Q

When should post-insemination lavage be performed?

A

no sooner than 4 hours post insemination (usually wait 6-8 hours)

87
Q

What is Persistent Post-breeding Endometritis aka Delayed Uterine Clearance (DUC)?

A

Inability to clear intraluminal fluid within 12-48 hours post-breeding

88
Q

What is the pathogenesis of DUC?

A

Normal inflammatory response post insemination leads to an influx of PMNs into uterine lumen due to chemotactic effect of sperm. There is then a sustained inflammatory process after ovulation results in luteolysis +/- early embryonic death (prostaglandin release from endometrium)

89
Q

What is DUC most common in?

A

Mares bred with frozen/thawed semen > cooled, shipped > liver cover
Use extender to mitigate

90
Q

How is DUC diagnosed?

A

via ultrasound

91
Q

What will you see on ultrasound in a mare with DUC?

A

excessive, echogenic, intraluminal fluid > 12 hours post breeding

92
Q

How is DUC treated?

A

Uterine lavage (4-12 hours post-breeding) and Ebolics (4-24 hours post-breeding)

93
Q

What ecbolics can be used to treat DUC?

A

Oxytocin and Cloprostenol

94
Q

The probability of a successful pregnancy in a mare with DUC is significantly lower if a mare is bred more than _ cycles?

A

3

95
Q

How is DUC prevented?

A

Use minimal contamination breeding techniques, clean mare and stallion before breeding, extend semen with appropriate antibiotics, use minimum insemination dose, and do not indiscriminately use intrauterine antibiotics

96
Q

What are the three important equine venereal diseases?

A

Contagious equine metritis (CEM), coital exanthema, and Dourine

97
Q

What is Contagious Equine Metritis caused by?

A

Taylorella equigenitalis

98
Q

How is Contagious Equine Metritis transmitted?

A

Venereally, fomites, or in utero or intrapartum

99
Q

Where does Taylorella equigenitalis live in the reproductive tract?

A

In the clitoral sinuses of the mare and urethral fossae of stallions

100
Q

What clinical signs are associated with Contagious Equine Metritis?

A

Shortened diestral periods, copious mucopurulent discharge, severe and acute endometritis, and early abortion

101
Q

When does Contagious Equine Metritis resolve?

A

In 14 days

102
Q

How is Contagious Equine Metritis diagnosed?

A

clitoral sinus swabs

103
Q

What is the process for getting a Contagious Equine Metritis diagnosis?

A
  1. Swab the clitoral sinus swab
  2. Transport the sample in Amies medium supplemented with charcoal within 24 hours off colleciton
  3. Cultured on chocolate blood agar by an accreditied lab
  4. The culture is incubateed for 48-72 hours under microaerophilic and aerobic conditions
104
Q

Is Contagious Equine Metritis reportable?

A

yes

105
Q

What is the recommended treatment for Contagious Equine Metritis?

A

It is sensitive to a wide range of antibiotics and antiseptics, intrauterine antibiotics, thorough cleaning of the clitoral fossa and sinuses, and a clitoral sinusectomy in mares that still culture positive after treatment

106
Q

What do you want to clean the clitoral fossa and sinuses with in a mare with Contagious Equine Metritis?

A

chlorhexidine and packing with chlorhexidine or nitrofurazone ointment for 5-7 days

107
Q

How is Contagious Equine Metritis prevented?

A

Mares should have a negative clitoral culture before and after arrival at a breeding farm AND a negative endometrial and clitoral culture during early estrus prior to breeding

108
Q

What causes coital exanthema?

A

EHV-3

109
Q

What clinical signs are associated with coital exanthema?

A

1-3mm painful vesciles (pustules/ulcers), appears 5-7 days after contact, genital area of mares and stalilions, permanent loss of pigmentation is common

110
Q

When do mares typically heal from coital exanthema?

A

in 7-10 days

111
Q

How is coital exanthema diagnosed?

A

clinical signs, serology, and intranuclear inclusion bodies in a histopathology sample

112
Q

How is coital exanthema treated?

A

No breeding until the lesions resolve, antiseptic ointment can be used to prevent secondary bacterial infection

113
Q

What causes Dourine?

A

Trypanosoma equiperdum

114
Q

Where is Dourine found?

A

Africa, South America, Middle East, and Asia

115
Q

What clinical signs are associated with dourine?

A

low-grade chronic fever, urticara, muscle wasting, collapse, death

116
Q

What mare specific clinical signs are associated with Dourine?

A

mucoid vaginal discharge, edema

117
Q

What stallion specific clinical signs are associated with Dourine?

A

scrotal and preputial edema extends to the ventral abdomen and chest

118
Q

How is Dourine diagnosed?

A

Clinical signs/history, organism observed on smears/aspirates of plaques, discharges, CSF, and blood, and serologic testing

119
Q

What is the treatment for Dourine?

A

none - euthanize to prevent spread

Disturbances in Reproduction (49 decks)

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