Equine reproduction 1, 2, 3 and 4 Flashcards
1
Q
What is the HBLB?
A
Horserace Betting Levy Board - produces codes of practice annually, veterinary committee meets annually, represents UK, Ireland, France, Germany and Italy
2
Q
What bacterial infections can affect equine repro tracts?
A
Taylorella equigenitalis (CEMO) Klebsielle pneumoniae (1,2 and 5) Pseudomonas aeruginosa
3
Q
What viral infections can affect equine repro tracts?
A
EVA EHV-1 EIA EHV-3 = Equine Coital Exanthema
4
Q
What does Trypanosoma equiperdum cause?
A
Dourine
5
Q
What causes Strangles?
A
Streptococcus equi
6
Q
How do you screen stallions for bacterial infections? And viral?
A
Tease to penile erection Stand by stallion’s left shoukdeer Hold penis with gloved hand Pre-moistened swabs (urethra, urethral fossa and diverticulum, penile sheath/prepuce for preputial smegma, (pre-)ejaculatory fluid). 2 sets but no less than 7 days apart. VIRUSES 1 serum sample for EVA titre (vaccinated with Artervac - most - will be positive) 1 serum sample for EIA (ELISA/Coggins test)
7
Q
How do you do pre-season screening of mares? Bacterial? Viral?
A
1st Jan - 15th Feb: swab late foaling mares one month before due date additional clitoral swab for dystocia/treated mares (Klebsiella and Pseudomonas) BACTERIAL: 1 set - clitoral sinus and fossa swabs VIRUSES: 1 serum sample - EVA titre 1 serum sample - EIA (Coggins/ELISA) test
8
Q
How do you screen mares who have suffered dystocia?
A
additional clitorial swab in addition to endometrial swab and smear when in oestrous more than 7 days after AB treatments have finished. Aerobic cultures to rule out: P. aeruginosa K. pneumoniae
9
Q
How are swabs transported?
A
fully immersed in Amies charcoal transport medium, to arrive <48 hours after collection
10
Q
What aerobic cultures are run of the swabs?
A
Blood and McConkey’s agar for up to 48 hours
11
Q
What microaerophilic cultures are run for the swabs?
A
Haemolysed CEMO agar with and without added streptomycin for at lest 7 days
12
Q
How is K. pneuomoniae types 1,2 and 5 confirmed?
A
capsule typing (Quellung) with Public Health Laboratory antisera
13
Q
How is Qaulity Control monitored?
A
Run positive CEMO culture plate in CO2 incubator
14
Q
How is Quality Assurance monitored?
A
biannual aerobic and microaerophilic culture tests from APHA administrated by HBLB (to give certification)
15
Q
How else can. T.equigenitalis, K. pnneumoniae and P. aeruginosa be tested?
A
qPCR (Qiagen, UK) QC - run + and - T. equigenitalis controls in each test QA - biannual swab tests from VLA administrated by HBLB - certification
16
Q
What are ‘true venereal diseases’?
A
I.e. pathogens that invade the repro tract, not as a result of contamination EXAMPLES = K. pneumoniae 1,2 and 5
17
Q
Where does a stallion ejaculate? How does mare cope with this?
A
STALLION: locks glans penis into cervix and ejaculates into uterus (everything: sperm, seminal plasma and male/female contamination)immune response, young mars cope well. MARE: myometrial contractions expel contents, huge leukocyte response against sperm/semen,
18
Q
What might indicate bacterial venereal infection in the mare? What actions need to be taken?
A
vaginal discharge 2days + after mating/AI early return to oestrous (< 15 days) no clinical signs ACTIONS Swab uterus, clitoral fossa, sinuses Stop mating/AI
19
Q
List some common secondary pathogens of the repro tract. 4
A
S. zooepidemicus E.coli S.aureus Bacteroides fraginelis
20
Q
Treatment options - equine bacterial venereal diseases
A
improve management of teasing and stud hygiene trace contacts, notify authorities treat uterus (appropriate ABs) clitorectomy (to remove carrier status) re-swab 3x7 days or more after treatment only mate when negative swab results confirmed
21
Q
What are mares prone to with increasing age?
A
increasing age –> vulva slopes –> pneumovagina –> increases risk of vaginitis, cervicitis, endometritis
22
Q
What does EVA (notifiable) cause?
A
bright-red conjunctivitis fever depression filled leggs head skin rash abortion/early pregnancy failure
23
Q
Diagnosis - EVA
A
blood samples (Abs) Nasopharyngeal swabs and tissues (PCR and culture)
24
Q
Control - EVA
A
Stop mating/AI/teasing trace contacts, notify authorities follow-up blood sample after 1 month (look for declining or static titres) 1/3 stallions become permanent shedders - semen cultures –> euthanasia if positive pre-vaccination seronegative test results in passport 6-monthly vaccination of stallions - Artervac No carrier status in mares - mares and geldings with static or falling seropositive titre are safe
25
Clinical signs - EHV-1
respiratory infection, nasal discharge weanlings/yearlings/horses out of training abortion ataxia, paralysis, incontinence (cauda equina problems)
26
Diagnosis - EHV-1
blood samples nasopharyngeal swabs PCR EHV-1 and EHV-4 ABORTION CASES: PME - foetus and placental membranes histopathology bacteriology mycology PCR EHV-1 and EHV-4 necrotic foci in liver with type A inclusion bodies
27
Outline the vaccination protocol for EHV-1
Equip 1,4 - licensed against abortion January and July (all pregnant mares) Good studfarm geographical organisation (horse cohorting essential)
28
Which EHV is particularly prone to symptomless carrier recrudesence?
EHV-4
29
Where is Dourine (Trypanosoma equiperdum) found?
North Africa and Italy (classical sign is silver dollar lesions on skin)
30
Clinical signs - Strangles - 3
Respiratory infection (nasal discharge, submandibular abscesses) Internal abscesses (pneumonia, colic, diarrhoea, weight loss) Youngsters
31
Diagnosis - Strangles
(Remember this is endemic) Discharge - nasopharyngeal swabs DON'T treat with ABs!
32
Treatment - Strangles
Contentious Early (pre-abscesses) use penicillin Abscess - hot fomentation Carriers: guttoral pouch washes Vaccine - was withdrawn, not available, use only after risk assessment
33
Diagnosis - Strangles
Nasopharyngeal swabs tracheal and guttural pouch washes - PCR Blood sampling - reveals challenge, not active disease (2 weeks to positivity)
34
How do imports from EU countries get treated?
No legal requirements for pre-import CEM swabs or EVA or EIA blood tests (UK horse industry must follow a voluntary Code of Practice for their own preservation).
35
Outline features (ovaries, cerivx, P4 levels) of a mare in anoestrous. Recommendations?
OVARIES: small, inactive CERVIX; pale and dry, not shut tight P4: \<1ng/ml RECOMMENDATION: artificial lighting, time
36
Outline features (ovaries, cerivx, P4 levels) of a mare in transitional phase. Recommendations?
OVARIES: multiple, non-maturing follicles CERVIX: pale and dry, not shut tight P4: \<2ng/ml RECOMMENDATION: 10 days oral allyl trenbolone and check 3 days later
37
Outline features (ovaries, cerivx, P4 levels) of a mare in persistent dioestrous. Recommendations?
OVARIES: functional CL, variable follicles CERVIX: pale and very dry, shut tight P4: \<2ng/ml RECOMMENDATION: PGF2a, IM
38
What should you monitor on each mare? 3
cyclic behaviour ovarian function uterine competence
39
When is teasing done?
Mon, Weds, Fri Daily during oestrous From 14 days after last mating (to see if coming back into season or pregnant)
40
Mare behavioural signs of oestrous
submissive ears forward legs straddled tail held high urinating everting clitoris/ winking clitoris
41
Mare behavioural signs of dioestrous
violent ears back screaming tail clamped down
42
Mare behavioural signs of transitional phase
ambivalent
43
What happens to the mare prior to first show to teaser?
Inspect perineum and vulva Vaginoscopy - endometrial swab and smear tests (for normal endometrial cells or leukocytes - latter indicates endometritis) 1. Rectal palpation - ovaries and uterus 2. Ultrasound scan - ovaries and uterus
44
What should be checked for on a perineal examination?
Signs of vulval discharge, injury, competence Discharge - vaginoscope, swab/smear, treat and re-examine next oestrous Injury - repair Incompetence - Caslick's vaginoplasty or Pouret's perineoplasty surgery (should have been dealt with earlier)
45
What stage of the cycle is this cervix? Why?
oestrous (relaxed, pink, moist)
46
What stage of the cycle is this cervix? Why?
Dioestrous (tight, pale, dry)
47
What should be checked for using a vaginal speculum?
Cervix appearance - stage of cycle Urovagina Cervical discharge Injury Endometrial swab and smear if cervix is relaxed - screen for evidence of acute endometritis (PMNs). If positive, treat uterus with 3 d course and examine next oestrous.
48
What should you check for on rectal palpation?
ovarian follicular size, consistency, position uterine size, consistency and homogeneity Repeat examine at 24-48 hours until ovulation can be predicted and mating recommended.
49
What should you check for on ultrasound?
ovarian follicular size, shape and deformability copora haemorrhagica and lutea uterine size, wall thiness and fold oedema lumenal fluid, quantity and echogenicity pregnancy or FBs Repeat examine at 24-48 hours until ovulation can be predicted and mating recommended.
50
When do most mares ovulate?
at night
51
Where does fertilisation occur?
uterine tubes
52
When does conceptus uterine migration occur?
by day 4
53
What does the uterus fill with in cases of uterine cysts?
fills with lymphatic fluid
54
For how long is the equine conceptus hypermotile?
up until day 19 (if they get stuck in horn, MRP fails)
55
List some uterine abnormalities that can occur
pneumouterus urometra (highly reactive CaCO3 crystals) pyometra (turbid fluid due to leukocytes) mural haematoma translumenal fibrous adhesions uterine FB
56
How can ovulation be predicted in mares?
- cervix: fully relaxed, pink, moist - soft, deformable \>3cm diameter follicle, moves towards ovulation fossa - uterus loosing fold oedema - aim for mating on day when ovulation will occur that might
57
How many matings should you aim for?
one mating per oestrous period (minimise uterine challenge, minimise stallion ejaculations, hCG or GNRH implasnts)
58
What will you see 48 hours after mating?
OVULATION EXAMINATION: RECTAL: loss of ovarian follicle, pain/discomfort ULTRASOUND: ovarian corpus haemorrhagicum, lumenal fluid, quantity and echogenicity Repeat mating if not ovulated Treat uterus if excessive/turbid uterine fluid: 3L sterile saline flush, 1g ceftiofur sodium i.u., 25 i.u. oxytocin IV
59
How does uterus feel in early pregnancy?
very tonic in early pregnancy, sometimes with perceptible bulge
60
How do you treat persistent dioestrous?
PGF2a injection after repeat examination at 48 hours
61
How do you deal with twins in a mare?
manipulate foetuses (early = motile), put transducer between foetuses, push one away and you will feel it go 'pop' (and die). mares cannot carry two offspring.
62
When does the foetus become visible on ultrasound?
about day 20
63
When does foetus start to come away from the wall?
about day 25. heartbeat visible
64
At what point is foetal anatomy visible?
6 weeks/ 42 days
65
Is bradycardia of foetus a sign of distress?
Yes (if HR is slow enough to count, it is probably too slow)
66
What do you do in cases of pregnancy failure (no foetal heartbeat)?
evacuate uterus with PGF2a injection and large volume saline and AB irringation. submit initial flushings for lab investigation to differentiate septic from non-septic causes.
67
What veterinary interventions are needed for pregnant mares?
Routine vaccinations and anthelmintic treatments Otherwise minimal until foaling unless illness, injury or abortion or are classified as high risk pregnancies
68
When should you gynacologically examine barren and rested mares?
autumn
69
What is meant by 'waxing up'?
when mare develops a waxy secretion at the tip of her teats when close to full term and udder is full of colostrum
70
What is the 1st stage of labour?
usually evening/night nest-making variable duration progresses and shows colic, frequently passes small quantities of urine and small droppings restless take several attempts to lie down, some apparent difficulty looks at flanks contractions increase abdominal pain roll, get up and down several times
71
When do you need to perform an episiotomy?
on Thoroughbred mares who have had Caslick's surgery previously or else the vulva will be torn during parturition (difficult to become pregnant after this).
72
What is the sign that ends 1st stage and starts 2nd stage labour?
rupture of chorioallantois
73
What should you do during 2nd stage of labour?
examine mare internally to check foal is coming correct way
74
Outline 2nd stage labour
violent abdominal straining unbroken, smooth coloured amnion starts to protrude from vulval lips allantoic fluid expelled (whiteish) muzzle and 2 front legs appear amnion still intact then chest expelled, now gentle assistance delivery
75
How might some first foal mares give birth differently?
may attempt to foal standing up (or if feel disturbed/insecure)
76
What is 3rd stage of labour?
stud groom ties the amnion up into a ball so that it is not damaged if mare stands up suddenly placental release usually occurs within an hour of birth, some take longer check to make sure placenta is complete, with the tips of both horns intact
77
What should the placenta be checked for?
tips of both horns posterior (cervical pole) amnion umbilical cord
78
What part of the placenta is most likely to be retained?
tip of non-pregnant horn
79
True/false: foals are born agammaglobulinaemic
True - no transfer of maternal Abs during pregnancy. highly dependent on good quality immunity being established in first 12 hours
80
How is foal positioned during normal pregnancy and foaling?
ventral or ventrolateral, head and forelimbs flexed normally twists to anterior presentation
81
What is meant by 'red bag' delivery?
if waters don't break, placenta can be seen thick, red and unbroken at vulval lips. If allowed to continue, the placenta is expelled as foal is born (i.e. too early) and ofal is at risk of asphyxiation. Placenta must then be opened manually.
82
Why might uterine inertia occur? Treatment?
Low calcium in blood Treat = oxytocin (IM) or Ca as appropriate, manual assistance Quite rare.
83
What is vaginal evisceration?
large colon tares through vagina. Anaesthetise and give emergency C-section then give more barbiturates to EUTHANISE (not recoverable)
84
Can a foal be delivered in the posterior position?
Yes, can be. Foetus tends to impact when half delivered. Reduced umbilical blood flow --\> deliver rapidly. Resuscitate with O2. Monitor foal for NMS.
85
What do you do if one foreleg is back? Or head and neck back?
Keep mare standing Pull mare's tongue out (straining impossible) Epidural analgesia Lots of vaginal lubrication Repel foetus Ropes Deliver when in normal posture Both presentations dealt with same way
86
What do you do if the foal is coming in a breech position?
Epidural analgesia Live foetus --\> c-section (must be in hospital. midline or flank depends on surgeon's preference) Dead foetus --\> c-section + foetotomy
87
Outline an epidural anaesthesia protocol
6 inch spinal needle 1st intercoccygeal space 7-10ml lidocaine (2%) 7.5ml xylazine (1%)
88
What is an embryotome?
a cutting instrument for removal of a foetus when normal birth is not possible
89
What may cause pain after foaling: SOON 28-48 hours and WEEKS/MONTHS?
SOON: Uterine artery haemorrhage, uterine rupture, colonic/caecal rupture LATER: colon torsion
90
Signs of a fatal haemorrhage 3
severe colic or collapse very pale MM shock
91
Signs of a contained haematoma
less severe colic normal MM mass on rectal exam
92
Which of these are usually fatal: caecocolic rupture uterine prolapse uterine rupture rectal prolapse
usually all
93
What can a retained placenta progress to?
septic metritis laminitis death of mare
94
Treatment - retained placenta
Oxytoxin drips: 0.5 i.u. in 500ml saline every 2 hours ABs and non-steroidal analgesics/anti-endotoxic doses of flunixin meglamine collect chorioallantois and pump in weak (t tear out placenta in fragments unless no alternative daily large volume uterine flushes and maintain systemic ABs and anti-endotoxics Beware laminitis (frog support, check)
95
What causes obturator paralysis in mares?
doing the splits whilst foaling
96
When is colon torsion seen? Signs? What does outcome depend on? Treatment? 1
WHEN: 24-48 hours after foaling, weeks-months later SIGNS: severe violent colic OUTCOME DEPENDS ON: early Dx, early surgery, degree of 'twist' TREATMENT: colopexy
97
What is meant by 'foal heat'?
at 7-10 days after foaling, the first oestrous after foaling
98
What are cervical injuries?
Mucosal splits (usually heal with time) Trans-os adhesions (give fucidin/hydrocortisone treatment) Lacerations (surgery sometimes necessary) Incompetence (allyl-trenbolone = regumate) Guarded/poor prognosis for pregnancy maintenance
99
How can perineal lacerations be described?
minro 1st degree 2nd degree 3rd degree rectovestibular fistulae
100
What is a 1st degree laceration? Treatment?
- small tears of MM of vulva and vestibule - usually heal uneventfully or with minimal surgical interference, as for Caslick repair - 'no vulva, no broodmare'
101
What is a 2nd degree laceration? Treatment?
involve deeper strucutres (constrictor vulvae mm, perineal body) require surgical correction (immediate/next day, then wait for mucosal healing)
102
What is a 3rd degree laceration? Treatment?
tearing of vagina/vestibular walls, perineal body, anal sphincter, rectal wall common opening of rectum and vestibule (cloaca) Treatment - surgical correction, immediate first aid, regular cleaning to mucosal healing by 10 days, surgical reconstruction (1st phase at 4-6 weeks, 2nd phase at 4-6 weeks later)
103
Treatment - rectovestibular fistulae
most but not all require surgical correction (immediate first aid, clean vulva examine at 4-6 weeks and determine size and position of fistula). If caudal and small leave as long as possible to heal as small as possible If more cranial and large, convert into a 3rd degree lacteration and reconstruct immediately
104
What is the 1st stage of repair of a 3rd degree laceration?
PREPARATION: empty rectum clean site thick, wide stay sutures good view good analgesia relaxed (mare and surgeon!) SURGERY: reconstruct damaged rectovaginal shelf back to near vulva, leave relaxed anus to allow defaecation, daily wound treatment for 7 dyas, AB and anti-inflammatory drugs, exercise
105
What is the 2nd stage of repair of a 3rd degree laceration?
PREPARE (as for 1st stage) SURGERY 4-6 weeks after 1st stage Repair perineal body Aftercare (as for Caslick's surgery)
106
Do perineal lacerations affect future fertility?
not significant if surgical repair is good no predisposition to recur at future foalings
107
What is a permanent feature of 3rd degree repairs?
anal air aspiration
108
What can be seen on ultrasound of a 14 day old conceptus?
clear hyperechoic circular mobile conceptus in either uterine horn or uterine body
109
At what point is the foetus more deformable?
day 20 conceptus still clear hypoechoic live heart beat seen, about 2.3mm
110
When can the junction between the yolk sac and chorioallantoic placentae be seen?
day 35 (also the developing amnion can be seen at this point)
111
Outlien endometrial cups
feotal cells migrate from chorionic girdle into endometrium at about day 35 and form a ring of cup-like structures which secrete eCG which prevents a return to oestrous. Immunologically rejected by day 100
112
When can the head/neck/thorax/abdomen/parts of limbs be seen clearly?
day 59
113
How is a filly foetus identified?
perineum of foetus shows a bilobed genital tubercle (GT) under the tail (day 65)
114
How is a colt foetus identified?
transverse view of abdomen shows a bilobed genital tubercle (GT) near the umbilicus
115
What are the different variations of twins that could form? 4
unilateral separated - similar size, separated in same uterine horn unilateral adjacent - similar sized, adjacent capsules touching in same uterine horn bilateral asynchronous - different sized, separated in different uterine horns horn/body asynchronous - different sized, larger one in uterine horn, smaller one in the uterine body
116
What does an aborted foeuts that is haemorrhagic suggest?
cardiovascular embarrassment
117
What are the 3 recognised true equine venereal bacterial pathogens?
Taylorella equigenitalis (CEMO) Klebsiella pneumoniae (1, 2 and 5) Pseudomonas aeruginosa
118
Which bacteria can affect the long term health of a mare's endometrium?
Streptococcus zooepidemicus Escherichia coli Staphylococcus aureus
119
What are the different swab types for sampling a mare? What transport medium is required?
Narrow tipped - clitoral sinuses Normal tipped - urethral opening, clitoral fossa Transport medium - Amies with charcoal for all bacterial cultures and qPCR No transport medium - endometrial smears.
120
Where are the clitoral sinus, clitoral body and clitoral fossa located in the mare?
See image
121
When do you take a combined urethral opening, clitoral fossa and sinus swab?
Industry screening only NOT for export swabs Narrow-tipped swab in urethral opening, all around clitoral fossa and then in central clitoral sinus. Collect pea of 'smegma' if available
122
What should endometrial swabs be submitted for?
Aerobic culture (low risk mares) Microaerophilic cultures or CEMO qPCR (high risk mares and mares with signs of inflammation or discharge or 'short-cycling' mares)
123
How do you make an endometrial smear?
make smear (gelatine-coated slides), fix and refer to stain smear with pre-stained slides
124
What are the signs from an endometrial smear of acute endometritis?
Endometrial cells - smear quality control PMNs - signs of inflammation - should be none or only the occasional PMN seen: 0 = none +/- occasional, 30% cells seen
125
What does this show? Actions?
Normal endometrial epithelial cells only ANy bacterial isolates are contaminants or commensals therefore = normal endometrium, therefore mare is fit for mating.
126
What does this show? Actions?
\> or equal to 1 PMNs --\> suggests acute endometritis, bacterial isolates are opportunist pathogens, mare not fit for mating, treat mare, wait until next oestrous to confirm 'clean' before mating
127
How many functional seals are there between the uterus and exterior?
3 - cervix, vestibular seal and vulval seal (closed in dioestrous, in oestrous, vulva and cervix relax but vestibular seal intact if upper commissure of vulva is at level of pelvis)
128
What does a low pelvis in relation to the upper commissure of the vulva predispose to?
pneumovagina
129
What does a low pelivs in relation to the upper commissure of the vulva in combination with a sloping vulva predispose to?
Pneumovagina complicated by faecal contamination
130
How does perineal conformation change with age and multiparity? 3 What does this predispose? 3
abdomen sinks anus displaces cranially upper commissure of vulva dragged cranially leading to sloping vulva PREDISPOSES: pneumovagina, cervicitis and endometritis REQUIRES:Caslick vulvoplasty and Pouret perineal resection (if severe)
