Exam 3 (horses)

Question 1

Normal Estrus Cycle in Mares, estrus cycle length, length of estrus, length of diestrus

Answer 1

o Long day breeders (April- October)
o Photoperiodic control of reproduction

Estrous cycle length
 21 days

Length of estrus
 7 days (3 to 12 days)
 Ovulation occurs in the last 24 to 48 hours of estrus
 Estrogen causes uterine edema

Length of diestrus:
 14–15 days
 Progesterone causes max uterine tone

Question 2

Basics of Advancing Horse Breeding Season

Answer 2

o Start 60 days before desired breeding date
o Apply 16 hours of light per day
o 10 foot-candles at mare eye level, mare w/in 8 feet of 200 watt incandescent bulb, or mask
o Stallion needs to be on light
o light+ progesterone OR
o light + progesterone + GnRH OR
o Light + Dopamine antagonist

Question 3

Using Progesterone to Advance Breeding Season

Answer 3

o Used if mare is not transitioning fast enough

Short acting progesterone
 Average days to estrus: 4-7
 Average days to ovulation: 7-12

Long-acting progestogen
 Ovulation at 18 – 26 days

Question 4

Horse Breeding Options

Answer 4

o Natural cover (required for some breeds)
o Cooled semen (most common)
o Frozen semen
o Embryo transfer
o Oocyte transfer

Question 5

Requirements for Shipping Equine Semen in WA

Answer 5

o Current Coggins test and health certificate
o Negative EVA test from the current calendar year or proof of vaccination
o Semen permit number issued by the WSDA
o Semen evaluation paperwork

Question 6

How to Naturally Breed Horses

Answer 6

Pasture mating
 high risk for mares and stallions

In-hand mating (old approach)
 Tease and breed mare every 48 hours starting on the 3rd day of estrus
 Never go beyond 12 days of estrus

In-hand mating (modern approach)
 Limit # breeding in mares susceptible to endometritis
 Efficient use of stallions
 Use Minimum contamination breeding technique
 Monitor follicular growth and induce ovulation
 Breed at the time of induction of ovulation or 24 hours later

Question 7

When to Induce Ovulation & Timing of Artificial Insemination in the Mare

Answer 7

o Mare is monitored by ultrasonography

When to Induce Ovulation Pharmacologically
 Follicle > 30 mm (GnRH, Deslorelin)
 Follicle >35 mm (hCG)
 Presence of uterine edema

Timing of insemination
 Cooled shipped semen: 24 hours post induction (12 to 24 hours before ovulation)
 Frozen semen: 2 doses 24 and 40 hours post induction OR 1 dose after ovulation

Question 8

Drugs for Induction of Ovulation

Answer 8

Human chorionic gonadotrophin (hCG)
 LH activity
 Can cause anaphylactic reactions
 Less efficacious if repeated
 Ovulation in 24 to 48 hours

Deslorelin
 GnRH analogue
 ovulation in 42-52h

Question 9

Endometritis After Insemination

Answer 9

o Check ultrasound 24hrs post insemination for ovulation & fluid accumulation
o All mares will have some endometritis after breeding (insemination)
o NOT normal to have persistent endometritis

Question 10

Pregnancy Diagnosis in Mare; day 14, 25, 56, 90

Answer 10

14 days post-ovulation
 Check for double ovulation and twins
 Check quality of CL
 Place high risk mares on Progesterone therapy

25-30 days
 Fetal heartbeat

56-65 days
 Fetal sexing

90 –100 days
o Check mares w/ repro problems

o Check at 5 months

Question 11

Nutritional Care of Pregnant Mare

Answer 11

Up to 8mo
 Feed 1.5-2% BW

Last trimester
 Fetal grows 1lb /day
 Feed 2.25-2.5% BW
 Total protein of 12-14%
 Ca/P ratio 1.2- 1.5:1

Question 12

Vaccines / Deworming for Pregnant Mare

Answer 12

4- 6 weeks before due date
 Influenza
 Eastern and Western encephalitis
 Tetanus
 Rabies
 West Nile virus

5, 7, & 9 months of pregnancy
 Equine Herpesvirus 1 (EHV-1, Rhinopneumonitis)

Other Vaccines
 Botulism
 Rotavirus
 Streptococcus equi

Deworming
 Ivermectin 10 days before due date

Question 13

Equine Coital Exanthema; Transmission, Clinical Signs, Diagnosis, Treatment

Answer 13

o EHV-3

Transmission
 Direct contact with lesions
 Mechanical (instruments, personnel)
 Incubation 5 to 9 days

Clinical Signs
 Small (2-3 mm) papules progressing to pustules then ulceration on vulva & prepuce
 Erosions with scab
 Heal in 2-3 weeks
 Stallions have decreased libido

Diagnosis
 Serology
 Viral inclusion
 PCR

Treatment
 Ganciclovir bid for 13 days reduce severity of lesions and duration of excretion
 Do not breed until lesions heal

Question 14

Equine Viral Arteritis; Epidemiology, Transmission, Clinical Signs, Diagnosis, Prevention

Answer 14

Epidemiology
 Worldwide distribution
 Endemic in US, Standardbred population
 Reportable disease in 40 states
 Virus is androgen dependent
 Stallions can be lifelong carriers

Transmission
 Main source Shedding stallions
 Aerosol
 Vertical
 Fomites

Clinical Signs
 Incubation 2-14 days
 Edema due to arteritis
 vasculitis
 Fever
 Respiratory disease
 Abortion 8 to 30 days post infection @ 3-10mo old
 Foal can be born infected

Diagnosis
 Serology
 Virus isolation in semen

Prevention
 Vaccination of stallions
 Annual booster no less than 3-4 weeks prior to breeding
 Vaccination of mares bred to infected stallions
 Only breed to EVA negative stallions
 Horses need to be isolated for 3 weeks following vaccination

Question 15

Contagious Equine Metritis; Agents, Etiology, Clinical Signs

Answer 15

Agents
 Taylorella equigenitalis
 Taylorella asinigenitalis (donkeys)
 Gram (-) microaerophilic coccobacillus

Etiology
 Reportable
 Transmitted thru venereal from carrier stallions, fomite, or vertical

Clinical Signs
 No signs in stallions
 Copious gray vaginal discharge within 24-72 hours (persists for one cycle)
 Cervicitis persists longer and positive cultures may be obtained for as long as 6 weeks
 Endometritis, salpingitis
 Infertility
 Pregnancy loss

Question 16

Contagious Equine Metritis; Diagnosis

Answer 16

 Culture requires special media
 Serology not recommended
 PCR is now the gold standard (University of Kentucky)
 Test imported stallions
 Breed and test if mares become positive

Sample Location
* Clitoral fossa, sinus, or vaginal discharge form mares
* Pre-ejaculatory fluid
* Semen
* Urethral & fossa swab in stallion

Question 17

Contagious Equine Metritis; Treatment

Answer 17

Stallions
* Wash penis daily for 5 days w/ 5% chlorhexidine gluconate ->
* rinse and pack with nitrofurazone ointment ->
* parenteral penicillin ->
* re-culture 7 days after

Mares
* Intrauterine: Penicillin, ampicillin
* Clean the clitoral fossa and flush clitoral sinus: chlorhexidine gluconate 4%, pack with nitrofurazone 0.2% or silver sulfadiazine 1%
* Clitoral sinusectomy

Question 18

Dourine; Agent, Epidemiology, Clinical Signs, Diagnosis, Treatment

Answer 18

Agent
 Trypanosoma equiperdum
 Protozoa

Epidemiology
 Venereal disease
 No vectors known
 Reportable disease

Clinical Signs
 Slow to develop (up to 20 weeks)
 Genital edema, vaginal or urethral discharge, weight loss ->
 Fever, edema and ulceration of external genitalia, Cutaneous plaques (silver dollar), Ventral edema ->
 Anemia, neurologic disorders, paresis, death

Diagnosis
 CF test
 PCR

Treatment
 Euthanasia

Question 19

Contraception Options in Horses

Answer 19

o Owner education
o Ovariectomy
o Immunization against GnRH (very good but not available in US)
o tubal ligation
o vasectomy of stallions

Question 20

Options for Estrus Suppression in Mares

Answer 20

Altrenogest
 Ovarian activity will continue
 0.044 mg/kg

Progesterone
 Ovarian activity will continue
 0.2 mg/kg

Glass marbles
 poor efficacy, dangerous, counter-indicated

Oxytocin injections
 Downregulates ability to produce PGF2-alpha
 efficacy 70%, 45 to 50 days
 60 IU, IM SID from day 7 to day 14 after ovulation
 60 IU, IM SID for 30 days

Question 21

Granulosa-theca Cell Tumor; Basics, Clinical Signs, Diagnosis

Answer 21

o Most common ovarian tumor in the mare
o Typically benign, slow growing, non-metastatic
o Affected ovary is large and non-affected ovary is very small

Clinical Signs
 Stallion-like, aggressive (most common)
 Anestrus
 Nymphomania

Diagnosis
 Transrectal palpation (different size ovaries)
 Transrectal ultrasonography
 Testosterone >100 pg/mL
 Inhibin >0.8 ng/mL
 Anti-Mullerian Hormone 3.8-8.0 ng/mL (diagnostic >8)

Question 22

Anestrus Due To Persistent Corpus Luteum; Basics, Treatment

Answer 22

o Diestrus can last 60 to 90 days
o Normal ovarian size but CL present
o Uterus has tone (no pregnancy)

Treatment
 PGF2α (Dinoprost thrometamine – may cause colic)
 PGF2α Analogue (cloprostenol, less side effects)
 Spontaneous recovery possible

Question 23

Anestrus Due To Persistent Endometrial Cups; Basics, Diagnosis

Answer 23

o Embryonic Death (>35 days)
o Endometrial cups already formed

Diagnosis
 Normal genital tract on palpation
 eCG (commercial kits)
 Biopsy or hysteroscopy
 Check for reasons of embryonic loss: Fibrosis, metritis, iatrogenic

Question 24

Anestrus Due to Ovarian Tumors

Answer 24

o Not very common
o Granulosa-Theca cell tumor (GTCT)
o Luteoma (rare)
o Need to differentiate from other causes of ovarian enlargements

Question 25

Reasons for Abnormal Estrus Cycle in the Mare

Answer 25

Abnormal interval between ovulations
 Aging
 Anovulatory hemorrhagic follicles
 Unilaterally functional ovary?

Abnormal duration of estrus
 Short or Split-heat (common in transitional mares)
 Long estrus (NO OVARIAN FOLLICULAR CYSTS IN THE MARE!!!)

Abnormal duration of the luteal

Question 26

Reasons for Abnormal Luteal Function in the Mare

Answer 26

Failure of ovulation
 Anovulatory hemorrhagic follicle
 Equine metabolic disease

Short luteal phase
 Early release of PGF2α from the endometrium (endometritis, intrauterine treatment)
 Abnormal corpus luteum function

Lengthened luteal phase
 Persistent CL with spontaneous recovery
 Early embryonic death

Question 27

Oviductal Mass in the Mare; What, Diagnosis, Treatment

Answer 27

o Failure to fertilize
o Type I collagen
o At the ampulla-isthmus junction

Diagnosis
 By exclusion of all other causes

Treatment
 Application of PGE2 onto the oviduct (laparoscopy)
 Application of PGE1(misoprostol) by intrauterine infusion
 Hydrotubation (hysteroscopy)

Question 28

Early Embryonic Loss

Answer 28

 If the embryo dies before Day 14-15, the mare will return to estrus within a normal interval
 Embryo quality
 Uterine environment (MOST common)
 Abnormal hormonal environment

Question 29

Uterine Cysts; Factors, Origin, Effect on Fertility, Treatment

Answer 29

Factors
* Aged mares

Origin
* Vascular changes
* Lymphatic cysts

Effect on fertility
* Reduced embryo mobility
* Abnormal placentation
* Compromised cervical tone

Treatment
* Aspiration
* Cauterization, laser ablation

Question 30

Endometriosis; Risk Factors, DIagnosis

Answer 30

Major cause of infertility in mare
o Risk Factors
 Older
 Breed
 Abnormal anatomy
 Endocrine disorders (PPID, metabolic syndrome etc)

Diagnosis
 Large thick edematous uterus, Overt uterine edema, & Intrauterine fluid accumulation found on transrectal palpation and ultrasound
 Cervicitis or fluid in the vagina/discharge on Vaginal exam
 Endometrial cytology >2PMNs per high power field
 Endometrial culture (best to culture from biopsy)
 Biopsy (GOLD STANDARD)

Question 31

Endometritis; Common Agents, Treatment

Answer 31

Common Agents
 Strep
 E. coli
 Pseudomonas
 Klebsiella
 Can have fungus as well

Treatment
 Correction of predisposing factors (caslicks etc)
 Intrauterine antibiotics
 Uterine lavage
 Elimination of biofilm
 Immunostumulation
 Systemic antibiotics
 Anti-inflammatories
 Breeding management

Question 32

Endometritis; Antibiotic Choice

Answer 32

 Culture and sensitivity results and disposition in uterine tissue
 Do not mix antibiotics unless synergistic effect well documented
 Amikacin & gentamycin need to be buffered
 Enrofloxacin & Baytril® very harmful
 Infuse daily for 4 to 5 days
 Volume depends on size of the uterus
 Maiden mares: 35 to 50 ml
 Older mares: 60 to 150 ml
 May need to treat vagina and clitoral sinuses

Question 33

Treatment of Fungal Endometritis

Answer 33

 Correction of anatomical defects
 Uterine lavage
 Uterine infusion w/ 250 ml 2% acetic acid for 3 to 4 minutes
 Systemic +/- topical antifungals
 Topical treatment of vagina and clitoris
 Azoles or Polyenes

Question 34

Persistent Mating Induced Endometritis; Treatment

Answer 34

Oxytocin
* 10-20 IU, IM (3 to 4 times /day starting 4 hours post AI)

Carbectocin
* Long acting oxytocin analogue (not available in the USA)

Cloprostenol
* 250 μg IM, 4 to 8 hours post AI
* More sustained uterine contractions compared to oxytocin
* Premature luteolysis if given frequently or used more than 2 days post-ovulation

Question 35

“Old Maiden Mare Syndrome”; Factors, Treatment

Answer 35

Factors
 Tight cervix
 Fluid accumulation pre and post insemination

Treatment
 Relax cervix
 Topical PGE1 (misoprostol)
 Topical N-butylscopolammonium bromide

Question 36

Pyometra; Causes, Clinical SIgns, DIagnosis, Treatment

Answer 36

Causes
 Cervical stenosis or fibrosis
 Vaginal adhesions
 Prolonged progesterone treatment
 CL not always present

Clinical Signs
 Intermittent purulent discharge
 Overdue
 Anestrus

Diagnosis
 Transrectal palpation
 ultrasonography

Treatment
 Broodmare
* oocyte aspiration
 Pleasure mare
* Ovariectomy
* Ovariohysterectomy
* Cervical stent
* Cervical wedge resection

Question 37

Uterine Masses/Neoplasias; Tumors, Clinical Signs, Treatment

Answer 37

Tumors
 Leiomyma (most common)
 Adenocarcinoma
 Lymphosarcoma

Clinical Signs
 Usually, solitary
 Well-circumscribed
 Involves myometrium

Treatment
 Large masses require partial hysterectomy (mares can still carry a pregnancy)

Question 38

Persistent Hymen

Answer 38

o Incidental finding in maiden mares
o Accumulation of mucus in the vagina and uterus can bubble out of the vulva
o Easily ruptured manually but may require surgical excision

Question 39

Mastitis; Clinical Signs, Diagnosis, treatment

Answer 39

o Usually occurs after weaning

Clinical signs
 Swollen, warm udder
 Ventral edema
 Fever
 Hind limb lameness

Diagnosis
 Cytology and culture of milk
 SerS. equi ous, serosanguinous or purulent
 zooepidemicus most common isolate
 Ultrasound

Treatment
 Systemic antibiotics,
 NSAIDs
 Frequent milking
 Hot-packing or hydrotherapy

Question 40

Mammary Gland Neoplasia; Clinical Signs, Diagnosis, Treatment

Answer 40

o Adenocarcinoma is MOST common

Clinical signs
 Mammary gland enlargement
 Pain
 discharge
 Skin lesions
 Weight loss

Diagnosis
 Ultrasonography
 Cytology (FNA)
 Biopsy

Treatment
 Mastectomy
 Chemo
 Radiation

Question 41

“Witch’s Milk”

Answer 41

 Lactating Neonatal Fillies
 Elevated lactogenic hormones of maternal origin in fetal circulation

Question 42

Galactorrhea; Basics, Treatment

Answer 42

 Milk production in non-pregnant /foaling mares
 Elevated prolactin
 Pituitary Pars Intermedia Dysfunction
 Rule out mastitis

Treatment
* Treat PPID with pergolide or cyproheptadine
* Treat others with pergolide or bromocriptine
* decreased feed (protein and energy)
* Do not milk out as it will stimulate more lactation

Question 43

Signs of impending pregnancy loss

Answer 43

o Irregular and indented vesicle
o Fluid in the uterine lumen
o Echogenic spots (speckling) of the embryonic vesicle
o No fetal heartbeat
o Poor definition of fetal structures
o Increased echogenicity of fetal fluid
o Largest diameter of the fetal vesicle is 2 standard deviation smaller than the mean of the age of pregnancy
o Slow growth in size
o Failure of fixation
o Echogenic ring within the vesicle
o Disorganized membranes and collapsed amnion
o Increase edema and exaggerated endometrial folds
o Presence of fluid surrounding the embryonic vesicle

Question 44

Fetal Heart Rate

Answer 44

o 1.5 to 1.8x that of the dam
o Faster in early pregnancy
o Decreases from 120 bpm in the first 3 months to 60 bpm in the last couple of weeks
o Fetal activity and increased heart responses occur 48 to 72 hours prior to parturition

Question 45

Normal Combined Uteroplacental Thickness

Answer 45

o Seen on transrectal US

151-270 days
 <7mm

271-300 days
 <8mm

301-330 days
 <10mm

> 331 days
 <12mm

Question 46

Progesterone & Estrogen During Pregnancy

Answer 46

Progesterone/Progestogen
 Main source in the first trimester is the Ovary
 Main source past 80 days is the placenta
 Don’t want to see large jumps or drops in progesterone levels
 Progestin Decreases myometrial activity and prevents abortion
 Progesterone peaks 24-48hrs prior to parturition

Estrogens
 From fetal gonads
 Total estrogens should be > 1000 pg/ml

Question 47

Symptoms of Fetal Stress & Imminent Abortion

Answer 47

Fetal Stress
o Persistent fetal tachycardia or bradycardia
o Large or progressively enlarging areas of placental detachment
o Rapid drop in progestins

Imminent Abortion
o Large or progressively enlarging areas of placental detachment
o Premature mammary development and lactation

Question 48

Managing Compromised Pregnancy

Answer 48

Limit effect of prostaglandin
 Flunixin acutely
 Firocoxib longer term

Ensure myometrial quiescence
 Altrenogest
 Isoxsuprine
 Clenbuterol

Antibiotics (placentitis)
 TMS
 Potassium Penicillin
 Gentamicin

Improve oxygenation and reduce effect of inflammation byproducts
 Vit E
 Pentoxifyline
 Oxygen insufflation

Support fetal metabolism
 Dextrose

Question 49

Bacterial Abortion: Placentitis; Ascending Agents, Hematogenous Agents, Focal Agents

Answer 49

Ascendent agents
 Streptococcus spp.
 Staphylococcus spp.
 E.coli
 Klebsiella spp
 Enterobacter spp.
 Pseudomonas spp.

Hematogenous Agents
 Lepto

Focal Agents
 Nocardioform

Question 50

Bacterial Abortion: Placentitis; Clinical Signs

Answer 50

 Premature mammary gland development
 Mucopurulent vaginal discharge (ascendant placentitis)
 Persistent fetal tachycardia
 Uteroplacental unit
 Thickening of the uterine wall (>13 mm)
 Increased CUPT (>17.5 mm)
 Areas of placental separation on ultrasound
 Increased total progestogen concentration
 Decreased total estrogens
 Elevation of acute phase proteins (Serum amyloid A and Haptoglobin)

Question 51

Leptospirosis; Clinical Signs of Mare & Fetus

Answer 51

Mare
 Fever
 Hematuria
 Acute renal failure
 Uveitis may develop weeks after abortion
 Stillborn or weak foals
 Mid to late term abortion (last 3 months of gestation)
 Not all infected mares abort
 Placentitis not involving cervical star

Fetus:
* Mild to moderate icterus
* Liver enlargement, hepatitis
* Tubulonephrosis and interstitial nephritis

Question 52

Leptospirosis; Diagnosis, Prevention

Answer 52

Diagnosis
 Fetal and placental lesions
 Fetal antibodies Isolated from placenta or renal tubules
 Immunohistochemistry of the placenta umbilical cord or fetal kidney and liver
 PCR
 High-titers agglutinating antibody in mare (>1:6,400 often > 12,800)

Prevention
 Isolation of aborting mare for 14 to 16 weeks
 Urine testing by FAT for shedding
 Antibiotics for shedders
 Limit exposure to stagnant water
 Control of reservoir animals
 Vaccine is available

Question 53

Nocardioform Placentitis; Clinical Signs

Answer 53

 Chronic placentitis
 Late term abortion or premature birth, low birth weight
 Severe exudative, mucopurulent, and necrotizing placentitis at the junction of the placental body and horns
 Fetus severely underdeveloped

Question 54

EHV Abortions; Agents, Transmission, Clinical Signs, Diagnosis, Prevention

Answer 54

Agents
 EHV-1 most common
 EHV-4 possible but rare

Transmission
 Respiratory
 Abortion may be stress related
 May occur in vaccinated mares (reactivation of latent infection)

Clinical Signs
 Abortion usually 7 months to term
 Abortion- fresh fetus
 Fetuses > 8 moths present characteristic lesions particularly with EHV-1

Diagnosis
 Necropsy of fetus
 Virus isolation
 PCR

Prevention
 Vaccine at 5, 7, 9 months of pregnancy
 Separate pregnant mares form carriers

Question 55

Fungal Abortions; Agents

Answer 55

 Asper
 Mucor

Question 56

Mare Repro Loss Syndrome

Answer 56

o Eastern Tent Caterpillars from cherry trees
o Early & late fetal loss
o Placentitis
o Foal uveitis
o Foal endocarditis

Question 57

Abortion & Twinning; Unilaterally Vs Bilaterally Fixed

Answer 57

Unilaterally Fixed
 Usually reduced to one foal at 40 days

Bilaterally Fixed
 Mid to late term abortion of both
 Premature foaling

Question 58

Abortion & Twinning; Diagnosis, Treatment

Answer 58

Diagnosis
 Transrectal ultrasound up to 70 days
 Don’t get confused w/ uterine cyst

Treatment
 Crush one of the oocysts

Question 59

Treatment Options for Twin Pregnancies Past 30 days & Past 65 Days

Answer 59

> 30 Days
 Transvaginal ultrasound guided aspiration of one vesicle
 Intra-cardiac injection
 Wait and see
 Abort both and loose season

> 65
 Transabdominal Intra-cardiac injection
 Cervical dislocation
 Surgical removal
 Abort both and loose season
 Complications

Question 60

Most Common Non-Infectious Causes of Abortion in Mare

Answer 60

Twins (most common cause of lawsuits)

Umbilical cord torsion
 Thoroughbreds
 Cord longer than 90cm
 Greater than 7 twists

Question 61

Uterine Torsion; Clinical Signs, Diagnosis, Treatment

Answer 61

Clinical Signs
 Colic
 ADR

Diagnosis
 Transrectal palpation

Treatment
 Mare on side of torsion -> plank on other side -> role at least 3 times
 Midline laparotomy
 Standing Flank laparotomy (preferred)

Question 62

Hydrops; Types, Diagnosis, Treatment

Answer 62

Hydrops allantois
 Excessive accumulation of allantoic fluid

Hydrops amnii
 Excessive amount of amniotic fluid
 edematous umbilical cord
 abnormal fetus Diagnosis

Diagnosis
 Palpation
 Girth measurement

Treatment
 Induction of abortion/parturition
 Conservative management
 Humane euthanasia

Question 63

nduction of Parturition & Termination of Pregnancy

Answer 63

o Manual cervical dilation
o Allantochorion punctured with scissors
o 34 Fr Foley Catheter with 100ml balloon into allantoic cavity
o Controlled drainage
o Ensure hydration

Question 64

Fescue Toxicity; Toxins, Endocrine Effects, Clinical Signs, Treatment

Answer 64

o Endophyte: Acremonium coenophialum
o Alkaloids: Ergovaline, Loline

Endocrine effects
 Low plasma progesterone concentration
 Low relaxin level

Clinical effects
 Prolonged gestation
 Placental edema thickening
 Premature placental separation (Red bag)
 Abortion
 Agalactia
 Weak /immature foals

Treatment
 Remove from pasture
 Domperidone

Question 65

Mustard Toxicity; Toxins, Endocrine Effects, Clinical Signs

Answer 65

o Brassica spp

Endocrine effects
 goitrogenic

Clinical effects
 Prolonged gestation
 Mandibular prognathism
 Poor development (prematurity signs)
 Incomplete ossification of the cuboidal bones (very important for survival)
 Flexural deformities of the forelimbs
 Ruptured digital extensors
 Hydrocephalus, patent urachus

Question 66

Body Wall Defects in the Mare; Causes, Diagnosis, Management

Answer 66

Causes
 Severe ventral edema
 Hernia
 Prepubic tendon rupture
 Rupture of the mammary ligament
 Udder edema

Diagnosis
 Age
 Look for PPID
 Transrectal palpation
 Ultrasound

Management
 Confine / control exercise
 Control food and water intake
 Symptomatic treatment in case of ventral wall edema
 Support body wall
 Pain management
 Close monitoring for foaling
 Induction of parturition when appropriate

Question 67

Equine Gestation Length

Answer 67

o 335-342 days
o <320d = high risk foals

Question 68

Foaling Management

Answer 68

o Move to foaling location & open Caslick’s 4-6wks before expected foaling
o Check mare frequently
o Plan for colostrum supply
o Educate client on expected behavior

Question 69

Biochemical Tests on Mammary Secretions for predicting and monitoring readiness for foaling

Answer 69

o Increase in Calcium (>200 ppm)
o Decreased pH (<6.5)
o Inversion of Na+/K+ (decrease in Na+ and increased K+)

Question 70

Clinical Signs of Imminent Parturition

Answer 70

o Pelvic ligaments relaxation
o Elongation & edema of the vulva
o Mammary development: Increase in size 1 month before parturition
o Colostrum formation 1 to 3 days
o Change in secretions
o Waxing 24 to 48 hours before parturition

Question 71

What Happens During Stage 1, Stage 2, & stage 3 of Labor

Answer 71

Stage 1 of Labor
o 1-4hrs
o Myometrial contractions, increased oxytocin release
o Restlessness
o Tail switching
o Looking at the flank
o Frequent micturition, defecation
o Laying down and getting up frequently
o Yawing
o Flehmen
o Sweating (neck, shoulder, flank)
o Foal turns from dorso-pubic to dorso-sacral presentation
o Ends with rupture of the chorioallantois

Stage 2 of Labor
o 17-20 mins
o Should not go beyond 30 mins
o Passage of foal through the cervix into the birth canal
o Powerful expulsive abdominal contractions

Stage 3 of Labor
o Placenta expelled inside out
o Most mares deliver placenta within 45 minutes of foaling
o Retained placenta if fetal membranes are not expelled within 3 hours

Question 72

Induction of Parturition; Risks, Requirements, Drugs

Answer 72

o Increased risk of foal hypoxia, retained placenta, and dystocia

Requirements
 Mares should be at least 330 days
 Cervix should be relaxed
 Mammary gland secretions 200 ppm

Drugs
 Oxytocin
 bolus delivered in 60 mins
 small dose
 larger dose in 1L saline w/ slow infusion

Question 73

When to Intervene in Stage 1 & 2 of Labor

Answer 73

1st Stage of Labor
 Increasing and more intense signs of discomfort w/out progression
 Premature placental separation (“Red bag”)

2nd Stage
 No progress 5 minutes after the appearance of the amniotic sac
 Assess presentation, position, posture

Question 74

Approach for Standing Manipulation During Dystocia; Drugs, Ideal Reasons

Answer 74

Sedation
 Xylazine + butorphanol
 Detomidine + butorphanol

Caudal epidural
 5-8 ml of lidocaine 2%
 Xylazine in 10 ml of 0.9% sterile saline
 Combination of lidocaine 2% + Xylazine

Uterorelaxant
 Clenbuterol
 Buscopan

Ideal for
 Some postural abnormalities
 Uterine inertia (selenium deficiency)
 large breeds
 fetotomy
 Keep manipulation to no more than 20 minutes

Question 75

Controlled Vaginal Delivery; Drugs, Timing, Reasons

Answer 75

o General anesthesia w/ xylazine, xylazine+butorphanol, ketamine, ketamine+diazepam
o Hoist
o Manipulation should be kept to 15 mins

Reasons
 Shoulder flexion
 Ventral deviation of head & neck
 Hock flexion
 Unilateral and bilateral hip flexion

Question 76

C-Section

Answer 76

o Anterior presentation most common reason
o Posterior presentation second most common reason
o Sooner rather than later

Question 77

Fetotomy

Answer 77

o Ideally in standing position
o Attempt only if one has experience with technique
o Birth canal is wide enough and fetus is easily accessible and does not show severe abnormalities
o Provide heavy sedation and caudal epidural anesthesia
o Provide ample lubrication and give clear instruction to assistant
o Well-planed cuts based on determination of the position and posture of the fetus.
o Partial fetotomy (2 or less cuts) preferred
o Supportive therapy intravenous fluids, broad spectrum antimicrobials, pain management, NSAIDs

Question 78

General Care Post-Dystocia; Foal, Mare

Answer 78

Foal
 Resuscitation and routine foal care
 Check for broken ribs

Mare (see details in “postpartum disorders”)
 Monitor Defecation (fecal softener, mash, mineral oil)
 Monitor Urination
 Pain management
 Uterine lavage
 Tetanus prevention
 Monitor temperature daily for at least 3 days
 Monitor digital pulse

Question 79

Reproductive tract examination of the Post foaling mare

Answer 79

o Use vaginal speculum NOT tube speculum
o Look for lesions to vaginal wall, urethral opening, & cervux
o Manually feel the cervix for lesions
o Red/brown discharge is normal lochia unless smelly
o Look for symmetry of mammaries
o Brix test on colostrum

Question 80

Postpartum Exam of Foals; Basics to look for, milestones

Answer 80

o Don’t handle TOO much or may be rejected by mare
o Disinfect umbilicus w/ Chlorhex
o Temp 99-101.5
o Check IgG for passive transfer at 12-18hrs

Mile Stones
 Spontaneous breathing w/in 1 min
 Sternal in 1-2min
 Suckling reflex w/in 2-20mins
 Stand in 1-2hrs

Question 81

Neonatal Foal Distress Scoring

Answer 81

o Check at 1 minute and again at 4 mins post delivery
o Normal foal will have 7-8 points
o Depressed foal 4-6 points
o Markedly depressed 0-3

Heart Rate
 Absent = 0
 <60 – 1 point
 >60 – 2 points

Respiration
 Absent = 0
 Slow/irregular = 1
 >60 & regular = 2

Muscle Tone
 Limp/floppy = 0
 Some flexion = 1
 Sternal = 2

Nasal Stimulation
 No response = 0
 Slight grimace = 1
 Cough/sneeze = 2

Question 82

Postpartum & the Placenta

Answer 82

o Should be passed in 3hrs or less
o Collect all fetal membranes & refrigerate

Weight of placenta
 Should be 9-12% of foal’s weight
 Heavy placenta may be indicative of placentitis
 Light Placenta may indicate fetal abnormalities

Examine Placenta for Completeness
 Lay out in F shape w/ fetal uterine horn as long arm
 Non-fetal horn has high chance of staying attached to mare
 There is normal avillous chorionic surface at the cervical star and tips of the uterine horns

Question 83

Placental Abnormalities

Answer 83

o Plaques
o Mucopurulent discharge
o Avillous areas
o Too small
o Incomplete (emergency)
o Placentitis (emergency)
o Submit smears and/or culture of anything weird on placenta

Question 84

Normal Mare Timeline Postpartum

Answer 84

o Postpartum estrus at 5-7 days
o Uterine involution by 7 days
o Lochia reslved by 15 days
o Fine to breed mare who is ovulating 10 days postpartum
o Do not breed mares who are ovulating earlier than 10 days postpartum

Question 85

Instructions to Owner During Emergency

Answer 85

o Confine foal & mare to quiet area
o Do not use sedatives on mares (hypotension is BIG risk)
o Allow dead foal to stay w/ mare for ~3hrs
o Bring placenta to hospital
o Bring foal anywhere you take mare

Question 86

Evaluation of ADR Mare Post Foaling

Answer 86

o CBC/Chem
o If mare is depressed, colicky, ataxic, not urinating, etc, ultrasound & abdominocentesis

If a single parameter is changed:
 increased TP, increase WBC or % neutrophils
 monitor & repeat abdominocentesis in a few hrs

If 2 parameters are changed
 TP>30 g/L, WBC >15 x109/L, >80% neutrophils
 immediate action is required

Question 87

Retained Placenta; Treatment

Answer 87

Oxytocin
 10-20 IU every 2 hours
 Or CRI 1IU/min
 No Oxytocin needed if foal is alive & nursing

Chorioallantoic distension (Burns technique)
 Start w/ this technique if retained placenta is fresh
 If uterus is tight/contracted give Buscopan first
 Destend chorioallantoic sac w/ sterile saline
 Results within 5 to 40 minutes
 Evaluate Ca levels in non responsive mares and spike fluids with Ca gluconate if needed

Umbilical vessel catheterization and infusion
 Must be retained <8hrs
 Oxytocin 10-20IU IM
 Incise umbilical vessel & place stallion catheter inside
 Connect water hose
 Success w/in 5-10 mins

Question 88

Toxic (Septic) Metritis; Agents, Clinical Signs, Clin Path, Diagnosis, Treatment

Answer 88

Agents
o E. coli
o Klebsiella

Clinical Signs
o Retained Placenta for >6hrs
o Thick brown foul smelling vaginal discharge
o Endotoxemia
o fever, depression,
o tachycardia,
o injected mucous membranes,
o toxic line,
o bounding digital pulses,
o laminitis,
o gastric reflux

Clin Path
o Hyperfibrinogiemia
o Leukopenia/cytosis
o Elevated TP & WBCs on abdominocentesis

Diagnosis
o Transrectal Ultrasound to look for fluid filled uterus and maybe retained tissues

Treatment
o Fluids
o Flunixin
o Systemic Iv antibiotics
o Lavage, lavage, lavage uterus w/ warm fluids & salt
o Monitor first lavage w/ ultrasound to ensure fluid isn’t leaking into abdomen thru a uterine tear

Question 89

Perineal Lacerations / Rectovaginal Tears; Degrees

Answer 89

First degree lacerations
 Mucous membrane of the vestibule
 skin of vulvar lip

Second degree laceration
 Vestibular mucosa & submucosa
 skin of the dorsal commissure of the vulva and the perineal body muscle

Third degree RV-tea8u
 “Cloacal formation”
 Rectal mucosa & submucosa,
 perineal septum
 anal sphincter
 no more perineal body

Question 90

Perineal Lacerations / Rectovaginal Tears; Management

Answer 90

Medical management
 Antimicrobials
 NSAID’s
 tetanus preventative
 Fecal softener (bran mash)
 Artificial insemination for foal heat
 Need to be completely healed if regular breeding at foal heat

Surgical management
 Usually for 3rd Degree
 2-3x/day: clean vagina & place tampon w/ lanolin to avoid adhesions
 Wait MINIMUM 6 weeks to allow second intention healing

Question 91

Perineal Bruising & Vulvar Hematoma; Basics, treatment

Answer 91

o Hematomas may occur in conjunction with bladder atony
o Large contained hematomas may become retroperitoneal hemorrhage
o Pressure necrosis from the foaling may lead to seroma/abscess formation w/in the pelvic canal which may eventually break out into the vagina, perineum, or into the abdominal cavity
o Hematomas can prevent urination & defecation
o Can cause perivaginal fat necrosis in high body condition mares

Treatment
 Support
 Make sure they can urinate and defecate

Question 92

Cervical Laceration; Causes, Diagnosis, Treatment, Prognosis

Answer 92

Causes
 Oversized fetus
 Obstetrical chains/ fetotomy wire
 “Normal” parturition

Diagnosis
 Manual palpation of the cervical canal

Treatment
 Can heal on own in ~7days if partial thickness
 Surgery if full thickness 4-6wks after parturition

Prognosis
 fertility variable, depends on degree

Question 93

Postpartum Hemorrhage; Locations, Predisposing Factors, Clinical Signs

Answer 93

o Common postpartum emergency & cause of postpartum death

Location
 Broad ligament
 Intra-uterine
 Intra-abdominal
 Vaginal
 Vestibular-vaginal sphincter

Predisposing Factors
 Older
 Dystocia
 Pregnancy sclerosis
 Cu deficiency
 R side more common
 Anesthetizing for controlled vagina delivery & mare drops to quickly -> uterine artery

Clinical Signs
 Colic, sweating
 pale or normal mucous membranes
 tachycardia
 Flehmen response
 muscle fasciculation
 w/in 24 hours of foaling (or of artery rupture)
 may have hemorrhagic vaginal discharge

Question 94

Postpartum Hemorrhage; Diagnosis, Treatment

Answer 94

Diagnosis
 Weak thready pulse
 hypovolemic shock
 Transrectal palpation of distended broad ligament (if it is the site of hemorrhage)
 Ultrasound transrectally or transabdominally
 Demonstrate site of hemorrhage
 Abdominocentesis shows hemoabdomen
 Anemia or normal PCV(splenic contraction)
 Hypoproteinemia
 Hypofibrinogenemia
 Leukopenia/leukocytosis

Treatment
 be very careful w/ sedation to avoid sudden changes in blood pressure
 Sedation (acepromazine) -> hypotension -> collapse
 Twitch or excitement -> hypertension -> bleed more
 Minimize excitement, Place in dark, quite stall
 Flunixin meglumine + butorphanol
 Corticosteroids (to prevent shock)
 Nasal insufflation + Pentoxifylline
 Fluid therapy hypertonic saline followed by LRS (too fast may cause increased bleeding)
 Whole blood transfusion if PCV < 15%
 Naloxone hydrochloride
 Aminocaproic acid
 Yunnan Baiyao

Question 95

Uterine Tears or Rupture; Locations, Clinical Signs, Diagnosis

Answer 95

o Dystocia or NORMAL parturition

Locations
 dorsocranial to cervix
 tip of gravid horn

Clinical Signs
 Depend on site/size of tear and progression of peritonitis
 Fever
 Peritonitis
 tachycardia
 Severe pain/colic after uterine lavage
 High risk of evisceration into the uterine tear
 Associated with retained placenta

Diagnosis
 Abdominal ultrasound
 Contamination in abdominocentesis

Question 96

Uterine Tears or Rupture; Treatment

Answer 96

Surgical:
* Ventral midline celiotomy
* Flank laparoscopy
* Vaginally in dorsal recumbency

Medical:
* If small tear, may heal on its own
* May incur higher costs than surgery due to ongoing management
* Antibiotics
* Anti-inflammatories
* Anti-endotoxin therapy
* Abdominal lavage
* Laminitis prevention

Question 97

Partial inversion (intussusception) of the uterine horn and uterine prolapse ; Risk Factors, Clinical Signs, Diagnosis, Treatment

Answer 97

Risk factors
 Aggressive traction on a retained placenta
 Excessive use of oxytocin

Clinical signs
 Colic not responsive to tranquilizers
 Tachycardia
 Prolapse visible

Diagnosis
 transrectal palpation
 Abdominocentesis may show an increased TP but stable WBC

Treatment
 Caudal epidural or general anesthesia is required for replacement
 Manual replacement and distension of the uterus with large volume of warm water with added salt and iodine (if partial prolapse)
 Clean prolapsed tissue. Can apply osmotic agents (ie, sugar). Manual replacement without perforating the tissues (if complete prolapse)
 Can place Caslicks to keep everything in but not always necessary

Question 98

Vaginal Prolapse; Secondary to, Treatment, Prognosis

Answer 98

Secondary to
 Dystocia
 Persistent straining

Treatment
 Keep tissues clean and moist
 Caudal epidural
 Place urinary catheter to decrease size of bladder

Prognosis
 Must differentiate vaginal prolapse from bladder eversion through a vaginal rent

Question 99

Rectal Prolapse / Evisceration

Answer 99

o Prolonged dystocia
o Forceful obstetrical manipulation
o Tenesmus
o Needs Surgical treatment

Question 100

Large Colon Volvulus in Postpartum Mare

Answer 100

o Most common colic postpartum
o So much space after parturition -> very easy for colon to twist
o Very painful, tachycardia, toxic/blue MMs
o So colicky that often unsafe to examine
o Good prognosis with prompt surgical correction (within 30-60 minutes)
o Can be fatal with prolonged interval to treatment (> several hours)

Question 101

Ruptured Cecum & Peritonitis in Postpartum Mare

Answer 101

o Abdominocentesis will show feed material in the abdomen

Question 102

Ischemic necrosis of small intestine, small colon, and/or mesentery in Postpartum Mare

Answer 102

o due to compression by the foal
o May only be identified at surgery
o may have indications on abdominocentesis or transabdominal ultrasonography

Question 103

Eclampsia (Lactation tetany); Risk Factors, Clinical Signs, Diagnosis, Treatment

Answer 103

Risk Factors
 Draft horses
 Minis or ponies

Clinical Signs
 Restlessness
 Tachypnea
 Dull eyes
 Muscle fasciculations
 Clonic spasm
 Recumbency

Diagnosis
 Low serum Ca levels

Treatment
 IV fluids w/ Ca borogluconate

Question 104

Agalactia; Basics, Causes, Treatment

Answer 104

o No mammary development & lactogenesis
o Failure of passive transfer risk for foals

Causes
 Fescue toxicity
 Malnutrition in late gestation

Treatment
 Domperidone (dopamine antagonist; most commonly used)
OR
 Sulpiride twice daily (more bioavailable)
 Start one med above 10-15 days before foaling and continue for 5 days after foaling

Question 105

Treatment for Foal Rejection

Answer 105

o Positive reinforcement when foal is around
o high dose prostaglandin PGF2α (causes pain like foaling)

Question 106

Selecting Stallions for Breeding

Answer 106

o capable of achieving 75% pregnancy rate in the breeding season if:
o Natural cover: 40 mares
o Artificial insemination: 120 - 140 mares

Question 107

Breeding Soundness Exam for Stallions

Answer 107

Testicular palpation and measurements
 Total scrotal width
 Length, height, and width
 Volume converted to grams
 16-20 million sperm per gram of testicular tissue

Semen collection and evaluation
 2 ejaculates one hour apart
 Measure Total number of sperm/ejaculate
 Total number of normal progressively motile sperm should be at least 1 billion in the second ejaculate

Question 108

Cryptorchidism; Basics, Treatment

Answer 108

o Considered if both testes are not in scrotum at birth
o most common development abnormality
o abdominal common for L or bilateral
o inguinal common for R

Treatment
 hCG or GnRH to help inguinal testes descend (Tibary does not like)
 Castration (best to not breed cryptorchid males)

Question 109

Cryptorchidism; Diagnosis

Answer 109

 HCG Stimulation Test
* Give hCG
* test Testosterone before & 2hrs after hCG
* >100 usually means teste present
 Anti-Mullerian Hormone
* Secreted by Sertoli cells
* Best single test
* May be low if testicular degeneration
 Transabdominal or transrectal ultrasound
* Determine location of testes for sx
* Determine size
* Determine any associated pathology

Question 110

Balanitis / Balanoposthitis causes

Answer 110

Lesions on Penis

Viral
 Most common
 Coital exanthema (EHV-3)

Smegma accumulation
 Cause secondary bacterial or fungal issues

Parasites
 2nd most common cause
 Summer sores due to Habronema larvae

Question 111

Penile Neoplasia; Types, Diagnosis, Treatment

Answer 111

Types
 Squamous cell carcinoma on penis & aggressive
 Melanoma found on scrotum in gray horses

Diagnosis
 Histo

Treatment
 If SCC is small – 5-fluoracil or cisplatin
 If larger – Sx: reefing or phallectomy

Question 112

Paralysis of the Penis; Causes, Symptoms, Treatment

Answer 112

Causes
 Exhaustion & starvation (most common)
 Damage to sacral nerves
 Infectious dz
 Tranquilizers
 Trauma

Symptoms
 Flaccid penis w/ edema or excoriation

Treatment
 Medical/physical management if early
 Phallectomy

Question 113

Hydrocele of Testicle; Causes, Diagnosis, treatment

Answer 113

Causes
 High temp & humidity
 Following abdominal sx

Diagnosis
 Fluid around testicle on ultrasound
 May be palpated

Treatment
 Exercise
 Areas to cool off in
 Sterile drainage

Question 114

Seminoma; Clinical Signs, Treatment

Answer 114

Clinical Signs
 Enlargement of one teste
 Soft/fluctuant testicle
 NO overproduction of hormones
 Common mets

Treatment
 Castration w/ as much of spermatic cord as possible

Question 115

Self-mutilation in Stallions; Causes, Management

Answer 115

o Flank biting & vocalizing

Causes
 Pain
 Smell of another stallion
 Learned behavior

Management
 Address pain
 Physical device treatments to reduce self-mutilation
 Provide distractions
 Diet change
 Long-acting tranquilizers (fluphenazine)
 Tricyclic anti-depressants (imipramine and clomipramine)
 Nutritional supplement of l-tryptophan
 Progesterone treatment (only for VERY aggressive; affects fertility)
 Odor masking

Question 116

Impotentia generandi Vs coeundi

Answer 116

Impotentia generandi
o Ejaculation issues
o Poor semen quality

Impotentia coeundi
o Mounting problems
o erection failure

Question 117

Poor Libido

Answer 117

o Often learning problems in young stallions or stallions retired from performance
o No response to an estrous mare after a period of 10 minutes
o No secondary behaviors
o Donkeys may take a lot longer

Question 118

Erection Failure Causes

Answer 118

 Painful lesions on penis
 Compromised blood flow
 Penile deviation due to use of stallion rings

Question 119

Ex-copula Induction of Ejaculation for Ejaculation Issues

Answer 119

o Give Imipramine
o Give Xylazine a couple of hours later

Question 120

Musculoskeletal Problems & Ejaculation Problems; Stats, Management

Answer 120

o 50% of ejaculatory disorders

Management
 NSAIDs prior to breeding or sperm collection
 Enhance sexual arousal
 Accommodate for musculoskeletal deficiencies
 Ex-copula induced ejaculation
 Be aware that Musculo-skeletally compromised stallions may have poor semen quality

Question 121

Hemospermia; Causes, Diagnosis, Treatment

Answer 121

Cause
 Urethral defects / rents at ischial tuberosity (most common)
 Vesiculitis
 Urethritis
 Urolithiasis
 Lesions on penis
 Early squamous cell carcinoma

Diagnosis
 Examine urethral process w/ endoscope

Treatment for Urethral rent
 Sexual rest is easiest but cost owner time
 Sub-ischial urethrotomy left to heal by 2nd intention (most common)
 Sub-ischial urethrotomy w/ PU if severe
 Can try to wash/remove blood from ejaculate if low quantity

Question 122

Urospermia; Signs, Diagnosis, Management

Answer 122

Signs
 Large ejaculate volume
 Change in color
 Urinary sediment in ejaculate
 Poor sperm motility due to pH change

Diagnosis
 Smells like urine
 Creatinine >2
 Azostix

Management
 No real treatment
 Can fractionate ejaculate or “wash”

Question 123

Reasons for Azoospermia Vs Oligozoospermia

Answer 123

Azoospermia
 Complete testicular degeneration
 Orchitis
 Testicular hypoplasia
 Epididymal blockage (bilateral)

Oligozoospermia
 Defined as <2 billion sperm in 2nd ejaculate
 Testicular degeneration
 Incomplete ejaculation (sperm accumulator)
 Retrograde ejaculation

Question 124

Work-up for Azoospermia

Answer 124

o Measure alkaline phosphatase

AlkPhos 7,000-36,000
 Testicular problem
 Measure testes
 Ultrasound testes & spermatic cord
 Testicular biopsy

AlkPhos <1000
 Some sort of obstruction
 Transrectal ultrasound/palpation to look for outflow obstruction
 Examine urine for retrograde ejaculation

Question 125

Sperm Accumulation; Signs, Diagnosis, Treatment, Management

Answer 125

Clinical Signs
 infertility
 Multiple azoospermia ejaculates followed by ejaculate highly concentrated w/ semen

Diagnosis
 Transrectal ultrasound shows large, dilated ampullae

Treatment
 Rectal massage of ampulae
 Oxytocin
 PGF2-alpha

Management
 Collect semen on regular basis to avoid re-stasis

Question 126

Testicular Degeneration; Causes, Clinical Signs, Treatment

Answer 126

Causes
 Commonly, use of steroids or altreogest
 Age
 Malnutrition

Clinical Signs
 Increased spheroids in ejaculate
 Teratozoospermia

Treatment
 None

Question 127

Pyospermia/Seminal Vesiculitis; Cause, Clinical Signs, Diagnosis, Treatment, Management

Answer 127

Cause
 Bacteria
 Urethritis
 Cystitis
 Iatrogenic due to endoscopy

Clinical Signs
 Inflammatory cells in ejaculate
 +/- microscopic blood in ejaculate
 May strain/posture after breeding or urinating
 Can be transmitted to mares and cause endometritis

Diagnosis
 Catheterize, massage, culture

Treatment
 Direct flushing of vesicles
 Systemic antibiotics

Management
 Minimal contamination breeding through:
 putting antibiotics in mare before breeding
 using extender
 fractionating ejaculate

Question 128

Priapism; Cause, Pathophysiology, Treatment

Answer 128

Causes
 Acepromazine
 Spinal cord lesions
 Purpura hemorrhagica
 Neoplasia

Pathophysiology
 Failure of sympathetic stimulation necessary for detumescence ->
 Increased carbon dioxide tension and increased viscosity of the stagnant blood leading to venous occlusion ->
 Urinary difficulty or blockage leads to more metabolic compromise

Treatment
 manual massage and lubrication in conjunction with cold hydrotherapy or ice water baths
 Suspension of the penis with a bandage/sling
 Slow IV administration of anticholinergic (benztropine mesylate)
 Systemic diuretics, corticosteroids, Diphenhydramine, terbutaline
 Surgical flushing of the corpus cavernosus penis (final action done at referral center)

Question 129

Penile or Preputial Injury Treatment

Answer 129

 Massage to reduce edema
 May use glycerine to reduce edema
 Bandage
 Sling
 Hydrotherapy
 Protection of tissue
 Empty bladder if stallion is painful & difficulty urinating
 Reduction of edema can take several weeks
 Sexual rest for 3-4 wks after recovery

Question 130

Spermatic Cord Torsion; Clinical Signs, Diagnosis, Treatment, Fertility

Answer 130

Clinical Signs
 Sudden Testicular/Scrotal Enlargement
 None to sever colic depending on degree of torsion (none if <180)
 Very tight prepuce

Diagnosis
 Palpation of scrotum
 Ultrasound of scrotum looking for lack of fluid, thickened vessels

Treatment
 Unilateral castration

Fertility
 Good post castration if no complications

Question 131

Testicular Hemorrhage; Clinical Signs, Diagnosis, Treatment

Answer 131

Clinical Signs
 Sudden Testicular/Scrotal Enlargement
 Very tight prepuce

Diagnosis
 Evidence of hemorrhage on ultrasound

Treatment
 Unilateral castration

Question 132

Inguinal / Scrotal Hernia; Clinical Signs, Diagnosis, Treatment

Answer 132

Clinical Signs
 Sudden Testicular/Scrotal Enlargement

Diagnosis
 Movement of intestinal loops on ultrasound of scrotum

Treatment
 Unilateral castration

Question 133

Orchitis; Agents, Clinical Signs, Diagnosis, Treatment

Answer 133

Agents
 Strep equi
 Salmonella abortus

Clinical Signs
 Sudden Testicular/Scrotal Enlargement

Diagnosis
 Testicular abscess seen on ultrasound

Treatment
 cold water hydrotherapy
 systemic antibiotics
 unilateral castration

Question 134

Scrotal Abscess; Clinical Signs, Diagnosis, Treatment

Answer 134

Clinical Signs
 Sudden Testicular/Scrotal Enlargement
 +/- lesions or necrotic tissue on prepucial skin

Diagnosis
 Ultrasound shows abscess in scrotum (not involving testicle)

Treatment
 NSAIDs
 Systemic antibiotics
 Drainage of abscess