Mare Breeding Soundness Exam Flashcards
what is a BSE?
a series of diagnostic procedures to identify:
- cause of subfertility
- elaborate treatment plan
- give prognosis for fertility
when do you perform a mare BSE?
- fall!! or spring most commonly
- after pregnancy loss
- pre-purchase exam
- prognosis for fertility
- always recommend to do when mare is in heat
-collecting samples from the uterus so increased risk of infection, but when in estrus uterine defenses are increased!
-if perform during diestrus: to check cervical function/tone and/or endometrial glands
what are the components of a mare BSE?
- repro history
- physical exam
- rectal palpation
- rectal ultrasound
- vaginoscopy
- vaginal palpation
- uterine culture
- uterine cytology
- uterine biopsy
+/-
10. uterine endoscopy
11. endocrine tests
12. cytogenic tests
13. laparoscopy or laparotomy
14. scintigraphy
describe obtaining a repro history for mare BSE
- mare ID
- repro status
-maiden: never bred
-wet or foaling: nursing a foal
-barren: failed to conceive or maintain pregnancy after breeding
describe physical exam for BSE
- don’t want over or underconditioned
- want good musculoskeletal (good legs!)
-if not, may consider embryo transfer if mare with good genetics but injured
describe anatomical barriers to uterine contamination
- vulva
-normal conformation: vertical (less than 10 degree angle so poop slide down) and 2/3 of opening below level of ischium
-abnormalities: tilted, lacerations, etc.
-vulvar discharge abnormal in mares!!!
–mucopurulent = infection
–urine pooling - vestibulo-vaginal fold
- cervix
describe transrectal palpation and ultrasound
always before vaginal exam, to help guide vaginal exam and also to rule out pregnancy (early preg mares may show signs of heat)
- rule out pregnancy!!
- determine stage of estrous cycle
- detect physical abnormalities: size, location, tone, symmetry, contents
describe unique mare ovarian structure and which structures are palpable
medulla on outside, cortex (produces follicles) on inside with ovulation fossa as only cortex exposure and ONLY site of ovulation
may feel surface of follicles on rectal palpation if big enough to bulge out
corpus hemorrhagicum may also be palpable
BUT corpus luteum is NOT palpable!! need ultrasound!! (ultrasound also useful to ID pathology and changes of ovary and uterus)
describe vaginal exam
recommend vaginoscopy before stick a hand in there and irritate everything!
-use disposable (cardboard) or reusable (Caslick’s) specula to see vestibule, vagina, and cervix
- eval integrity of mucosa and structures
- look for exudate, urine, or air
- determine stage of estrus cycle
-in heat = cervix open and relaxed
-make sure appearance of cervix matches what saw on ultrasound (ovary with big follicle and uterine edema = in estrus and cervix should be open and relaxed, if closed, suspect cervical fibrosis)
describe the implications of cervical lacerations
if cause an inability to close can lead to repeated ascending infection
if cause an inability to open, can lead to delayed clearing of infection
good news: can repair!
when laceration present: foaling rate is 0%
when repair: foaling rate increase to normalish of 62-80%
describe vaginal pathology examples
- persistent hymen at vestibulovaginal junction (mare cannot evacuate mucus secretions and stallion cannot get it)
-just stick a hand in an open it up - varicose veins: increased capillary permeability can lead to bleeding, usually not require treatment unless stick out of vulva
describe uterine culture and cytology
- collect during estrus
- use guarded swabs or low-volume lavage
-important to not contaminate with normal vaginal flora as passing swab! only expose swab once in uterine lumen - submit anaerobic culture and sensitivity
- goals of bacterial culture:
-screen for venereal endometritis: Klebsiella pneumonia type 1, 2, or 5, pseudomonas aeruginosa, taylorella equigenitalis (CEM)
-screen for ascending endometritis: streptococcus zooepidemicus, E. coli - uterine isolates: NO NORMAL RESIDENT FLORA, should have NO GROWTH
-most common infections are streptococcus zooepidemicus, E. coli
describe normal uterine cytology; plus what vaginal contamination and acute endometritis look like
normal: should match culture and just be endometrial cells, can be in sheets or isolated
-contamination from vagina: squamous epithelial cells, degenerate PMNs
-acute endometritis: neutrophils (common) and eosinophils (fungal infection/yeast or pneumouterus/air aspiration)
2 most commonly used interpretation criteria:
Asbury: positive if ratio of epi cells to neutrophils >10:1, of if more than 1 neutrophil in 5 high powered fields
Brook: negative
describe interpretation of uterine cytology
2 most commonly used interpretation criteria:
1. Asbury: positive if ratio of epi cells to neutrophils >10:1, of if more than 1 neutrophil in 5 high powered fields
- Brook: negative if no PMNs in 10 fields, doubtful if 1-5 PMNs in 10 fields, positive if >5 PMNs in 10 fields
or:
positive uterine culture (bacterial growth) AND positive uterine cytology (PMNs): endometritis
positive uterine culture and negative uterine cytology: contamination or gram negative bacteria
negative culture and positive cytology: anaerobes, poor technique, noninfectious irritation, or antibiotics
negative for both: no endometritis
what are the goals of uterine biopsy? method?
- determine presence and extent of
-endometrial degenerative changes: to give an idea of endometrial function
-inflammatory changes that may not see with cytology (chronic or subclinical)
- prognosis for fertility!! the one test that will allow you to do this!
method: collect a piece of one of the uterine folds, no sedation needed bc no pain receptors in uterine endometrium
