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Repro II > Mare Infertility > Flashcards

Mare Infertility Flashcards

1
Q

describe uterine defense mechanisms

A
  1. anatomical barriers:
    -vulva
    -vestibulo-vag junction
    -cervix
  2. immune system:
    -neutrophils
    -IgA
  3. physical clearance:
    -myometrial contractions
    -cervical relaxation
    -uterine position
    -lymphatic drainage
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2
Q

what is the main cause of infertility and the 3rd most common medical problem (after colic and resp disease?)

A

endometritis

endometritis: superficial infection of endometrium (not life threatening)

metritis: deeper infection of endo AND myometrium (more serious and life threatening)
perimetritis: of serosa, most commonly a secondary condition (usually to peritonitis)
pyometra: buildup of pus (in mares, usually due to endometritis)

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3
Q

what are the 4 types of endometritis?

A
  1. breeding-induced endometritis (BIE)
  2. chronic bacterial
  3. venereal
  4. chronic degenerative endometritis (endometrosis)
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4
Q

describe the physiologic response to breeding

A
  1. sperm transport to the oviduct is complete in 4 hours
  2. residual sperm induce inflammatory response in ALL mares
    -peaks at 6 hours
    -resolves in 24 hours
    -all mares will have transient endometritis in response to breeding!!
  3. failure to evacuate uterine contents (residual sperm) leads to breeding-induced endometritis (BIE)
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5
Q

describe clinical diagnosis of BIE

A
  1. history:
    -multiparous, older mares
    -failure to conceive or embryonic loss
  2. intrauterine fluid >24 hours after breeding
    -may or may not see vulvar discharge depending on how much fluid there is
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6
Q

describe treatment of BIE

A
  1. minimize inflammation!
    -breed once per estrous cycle
  2. evacuate uterine contents:
    -uterine lavage
    -ecbolic drugs
  3. restore homeostasis of immune system
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7
Q

describe uterine lavage

A

goals:
-remove residual sperm and inflammatory products
-stimulate uterine contractions
-recruit fresh neutrophils and opsonins

method:
-use LRS or sterile saline
-use about 1-2L at a time and flush until clear

timing:
-no earlier than 4 hours after breeding (sperm must be in oviduct before flush or no breed)
-at diagnosis or 4-6 hours post AI up to 12-24 hours post breeding
-can even try 2-3 days post ovulation (embryo arrives in uterus around day 5)

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8
Q

describe ecbolic drugs

A
  1. oxytocin:
    -causes contractions for 20-50 min
    -give every 2-6 hours
    -induces very fast clearance (begin evacuating most of contents within 30 min)
    -can give after ovulation
  2. PGF2a:
    -causes contractions for 2-4 hours
    -give SID or BID
    -use BEFORE ovulation!!!
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9
Q

describe chronic bacterial endometritis

A
  1. can be due to:
    -contamination during mating
    -ascending infection if poor vulvar confirmation: self-contamination when vulva not seal properly
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10
Q

list the causes and consequences of poor vulvar conformation

A

causes:
-conformation: flat topped croup, high tail setting, sunken anus
-age and parity
-poor body condition
-trauma

consequences:
-pneumovagina
-urovagina
-fecal contamination
-ascending endometritis
-ascending placentitis

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11
Q

describe pneumovagina and pneumometra

A

also called wind sucking

aspiration of air into vagina and uterus

-see white lines on ultrasound

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12
Q

describe urovagina and urometra

A
  1. urine pooling: accumulation of urine in vagina and uterus
  2. predisposing factors:
    -pneumovagina
    -pregnancy, post-partum, estrus
    -inadequate Caslick’s suture
    -urinary tract disorders
  3. chemical and bacterial endometritis will decrease sperm and embryo viability
  4. diagnosis:
    -evidence of urine scalding
    -calcium carbonate crystals in cultures from vagina and uterus
  5. treatment:
    -surgical corection
    -pre and post breeding uterine lavage and ecbolics
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13
Q

describe diagnosis of bacterial endometritis

A
  1. +/- mucopurulent discharge
  2. +/- uterine fluid
  3. culture: most commonly strep zoo, PMNs in cytology
  4. biopsy = final answer
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14
Q

describe treatment of bacterial endometritis (4)

A

1, physically remove uterine contents
-lavage

  1. control bacterial growth
    -can choose intrauterine or systemic
    -amikacin, ampicillin, chloramphenicol, gentamicin, pen K or pen Na, polymyxin B, ticarcillin, timentin
    -DONT use intrauterine enrofloxacin!!! very basic pH, will slough off endometrium (caustic), can use IV or oral tho
    -intrauterine infusions: lavage first to clean uterus, then infuse 60-100mL (diluted total volume), daily for 3-5 days during estrus (immune defense working the best so mare will help you)
  2. restore homeostasis of immune system
    -immunostimulants
    -can also use NSAIDs, but prevent release of PGF2a which is needed for ovulation so if give prior to ovulation risk not ovulating!
  3. restore anatomical barriers
    -Caslick’s suture to restore vulva barrier
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15
Q

describe sexually transmitted/venereal endometritis

A

stallions are asymptomatic!! so diagnosis comes from mares developing endometritis or not getting pregnant when bred to same stallion

can be caused by:
-taylorellis equigenitalis: causes contagious equine metritis: REPORTABLE
-pseudomonas aeruginosa
-klebsiella pneumonia

transmission:
-stallion to mare during live cover or AI
-stallion to stallion if using same dummy or phantom
-mare to foal

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16
Q

describe contagious equine metritis disease course in mares

A
  1. transmission from natural mating, AI, or contaminated equipment
  2. can become asymptomatic carriers
  3. or once infected, within 2-12 days, some mares will develop acute endometritis, infertility, short diestrus, lots of mucopurulent vulvar discharge
    -some will clear infection recover within 14d
    -some cannot clear infection and become asymptomatic carriers
17
Q

describe CEM testing

A

cultures at days 1, 4, and 7 of the clitoris (sinuses and fossa) and endometrium/cervix, requires Amie’s charcoal refrigerated, complement fixation, special test and PCR
-AKA will not show up on routine BSE

18
Q

describe treatment of carrier animals of CEM

A
  1. local treatment: daily for 5 days
    -remove smegma
    -scrub with 2% clorhexidine
    -rinse and dry
    -pack with 0.2% nitrofurazone or 1% silver sulfadiazine cream
  2. 1 week post treatment: retest: repeat 3 sets of culture
    -if no growth: infection is cleared
    -if growth of taylorella: repeat treatment/testing cycle
  3. +/- systemic antibiotics for 10 days
    -taylorella is sensitive to most antibitiotics!
    -not difficullt to treat, just hard to diagnose
19
Q

describe endometrosis

A
  1. chronic degenerative condition
  2. periglandular or subepithelial fibrosis: no milk and also atrophy
  3. common in older mare; irreversible and untreatable
  4. pregnancy loss due to glandular and epi dysfunction
  5. diagnosis: uterine biopsy
  6. treatment: management and embryo transfer
20
Q

describe endometrial cysts

A
  1. can be single or multiple
  2. can be glandular: secondary to fibrosis, not visible grossly
  3. can be lymphatic: lymphangiectasia
  4. may look like an embryo
  5. breeding consequences:
    -conception occurs
    -pregnancy loss before 90d: cysts blocks embryo mobility=no maternal recognition of preg, fibrosis and gland dysfunction
  6. treatment:
    -laser ablation
    -hypertonic saline infusion
    -mechanical cutterage
    -aspiration

Repro II (28 decks)

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