Pregnancy and neonatology - equine Flashcards
1
Q
how long is the equine preen in days
A
336d
2
Q
are overdue foals a cause for concern? and why
A
no. variable time to conception
3
Q
where does fertilisation occur?
A
ampulla
4
Q
how long does the embryo remain in the oviduct until it enters the uterus
A
5-6d
5
Q
why does the eq conceptus migrate around the uterus
A
to release maternal recogn of pregnancy hormone to the endometrium which prevents the release of PGs
6
Q
when does the eq conceptus fix into position and where
A
d15-16 at the base of a horn
7
Q
when does eq placental attachment begin
A
d36
8
Q
what also occurs at the same time of placental attachment
A
production of the endometrial cups
9
Q
what do the endometrial cups secrete
A
eCG
10
Q
what is the purpose of eCG
A
to maintain primary CL and encourage formation of 2ry CL
11
Q
between the prog from CL and eCG from endometrial cups, how long do they support the preg
A
5mths
12
Q
how long does the maternal recog of pregnancy prevent regression of CL
A
14d+
13
Q
when do the cups degenerate
A
d70-150
14
Q
after d200 when all the CLs are degenerate what maintains the pregn
A
foetal placental progesterone
15
Q
what is the significance of the endometrial cups wrt abortion
A
once in place the mare will not cycle until next year. this isn’t good if you want to breed her this year - so do the scan before d35
16
Q
what is the first sign of successful conception
A
failure to run to oestrous
17
Q
how can you determine pregnancy using lab results
A
blood samples - eCG from d45-90; oestrogen sulphate d120+
urine - oestrogen sulphate d150+
faecal - oestrogen sulphate, not v reliable
18
Q
describe the theory of rectal palpation (clinical skills)
A
lube insert arm empty any faeces feel for intercornual lig the horns bend up follow horns to softly feel ovaries any contractions - remove arm back assess cervix, ovaries and uterine tone
19
Q
when can most people rectally pregnancy dx
A
d40
20
Q
when can most people undertake rectal u/s
A
d10+ be careful though
21
Q
what age is the first scan post-mating
A
d14 (and d16 to check if twins, up to here they are motile, so will have moved around each other)
22
Q
at what age of the embryo is the heartbeat scan
A
d24. also another opportunity to check for twins
23
Q
is a 3rd scan necessary?
A
no - death unlikely now BUT if you want - at 6wks
24
Q
what size will the ‘embryo cyst’ be at d14, d16, d25
A
d14 - 1cm
d16 - 1.5cm
d25 - 3cm
25
if the O will only pay for 1 x scan - when should it be?
d28-35. can check alive, check for twins
26
when would transabdo scanning be implemented to look at a foetus
6mths +
27
when is early embryonic death classified from; when is abortion and when is still birth
```
EED = d0-40
abortion = d40-300
stillbirth = d300+ (gestation = 336, foal could not survive here, so not strictly speaking still birth - definitions change!!!)
```
28
what re the common causes of pregnancy failure
viral - EHV-1 and EVA, bacterial, fungal, maternal illness/stress, twins, abnormalities, umbilical torsion
29
what are the causes of EED
older mares
breeding on foal heat
congenital abn
fibrotic/inflamed uterus
30
describe the properties of EHV-1 and abortion
- when abortion seen
- transmission
- dx
- tx
- prevention
ubiquitous,
late abortion >5mth - foal may be alive, but will shortly die
transmission = resp, aborted material, vaginal d/c
n-pharyngeal swap or aborted material PCR
no tx, just separated mares from young stock
prev = vaca @ 5, 7, 9 mth of pregnancy
31
describe the properties of EVA
| - dx, tx, prevention..
Notifiable in stallions and mares mated wi last 14d
stallions become persistent shedders
mares recover
vaccine available but test beforehand
32
what are the common causes of bacterial abortion
e coli
strep
staph
sometimes salmonella and lepto
33
how do bacteria cause abortions
ascendng infections, haematogenous spread and at breeding. tx with abx and NSAIDs
34
what is the only common cause of fungal abortion
aspergillus
35
why can't mares have twins
placenta needs to be attached to 70% of foal to provide adequate nutrition
36
are unilateral or bilaterally distributed twins more likely to survive
unilateral as because of the shared space, the one is mor likely to die sooner (thus not compete for space when actually dead..)
37
what is the % likelihood of a twin pregnancy producing 1 x live foal
63%
38
to complete a twin reduction whats necesary
to relax rectum, give NSAIDs to prevent inflammation damaging remaining foal and 'pop' or damage it. check again in 24hrs to check successful
39
often there are not many signs of abortion, unless the mare is systemically ill (and that is the cause of the abortion)
vaginal d/c
running milk (prematurely)
colic/foaling signs
40
occasionally need to induce abortion- how would you do it?
3mth = repeated PG inj (2x/day bw d80-150) - abort after 2-5d
dilation of cervix + uterine lavage
transabdominal inj of KCl into f. heart
dislocate f. neck per rectum
41
how would you induce foaling
inj 1-2ml oxytocin very 20 min until starts to foal (mare must be nearly ready though - risk of rupture, torsion, dystocia, retained membranes!)
42
when is a female horse called a mare, and when a filly?
4yo = mare
43
how do you desc the oestrous of the mare
long day poly oestrous
44
what is the transitional period of mare oestrous
beginning and end of season (summer) where irregular cycling - about 6wks. in this period transitional follicles are seen, but none ovulate
45
when is puberty in the filly
12-24mo
46
how long is the oestrous cycle
21d
47
oestrous lasts ?
4-6d (longer and weaker in spring, shorter and stronger in autumn)
48
when is the mare receptive to the stallion
more than 24hrs before she ovulates! which means during the first 1-5days of oestrous ish
49
how big is the dominant follicle when it ovulates
>35mm
50
how long is the CL NOT responsive to PGs
3-4d
51
when does the endometrium start to produce PGs
d15+ --> luteolysis
52
what is the common trade name for PG
estrumate
53
what is the common trade name for progesterone
regumate
54
why might you use PG injections to regulate oestrous
induce luteolysis to get oestrous to commence in 3-5d
| also to induce abortion
55
why might you use progestogens to regulate oestrous
to suppress it - upon withdrawal, oestrous will commence shortly
PRID used in cattle
56
what is the purpose of equine chorionic gonadotrophin (this is a GnRH natural hormone0
given in oestrous to encourage the dominant follicle to ovulate wi 24hrs (so mate immediately - as won't accept him 24hrs before ovulation!!)
57
name a common trade name for GnRH analogue
deslorelin
58
when do you give GnRH analogue to manipulate equine oestrous
implant, s/c when follicle >30mm (dominant just about to ovulate) - will induce in 48hrs. takes a little longer the eCG
59
how do people bring the breeding season forward
artificial lighting over winter: 16hrs light, 8 hrs dark, 2-4wks before winter solstice - mares ovulate 10wks later
60
how long is the unfert oocyte live for
12 hrs
61
how long do sperm live
48hrs - so mate 24-48hrs before ovulation
62
how can you tell when a mare is in oestrous by scannig
dom follicle in 1 x ovary
uterine oedema - cartwheel appearance (this decreases 24hrs before ovulation)
soft cervix - droopy folds,
behaviour
63
what is a general protocol if, upon scanning the mare is in oestrous and when she isn't
if she is = scan again in 24 hrs to see if ovulated
| if she isn't = give PG and scan in 3-5d to see if in oestrous
64
what signs from the dom follicle indicate imminent ovulation
pointing and softening
65
how does the CL appear on scan
hyperechogenic surrounded by follicles developing
66
when is it worth scanning post-mating
12-48 hrs after - assess if she ovulated, if not mate again; to see if twin ovulation and check for fluid in uterine lumen --> endometritis (common)
67
what are the 3 preventative mechanism of bacterial entry to the uterus
1. vulva seal
2. vestibular seal
3. cervical competence
68
what happens when the 3 mechanisms preventing bacterial entry to the uterus fail (don't say bacteria gets in)
- pneumovagina --> predisposes to urovagina --> cervicitis and bacterial contamination
this leads to endometritis which = failure of pregnancy
69
whats the ideal mare perineal conformation
top of vulva level with the ischium
no more than 4cm of the vulva over the pelvic brim
no greater than 10 degree slope of the vulva
70
how do you correct a poor vulva conformatin
caslicks vulvoplasty
- under LA and sedation
- remove sutures after 2wks
- need to be re-oponed before foaling
71
how do you correct a persistent CL
PG
72
how do you correct anovulatory follicles
these just get massive and do nothing
| either regress in 4-6wks OR give PG and hope responds
73
granulose cell tumour
signs are either nymphomania or stallion like behaviour
| dx by scanning and anti-mullerian hormone in blood
74
why is endometritis a big issue
doesnt prevent conception
| DOES prevent implantation and inflammatory PGs may speed up luteolysis
75
what are the 3 types of endometritis
1. chronic infectious metritis
2. free fluid in the lime
3. mating induced endometritis
76
what are the causes of chronic infectious metritis
- poor perineal conformation
- reduced uterine immune defence
- strep. zooepidemicus, e coli, pseudomonas, klebsiella, some fungi
- venereal dz = contagious equine metritis = notifiable!
77
what are the causes of free fluid in the uterine lume
- from oestrous uterine oedema
- sterile but good to grow bacteria
- inflammatory itself to the endometrium
- delayed clearance due to poor motility
78
what are the reasons behind mating induced endometritis
- semen in inflam
| - abnormal uterine defences may reduce ability to cope with normal inflammation (from examination, mating, foaling..)
79
if you ID endometritis what do you do
uterine swab and smear
cytology
use a speculum or at least a guard
biopsy
tx BEFORE d5 as the conceptus is stallion the oviducts
tx = lavage, oxytocin, intrauterine abx, AI next time
80
what is chronic degenerative endometrial disease
progressive deign of endometrium, replaced by fibrosis
from 11yo+
pregnancy slows progression (e.g. brood mares get it later)
81
uterine cysts are a cause of infertility Y or N
NOT. they just look like follicles
82
what are the common pre-breeding disease clearances protocols
- clitoral swab for CEM, klebsiella, pseudominas
- blood for EVA
- strangles serology
83
what is the diff bw premature and dysmature
pre - foal
84
what are the signs of 'immaturity' in a foal
```
domed head
floppy ears
silky hair
low both
long time to stand weak
tendon laxity
incomplete ossification of tars + carpal bones
if severe = index cortisol response and near/renal/endocrine/CV balance
```
85
what type of placenta does a horse have? whats does this mean for the foal
diffuse epitheliochorial
| no Ab transfer, NEEDS colostrum
86
what age is foal most at risk of dz
2mo as that when maternal levels of IgG fall, and foals haven't increased enough
87
what is the half life of maternal IgG in foal
20d
88
how is colostrum absorbed
by special enterocytes via pinocytosis, the only live for 24hrs max, therefore max abs is
89
how much colostrum should foal get wi first 6hrs>
1L minumum
90
when is the best time to test for colostrum uptake and how?
at 12ho as then time to orally top up before 24hrs. the peak IgG is at 18ho
how = ELISA (SNAP) - expensive,
ZnSO4 tub,
TP or Tot globulin,
glutaraldehyde coagulation (inacc if DH)
91
what parameter defines FPT of IgG
92
how soon after birth should a foal have a suck reflex, stand and suck
```
20min = sucking reflex
1hr = stand
2hr = suck
```
93
if a 'healthy' foal appears not to suck much should you tube it>
Yes always, RF to septicaemia too great, better safe than sorry approach
94
when, why and how do you give plasma tx to a foal
- after 24ho if FPT recognised, if foal immunodef syndrome
- immunoglob, ag, ab
- 3L mare blood IV after it has settled and separated
95
what is the norm foal neonate HR, temp and RR
temp = 37.2-38.9 (adult - 36.5-38.4)
HR (birth) = 40-80; (1wo)= 60-100 (adult = 30)
RR (birth) = 45-60; (1wo) = 35-40; (adult = 15)
96
by how old should meconium be passed by
24ho
97
when should urine be passed by
6-10 ho (colt
98
what is the av birth weight
50kg, 1kg av gain per day
99
how do you ID sepsis
blood culture - not gonna be great if you've been giving abx remember
- umb infection (u/s)
- pneumonia (xray, blood gases)
- arthritis/osteomyelitis (synovial fluid analysis/xray)
100
how does bacterial and aspiration pneumonia appear on xray
focal, ventral bronchioalvlae and hilar area
101
how does viral pneumonia present on xray
diffuse and intersitial
102
how does atelectasis appear on xray
just alveolar, bronchi are clear
103
what basic tx will a septic foal recieve
```
ABX (ahminoglycosides - dont cause RF; penicillin)
IVFT
NSAID - flunixin
anti-ulcer sucralfate
intensive nursing -
20%Bwt in milk/d
circulatory and resp support (dobutamine, and b-dilators, postural, i/n O2)
diuretics is oliguria persists
```
104
what is the most common cause of a 'weak, depressed, off suck'foal?
septicaemia
105
what are the common pathogens which cause septicaemia?
gram - = e coli, actinobaccilus, salmonella, proteus, klebsiella,
gram + = haemolytic strep and staph and clostridia
106
what gram does penicillin affect
gram +
107
what gram does gentamicin affects
gram -
108
what ar the clinical signs of septicameia
- injected sclera (v bloody conjunctiva)
- inc RR and effort
- not consistent temp
- severe lameness, joint swelling
- hypopyon (pus in anterior chamber of eye)
- congested, dark mm and petechial haem +
109
what is the pathogenesis of SIRS
systemic inflammatory response syndrome
- Ag attack emphases --> cytokines produced
- inflam mediators cause +++ vasodil
- inc BMR
- inc CO, initially (hyper dynamic) THEN gives up (hypo dynamic) after this = refractory = give up..
- = multiple organ failure and ..death
110
what are the ddx for respiratory signs in a foal (other than septicaemia..)
viral, bacterial pneumonia, meconium aspiration, pneumo/haemothorax, pulmonary hypertension and central rest depression
111
in older (arab) foals with recurrent respiratory infections, what should you be concerned about?
SCID
112
what is SCID and how to dx
```
failure to produce B and T l# that function
autosomal recessive n arabs/x
apparent at 2mo+
lymphopaenia EVEN if WBCC normal!
only confirm dx on PM
```
113
what is perinatal asphyxia syndrome (PAS)?
'dummy foals' due to hypoxic ischaemic encephalotopathy
| - from repercussion injury to brain, kidneys, GI in utero OR at birth
114
how do you tx PAS
basic care as norm, good px if NOT septic too
| give dimethyl sulfoxide IV for the cerebral oedema
115
what are the presenting signs of a rupture bladder in a foal and what dx signs are found
- dysuria at 2-3do; abode distention develops
| - dx = post-renal azotaemia as urine equilibrates with serum e-lytes; u/s = fluid
116
what is ban about a normal foals creatinine and urea
?creatinine = 40% higher than adults
urea = v low due to liquid diet
and proteinuria Normal from d1-3
117
why is it impt to stabilise the foal before operating on the bladder
because the - hyperkalaemic = induce arrhythmias so give 0.9 saline w glucose
- resp distress and atelectasis needs to be corrected - give O2, IPPV
- remove abdo fluid
- IVFT for acidosis too
118
what are some ddx of a foal with colic
- meconium impaction
- ruptured bladder
- overfeeding/lactose into (indicated if worsens after feeding)
- gastric ulcers
- obstruction
- congen
119
what are 4 poss causes of jaundice and paresis
tyzzers dz
EHV-1
sepsis
XS Fe++
120
what are 2 causes of anaemia in the foal
haem+
| hemolysis
121
the mare of a foal with neonatal isoerythrolysis can be stripped out and the foal put back, how can you tell when this is safe
agglut test with foal blood and colostrum - if agglut - not safe.
122
if you need to give an NI foal and transfusion, can you use the mares blood
yes - only her RBC not plasma though
123
what is foal immunodeficiency syndrome (FIS)
dales/fell
anaemia, weakness from 3wo
immunoddef + 2ry illnesses, fatal
124
what are the common path of foal d+
- foal heat d+
- clostridia
- septicaemia (e coli, salmonella)
- campy
- rotavirus (older foals)
125
wy do foals get d+ at foal heat
pos changes in milk comp, mare hormones.. etc doesn't matter - self limiting
126
why is clostridial d+ so nasty
- severe p/acute often fatal
- necrotising (smells really bad)
- C. diff and perfringens most common = commensal!
- contagious+++
tx = pen
127
what are causes of d+ in the older foal
rotavirus
coronavirus, adenovirus (immunocompromised only)
crypto
giardia
rhodococcus equi (abscesses in lungs and GIT)
128
what is the causal organism of equine proliferative enteropathy
lawsonia intracellular - same as pigs
