21 Mare BSE and Infertility

a. conformational eval.

b. culture, cytology, biopsy

c. vaginal speculum

e. palpation per rectum

Select the regular parts of a mare BSE:

a. conformational eval.

b. culture, cytology, biopsy

c. vaginal speculum

d. endoscopy

e. palpation per rectum

f. oviduct patency

Uterine biopsy

What test is a good prognostic indicator of whether a mare can carry a foal to term?

1. clean rectum of feces

2. complete ultrasound of repro tract

3. tail wrap/wash perineum

4. vaginoscopy

5. manual vaginal exam

6. uterine culture/cytology

7. uterine biopsy

Describe the order of procedures after the conformation evaluation in mares for a BSE

1. clean rectum of feces

2. complete ultrasound of repro tract

3. tail wrap/wash perineum

4. vaginoscopy

5. manual vaginal exam

6. uterine culture/cytology

7. uterine biopsy

Put the following things in order for testing equine BSE

a. uterine culture/cytology

b. uterine biopsy

c. tail wrap/wash perineum

d. manual vaginal exam

e. vaginoscopy

f. clean rectum of feces

g. complete ultrasound of repro tract

Right image

this is the "windsucker" test

Which shows the correct conformation?

No, incorrect apposition of vulvar lips

Is this correct conformation?

Glass, reusable, vaginoscope

What is this?

UTERINE

note: in dogs you do vaginal to stage their cycle

Do you typically do a vaginal or a uterine cytology for horses to look for inflammation and infection?

Grades 1, 2a, 2b, 3

What are the different grades of uterine biopsies in mares?

Grade 3 = less than 10% expected foaling rate

DECREASED

Grade 3 uterine biopsy grades in mares indicate increased or decreased expected foaling rate?

She is either truly not cycling (ex. pregnant, retained endometrial cups, pseudohermaphrodite, out of season) or estrus is not being detected

Why might a mare not be cycling (broad), no estrus detected?

Day 40-120

When are endometrial cups present in equine pregnancy?

Endometrial cups

In horses, the embryo settles at base of uterine horn around day 17 and fixes. After it fixes, it has chorionic girdle and those embryonic trophoblast cells move up into the uterus and form WHAT, which produces eCG?

Bloodwork

How do you diagnose retained endometrial cups in horses?

Endometrial cups

What are these white things in the mare?

Diestral ovulation

This occurs when a mare already has a CL but still manages to ovulate during the diestrus period, causing an immature CL at the time she is releasing PGF2alpha, causing the appearance of a long diestrus

Beyond 15 days

When is CL lifespan considered "prolonged" in mares?

Pyometra

What happens when there is failure of PGF2alpha to release in mares?

Female = infantile tract and small ovaries

Gonadal dysgenesis horses are phenotypically male or female

63XO

note: gondal dysgenesis refers to a genetically female (phenotypic) horse with underdeveloped or non-functional ovaries, most commonly caused by the XO karyotype (missing one X chromosome).

What is the most common genotype for gonadal dysgenesis in mares?

No, they are sterile

Can gonadal dysgenesis horses breed?

Male

Is it more common to have a male or female pseudohermaphrodite horse?

MALE

A horse with testicles and a penis but externally female are male or female pseudohermaphrodites?

FEMALE

A horse with male external like features but ovaries are male or female pseudohermaphrodites?

Granulosa Theca cell tumor

What is the most common type of ovarian tumor in horses?

Granulosa theca cell tumor

Aggression, nymphomania, and stallion-like behavioral changes are typical of WHAT TUMOR TYPE in mares?

Enlarged ovaries with loss of ovulation fossa. Small contralateral ovary (bc of hormones the tumor produces)

How do you diagnose granulosa theca cell tumors in mares

Hormone panel

note: progesterone low, inhibin high with granulosa theca cell tumor versus hematoma

How do you differentiate granulosa theca cell tumors from ovarian hematomas in mares?

New environment, too familiar with/don't like stallion, maiden mares, wet mares (lactating)

Why might mares show behavioral anestrus?

Reproductive senescence (a type of ovarian shutdown)

What occurs in aged mares over 25 y.o., causing them to stop cycling due to limited number of oocytes?

Endometritis, semen reaction, metritis, pyometra, immunologic clearance, poor cervical dilation

Name some reasons why a mare might have been bred, but unable to concieve?

1. vulva

2. vestibulo vaginal fold

3. cervix

3 physical barriers to uterine defense in mares?

Minor

Immunologic defects are thought to be a major or minor contributor to a mare's failure to conceive

Cervix stays tightly closed, so at breeding semen goes into uterus but can't get out and myometrial contractions aren't enough to get it out because it is closed so tight

What happens if cervical dilation is poor in mares, esp. older maiden?

note: maiden = horse that has not given birth before

Within a few hours for fluid and within 36-48 hours for bacteria

Fluid tends to accumulate at the base of the uterus in mares. A normal mare should be able to eliminate fluid from the uterus within HOW LONG post-breeding/challenge?

Poor uterine defense, everything falls forward, delayed uterine clearance and often get post breeding endometritis

What does it mean when there is a "susceptible mare"?

Endometritis

What is the term for inflammation of the inner layer of the uterus

b. frozen

What type of semen is post-mating induced endometritis most associated with in mares:

a. fresh

b. frozen

30% of normal mares may culture positive during estrus

You culture horses with suspected endometritis. What do you NEED TO KEEP IN MIND when culturing horses that may cause "false positive" for endometritis?

When bred with frozen semen = reaction

TO DECREASE = seminal fluid

When do horses tend to have a semen reaction? What can help to minimize this inflammatory reaction in the mare?

Correct anatomical barrier defects, LAVAGE UTERUS, antibiotics

How do you treat endometritis in mares?

Clitoral fossa

What place is a reservoir for endometritis in mares?

Post-partum

When do you normally see metritis in mares?

Metritis

This is a contamination of the uterus in the muscle layer only where the mares can become systemically ill

Negative

Metritis is typically caused by gram positive or negative endotoxic organisms

K-pen and gentamicin, systemic therapy, local lavage therapy, oxytocin, non-iodinized salt

How do you manage a horse with metritis?

true

TRUE OR FALSE: mares with pyometra do not typically show signs of systemic disease

Pyometra

Cervical adhesions, dystocia with trauma, and decreased endometrial resistance are typical causative agents of WHAT in horses

CL

note: if you think its a pyometra but there is no CL, then its endometritis

Pyometra is ALWAYS associated with WHAT?

endometrial release of PGF2alpha with early inflammation = lyse CL --> endometritis. May ovulate again and cause pyometra again

Extensive damage may prevent PGF2alpha release and cause further extensive damage to mares

Why does pyometra cause more damage to the uterus than endometritis in mares?

Anything that causes PGF2alpha release

What is luteal deficiency associated with in mares?

Luteal deficiency

note: luteal deficiency is a condition where the corpus luteum does not produce enough progesterone to support a pregnancy, leading to primary infertility or pregnancy loss

Failure of maternal recognition of pregnancy in mares can cause what?

Altrenogest, progesterone

How do you treat luteal deficiency?

Early embryonic death

What is the term for when a mare is pregnant but looses the baby up to 45 days

Abortion

What is the term for expulsion of the fetus in mares after organogenesis, around 45-300 days but before the foal can survive on its own

Immature foal

What is the term for signs of prematurity in the foal, but delivered greater than 320 days

Dysmature foal

What is the term for a foal that is not appropriately mature for the stage of pregnancy it is in, typically more mature, associated with placentitis or amnionitis

Postmature foal

This refers to a foal that is born greater than 365 days

xx

note: THE DIFFERENCE BETWEEN PSEUDOHERMAPHRODITE AND GONADAL DYSGENESIS:

A horse with gonadal dysgenesis has underdeveloped gonads, while a pseudohermaphrodite has gonads of only one sex (either testes or ovaries) but possesses ambiguous external or internal genitalia of the opposite sex.