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theriogenology > Clinical Examination of the Broodmare > Flashcards

Clinical Examination of the Broodmare Flashcards

1
Q

What restraint is recommended for reproductive exams in mares?

A

usually minimal needed

  • place in stall with a kick gate
  • tie tail and put to the side to keep hair out of rectum
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2
Q

What are 3 options for chemical restraint for reproductive exams in mares? How long does it take for them to take effect?

A
  1. Xylazine - 3-5 mins
  2. Detomidine - 3-5 mins
  3. Acepromazine - 20-40 mins

start with a low dose and repeat as needed - need to keep mare from laying down for a proper exam

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3
Q

Where are IV sedatives injected in horses? Why does this need to be done carefully?

A

jugular vein —> concentrate on upper 1/3 of the vein to avoid the carotid artery and injecting drugs into CNS circulation

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4
Q

Why are breeding soundness exams performed on mares?

A
  • prepurchase
  • prebreeding
  • cases of infertility
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5
Q

What are the 3 physical barriers to the equine uterus?

A
  1. vulva (abnormal alignment = ascending infection)
  2. vestibulovaginal (transverse) fold
  3. cervix
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6
Q

What normal external genitalia should be seen in mares?

A
  • vulvar lips/labia —> examine perineal conformation!
  • clitoris —> everts when in estrus
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7
Q

What is considered normal perineal conformation in mares? Where should the vulvar opening be located?

A

vulva sound be vertically oriented with an angle of declination <10 degrees and the labia should meet without disruption of the mucosal seal

2/3 or more of the vulvar opening should be below the pelvic brim —> more space between anus to avoid fecal contamination

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8
Q

What is Caslick’s index? What is normal?

A

distance between dorsal commissure and pelvic brim x vulval angle

< 100 —> 100-150 = further evaluation, >200 = vulvoplasty required

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9
Q

What is the Windsucker test?

A

upon separation of the vulvar lips and visualization of the vestibulovaginal fold, no air should enter the vagina

  • positive Windsucker means there is a weak transverse fold or cervix allowing air into the uterus
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10
Q

Normal perineal conformation, mare:

A

able to palpate pelvis with at least 2/3 of vulvar lips below

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11
Q

What is poor perineal conformation associated with in mares?

A
  • pneumovagina
  • low pregnancy rates
  • ascending placentitis
  • abortion
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12
Q

Poor perineal conformation:

A
  • not perpendicular
  • close to anus
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13
Q

Poor perineal conformation:

A

history or prior tear/dystocia

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14
Q

Poor perineal conformation:

A
  • not sealed
  • deviated to the left
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15
Q

Positive Windsucker tests:

A

able to hear air go into vagina!

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16
Q

Negative Windsucker test:

A
  • normal membrane = unable to see cervix
  • good barrier against air!
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17
Q

What is important about properly locating the clitoris and sinuses during examination of the equine reproductive tract?

A

important place to collected samples and transmission of Contagious Equine Metritis (CEM) —> Taylorella equigenitalis

18
Q

What is a normal accumulation seen in the clitoral fossa/sinus in mares?

A

smegma —> “bean”

19
Q

Urovaginal/urine pooling:

A
  • urine able to move cranially, making the mare unable to completely urinate
  • can cause infertility during estrus —> embryo does not do well in this environment!
20
Q

Endometritis:

A

purulent d/c

21
Q

Cervical tear:

A

may require a digital exam

22
Q

How are transrectal reproductive exams performed?

A
  • reach for and locate cranial uterus
  • follow each horn and palpate ovaries and feel for ovulation fossa
  • work back and try to palpate cervix —> less cartilage, should be tight and small in diestrus, and larger and more relaxed in estrus

uterus NOT retracted - broad ligament arranged differently

23
Q

What are the target structures observed on transrectal palpation?

A
  • LANDMARK = cranial margin of the uterus
  • ovaries - size, ovulation fossa, follciles, consistency (U/S required for CL)
  • uterus - tone, size
  • cervix - tone
24
Q

L and R ovaries and follicles, U/S:

A

could be cysts, more commonly found paraovarian

more of an issue if it blocks the ovulation fossa, impairing fertility

25
Q

Cross-section of uterine body, U/S:

A

r/o edema (estrus) vs. fluid from inflammation or infection

  • particles in fluid = debris, cells
26
Q

Cross section of uterine body:

A

cysts - more common in older mares, must document size

  • more irregularly shaped compared to embryos
27
Q

R and L ovaries:

A

large follicles

28
Q

Uterus, U/S:

A

hyperechoic spots = air!

  • Windsucker +
29
Q

Uterine body, U/S:

A

likely an embryo due to regular shape

  • r/o cyst by rechecking for growth and movement
30
Q

When is uterine culturing and cytology useful?

A

detecting acute, active endometritis and other fungal/yeast infections

  • must use sterile technique
  • always do BOTH!
31
Q

Why is a double-guarded uterine swab preferred? How is culture and cytology preferred?

A

must pass through cervix to reach uterus —> helps swab remain sterile as it’s passed through

  • CULTURE = send swab to lab in transport tube
  • CYTOLOGY = gently roll on slide and stain with Diff-Quik
32
Q

What is an alternative to using uterine swabs for cytology?

A

low-volume uterine flush - 75% sens, 90% spec

  • look at fluid clarity —> cloudiness, debris, strands
33
Q

How is a low-volume lavage performed for uterine culture and cytology? How can the return of the uterine fluid be augmented?

A
  • elevate a 150-250 mL bag of 0.9% sodium chloride or other sterile fluid for gravitational flow
  • gently massage the uterus per rectum
  • lower the bag once it’s empty to allow a return of the fluid via gravity flow
  • centrifuge the recovered fluid, remove the supernatant, and resuspend the pellet
  • prepare a cytology slide/sterile sample for culture from the resuspended fluid

single dose of 10-20 IU oxytocin IV

34
Q

What is an indicator of inflammation of uterine fluid cytology slides?

A

ratio of 1 neutrophil to 40 epithelial cells

35
Q

What are these uterine cytology slides indicative of?

A
  • yeast infection
  • hyphae - fungal infection
  • crystals - likely urine pooling
36
Q

What is the purpose of uterine biopsies?

A

detecting chronic inflammatory, degenerative changes, like fibrosis and glandular degeneration

  • acute changes will not be represented
37
Q

How can cervical and uterine biopsy sampled be differentiated?

A

CERVICAL = no glands

UTERINE = glands

38
Q

What are the 4 grades of Kenny-Doig uterine classification? What effect on foaling rates is expected?

A

GRADE I = normal endometrium to focal inflammation or fibrosis - 80-90%

GRADE IIa = mild to moderate inflammation with 1-3 layers of fibroblasts around glands or <2 glandular nests - 50-80%

GRADE IIb = multifocal areas of moderate inflammation or fibrosis +/- 2-4 fibrotic nests - 10-50%

GRADE III = severe inflammation and/or diffuse fibrosis - <10%

39
Q

What is seen on these uterine biopsies?

A

L = normal endometrium

R = hemorrhage, inflammation

40
Q

What is seen on this uterine biopsy?

A

periglandular fibrosis - spindle cells around glands

41
Q

What is seen on this uterine biopsy?

A

fibrotic nest - severe fibrosis fills glands

theriogenology (22 decks)

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