Breeding soundness exam of the mare Flashcards
(20 cards)
What are 3 reasons for undertaking a breeding soundness exam of a mare?
Insurance exam
Pre-breeding checks
Infertility checks
Breeding soundness ≠ fertility
- consider what you will tell the owner
What basic steps are involved in a breeding soundness exam?
History Generaly physical exam Special reproductive exam ± special procedures/sampling Planning ahead
What aspects should be assessed in a general history for a breeding soundness exam?
Client's motivations/complaints - what do they want done? Mare ID Age Breed Vax/deworming status - individual & herd Housing status Training status Contact with other horses
What aspects should be assessed in a reproductive history for a breeding soundness exam?
Reproductive status (pregnant, foal at foot, non-pregnant)
Prior breeding records
Foaling/breeding Hx
Any hx of reproductive problems - abortions, RFM, assisted deliveries, dystocia
Last reproductive event
Aspects of a general physical exam (as part of a breeding soundness exam)
Overall condition - BCS
Hair coat condition - hirsutism/PPID
Vitals - TPR, HR, MM, CRT
Eyes (blindness = no photoperiod receptivity TF acycling)
Teeth
MSK exam (lameness = can’t stand being mounted)
What areas/organs are examined during a special reproductive exam (SRE) (in order)? How?
External exam (visual/palpation)
- udder
- discharge on tail/vulva > collect sample
- vulva
- perineum
- clioris
Internal exam
- rectal exam (1st) = uterus, ovaries, cervix, broad lig (palpation/US)
- vaginal exam = endometrium (speculum/manual)
What aspects of the udder are considered during a SRE?
Symmetry Activity - lactation/dry Fibrosis Signs of acute inflammation Ticks
Aspects of exam of external SRE
Anus/perneal body/vulva in a vertical line
Vulva below ischial arch
Fleshy vulval lips which create a seal
- no air intake when lips parted
Clitoris concealed in clitoral fossa ± swabs of fossa (CEM/Pseudomonas)
Aspects of rectal exam of SRE - what organs + what about them is important?
Uterus = body & horns > diameter, tone, wall thickness/oedema, contents (air/fluid/cysts/foetuses)
Ovaries = size, shape, ovulation fossa presence, follicles (presence/size/grade),
Cervix = tone + diameter
Broad ligament - check for haematomas
Pelvic cavity/bony pelvis - check for possible passage of foetus
Correlate all findings to the stage of the oestrous cycle!
Why is the rectal exam conducted before the vaginal exam during the internal SRE
Rule out pregancy
Avoid introducing air into vagina/uterus (> poor quality US images)
What does the thickness of the uterine wall indicate?
Stage of the oestrous cycle:
- Atonic uterus = anoestrus
- Thin wall (no oedema) = dioestrus
- Thick wall (endometrial oedema) = oestrus
Aspects of vaginal exam of SRE
Uterine exam (manual) = collect 2 endometrial swabs in dioestrus (>d5 post-OV - best time to Dx endometritis)
- uterus should be sterile
- high P4 = low defence/WBC
Speculum exam > Dx of persistent hymen, vaginitis, varicose veins, vaginal/cervical adhesions, urovagina
How is a vaginal SRE conducted?
Clean + dry perineum before exam (warm water/soap)
Use sterile gloves + sterile lube
Collect 2 endometrial swabs for culture + cytology (in dioestrus)
- double guarded swab > place in transport medium after withdrawal
Finish with IM PGF2a to induce luteolysis (prevent iatrogenic infection)
Cytological evaluation of uterine swab - what to look for?
WBCs - neuts/eosinophils
Endometrial cells
Bacteria (presence/#/shape/size)
- location = extracellular or inside neutrophils
Endometritis = > 1:10 nut:endometrial cells
- in dioestrus, should be sterile uterus
Culture evaluation of uterine swab - what to look for?
Relate to cytological findings
- FP = + culture but no bacteria on cytology
- FN = – culture but bacteria present on cyt.
What are indications for uterine biopsy?
High value mares
Mares dx w chronic endometritis
Infertility of unknown origin
Mares requiring expensive tx
Practical aspects of uterine biopsy
Introduce punch manually into uterus > move hand in rectum to push tissue into punch jaw > fix in Bouin’s medium
Avoid sampling near cervix - aim for base of uterine horn (location of embryo implantation)
Evaluation of uterine biopsy
Acute bacterial endometritis = neutrophils
Chronic endometritis = lymphocytes/macrophages
Fungal endometritis = eosinophils
Uro-/pneumovagina = eosinophils
Degree of fibrosis (# layers of fibrous tissue)
Grading categories = I (normal/healthy) – III (sever inflamm/diffuse fibrosis)
What special procedures may be undertaken & why?
Hysteroscopy = inspect/remove uterine cysts
Starch granule test = oviduct patency (blockage rare)
Blood samples
- serology = Ab tests (EVA/EIA/EHV-3)
- serum P4/eCG/oestrone sulfate
- heparin sample = karyotyping
- plasma sample = granulose cell tumours (inhibin/testosterone levels)
When should endometrial swabs be taken? why? What measures are taken to maintain uterine health?
Sample in dioestrous (>d5 post-OV)
- in health = sterile uterus
- P4 dominance = anti-inflame state > best time to Dx endometritis
Anti-inflammatory state = high risk of iatrogenic infection > TF follow vaginal exam w PGF2a (IM) to induce luteolysis
- CL only responsive to PGF2a from d5 post-OV
