Endometritis in horses is an inflammatory condition of the endometrium, the inner lining of the uterus, often resulting from bacterial infection. It is a significant reproductive disorder that can affect fertility in mares. The condition can be classified as acute or chronic, depending on the duration and severity of the inflammation. Common causative agents include Streptococcus equi subsp. zooepidemicus, Escherichia coli, and other opportunistic pathogens. Clinical signs may include abnormal uterine discharge, prolonged estrus, and failure to conceive. Diagnosis typically involves uterine cytology, culture, and biopsy. Treatment strategies often include antimicrobial therapy, uterine lavage, and management of underlying predisposing factors. This page compiles peer-reviewed research studies and scholarly articles that explore the etiology, pathophysiology, diagnostic methods, and treatment options for endometritis in equine reproductive health.
Ball BA.Fertilization rates were similar for normal and subfertile mares, and much of the difference in fertility between normal and subfertile mares was due to embryonic loss. Fertilization rate estimates for mares ranged from 71 to 96 per cent. The incidence of embryonic loss detected by ultrasonography between Days 11 and 50 was approximately 9 per cent for normal mares, and the estimated incidence of embryonic loss before Day 14 was also 9 per cent. Therefore, the estimated incidence of embryonic loss in normal mares between fertilization and Day 50 is approximately 18 per cent (Fig. 1). In subfer...
Watson ED, Stokes CR, Bourne FJ.Acute endometritis was induced in ovariectomized pony mares by infusion of a 1% solution of oyster glycogen. Maximum concentrations of immunoreactive leukotriene B4 in uterine washings coincided with the greatest rate of infiltration of neutrophils into the uterine lumen. Concentrations of immunoreactive leukotriene B4 decreased to basal levels 6 h after infusion and were unaffected by administration of ovarian steroids to ovariectomized mares. Uterine washings from mares with persistent endometritis did not contain significantly different concentrations of leukotriene B4 from genitally normal...
Boyd EH, Allen WE.Plasma concentrations of neomycin were measured after intrauterine infusion of 3.3 mg/kg neomycin sulphate. Mares infected two hours previously with an intra-uterine infusion of beta-haemolytic streptococci absorbed approximately 12 per cent of the neomycin in both the oestrous and the luteal phases of the cycle. Normal mares in oestrus absorbed 6 per cent of the neomycin infused and luteal mares absorbed 56 per cent. In infected mares the peak plasma concentrations occurred two hours after neomycin infusion, earlier than in healthy mares. Cervical flushings after neomycin infusion in infected...
Watson ED, Stokes CR, Bourne FJ.Both random and directional migration of blood neutrophils from 9 mares susceptible to persistent endometritis were significantly less (p less than 0.05) than neutrophils from 8 resistant mares. Serum from susceptible mares had significantly more (p less than 0.01) chemotactic activity than serum from resistant mares. Although phagocytosis of yeast blastospores by blood neutrophils from 4 resistant and 3 susceptible mares was similar, uterine neutrophils from susceptible mares were significantly worse (p less than 0.01) at phagocytosis than uterine neutrophils from resistant mares. Uterine was...
Hansen PJ, Asbury AC.The release of opsonins into the uterine lumen of mares susceptible or resistant to endometritis was examined after intrauterine inoculation of a filtrate of Streptococcus culture fluid or vehicle. Uterine flushings were collected at 0.5 hour before and 2, 4, 6, 8, and 24 hours after inoculation on day 2 or 3 of estrus and on day 7 or 8 after ovulation. Amounts of opsonins in flushings were quantified as the H2O2 produced by leukocytes incubated with flushings-opsonized bacteria, compared with H2O2 produced by leukocytes incubated with nonopsonized bacteria. Opsonin values in flushings increas...
Woods GL, Baker CB, Baldwin JL, Ball BA, Bilinski J, Cooper WL, Ley WB, Mank EC, Erb HN.During 1985, linear-array ultrasonography was used to study early pregnancy loss in commercial brood mares: 600/1115 (54%) of the cycles resulted in detected pregnancy at Week 2 after ovulation and 80 (13%) of these pregnancies resulted in early pregnancy loss. The pregnancy loss rate was significantly higher (P less than 0.05) for twin pregnancies (10/41) than for singleton pregnancies (70/559). The pregnancy loss rate was significantly higher (P less than 0.05) at 2-4 weeks (29/60) than at 6-8 weeks (12/60). The pregnancy rate was significantly less (P less than 0.05) for post-partum mares i...
Asbury AC, Hansen PJ.Fourteen mares, 7 susceptible and 7 resistant to bacterial endometritis, were used to provide circulating and uterine-derived neutrophils. Uterine neutrophils were recruited by inoculating cell-free filtrates of Streptococcus zooepidemicus, or control vehicle. Mares were assigned to schedules for collection of neutrophils at oestrus or dioestrus. Phagocytic activity of circulating and uterine cells was evaluated by an assay for chemiluminescence after addition of opsonized streptococci. Chemiluminescence generated by circulating neutrophils was greater (P less than 0.05) for susceptible mares ...
Watson ED, Stokes CR, David JS, Bourne FJ, Ricketts SW.Intrauterine infusion of 1 per cent oyster glycogen solution was used to induce acute endometritis in four genitally normal mares. Numbers of viable neutrophils recovered in uterine washings had increased by 1 h after infusion and remained elevated for at least 72 h. There was a significant correlation between numbers of viable neutrophils and total protein concentrations and between prostaglandin (PG)F and PGE2 concentrations in washings. There was also a significant relationship between concentrations of 15-keto-13, 14-dihydro PGF2 alpha in plasma and PGF in washings. Intrauterine concentrat...
Liu IK, Cheung AT, Walsh EM, Ayin S.The functional competence of uterine-derived polymorphonuclear neutrophils (PMNs) from 28 mares was measured for migration responsiveness by use of a chamber (filter) assay. Uterine infection was induced with Streptococcus zooepidemicus in mares considered resistant to chronic uterine infection (Grade I). In sequential analysis of uterine flushings obtained from these mares 5, 12, 15, 20, and 25 h after infection was induced, PMNs showed an initial rise at 12 h (from 5), then a general decline in migration response and in concentration of cells per ml from 12 through 25 h post-inoculation. In ...
Woods GL, Hillman RB, Schlafer DH.To evaluate embryo transfer as a possible method to circumvent infertility in mares, embryos from 14 normal and 14 infertile mares were collected three times and examined. Fewer flushes (p less than 0.05) from normal than infertile mares (1/42 vs 9/42) contained only abnormal embryos whereas more flushes (p less than 0.05) from normal than infertile mares contained one or more normal embryos (28/42 vs 8/42). More flushes (p less than 0.05) from normal than infertile mares contained embryos (29/42 vs 17/42). The embryo diameters (mm) at either day-7 or day-8 post ovulation were greater (p less ...
Cheung AT, Liu IK, Walsh EM, Miller ME.The host defense competence of uterine-derived polymorphonuclear leukocytes (PMN) from mares considered resistant (grade I uteri) and susceptible (grade III uteri) to chronic endometritis was evaluated for phagocytic and killing (bactericidal) capacities, using a fluorochrome assay. Peripheral blood PMN from noncategorized mares and from grade I and grade III mares were used as controls. Uterine-derived PMN from mares with grade I uteri were functionally competent for phagocytosis and killing of Candida albicans, whereas uterine-derived PMN from mares with grade III uteri had significantly les...
Youngquist RS, Blanchard TL, Lapin D, Klein W.Four groups of five pony mares each were used to determine if the intrauterine infusion of EDTA-Tris solution caused adverse effects on the endometrium. The uteri of mares were infused with either saline or EDTA-Tris solution or biopsied or sham-biopsied without infusion. Acute endometritis developed in one (20%) to three (60%) mares in each group during the seven days following treatment, but there were no differences (P > 0.05) in the incidence of endometritis among the groups. Endometrial fibrosis was not evident in biopsies taken on days 14, 30 and 60 following infusion of saline or EDT...
van Dyk E, Immelman A, van Heerden JS.After isolation of Pseudomonas aeruginosa from endometrial biopsies of 6 mares they were treated with amikacin sulphate. Three were treated by intra-uterine application of the drug, in one the drug was given by intramuscular injection, in another the intravenous route was used while in the last mare simultaneous local and intravenous treatment was applied. An intra-uterine Tris-EDTA instillation preceeded the uterine amikacin instillations to aid in the breakdown of the capsule around the bacterium. Serum concentrations of amikacin were determined after intravenous and intramuscular administra...
Asbury AC, Schultz KT, Klesius PH, Foster GW, Washburn SM.Ten mares, 5 resistant and 5 susceptible to bacterial endometritis, were examined for differences pertaining to the efficiency of phagocytosis of bacteria by neutrophils in the uterus. An assay for chemiluminescence was used to evaluate various schemes of opsonization and relate them to phagocytic rate. 123I-labelled albumin was used to measure protein migration to the inoculated uterus. Neutrophil numbers moving to the uterine lumen were determined. Before inoculation resistant mares were found to have substances in their uterine secretions that opsonized bacteria, resulting in effective phag...
Allen WE.The situations and conditions that can disrupt the mares normal oestrous cycle are described. Season of the year is a major influence; maximum reproductive efficiency does not totally coincide with the artificially defined "breeding season". Other abnormalities are associated with spontaneously persistent luteal function, psychological influences over behavioural activity, the presence of endometritis, multiple ovulation, reproductive behavior after pregnancy failure and granulosa cell tumours.
Dawson FL.Mares rarely ovulate in winter; ovulation is induced by increase in daylight length. Ova accumulate in the oviducts of unserved mares. During pregnancy, corpora lutea accumulate; all regress together at mid pregnancy. Plasma progesterone levels rise and oestrogen levels fall towards the end of pregnancy. Methods are available for early termination of pregnancy and for induction of parturition. Pregnancy can be diagnosed efficiently by rectal examination, and by immunological assay of pregnant mare serum gonadotrophin. Service at the foal heat is associated with an increased prevalence of early...
Nitschelm D, van der Horst CJ.It appeared that in mares suffering from endometritis the concentrations of pregnenolone, of the compound "5.4", and of progesterone in the blood during the first 2 days of the heat period were significantly higher than in normal cycling mares, in which the concentrations of all steroids were less than or equal to 1 ng/ml. In five endometritis mares the "5.4" and progesterone concentrations decreased after the first days of the heat period, and at about two days before ovulation the values were comparable to those of normal cycling mares. Eight mares suffering from a severe endometritis did no...
Spincemaille J, Coryn M, Vandekerckhove D, Vandeplassche M.Prostaglandin F2alpha (PGF2alpha), administered by untrauterine infusion and intramuscular injection, was used to induce oestrus and ovulation in non-cyclic mares. A satisfactory response rate (80% or more) was obtained and the dose (2-5--7-5 mg) and the time taken for ovulation to occur (up to 9 days) was the same irrespective of the route of administration. Only about one-half of the mares conceived to mating at the induced oestrus but the low conception rate could be attributed to the infertile condition of the mares. Plasma progesterone remained at basal levels after PGF2alpha and oestroge...
Varadin M.Infertility, resulting from failure to conceive during the preceding breeding season, was caused by various forms of endometritis in forty-four mares of Highland and Arabian breeds in Yugoslavia. Chronic mucopurulent and latent catarrhal endometritis occurred most frequently. Douching of the uterus on alternate days for 9 days with warm and cold sterile salt solutions (ranging from 7% to 1% w/v) in the early autumn resulted in conception in 47-7% of mares at an average of 15-2 days after the onset of treatment, and another 36-7% becoming pregnant in the following spring. Mating at the wrong st...
Miragaya MH, Woods GL, Losinno L.The occurrence of uterine and oviductal inflammation, and fertilisation rates, were measured on Day 3 post ovulation in inseminated mares that had either exhibited intrauterine lumenal fluid during a previous dioestrus (Experiment 1) or had acute endometritis induced by intrauterine infusion of 1% glycogen (Experiment 2). Endometritis was assessed by uterine cytology and histology whereas oviductal inflammation was measured histologically. Fertilisation rates were calculated from the percentage of cleaved ova recovered by retrograde flushing of the oviducts. Mares with or without pre-existing ...
Sikora M, Król J, Nowak M, Stefaniak T, Aubertsson G, Kozdrowski R.Endometritis is a common problem in a broodmare practice, often leading to infertility. The diagnosis is based on several methods such as cytology, bacteriology and histopathology; however the outcome of these methods may be inconclusive even when used together. The objectives of this study were: (1) to investigate the usefulness of acute phase proteins as an additional diagnostic tool for diagnosis of subclinical endometritis in mares and (2) to evaluate the association between macroscopic changes in uterine flushes and inflammation of the uterus. Materials were collected from 53 Icelandic ma...
Allen WE.The situations and conditions that can disrupt the mares normal oestrous cycle are described. Season of the year is a major influence; maximum reproductive efficiency does not totally coincide with the artificially defined "breeding season". Other abnormalities are associated with spontaneously persistent luteal function, psychological influences over behavioural activity, the presence of endometritis, multiple ovulation, reproductive behavior after pregnancy failure and granulosa cell tumours.
Madill S, Troedsson MH, Alexander SL, Shand N, Santschi EM, Irvine CH.The aim of this study was to investigate the effect of different breeding stimuli on uterine contractility and pituitary oxytocin release in five oestrous mares, in order to design better treatments for mares with defective physical uterine clearance mechanisms. Electrodes and strain gauges were implanted surgically on the uterine myometrium and myometrial activity was monitored with a Grass polygraph. A catheter was placed non-surgically in the intercavernous sinus of each oestrous mare to sample pituitary venous blood and a second catheter was placed in the jugular vein. Continuous sampling ...
Buczkowska J, Kozdrowski R, Nowak M, Raś A, Staroniewicz Z, Siemieniuch MJ.Endometritis is a major cause of infertility in the mare. Therefore, the diagnosis of this disease is very important in veterinary practice. The objective of this study was to compare bacteriological and cytological results obtained from the mare uterus using biopsy (EB) and cytobrush (CB) techniques and relating these findings to the presence of polymorphonuclear cells (PMNs) in endometrial tissue as the gold standard for detection of endometritis. In particular, we tested the hypothesis that endometrial cytology and microbiology data obtained from material collected using the EB and CB techn...
McDonnell AM, Watson ED.Four pony mares were used in a cross-over study to investigate the effect of different treatments on experimentally-induced endometritis. The mares were treated with progesterone to facilitate establishment of uterine infections. They received an intrauterine infusion of Streptococcus zooepidemicus 5 days after the start of progesterone therapy. Five days later, they were treated by intrauterine infusions of 2 g ampicillin in 50 ml sterile water or by sterile water without antibiotic for 3 consecutive days. Prior to infusion of Strep. zooepidemicus, no bacteria were cultured from the uteri of ...
Varadin M.Infertility, resulting from failure to conceive during the preceding breeding season, was caused by various forms of endometritis in forty-four mares of Highland and Arabian breeds in Yugoslavia. Chronic mucopurulent and latent catarrhal endometritis occurred most frequently. Douching of the uterus on alternate days for 9 days with warm and cold sterile salt solutions (ranging from 7% to 1% w/v) in the early autumn resulted in conception in 47-7% of mares at an average of 15-2 days after the onset of treatment, and another 36-7% becoming pregnant in the following spring. Mating at the wrong st...
Pyörälä S, Taponen J, Katila T.Use of antimicrobials for veterinary indications related to reproduction in cattle and horses is reviewed. Antimicrobial compounds are widely used to treat and prevent infections of reproductive organs. Total amounts of antimicrobials for such purposes, estimated by weight, are low compared with major uses in food animals. The most common reproduction-related indication in cattle is mastitis. The number of intramammary products available for treatment of mastitis in the European Union is high. Metritis and endometritis also require antimicrobial treatment of cattle and specific products for in...
Hemberg E, Kindahl H, Lundeheim N, Einarsson S.The objectives of this study were to investigate: (i) relationships between early foal health and their dams' reproductive health at mating/conception as well as after parturition and (ii) health status during early foal life and its association with performance as an adult. The study included 35 foals showing clinical symptoms indicating septicaemia, sometimes in combination with other disturbances, within their first 18 h postpartum (Group I). Eighty-eight foals that were healthy during their first few days of life were used as control (Group II). All foals were born in the same region of Sw...
Vanderwall DK, Woods GL.To determine the effect on fertility of large-volume uterine lavage with lactated Ringer's solution (LRS) performed immediately prior to insemination in mares. Methods: Prospective randomized controlled study. Methods: 20 mares. Methods: Control mares (n = 10) were inseminated with 1 billion (estimated before cooling) progressively motile spermatozoa that had been cooled in a passive cooling unit for 24 hours. Mares (n = 10) in the treatment group were inseminated with 1 billion progressively motile spermatozoa (cooled as described for control mares) immediately after uterine lavage with 4 L o...
Woods GL, Hillman RB, Schlafer DH.To evaluate embryo transfer as a possible method to circumvent infertility in mares, embryos from 14 normal and 14 infertile mares were collected three times and examined. Fewer flushes (p less than 0.05) from normal than infertile mares (1/42 vs 9/42) contained only abnormal embryos whereas more flushes (p less than 0.05) from normal than infertile mares contained one or more normal embryos (28/42 vs 8/42). More flushes (p less than 0.05) from normal than infertile mares contained embryos (29/42 vs 17/42). The embryo diameters (mm) at either day-7 or day-8 post ovulation were greater (p less ...
van Dyk E, Immelman A, van Heerden JS.After isolation of Pseudomonas aeruginosa from endometrial biopsies of 6 mares they were treated with amikacin sulphate. Three were treated by intra-uterine application of the drug, in one the drug was given by intramuscular injection, in another the intravenous route was used while in the last mare simultaneous local and intravenous treatment was applied. An intra-uterine Tris-EDTA instillation preceeded the uterine amikacin instillations to aid in the breakdown of the capsule around the bacterium. Serum concentrations of amikacin were determined after intravenous and intramuscular administra...
Asif S, Umar T, Umar Z, Jamil H, Feng H, Zhang P, Umer S.Endometritis plays an important role in mare infertility. Certain infectious agents interfere with the innate immune system of endometrium, causing a systemic inflammatory response that lasts for a long time and circulates via the blood or cellular degeneration, leading to endometritis due to bacterial endotoxins. Different small, non-coding RNA molecules are involved in many biological functions. For instance, microRNAs (miRNAs) are involved in the post-transcriptional regulation of gene expression. These miRNAs are important regulators of gene expression, primarily via inhibiting transcripti...
Lection J, Wagner B, Byron M, Miller A, Rollins A, Chenier T, Cheong SH, Diel de Amorim M.Endometrial biopsy is required to diagnose mares with chronic endometritis and endometrial degenerative fibrosis. An increase in understanding of equine reproductive immunology could be utilised to create less-invasive, time-efficient diagnostic tools especially when evaluating mares for chronic endometritis. Objective: To evaluate inflammatory cytokine and chemokine concentrations in uterine fluid samples collected by low-volume lavage (LVL) as a potential screening diagnostic biomarker for endometritis. Methods: Prospective cross-sectional clinical study. Methods: Forty-six mares underwent a...
Silva JA, Castañares M, Mouguelar H, Valenciano JA, Pellegrino MS.Endometritis, the inflammation of the endometrium, is the leading cause of subfertility in mares, and therefore responsible for major economic losses in the horse industry worldwide. It is generally treated with uterine lavages combined with ecbolic agents and local or systemic antibiotics. However, since antibiotic overuse has been associated with antimicrobial resistance in mares with persistent endometritis, new prevention and treatment alternatives are needed. One such alternative could be the use of probiotic lactic acid bacteria (LAB) isolated from the host. Thanks to their species speci...
Köhne M, Hegger A, Tönissen A, Heusinger A, Hader C, Görgens A, Sieme H.Antimicrobial-resistant bacteria pose a serious threat to the wellbeing of animals and humans. In equine reproduction, endometritis caused by facultative microbial pathogens is a condition, which is usually treated with antibiotics. Data from Germany on prevalence of facultative pathogenic microorganisms cultured in samples from the equine uterus and the frequency of multi-drug resistant (MDR) bacteria is lacking. The aim of the study was to provide representative numbers for both. Microbiological culture results (n = 28,887) of endometrial samples submitted to a large veterinary diagnostic ...
Köhne M, Hegger A, Tönissen A, Hofbauer L, Görgens A, Sieme H.Bacterial endometritis is a major problem in equine reproduction usually treated with antibiotics, however reports of success rates are scarce. This study collected data from mares diagnosed with intrauterine bacterial growth and compared the outcome of different therapies for bacterial endometritis in German stud farm practice. Data on mares with positive uterine culture results were collected retrospectively in veterinary practices (n = 5; 2018-2022). Information relating to 30 factors (mare, diagnostics, therapy, pregnancy rate) of bacterial endometritis cases (n = 772) were recorded an...
Virendra A, Gulavane SU, Ahmed ZA, Reddy R, Chaudhari RJ, Gaikwad SM, Shelar RR, Ingole SD, Thorat VD, Khanam A, Khan FA.The application of high throughput technologies has enabled unravelling of unique differences between healthy mares and mares with endometritis at transcriptomic and proteomic levels. However, differences in the uterine microbiome are yet to be investigated. Objective: The present study was aimed at evaluating the differences in uterine microbiome between healthy mares and mares with endometritis. Methods: Low-volume lavage (LVL) samples were collected from the uterus of 30 mares classified into healthy (n = 15) and endometritis (n = 15) based on their reproductive history, intrauterine fl...
Martínez-Boví R, Sala-Ayala L, Querol-Paajanen A, Plaza-Dávila M, Cuervo-Arango J.PGF is commonly given at the end of embryo flushing (EF) to shorten the interval to the next oestrus and ovulation. Objective: To determine the effect of repeated EF on plasma progesterone concentration, percentage of mares with endometritis, unwanted pregnancy and subsequent fertility in mares flushed without the use of PGF . Methods: Controlled experiments. Methods: Nine mares were inseminated in seven consecutive cycles (n = 63), to either perform an EF (n = 54) 7-9 days after ovulation or left pregnant (n = 9). PGF was not used to induce oestrus. Ultrasound examination and bl...
Moroni R, Fanelli D, Camillo F, Rota A, Cantile C, Marmorini P, Salamone G, Ori M, Panzani D.Endometritis is a major cause of subfertility in mares. Multiparous old mares are more susceptible to developing endometritis given that ageing is associated with an altered immune response and with inadequate physiological uterine clearance after breeding, which can lead to degenerative changes in the endometrium. Molecules such as antimicrobial peptides (AMPs) have been proposed as endometritis markers in the equine species. Methods: Cross-sectional. Objective: To investigate the endometrial expression of defensin-beta 4B (DEFB4B), lysozyme (LYZ) and secretory leukocyte peptidase inhibitor (...
Zhang X, Mai Z, Gao Y, Zhao X, Zhang Y.Endometritis is a common condition in mares that causes significant economic loss. Lacking obvious clinical signs, the clinical diagnosis of endometritis in mares relies on case-by-case clinical examinations, which can be particularly inefficient in large-scale farms. Therefore, the identification of potential biomarkers can serve as a non-invasive and efficient screening technique for endometritis in mares. Objective: To compare the blood proteome between fertile mares and mares with endometritis to identify biomarkers potentially associated with the development of endometritis and validate t...
Retamar GC, Bustos CP, Guillemi EC, Becú T, Ivanissevich A, Mesplet M, Muñoz AJ.Streptococcus equi subsp. zooepidemicus (S. zooepidemicus) is a mucosal commensal of the lower genital tract in horses and is the most isolated bacterium causing endometritis in mares. The aim of this study was to determine the molecular diversity of S. zooepidemicus obtained from endometritis in mares in Buenos Aires province, Argentina. Thirty isolates obtained from the uterus of mares in 2005 and 2017 were studied. The MLST scheme was applied to identify the Argentinian genotypes and the clonal relationships and patterns of evolutionary descent were identified using the eBURST algorithm - g...
