Advances in the diagnosis and treatment of chronic infectious and post-mating-induced endometritis in the mare.
Abstract: Rapid physical uterine clearance is paramount for fertility. Mares that are unable to clear the by-products of insemination or foaling quickly may develop post-mating-induced or acute endometritis. If endometritis is not promptly resolved, the infection can become chronic. Endometritis can be difficult to identify because clinical signs, ultrasonographic and laboratory findings can vary between uterine pathogens. Some micro-organisms are associated with an influx of neutrophils and fluid into the uterine lumen while others are associated with only heavy debris on cytological specimens. Identifying the inciting cause may require more than swabbing the endometrium. Culturing endometrial biopsy tissue or uterine fluids are more sensitive methods for identifying Escherichia coli than culture swab while endometrial cytology identifies twice as many mares with acute inflammation than uterine culture swab. While post-mating-induced endometritis is classically treated with uterine irrigation and ecbolics and acute endometritis is treated with either systemic or intra-uterine antibiotics, these therapies are not always effective in resolving chronic uterine inflammation or infections. Mucolytics can be used to break up mucus produced by an irritated endometrium, steroids can modulate the inflammatory response associated with insemination and buffered chelating agents can remove biofilm, a protective mechanism used primarily by gram-negative organisms and yeast to evade the host immune response.
Publication Date: 2010-07-16 PubMed ID: 20591061DOI: 10.1111/j.1439-0531.2010.01634.xGoogle Scholar: Lookup
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Summary
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This study investigates the updated diagnostic and treatment strategies for persistent infectious and mating-induced inflammation of the uterus (endometritis) in mares. The research focuses on how mares that cannot quickly clear insemination or foaling products may develop acute endometritis, which if untreated, becomes chronic over time. It highlights the challenges of diagnosing endometritis due to varying clinical symptoms and laboratory results among different uterine infections. The article also provides an insightful comparison of different diagnostic methods and effectiveness of various treatments.
Diagnosis of Endometritis
The manifestation of endometritis varies greatly between different pathogens, making it challenging to diagnose:
- Some pathogens such as Escherichia coli are associated with an increased flow of white blood cells (neutrophils) and fluid in the uterus, leading to visible signs of inflammation.
- Other microorganisms produce a significant debris volume, identified through cytological examination, but may not necessarily display external clinical symptoms.
- The process of diagnosing endometritis often includes more than swabbing the endometrium. A uterine fluid or endometrial biopsy tissue culture is a more sensitive method for detecting some bacteria such as E.coli.
- Endometrial cytology identifies twice as many mares with acute inflammation than a culture swab of the uterus.
Treatment of Endometritis
Therapies for post-mating-induced and acute endometritis are not always effective in treating chronic uterus inflammation or infections:
- Post-mating-induced endometritis is generally treated with uterine irrigation and ecbolics. Acute endometritis is usually treated with systemic or intra-uterine antibiotics. However, these treatments may not always succeed in curbing chronic uterine inflammation or infections.
- Mucolytics can be used to break up mucus produced by an irritated endometrium, thereby aiding in cleaning the uterus of any debris from the inflammation process.
- Steroids can be used to control the inflammatory response associated with insemination, preventing the occurrence of endometritis post-mating.
- Buffered chelating agents can be employed to remove biofilms, which are protective mechanisms used mainly by gram-negative organisms and yeast to evade the host’s immune response. Therefore, these agents can aid in fighting off possible infections.
Cite This Article
APA
LeBlanc MM.
(2010).
Advances in the diagnosis and treatment of chronic infectious and post-mating-induced endometritis in the mare.
Reprod Domest Anim, 45 Suppl 2, 21-27.
https://doi.org/10.1111/j.1439-0531.2010.01634.x Publication
Researcher Affiliations
- Rood and Riddle Equine Hospital, Lexington, KY 40580, USA. mleblanc@roodandriddle.com
MeSH Terms
- Animals
- Anti-Bacterial Agents / administration & dosage
- Anti-Inflammatory Agents / administration & dosage
- Bacterial Infections / therapy
- Bacterial Infections / veterinary
- Biofilms
- Breeding
- Chelating Agents / administration & dosage
- Chronic Disease
- Endometritis / diagnosis
- Endometritis / therapy
- Endometritis / veterinary
- Expectorants / therapeutic use
- Female
- Horse Diseases / diagnosis
- Horse Diseases / etiology
- Horse Diseases / therapy
- Horses
- Mycoses / therapy
- Mycoses / veterinary
- Neutrophils
- Pregnancy
- Ultrasonography / veterinary
- Uterus / microbiology
- Uterus / pathology
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